[Immunogenicity and adverse events of SARS-CoV-2 vaccine in health workers]. / Inmunogenicidad y efectos adversos de vacuna SARS-CoV-2 en trabajadores de salud.

INTRODUCTION: The aim of this study was to evaluate the adverse effects and immune response associated with IgG anti S1 SAEA-CoV-2 antibodies among healthcare workers at Señor del Milagro Hospital in Salta city, after receiving two doses of COVID-19 vaccine. METHODS: A prospective cohort study was carried out from March 2021 to April 2022. Demographic, clinical data, adverse events supposedly attributed to vaccination (AEFIs) were collected and two samples were taken to measure serum antibody levels. RESULTS: 408 volunteers participated, 401 (98%) were vaccinated with Sputnik-V. The average age was 45.5 years with a predominance of the female sex (71%). AEFIs were reported in 188 (46.1%) and 121 (29.7%) after the first and second doses respectively (p<0.001). These events were mostly mild and transient, more frequent after the first dose. The first antibody test was positive in 99% with a mean titer of 9.7 (SD 3.7). The second dosage was positive in 88% with a mean titer of 6.4 (SD 4.4). Participants with a history of infection and previous positive testing showed significantly higher antibody titers (p<0.001). CONCLUSION: The AEFIs reported were mostly mild and transient. Mass vaccination and administration of the recommended dose are essential to achieve effective herd immunity. The majority of vaccinated healthcare workers developed antibodies and those who had the disease prior to vaccination had significant antibody titers.

Introducción: El objetivo de este estudio fue evaluar los efectos adversos y la respuesta inmune de anticuerpos IgG anti S1 SAEA-CoV-2 en el personal de Salud del Hospital del Milagro de la ciudad de Salta, posterior a recibir dos dosis de vacuna COVID-19. Métodos: Se realizó un estudio prospectivo de cohorte desde marzo de 2021 hasta abril 2022. Se recopilaron datos demográficos, clínicos, eventos adversos supuestamente atribuidos a la vacunación (ESAVI) y se tomaron dos muestras de sangre para medir los niveles de anticuerpos. Resultados: Participaron 408 voluntarios, 401 (98%) fueron vacunados con Sputnik- V. La edad promedio fue de 45.5 años con predominio del sexo femenino (71%). Los ESAVI fueron reportados en 188 (46.1%) y 121 (29.7%) luego de la primera y segunda dosis respectivamente (p<0.001). Estos eventos fueron mayormente de carácter leve y transitorios, más frecuentes luego de la primera dosis. El primer dosaje de anticuerpos fue positivo en 99% con una media de títulos de 9.7 (SD 3.7). El segundo dosaje fue positivo en 88% con una media de títulos de 6.4 (SD 4.4). Los participantes con antecedentes de infección y dosajes previos positivos mostraron títulos significativamente más altos de anticuerpos (p<0.001). Conclusión: Los ESAVI reportados fueron mayoritariamente leves y transitorios. La vacunación masiva y la administración de la dosis recomendada son esenciales para lograr una inmunidad colectiva efectiva. La mayoría de los trabajadores de la salud vacunados desarrollaron anticuerpos y aquellos que cursaron la enfermedad previa a la vacunación presentaron títulos significativos más elevados de anticuerpos.

Clinical and Serological Features in Latin American IgG4-Related Disease Patients Differ According to Sex, Ethnicity, and Clinical Phenotype.

BACKGROUND/OBJECTIVE: Data on IgG4-related disease (IgG4-RD) come almost exclusively from cohorts from Asia, Europe, and North America. We conducted this study to describe the clinical presentation, phenotype distribution, and association with sex, ethnicity, and serological markers in a large cohort of Latin American patients with IgG4-RD. METHODS: We performed a multicenter medical records review study including 184 Latin American IgG4-RD patients. We assigned patients to clinical phenotypes: group 1 (pancreato-hepato-biliary), group 2 (retroperitoneal/aortic), group 3 (head and neck-limited), group 4 (Mikulicz/systemic), and group 5 (undefined). We focused the analysis on how sex, ethnicity, and clinical phenotype may influence the clinical and serological presentation. RESULTS: The mean age was 50.8 ± 15 years. Men and women were equally affected (52.2% vs 48.8%). Fifty-four patients (29.3%) were assigned to group 1, 21 (11.4%) to group 2, 57 (30.9%) to group 3, 32 (17.4%) to group 4, and 20 (10.8%) to group 5. Male sex was associated with biliary tract (odds ratio [OR], 3.4; 95% confidence interval [CI], 1.36-8.26), kidney (OR, 3.4; 95% CI, 1.28-9.25), and retroperitoneal involvement (OR, 5.3; 95% CI, 1.45-20). Amerindian patients presented more frequently with atopy history and gallbladder involvement. Group 3 had a female predominance. CONCLUSIONS: Latin American patients with IgG4-RD were younger, and men and women were equally affected compared with White and Asian cohorts. They belonged more commonly to group 1 and group 3. Retroperitoneal and aortic involvement was infrequent. Clinical and serological features differed according to sex, ethnicity, and clinical phenotype.

Disfunción sexual en mujeres con esclerosis sistémica / Sexual dysfunction in women with systemic sclerosis

Introducción: la disfunción sexual (DS) es común entre las mujeres con enfermedades crónicas, incluyendo esclerosis sistémica (ES). Se ha asociado con características como la duración de la enfermedad, dolor, disminución de la actividad funcional, entre otras. Desde nuestro conocimiento, aún no contamos con datos locales. Objetivos: evaluar la frecuencia de DS en mujeres con ES; describir las características sociodemográficas, clínicas y psicológicas asociadas con la DS en mujeres con ES. Materiales y métodos: estudio observacional, analítico y de corte transversal. Se incluyeron mujeres de entre 20 y 59 años con diagnóstico de ES, según los criterios de clasificación del European League Against Rheumatism/American College of Rheumatology (ACR/EULAR 2013). Se excluyeron pacientes con enfermedades crónicas no controladas, otras patologías reumatológicas autoinmunes, e inactividad sexual o patología genitourinaria no relacionadas a ES en las últimas 4 semanas. La DS se evaluó con la versión en español del cuestionario índice de función sexual femenina (Female sexual function index, FSFI). Resultados: se incluyeron 56 pacientes. El 78,57% presentó DS y 19,64% era sexualmente inactiva debido a la enfermedad. Escala visual análoga (EVA) de fatiga (coeficiente β: -0,08, IC 95%: -0,14 a -0,02; p<0,01), edad (coeficiente β: -0,23, IC 95%: -0,40 a -0,05; p=0,01) y fibromialgia (coeficiente β: -11,90, IC 95%: -17,98 a -5,82; p<0,01) mostraron una asociación significativa e independiente con DS en el análisis multivariado. Conclusiones: la DS es frecuente entre las mujeres con ES, y las pacientes más jóvenes, sin fibromialgia y con menor fatiga presentaron una mejor funcionalidad sexual.

