La artritis reumatoide es una enfermedad inflamatoria con una prevalencia de hasta el 5% y con un impacto significativo sobre la calidad de vida. La artritis reumatoide representa una condición ...médica de alto costo; para el año 2010 se estimó un gasto anual de 4,8 millones de dólares, según un estudio realizado en Estados Unidos.
Realizar el análisis descriptivo de la literatura biomédica indexada en Medline entre 1996 y 2016 sobre temas relacionados con aspectos económicos de la artritis reumatoide.
El diseño es un análisis bibliométrico retrospectivo, de tipo descriptivo. Se realizó una búsqueda bibliográfica en Medline utilizando GoPubMed y Fabumed, y la siguiente estrategia de búsqueda: («Arthritis, Rheumatoid» Majr) AND («Costs and Cost Analysis» Majr) AND (1996:2016 dp).
Se obtuvieron un total de 350 referencias indexadas en 80 revistas diferentes. Rheumatology con 6 (1,71%) referencias fue la revista con mayor número de publicaciones, seguida por Clinical and Experimental Rheumatology con 5 (1,42%). Estados Unidos fue el país más productivo con 30 (8,57%) publicaciones. En Latinoamérica, Brasil aporta 3 publicaciones (0,85%), al igual que Colombia con 3 publicaciones (0,85%). A lo largo del periodo estudiado se observó una tasa de crecimiento de 41,4%.
Colombia ha aportado menos del 1% de la producción científica a escala mundial; teniendo en cuenta que los análisis económicos no son extrapolables, consideramos necesario el desarrollo de nuevas propuestas y contribuciones en esta área de investigación en nuestro país.
Rheumatoid arthritis is an inflammatory disorder with a prevalence of up to 5%, and with a significant impact on the quality of life quality. Rheumatoid arthritis is a high cost medical condition. According to a study carried out in the United States by 2010 an annual expenditure of 4.8 million dollars was estimated.
To perform a descriptive analysis of the Medline-indexed biomedical literature on economic aspects of rheumatoid arthritis published between 1996 and 2016.
The design is retrospective descriptive literature analysis, with a search performed in Medline using GoPubMed and Fabumed, with the following search strategy: (“Arthritis, Rheumatoid” Majr) AND (“Costs and Cost Analysis” Majr) AND (1996:2016 dp).
A total of 350 references were obtained on economic aspects of rheumatoid arthritis indexed in 80 different journals. Rheumatology, with 6 (1.71%) references was the top journal, followed by Clinical and Experimental Rheumatology with 5 (1.42%). The United States was the most productive country with 30 (8.57%) publications. In Latin America, Brazil and Colombia each contributed with 3 (0.85%) references. During the period studied, there was a growth rate of 41.4%
Colombia has contributed with less than 1% of scientific production worldwide, and taking into account that the economic analysis cannot be decontextualised, the development of new proposals and contributions in this research area in our country is considered necessary.
•One-fourth of our PPMS patients exhibited disease activity over one year.•Disability progressed in approximately one-third of these patients.•No cognitive decline, increased depression or stigma ...aggravation was evidenced.•There was no worsening of employment outcomes or disease impact.•A complex myriad of interrelations between study variables was detected.
Primary progressive multiple sclerosis (PPMS) has long been defined by progressive disability accrual in the absence of initial relapses. However, its underlying neurodegenerative process seems to be accompanied by central nervous system inflammation. A new classification defined multiple sclerosis courses according to clinical/radiological activity and progression. We provide further insight into PPMS activity according to this classification and other daily living aspects.
This was a multicentre, prospective, cohort study including 55 adult patients with PPMS according to 2010 McDonald criteria, within ten years from neurologic symptom onset and not receiving disease-modifying therapies during the past six months, who were followed up for 12 months. The primary study endpoint was the percentage of patients with active disease based on clinical relapses and/or magnetic resonance activity. Disability progression, cognitive function, physical/psychological impact, depression symptoms, stigma and employment were secondary endpoints.