Introduction: sexual impairment (SI) is common among women with chronic diseases, including systemic sclerosis (SSc). It has been associated with characteristics such as the duration of the disease, pain, decreased functional activity, among others. To the best of our knowledge, we still do not have local data. Objectives: to evaluate the frequency of SI in women with SSc. To describe the sociodemographic characteristics, disease itself and psychological items associated with SI in women with SSc. Materials and methods: observational, analytical, cross-sectional study. We included women between 20 and 59 years diagnosed with SSc according to 2013 classification criteria ACR/EULAR. We excluded patients with uncontrolled chronic diseases or other autoimmune rheumatologic diseases and patients who, in the last 4 weeks, had dyspareunia or were sexually inactive due to causes not attributable to their disease. SI was assessed using the Spanish version of female sexual function index questionnaire (FSFI). Results: 56 patients were included. 78.57% presented SI and 19.64% of them were sexually inactive patients due to the disease. Fatigue VAS (β coefficient: -0.08, CI 95%: -0.14 to -0.02; p<0.01), age (β coefficient: -0.23, CI 95%: -0.40 to -0.05; p=0.01) and fibromyalgia (β coefficient: -11.90, CI 95%: -17.98 to -5.82; p<0.01) showed significant and independent association with SI in the multivariate analysis. Conclusions: SI is frequent among women with SSc, and younger patients, without fibromyalgia and with less fatigue have better sexual function.

Disfunción sexual en mujeres con esclerosis sistémica / Sexual dysfunction in women with systemic sclerosis

Introducción: la disfunción sexual (DS) es común entre las mujeres con enfermedades crónicas, incluyendo esclerosis sistémica (ES). Se ha asociado con características como la duración de la enfermedad, dolor, disminución de la actividad funcional, entre otras. Desde nuestro conocimiento, aún no contamos con datos locales. Objetivos: evaluar la frecuencia de DS en mujeres con ES; describir las características sociodemográficas, clínicas y psicológicas asociadas con la DS en mujeres con ES. Materiales y métodos: estudio observacional, analítico y de corte transversal. Se incluyeron mujeres de entre 20 y 59 años con diagnóstico de ES, según los criterios de clasificación del European League Against Rheumatism/American College of Rheumatology (ACR/EULAR 2013). Se excluyeron pacientes con enfermedades crónicas no controladas, otras patologías reumatológicas autoinmunes, e inactividad sexual o patología genitourinaria no relacionadas a ES en las últimas 4 semanas. La DS se evaluó con la versión en español del cuestionario índice de función sexual femenina (Female sexual function index, FSFI). Resultados: se incluyeron 56 pacientes. El 78,57% presentó DS y 19,64% era sexualmente inactiva debido a la enfermedad. Escala visual análoga (EVA) de fatiga (coeficiente ß: -0,08, IC 95%: -0,14 a -0,02; p<0,01), edad (coeficiente ß: -0,23, IC 95%: -0,40 a -0,05; p=0,01) y fibromialgia (coeficiente ß: -11,90, IC 95%: -17,98 a -5,82; p<0,01) mostraron una asociación significativa e independiente con DS en el análisis multivariado. Conclusiones: la DS es frecuente entre las mujeres con ES, y las pacientes más jóvenes, sin fibromialgia y con menor fatiga presentaron una mejor funcionalidad sexual.

Introduction: sexual impairment (SI) is common among women with chronic diseases, including systemic sclerosis (SSc). It has been associated with characteristics such as the duration of the disease, pain, decreased functional activity, among others. To the best of our knowledge, we still do not have local data. Objectives: to evaluate the frequency of SI in women with SSc. To describe the sociodemographic characteristics, disease itself and psychological items associated with SI in women with SSc. Materials and methods: observational, analytical, cross-sectional study. We included women between 20 and 59 years diagnosed with SSc according to 2013 classification criteria ACR/EULAR. We excluded patients with uncontrolled chronic diseases or other autoimmune rheumatologic diseases and patients who, in the last 4 weeks, had dyspareunia or were sexually inactive due to causes not attributable to their disease. SI was assessed using the Spanish version of female sexual function index questionnaire (FSFI). Results: 56 patients were included. 78.57% presented SI and 19.64% of them were sexually inactive patients due to the disease. Fatigue VAS (ß coefficient: -0.08, CI 95%: -0.14 to -0.02; p<0.01), age (ß coefficient: -0.23, CI 95%: -0.40 to -0.05; p=0.01) and fibromyalgia (ß coefficient: -11.90, CI 95%: -17.98 to -5.82; p<0.01) showed significant and independent association with SI in the multivariate analysis. Conclusions: SI is frequent among women with SSc, and younger patients, without fibromyalgia and with less fatigue have better sexual function.