Eleven (25.6%) patients exhibited multiple sclerosis activity throughout the 12-month study follow-up. Fourteen showed non-active multiple sclerosis without progression, 11 non-active multiple sclerosis with progression, 6 active multiple sclerosis without progression and 4 active multiple sclerosis with progression; one patient with disease activity was not assessable for progression. Cognitive function scores remained unchanged or increased, disease physical impact was maintained and disease psychological impact significantly decreased. The proportion of patients with depression symptoms or stigma remained without significant changes as well as employment outcomes.
This study shows that one-fourth of PPMS patients may exhibit disease activity over one year, with disability progression in approximately one-third but without worsening of cognitive function, disease impact, depression, stigma or employment outcomes.
Data on characteristics and outcomes of coronavirus (COVID)-19 patients complicated with arterial thrombosis (AT) are scarce. Therefore, we carried out a systematic review (PRISMA, PROSPERO ...statements; PubMed, Scopus, and Web of Science) to identify risk factors, clinical presentation, treatment, and outcomes. We included publications from December 2019 to October 2020. Groups: (a) ischemic stroke, (b) thrombotic storm, (c) peripheral vascular thrombosis, (d) myocardial infarction, and (e) left cardiac thrombus or in-transit thrombus (venous system thrombus floating or attaching to the right heart). We considered 131 studies. The most frequent cardiovascular risk factors were: hypertension, diabetes, and dyslipidemia. A high proportion presented with asymptomatic, mild, or moderate COVID-19 (n = 91, 41.4%). We identified a high percentage of isolated ischemic stroke and thrombotic storm. Groups with higher mortality rate: intracardiac thrombus (1/2, 50.0%), thrombotic storm (18/49, 36.7%), and ischemic stroke (48/131, 36.6%). A small number received thromboprophylaxis. Most patients received antithrombotic treatment. The most frequent bleeding complication was intracranial hemorrhage, primarily with isolated stroke. Overall mortality was 33.6% (74/220). Despite a wide range of COVID-19 severity, a high proportion had AT as a complication of non-severe disease. AT can affect different vascular territories; mortality is associated with stroke, intensive care unit stay, and severe COVID-19.
Comprehensive evidence‐based guidelines for the practice of pancreas transplantation are yet to be established. The First World Consensus Conference on Pancreas Transplantation was convened for this ...purpose. A steering committee selected the participants and defined the questions to be addressed. A group of literature reviewers identified 597 studies to be included in summaries for guidelines production. Expert groups formulated the first draft of recommendations. Two rounds of discussion and voting occurred online, using the Delphi method (agreement rate ≥85%). After each round, critical responses of experts were reviewed, and recommendations were amended accordingly. Recommendations were finalized after live discussions. Each session was preceded by expert presentations and a summary of results of systematic literature review. Up to three voting rounds were allowed for each recommendation. To avoid potential conflicts of interest, deliberations on issues regarding the impact of pancreas transplantation on the management of diabetes were conducted by an independent jury. Recommendations on technical issues were determined by experts and validated using the Appraisal of Guidelines for Research and Evaluation (AGREE) II instrument. Quality of evidence was assessed using the Scottish Intercollegiate Guidelines Network (SIGN) methodology. Each recommendation received a GRADE rating (Grading of Recommendations, Assessment, Development and Evaluations).
This article presents the results of literature search and the methods used to provide evidence‐based guidelines for the practice of pancreas transplantation at the First World Consensus Conference on Pancreas Transplantation.