Realidade da ocorrência de eventos adversos em internação cirúrgica: estudo quantitativo e descritivo / Reality of the occurrence of adverse events in surgical internation: quantitative and descriptive study / Realidad de la ocurrencia de eventos adversos en internación quirúrgica: estudio cuantitativo y descriptivo

Objetivo: Verificar a ocorrência de eventos adversos como infecção do sítio cirúrgico, perda ou infecção do acesso venoso e quedas em pacientes internados em uma unidade de internação cirúrgica de um hospital de ensino do sul do Brasil. Método: Estudo quantitativo, exploratório-descritivo. Realizado de março a maio de 2019, em uma unidade de internação cirúrgica de um hospital universitário do sul do Brasil, com a utilização de dois roteiros estruturados. Foram incluídos e 128 participantes. Análise das variáveis categóricas representadas pela frequência absoluta e relativa e realizadas 701 avaliações. Resultados: Das 701 (100%) avaliações realizadas nos 128 (100%) participantes, houve eventos adversos em 104 (14,7%). Destes, 98 (14,0%) foram registrados mais de um evento adverso por avaliação. Os eventos adversos foram um (1,0%) queda, um (1,0%) infecção de acesso venoso, 33 (31,7%) infecção de sítio cirúrgico e 69 (66,3%) perda de acesso venoso. Conclusão: A ocorrência de eventos adversos evidencia a necessidade do gerenciamento de riscos e a melhoria da qualidade da assistência ao paciente no perioperatório. (AU)

Objective: To verify the occurrence of adverse events such as infection of the surgical site, loss or infection of the venous access and falls in patients admitted to a surgical inpatient unit of a teaching hospital in southern Brazil. Methods: Quantitative, exploratory-descriptive study. Held from March to May 2019, in a surgical inpatient unit of a university hospital in southern Brazil, using two structured scripts. 128 participants were included. Analysis of categorical variables represented by absolute and relative frequency and 701 evaluations were carried out. Results: Of 701 (100%) evaluations performed on 128 (100%) participants, there were adverse events in 104 (14.7%). these 98 (14.0%) recorded more than one adverse event per evaluation. Adverse events were one (1.0%) fall, one (1.0%) venous access infection, 33 (31.7%) surgical site infection and 69 (66.3%) loss of venous access. Conclusion: The occurrence of adverse events highlights the need for risk management and improving the quality of patient care in the perioperative period. (AU)

Objetivo: Verificar la ocurrencia de eventos adversos como infección del sitio quirúrgico, pérdida o infección del acceso venoso y caídas en pacientes ingresados en una unidad de hospitalización quirúrgica de un hospital universitario en el sur de Brasil. Métodos: Estudio cuantitativo, exploratorio-descriptivo. Se lleva a cabo de marzo a mayo de 2019, en una unidad de hospitalización quirúrgica de un hospital universitario en el sur de Brasil, utilizando dos guiones estructurados. Se incluyeron 128 participantes. Se realizaron análisis de variables categóricas representadas por frecuencia absoluta y relativa y 701 evaluaciones. Resultados: De las 701 (100%) evaluaciones realizadas en 128 (100%) participantes, hubo eventos adversos en 104 (14.7%). De estos, 98 (14.0%) registraron más de un evento adverso por evaluación. Los eventos adversos fueron uno (1.0%) caída, uno (1.0%) infección de acceso venoso, 33 (31.7%) infección del sitio quirúrgico y 69 (66.3%) pérdida de acceso venoso. Conclusión: La aparición de eventos adversos destaca la necesidad de gestionar el riesgo y mejorar la calidad de la atención al paciente en el período perioperatorio. (AU)

Myositis-specific antibodies and clinical characteristics in patients with autoimmune inflammatory myopathies: reported by the Argentine Registry of Inflammatory Myopathies of the Argentine Society of Rheumatology.

INTRODUCTION/OBJECTIVES: To describe clinical features in patients with inflammatory myopathies (IMs) from the Argentine Registry of Inflammatory Myopathies, and their relationship with myositis-specific antibodies (MSAs). METHODS: This cross-sectional study included 360 adult patients with dermatomyositis (DM), polymyositis (PM), and inclusion body myositis. Demographics, clinical, and serological characteristics were retrospectively recorded (2016-2019). MSAs were determined by immunoblotting. Patients who were positive for anti-Jo-1, Mi-2, and MDA5 were compared against a group of patients, taken as reference group, who were negative for all MSAs. RESULTS: Women 72%, median age at diagnosis was 47.3 years (18-82). The most frequent subtypes were DM (43.9%) followed by PM (30%).The most frequent MSAs were anti-Jo-1 (51/317), 16.1%; MDA5 (12/111), 10.8%, and Mi-2 (23/226), 10.2%. Anti-Jo-1 was associated (p < 0.05) with a higher frequency of chronic disease course, interstitial lung disease (ILD), arthritis, and mechanic's hands. Anti-Mi-2 was found in patients who had higher frequency of skin manifestations and higher CK values (p < 0.001). Patients with anti-MDA5 had normal or low CK levels. Anti-MDA5 was associated (p < 0.05) with skin manifestations, arthritis, and ILD. The rest of MSAs had frequencies lower than 8%. Anti-TIF1ϒ was found in eight DM patients and one had cancer. Anti-SRP was found in seven patients who had PM and elevated CK. CONCLUSION: Anti-Jo-1 was the most frequent MSA, and was associated with ILD; MDA5 was associated with CADM and ILD, and Mi-2, with classical DM. Despite the different prevalence with respect to other cohorts, the clinical characteristics for each MSA group were similar to the data reported in other studies. Key Points • This study describes the prevalence of MSAs in the Argentine Registry of IMs. • Anti-Jo-1 and anti-MDA5 were associated with ILD. • Anti-Mi-2 was the third most frequent MSA, associated with classical DM.

Development of a risk indicator score for the identification of interstitial lung disease in patients with rheumatoid arthritis / Desarrollo de una regla de predicción clínica para identificar enfermedad pulmonar intersticial en pacientes con artritis reumatoidea

Background: Clinically evident interstitial lung disease (ILD) affects 10%–42% of RA patients with prognostic implications. The aim of this study was to discern which factors are associated with the presence of ILD in RA patients and to develop a score that could help to stratify the risk of having ILD in RA patients. Methods: Case–control study. We included RA patients recruited from ILD and rheumatology clinics. We retrieved the following data: gender, age, presence of extra articular manifestations, disease activity scores, antibodies status, ESR, and medication use. Multivariate logistic regression was performed. A risk indicator score was developed. Results: Of 118 patients included in this study, 52 (44%) had RA-ILD (cases) and 66 (56%) had RA without ILD (controls). Twenty-six patients were male (22%), the mean age was 56.6±15.6 years. Five variables were significantly associated with the presence of ILD: male gender, smoking, extraarticular manifestations, a CDAI score>28, and ESR>80mm/h. The AUC of the final model curve was 0.86 (95%CI 0.79–0.92). Two potential cut-off points of the risk indicator score were chosen: a value of 2 points showed a sensitivity of 90.38% and a specificity of 63.64%, while a value of 4 points showed a sensitivity of 51.9% and a specificity of 90.9%. Conclusion: This study identified risk factors that could help identify which RA patients are at risk of having ILD through the development of a risk indicator score. This score needs to be validated in an independent cohort.(AU)