Biallelic loss-of-function (LOF) mutations of the NCF4 gene, encoding the p40phox subunit of the phagocyte NADPH oxidase, have been described in only 1 patient. We report on 24 p40phox-deficient ...patients from 12 additional families in 8 countries. These patients display 8 different in-frame or out-of-frame mutations of NCF4 that are homozygous in 11 of the families and compound heterozygous in another. When overexpressed in NB4 neutrophil-like cells and EBV-transformed B cells in vitro, the mutant alleles were found to be LOF, with the exception of the p.R58C and c.120_134del alleles, which were hypomorphic. Particle-induced NADPH oxidase activity was severely impaired in the patients' neutrophils, whereas PMAinduced dihydrorhodamine-1,2,3 (DHR) oxidation, which is widely used as a diagnostic test for chronic granulomatous disease (CGD), was normal or mildly impaired in the patients. Moreover, the NADPH oxidase activity of EBV-transformed B cells was also severely impaired, whereas that of mononuclear phagocytes was normal. Finally, the killing of Candida albicans and Aspergillus fumigatus hyphae by neutrophils was conserved in these patients, unlike in patients with CGD. The patients suffer from hyperinflammation and peripheral infections, but they do not have any of the invasive bacterial or fungal infections seen in CGD. Inherited p40phox deficiency underlies a distinctive condition, resembling a mild, atypical form of CGD.
INTRODUCTION AND OBJECTIVESDeterminants of chronic obstructive pulmonary disease (COPD) in the early stages of its natural history are not well known. Improving our knowledge of these factors will ...help to design interventions that can modify prognosis. Study objectives are: a) to characterize a COPD population of young adults aged 35-50 years from a multidimensional point of view; b) to compare these patients with smokers with normal lung function; and c) to create a cohort of young adults aged 35-50 years (smokers or former smokers), with and without COPD, who will be followed in the future to improve understanding of the natural history of the disease. PARTICIPANTS AND METHODThis is a case-control multicenter study aimed at establishing a well-characterized cohort of young adults, smokers or former-smokers, with and without COPD, for subsequent follow-up. A total of 311 participants (101 cases and 210 controls) were selected from approximately 30 primary care settings and 12 hospitals in 8 Spanish regions. Subjects were smokers or former smokers (>10 pack-years) aged 35-50 years. Diagnosis of COPD was based on a post-bronchodilator result of FEV1/FVC<70%. The main study variables were: questionnaires on health, symptoms, exacerbations and daily physical activity, lung function tests, blood and sputum samples, and low-dose computed tomography. In the statistical analysis, COPD patient characteristics will be described and compared with control subjects using a logistic regression analysis.
A new compound (1) formed by two antiparallelly disposed tetracyano thienoquinoidal units has been synthesized and studied by electrochemistry, UV/Vis‐NIR, IR, EPR, and transient spectroscopy. ...Self‐assembly of 1 on a Au(111) surface has been investigated by scanning tunneling microscopy. Experiments have been rationalized by quantum chemical calculations. 1 exhibits a unique charge distribution in its anionic form, with a gradient of charge yielding a neat molecular in‐plane electric dipole momentum, which transforms out‐of‐plane after surface deposition due to twisted→folded conformational change and to partial charge transfer from Au(111). Intermolecular van der Waals interactions and antiparallel trapezoidal shape fitting lead to the formation of an optimal dense on Au(111) two‐dimensional assembly of 1.
A new compound formed by two antiparallelly disposed tetracyano thienoquinoidal units is synthesized. Such species feature an in‐plane to out‐of‐plane switch of the electric dipole momentum upon adsorption and self‐assembly on Au(111).
Basal cell carcinoma (BCC) seems to originate from ultraviolet light-induced mutations involving the bulge or the outer sheath of the hair follicle cells. However, the etiopathogenic mechanisms ...involved in the development of these tumors in nonphotoexposed and in hairless areas remain unclear. The cytokeratin (CK) profile (including CK5/6, CK7, CK14, CK15, CK17, and CK19) from a series of different BCC subtypes developing in sun-exposed and non-sun-exposed areas, including hairless regions, was evaluated. The authors have observed that CK7 expression in BCC is associated with the anatomical localization of the tumor and its sun-exposition, but not with other factors such as histological subtype. The expression of this CK is higher in BCCs located in non-sun-exposed and nonhairy areas, such as the vulvar semimucosa and the nipple. Because CK7 is a marker of simple glandular epithelia, the authors suggest a glandular origin for BCCs located in hairless and nonphotoexposed areas.
PDF