Introducción: La enfermedad pulmonar intersticial (EPI) clínicamente evidente afecta al 10-42% de los pacientes con Artritis Reumatoidea (AR), con impacto en el pronóstico. El objetivo de este estudio fue identificar factores asociados y desarrollar una regla para estratificar el riesgo de EPI en pacientes con AR. Métodos: Estudio de casos y controles. Se incluyeron pacientes con AR de una clínica de enfermedades intersticiales y un servicio de reumatología. Se consignaron datos demográficos, manifestaciones extraarticulares, scores de actividad de la enfermedad, autoanticuerpos, tratamiento. Se analizó con regresión logística multivariada. Resultados: Se incluyeron 118 pacientes con AR, 52 (44%) con EPI (casos) y 66 (56%) sin EPI (controles). Veintiséis (22%) hombres, media de edad 56±15.6 años. Cinco variables se asociaron significativamente con la presencia de EPI: género masculino, tabaquismo, manifestaciones extraarticulares, CDAI> 28, y eritrosedimentación> 80mm/h. El área bajo la curva del modelo final fue 0.86 (IC 95% 0.79-0.92). Se escogieron dos potenciales puntos de corte del score: 2 puntos con una sensibilidad del 90.38% y una especificidad del 63.64%, y 4 puntos con una sensibilidad del 51.9% y una especificidad del 90.9%. Conclusión: Nuestro estudio identificó variables que podrían ayudar a identificar que pacientes con AR se encuentran en riesgo de presentar EPI.(AU)

Simulador de baixa fidelidade no cuidado de estomias intestinais / Low fidelity simulator in the care of intestinal stomas / Simulador de baja fidelidad en el cuidado de ostomias intestinales

Objetivo: descrever o desenvolvimento e a aplicação de um simulador de baixa fidelidade para capacitações sobre os cuidados com estomias intestinais. Método: trata-se de um estudo descritivo, do tipo relato de experiência, sobre a idealização, elaboração, confecção e aplicação de um simulador de baixa fidelidade, que consiste em um modelo de avental em relevo representando órgãos do trato gastrointestinal e tipos de estomias intestinais. Resultados: construiu-se o avental em relevo com feltro, tecido de algodão e fibra comum de preenchimento com poliéster. Utilizouse o simulador, após finalizado, para a capacitação de discentes e pacientes com estomia intestinal, a partir da qual se confirmou que ele possibilita a visualização do trato gastrointestinal e possíveis locais de confecção das estomias. Conclusão: conclui-se que o simulador se mostrou positivo para o desenvolvimento de habilidades e do autocuidado de pessoas com estoma intestinal e para o ensino de discentes, visto que os aproxima da vivência prática.(AU)

Objective: to describe the development and application of a low fidelity simulator for intestinal stoma care training. Method: It is a descriptive study, of the experience report type, about the idealization, elaboration, confection and application of a low fidelity simulator, which consists of a model of relief apron representing organs of the gastrointestinal tract and types of intestinal stomas. Results: The embossed apron was built with felt, cotton fabric and common filling fiber with polyester. The simulator was used, after completed, to train students and patients with intestinal stoma, from which it was confirmed that it allows the visualization of the gastrointestinal tract and possible sites of confection of the stomas. Conclusion: it is concluded that the simulator has proved to be positive for the development of skills and self-care of people with intestinal stoma and for the teaching of students, since it brings them closer to practical experience.(AU)

Objetivo: describir el desarrollo y aplicación de un simulador de baja fidelidad para el entrenamiento en el cuidado de la ostomía intestinal. Método: se trata de un estudio descriptivo, tipo relato de experiencia, sobre la idealización, elaboración, confección y aplicación de un simulador de baja fidelidad, que consiste en un modelo de delantal repujado que representa órganos del tracto gastrointestinal y tipos de ostomías intestinal. Resultados: el delantal en relevo se construyó con fieltro, tela de algodón y fibra común rellena de poliéster. Luego de simular, se utilizó el simulador para el entrenamiento de estudiantes y pacientes con ostomía intestinal, de lo cual se confirmó que permite la visualización del tracto gastrointestinal y posibles lugares para realizar los estomas. Conclusión: se concluye que el simulador resultó ser positivo para el desarrollo de habilidades y autocuidado de personas con estoma intestinal y para la docencia de los estudiantes, ya que los acerca a la experiencia práctica.(AU)

Development of a risk indicator score for the identification of interstitial lung disease in patients with rheumatoid arthritis.

BACKGROUND: Clinically evident interstitial lung disease (ILD) affects 10%-42% of RA patients with prognostic implications. The aim of this study was to discern which factors are associated with the presence of ILD in RA patients and to develop a score that could help to stratify the risk of having ILD in RA patients. METHODS: Case-control study. We included RA patients recruited from ILD and rheumatology clinics. We retrieved the following data: gender, age, presence of extra articular manifestations, disease activity scores, antibodies status, ESR, and medication use. Multivariate logistic regression was performed. A risk indicator score was developed. RESULTS: Of 118 patients included in this study, 52 (44%) had RA-ILD (cases) and 66 (56%) had RA without ILD (controls). Twenty-six patients were male (22%), the mean age was 56.6±15.6 years. Five variables were significantly associated with the presence of ILD: male gender, smoking, extraarticular manifestations, a CDAI score>28, and ESR>80mm/h. The AUC of the final model curve was 0.86 (95%CI 0.79-0.92). Two potential cut-off points of the risk indicator score were chosen: a value of 2 points showed a sensitivity of 90.38% and a specificity of 63.64%, while a value of 4 points showed a sensitivity of 51.9% and a specificity of 90.9%. CONCLUSION: This study identified risk factors that could help identify which RA patients are at risk of having ILD through the development of a risk indicator score. This score needs to be validated in an independent cohort.

Métodos de diagnóstico en el estudio de las Miopatías Inflamatorias Autoinmunes: Datos del Registro Argentino de Miopatías Inflamatorias de la Sociedad Argentina de Reumatología / Diagnostic methods in the study of Inflammatory Myopathies. Data from the Argentine Register: Argentine Rheumatology Society

Las Miopatías Inflamatorias Autoinmunes (MI) comprenden un grupo de enfermedades heterogéneas con presentación y características clínicas variables. Se distinguen subtipos clínicos como Polimiositis (PM), Dermatomiositis (DM), Miositis por cuerpos de Inclusión (MCI), Miopatía Necrotizante Inmunomediada (MNIM), Miositis de los Síndromes de Superposición, formas juveniles de MI (DMJ), Síndrome Antisintetasa (SAS) y Miopatía Asociada a Cáncer (MAC). La presencia de anticuerpos séricos y el infiltrado inflamatorio en la biopsia de músculo sugiere que se trata de una condición autoinmune. Realizar el diagnóstico de las MI suele ser un desafío y las herramientas diagnósticas no siempre están disponibles en la práctica diaria. Se obtuvo información sobre la disponibilidad de estos métodos del Registro Argentino de Miopatías Inflamatorias. El estudio de enzimas musculares, Anticuerpos Antinucleares (ANA), anticuerpo anti-Jo-1 y la tomografía computada de tórax, estuvieron disponibles para la mayoría de los pacientes mientras que la Resonancia Magnética de musculo (RM), el estudio de difusión de monóxido de carbono (DLco) y la biopsia muscular se realizaron en menos del 50% de los casos. La determinación de otros anticuerpos específicos de miositis, de importancia en el diagnóstico y pronóstico de la enfermedad se realizó, en mayor parte, a través de un subsidio de la SAR.

The Idiopathic Inflammatory Myopathies (IIM) comprise a heterogeneous group of acquired muscle diseases classified as polymyositis (PM), dermatomyositis (DM), Inclusion Body Myositis (IBM), Immuno Mediated Necrotizing Myopathies (IMNM), Overlap Myositis (OM), juvenile myositis, Antisynthethase Syndrome (ASS) and cancer related myositis (CAM). The presence of myositis specific antibodies in the serum and autoantibodies against target antigens and inflammatory infiltrates in muscle tissue suggests the autoimmune condition of the disease. The diagnosis of inflammatory myopathies is often a challenge and the disposal of diagnostic tools are not always available in daily practice. Information on the accessibility of these methods was obtained from the Argentine Register of Myopathies. The study of muscle enzymes, ANA, anti-Jo-1 antibodies and chest tomography were easy to get to most patients while muscle MRI, lung diffusion capacity for carbon monoxide (DLco) and muscle biopsy were performed in less than 50% of cases. Other myositis specific antibodies, necessary for disease diagnosis and prognosis, were mostly done through a subsidy from the Argentine Rheumatology Society.

Métodos de diagnóstico en el estudio de las Miopatías Inflamatorias Autoinmunes: Datos del Registro Argentino de Miopatías Inflamatorias de la Sociedad Argentina de Reumatología / Diagnostic methods in the study of myopathies Inflammatory Autoimmune: Data from the Argentine Registry of Inflammatory Myopathies of the Argentine Society of Rheumatology

Las Miopatías Inflamatorias Autoinmunes (MI) comprenden un grupo de enfermedades heterogéneas con presentación y características clínicas variables. Se distinguen subtipos clínicos como Polimiositis (PM), Dermatomiositis (DM), Miositis por cuerpos de Inclusión (MCI), Miopatía Necrotizante Inmunomediada (MNIM), Miositis de los Síndromes de Superposición, formas juveniles de MI (DMJ), Síndrome Antisintetasa (SAS) y Miopatía Asociada a Cáncer (MAC).La presencia de anticuerpos séricos y el infiltrado inflamatorio en la biopsia de músculo sugiere que se trata de una condición autoinmune. Realizar el diagnóstico de las MI suele ser un desafío y las herramientas diagnósticas no siempre están disponibles en la práctica diaria. Se obtuvo información sobre la disponibilidad de estos métodos del Registro Argentino de Miopatías Inflamatorias. El estudio de enzimas musculares, Anticuerpos Antinucleares (ANA), anticuerpo anti-Jo-1 y la tomografía computada de tórax, estuvieron disponibles para la mayoría de los pacientes mientras que la Resonancia Magnética de musculo (RM), el estudio de difusión de monóxido de carbono (DLco) y la biopsia muscular se realizaron en menos del 50% de los casos. La determinación de otros anticuerpos específicos de miositis, de importancia en el diagnóstico y pronóstico de la enfermedad se realizó, en mayor parte, a través de un subsidio de la SAR.

The Idiopathic Inflammatory Myopathies (IIM) comprise a heterogeneous group of acquired muscle diseases classified as polymyositis (PM), dermatomyositis (DM), Inclusion Body Myositis(IBM), ImmunoMediated Necrotizing Myopathies, (IMNM), Overlap Myositis(OM), juvenile myositis, Antisynthethase Syndrome (ASS) and cancer related myositis(CAM).The presence of myositis specific antibodies in the serum and autoantibodies against target antigens and inflammatory infiltrates in muscle tissue suggests the autoimmune condition of the disease. The diagnosis of inflammatory myopathies is often a challenge and the disposal of diagnostic tools are not always available in daily practice. Information on the accessibility of these methods was obtained from the Argentine Register of Myopathies. The study of muscle enzymes, ANA, anti-Jo-1 antibodies and chest tomography were easy to get to most patients while muscle MRI, lung diffusion capacity for carbon monoxide (DLco%) and muscle biopsy were performed in less than 50% of cases. Other myositis specific antibodies, necessary for disease diagnosis and prognosis, were mostly done through a subsidy from the Argentine Rheumatology Society.

Frequency of human leukocyte antigens class II-DR alleles (HLA-DRB1) in Argentinian patients with early arthritis.

Patients with rheumatoid arthritis (RA) or undifferentiated arthritis (UA) in the CONAART database (Argentine Consortium for Early Arthritis) were assessed for genetic risk factors for RA, specifically for HLA-DRB1 alleles and the PTPN22 rs2476601 polymorphism associated with progression to RA. This is a case-control study. Blood samples were obtained to determine HLA-DRB1 genotypes by PCR-SSO Luminex and PTPN22 (rs2476601) polymorphism by allelic discrimination. A control group of individuals from the general Argentinian population were obtained from the national register of cadaveric organ donors. A total of 1859 individuals were included in this analysis: 399 patients from the CONAART database (347 patients with RA at study end and 52 patients with UA at study end, mean follow-up time 25 ± 18 months) and 1460 individuals from the general Argentinian population. Compared with the controls, the HLA-DRB1*04 and DRB1*09 alleles were more commonly detected in patients with RA diagnosis (OR (95% CI) 2.23 (1.74-2.85) and 1.89 (1.26-2.81)) respectively. Both patients with UA and the general population showed higher frequency of DRB1*07, DRB1*11 and DRB1*15 alleles than patients with RA. PTPN22 rs2476601 polymorphism frequency was higher in RA and UA vs the general population; however, this was significantly different only for RA vs control group (OR [95% CI] = 1.81 [1.10-3.02], P = 0.018. HLA-DRB1 typing and PTPN22 allelic discrimination could distinguish between patients with UA, patients with early RA, and the general population in Argentina. This is the first study of HLA-DRB1 alleles and PTPN22 polymorphism associations with progression to early RA in an Argentinian population.

Antibiosis interaction of Staphylococccus aureus on Aspergillus fumigatus assessed in vitro by mixed biofilm formation.

BACKGROUND: Microorganisms of different species interact in several ecological niches, even causing infection. During the infectious process, a biofilm of single or multispecies can develop. Aspergillus fumigatus and Staphyloccocus aureus are etiologic agents that can cause infectious keratitis. We analyzed in vitro single A. fumigatus and S. aureus, and mixed A. fumigatus-S. aureus biofilms. Both isolates were from patients with infectious keratitis. Structure of the biofilms was analyzed through microscopic techniques including scanning electron microscopy (SEM), transmission electron microscopy (TEM), confocal, and fluorescence microscopy (CLSM) in mixed biofilm as compared with the single A. fumigatus biofilm. RESULTS: To our knowledge, this is the first time that the structural characteristics of the mixed biofilm A. fumigatus-A. fumigatus were described and shown. S. aureus sharply inhibited the development of biofilm formed by A. fumigatus, regardless of the stage of biofilm formation and bacterial inoculum. Antibiosis effect of bacterium on fungus was as follows: scarce production of A. fumigatus biofilm; disorganized fungal structures; abortive hyphae; and limited hyphal growth; while conidia also were scarce, have modifications in their surface and presented lyses. Antagonist effect did not depend on bacterial concentration, which could probably be due to cell-cell contact interactions and release of bacterial products. In addition, we present images about the co-localization of polysaccharides (glucans, mannans, and chitin), and DNA that form the extracellular matrix (ECM). In contrast, single biofilms showed extremely organized structures: A. fumigatus showed abundant hyphal growth, hyphal anastomosis, and channels, as well as some conidia, and ECM. S. aureus showed microcolonies and cell-to-cell bridges and ECM. CONCLUSIONS: Herein we described the antibiosis relationship of S. aureus against A. fumigatus during in vitro biofilm formation, and report the composition of the ECM formed.

Acesso à vacina contra a hepatite B entre parturientes que realizaram o pré-natal em Pelotas, Rio Grande do Sul / Access to hepatitis B vaccine by pregnant women attending antenatal care in Pelotas, Rio Grande do Sul State, Brazil / Acceso a la vacuna contra la hepatitis B entre parturientas que realizaron el prenatal en Pelotas, Rio Grande do Sul

Objetivo: avaliar a falta de acesso à vacina contra a hepatite B, motivos e fatores associados, entre parturientes que realizaram pré-natal no município de Pelotas, Rio Grande do Sul, Brasil. Métodos: estudo transversal de base populacional, incluindo todas as parturientes internadas nas maternidades do município por ocasião do parto, em período de 30 dias, no ano de 2013. Resultados: foram entrevistadas 352 parturientes; a falta de acesso à vacina foi de 23,1 (IC95 por cento: 18,5-27,6) e o principal motivo foi não indicação pelo médico (70,1 por cento); não foi encontrada associação entre falta de acesso e os fatores sociodemográficos estudados. Conclusões: o acesso à vacina contra a hepatite B entre parturientes foi limitado, principalmente devido a sua não recomendação por parte do médico; os resultados evidenciam a necessidade de estabelecer medidas e ações que proporcionem melhorias na atenção pré-natal, no que se refere às estratégias de vacinação contra o vírus da hepatite B.

Objective: to evaluate lack of access to hepatitis B vaccination, its reasons and associated factors in pregnant women attending antenatal care in Pelotas. Methods: this was a cross-sectional population-based study using primary data at the municipality maternity facilities, including all women giving birth during a 30 day period in 2013. Results: 352 women were interviewed. There was 23.1 percent (95 percent CI, 18.5-27.6) lack of access to hepatitis B vaccine and the main reason for non-vaccination was the absence of the doctor's recommendation (70.1 percent). No association was found between lack of access and the sociodemographic factors studied. Conclusions: the study found limited access to hepatitis B vaccine among pregnant women in Pelotas- RS, due mainly to the lack of the physician recommendation. The results highlight the need for measures and actions to improve prenatal care regarding HBV vaccination strategies.

Objetivo: evaluar la falta de acceso a la vacuna contra la hepatitis B, motivos y factores asociados, entre parturientas que realizaron el prenatal en el municipio de Pelotas, Rio Grande do Sul, Brasil.Métodos: estudio transversal de base poblacional, incluyendo a todas las parturientes internadas en las maternidades del municipio por ocasión del parto, en un período de 30 días, en el año de 2013.Resultados: se entrevistaron 352 parturientes; la falta de acceso a la vacuna fue de un 23,1% (IC95%: 18,5-27,6) y el principal motivo fue la no indicación por parte del médico (70,1%); no se encontró asociación entre la falta de acceso y los factores sociodemográficos estudiados.Conclusiones: el acceso a la vacuna contra la hepatitis B entre parturientes fue limitado, principalmente debido a la no recomendación por parte del médico; los resultados ponen en evidencia la necesidad de establecer medidas y acciones que proporcionen mejorías en la atención prenatal, en lo referente a las estrategias de vacunación contra el virus de la hepatitis B.

Efeito do cério na qualidade fisiológica de sementes de milho e no desempenho agronômico das plantas / Effect cerium on the physiological quality maize seed and agronomic performance of plants

Os elementos químicos terras raras, tais como Cério (Ce), podem ser utilizados como fertilizantes no manejo químico das culturas, visando a otimização no fornecimento de nutrientes às plantas, quando se buscam incrementos na produtividade agrícola. O objetivo do trabalho foi avaliar a qualidade fisiológica e o desempenho agronômico da cultura do milho, após tratamento das sementes com Ce. As sementes da cultivar Pioneer 30F53, foram imersas em solução aquosa, nas concentrações de 0, 5, 10, 15, 20 e 25 mg de Ce L-1, por uma hora. Após a imersão, foram realizados os testes de germinação, primeira contagem da germinação, classificação do vigor, comprimento e massa seca de plântulas, em laboratório. Em campo, sementes tratadas com a concentração de 12 mg de Ce L-1, escolhida após a primeira etapa de testes de laboratório, foram semeadas e durante o ciclo da cultura foram avaliados além do rendimento, número de dias até emergência de 50 % das plantas, número de folhas, diâmetro do colmo, estatura de plantas e número de dias até 50 % do florescimento. Concluiu-se que a aplicação de Ce em sementes de milho aumenta a germinação e o vigor das sementes, mas não influencia o crescimento vegetativo e reprodutivo. O tratamento com Ce pode induzir ao aumento do rendimento da cultura do milho.

The search for alternatives that provide increases in crop yields in agricultural systems is still present today. Chemical elements rare earths such as cerium (Ce) represent alternatives in the search for increases in agricultural productivity and has been used in several countries and many cultures. The objective of this study was to evaluate the physiological quality and agronomic performance of corn after seed treatment with Ce. Corn seeds Pioneer 30F53, since they were immersed in aqueous solution at concentrations of 0, 5, 10, 15, 20 and 25 mg L-1 Ce, for one hour. After the immersion, were performed tests of germination, first count germination, vigor classification, length and seedling dry weight in the laboratory. In the field, the seeds treated with a concentration of 12 mg L-1 Ce, previously chosen by laboratory tests were sown and during the course of the culture were measured as well as yield, number of days until emergence of the plants 50%, number leaf, stem diameter, plant height and number of days until 50% flowering. It was concluded that the application of Ce increases in corn seed germination and seed vigor, but no effect on the vegetative and reproductive growth. The treatment with Ce can induce an increase of the yield of corn.

Daño radiológico en al mano dominante de pacientes con artritis reumatoidea / Radiographic damage in the dominant hand of rheumatoid artritis patients

La Artritis Reumatoide (AR) es una enfermedad inflametoria crónica que compromete predominantemente manos. El objetivo de este trabajo fue determinar la prevalencia de daño radiológico en la mano dominante (MD) de pacientes con AR. Material y métodos: se realizó un estudio transversal, se incluyeron pacientes con AR (ACR 87Æ) de la consulta ambulatoria (noviembre de 2011 a julio de 2012). Se determinó la MD y se realizó lectura radiológica por un lector ciego validado, mediante Sharp van der Heijde modificado. Estadística: se realizó estadística descriptiva básica, y comparaciones mediante Chi2, test de Fisher o test de T para muestras relacionadas según correspondiera. Se consideró p<0,50 como significativa. Resultados: se incluyeron 52 pacientes, 43 mujeres (82,7%), la mediana de edad de 47 años (RIC: 41-56), de evolución de la AR de 10 años (RIC: 3-14). En 50 pacientes (96,2%), la mano derecha fue MD. No se encontraron diferencias estadísticamente significativas en el puntaje total de SvdH modificado, ni de pinzamiento, ni de erosiones. Los varones tuvieron el doble de puntaje medio erosivo, pero no significativo. Conclusión: no se puede demostrar asociación entre la MD y el daño radiológico. Debería estudiarse el subgrupo masculino en estudios de mayor poder estadístico

Rheumatoid Arthritis (RA) is an inflammatory disease that affects thehand joints. The aim of this study was to assess the prevalence of domi-nant hand affection in RA patients. Methods:A cross sectional study was designed that included RA pa-tients (ACR 87Æ criteria), that concurred to rheumatologic clinic, fromNovember 2011 to July 2012. Descriptive data was taken, and a radio-logic scoring by Sharp van der Heijde score was assessed comparingboth hands. Statistics:The variables were compared by Chi2, Fisher orT-student tests and a p <0.05 value was considered significant.Results: Fifty-two patients were included, 43 female (82.7%), 47 yearsof median age (IQR: 41-56), and 10 years of median disease evolution.In 50 patients (96.2%), the right hand was dominant. There were no dif-ferences between both hands in the total mSvdH score, nor the erosionnor the space narrowing score. Male patients were more prone to havehigher erosive scores, but the number was small (six).Conclusion: No association was seen between radiological damageand dominant hand. Male patients should be included in future studiesto clarify this issue in this sub-group of RA patients.(AU)

Daño radiológico en al mano dominante de pacientes con artritis reumatoidea / Radiographic damage in the dominant hand of rheumatoid artritis patients

La Artritis Reumatoide (AR) es una enfermedad inflametoria crónica que compromete predominantemente manos. El objetivo de este trabajo fue determinar la prevalencia de daño radiológico en la mano dominante (MD) de pacientes con AR. Material y métodos: se realizó un estudio transversal, se incluyeron pacientes con AR (ACR 87’) de la consulta ambulatoria (noviembre de 2011 a julio de 2012). Se determinó la MD y se realizó lectura radiológica por un lector ciego validado, mediante Sharp van der Heijde modificado. Estadística: se realizó estadística descriptiva básica, y comparaciones mediante Chi2, test de Fisher o test de T para muestras relacionadas según correspondiera. Se consideró p<0,50 como significativa. Resultados: se incluyeron 52 pacientes, 43 mujeres (82,7%), la mediana de edad de 47 años (RIC: 41-56), de evolución de la AR de 10 años (RIC: 3-14). En 50 pacientes (96,2%), la mano derecha fue MD. No se encontraron diferencias estadísticamente significativas en el puntaje total de SvdH modificado, ni de pinzamiento, ni de erosiones. Los varones tuvieron el doble de puntaje medio erosivo, pero no significativo. Conclusión: no se puede demostrar asociación entre la MD y el daño radiológico. Debería estudiarse el subgrupo masculino en estudios de mayor poder estadístico

Rheumatoid Arthritis (RA) is an inflammatory disease that affects thehand joints. The aim of this study was to assess the prevalence of domi-nant hand affection in RA patients. Methods:A cross sectional study was designed that included RA pa-tients (ACR 87’ criteria), that concurred to rheumatologic clinic, fromNovember 2011 to July 2012. Descriptive data was taken, and a radio-logic scoring by Sharp van der Heijde score was assessed comparingboth hands. Statistics:The variables were compared by Chi2, Fisher orT-student tests and a p <0.05 value was considered significant.Results: Fifty-two patients were included, 43 female (82.7%), 47 yearsof median age (IQR: 41-56), and 10 years of median disease evolution.In 50 patients (96.2%), the right hand was dominant. There were no dif-ferences between both hands in the total mSvdH score, nor the erosionnor the space narrowing score. Male patients were more prone to havehigher erosive scores, but the number was small (six).Conclusion: No association was seen between radiological damageand dominant hand. Male patients should be included in future studiesto clarify this issue in this sub-group of RA patients.

Metodología para la evaluación externa de la carrera de Estomatología / Methodology for external evaluation in odontology career

La investigación Metodología para la evaluación externa de la carrera de Estomatología estableció el objetivo de revisar la Guía para la Evaluación Externa de la Carrera (SEA-CU 02) contenida en el Sistema de Evaluación y Acreditación de Carreras Universitarias (SEA-CU), rediseñarla de acuerdo a las particularidades de la carrera de Estomatología en el contexto del Sistema Nacional de Salud de Cuba y recomendar validar la propuesta resultante para ser aplicada en los diferentes escenarios docentes donde se desarrolla la carrera. En la investigación participaron 25 expertos de la Facultad de Estomatología "Raúl González Sánchez" de la Universidad de Ciencias Médicas de La Habana que clasificaron como tales, acorde al criterio de inclusión establecido. A través de cuatro rondas de consultas utilizando el Método Delphi y el correo electrónico como vía de comunicación, se diseñó una nueva y específica Guía para la Evaluación Externa de la carrera de Estomatología en la cual coexisten requisitos generales de calidad para las carreras de la Educación Superior con requisitos específicos de calidad propios para esta en el contexto del Sistema Nacional de Salud con componentes de Organización y Administración de Salud Pública y de Administración Universitaria

The research study Methodology for the external evaluation of odontology career set the objectives of reviewing the Guide for External Evaluation of the Career (SEA-CU 02) included in the System of Evaluation and Accreditation of University Careers (SEA-CU), of re-designing it according to the particularities of the odontology studies within the context of the national health care, and of recommending the validation of the resulting proposal to be put into practice in the various teaching settings of the career. Twenty five experts from "Raúl González Sánchez" dental school in the Medical Sciences University of Havana, who were accepted according to the set inclusion criteria, participated in the study. Through four rounds of consultations using Delphi´s method and the electronic mail as communication channel, a new specific Guide for External Evaluation of Odontology career was designed, which combines general quality requirements for the higher education careers and specific quality requirement inherent to this specialty within the national health system, with elements of public health organization and management, and of university management

Metodología para la evaluación externa de la carrera de Estomatología / Methodology for external evaluation in odontology career

La investigación Metodología para la evaluación externa de la carrera de Estomatología estableció el objetivo de revisar la Guía para la Evaluación Externa de la Carrera (SEA-CU 02) contenida en el Sistema de Evaluación y Acreditación de Carreras Universitarias (SEA-CU), rediseñarla de acuerdo a las particularidades de la carrera de Estomatología en el contexto del Sistema Nacional de Salud de Cuba y recomendar validar la propuesta resultante para ser aplicada en los diferentes escenarios docentes donde se desarrolla la carrera. En la investigación participaron 25 expertos de la Facultad de Estomatología "Raúl González Sánchez" de la Universidad de Ciencias Médicas de La Habana que clasificaron como tales, acorde al criterio de inclusión establecido. A través de cuatro rondas de consultas utilizando el Método Delphi y el correo electrónico como vía de comunicación, se diseñó una nueva y específica Guía para la Evaluación Externa de la carrera de Estomatología en la cual coexisten requisitos generales de calidad para las carreras de la Educación Superior con requisitos específicos de calidad propios para esta en el contexto del Sistema Nacional de Salud con componentes de Organización y Administración de Salud Pública y de Administración Universitaria(AU)

The research study Methodology for the external evaluation of odontology career set the objectives of reviewing the Guide for External Evaluation of the Career (SEA-CU 02) included in the System of Evaluation and Accreditation of University Careers (SEA-CU), of re-designing it according to the particularities of the odontology studies within the context of the national health care, and of recommending the validation of the resulting proposal to be put into practice in the various teaching settings of the career. Twenty five experts from "Raúl González Sánchez" dental school in the Medical Sciences University of Havana, who were accepted according to the set inclusion criteria, participated in the study. Through four rounds of consultations using Delphi´s method and the electronic mail as communication channel, a new specific Guide for External Evaluation of Odontology career was designed, which combines general quality requirements for the higher education careers and specific quality requirement inherent to this specialty within the national health system, with elements of public health organization and management, and of university management(AU)