Background: An epidemic of Chikungunya Fever (CF) spread throughout South America in 2014. The acute manifestation of CF typically consists of febrile arthritis. The burden of the chronic articular manifestations remains a public health issue affecting activities of daily life. There is a very important impact on quality of life in patients affected by CF, even at chronic phase. The long-term functional status may also be affected by CF. Objectives: To evaluate longitudinally the disability, Health Related Quality of Life (HRQOL) and functional status of patients with CF and analyze the clinical and epidemiological factors associated with different outcomes. Methods: Patients with clinical and demographic diagnosis of CF and persistent articular symptoms were evaluated in a cohort study between May 2016 and December 2016. HRQOL was rated by Short-Form 12 (SF-12) and the functional status was checked through Health Assessment Questionnaire (HAQ) and the Global Functional Status (GFS). Data were divided per weeks after disease onset and were analysed (Spearmans's correlation coefficient and Mann-Whitney test). Results: Sixty-five patients (58 females), mean age of 51.3 (±13.3) were assessed. As expected, a significant correlation between pain related scores and Physical Health Composite Scale Score (PCS), HAQ and GFS was found (p<0.05)). Edema and morning stiffness correlated with PCS, HAQ and GFS status from 4 to 20 weeks after disease onset (p<0.05). There was improvement in scores of all instruments used from 4-8 weeks of disease to 12-16 weeks of disease (table 1). The worst indices of PCS, Mental Health Composite Scale Score (MCS) and GFS were scored in the first month, mean scores of 30.07±5.77, 38.13±8.54 and 3.15±1.07 respectively. Higher HAQ values were demonstrated between 4 and 8 weeks after disease onset (mean score 1.87±0.82).
BackgroundCapillary bed of labial mucosa may be a potentially useful area for assessing abnormalities on the microcirculation. Videocapilaroscopy of the labial mucosa (LVC) in 12/13 scleroderma (SCL) patients showed capillaries disturbance such as great disorganization and anarchic orientation(1).ObjectivesTo describe LVC features in SCL and compare them with healthy controls. (HC). To compare nailfold videocapillaroscopy (NVC) with LVC in HC and SCL patients.Methods≥16 years old patients with SCL (ACR-EULAR 2013) were included consecutively since June to July 2016. Smoking patients were excluded. For the evaluation of the LVC we performed a general displaying and then we studied following areas: a-central (1 cm from the frenulum), b-lateral right and left (both 2 cm from the frenulum) and c-labial border. For evaluation of the NVC, 200x images were obtained from 2nd to 4th fingers both hands and was classified according Cutolo in early, active, late patterns(2). For assesment through LVC: photographs (200x) for each subject were taken. We define quantitative characteristics as means of: capillary diameter, length and density. The average of these parameters was obtained from the evaluation of capillaries included in 1 mm2 of at least 2 continuous images. In addition, the visibility of the subpapillary venous plexus, architecture, dilatation of capillaries, presence of megacapillaries and avascular areas were qualitatively evaluated (photo 1). Each image was reviewed by two experienced observers. We conducted the same process describe above for each healthy control subject.ResultsTwenty two patients were included (18 female, age 47±11 ys) with SCL (limited 17, diffuse 5); NVC pattern: early 8, active 11, late 3. Healthy subjects 12 (11 female, age: 34±10 years).Average capillary density: 17±4.13 (13–26) in SCL vs 21±3.65 (16–28) in HC (p 0.00).Average capillary diameter: 43±13.54 (17–83) SCL vs 19±1.67 μm (16–21) HC (p 0.02).Mean capillary length: 185±34 μm (125–248) SCL vs 237±42 μm (178–313) HC (p 0.00).In 22 SCL patients were observed dilated capillaries in 20 (90%), megacapillaries (≥70 μm) in 10 (45%) and 7 (32%) showed disturbed architecture with lost areas of the normal U-shape and changes in the parallelism of the main axis of the capillaries. About subpapillary venous plexus in SCL: 7 (32%) were prominent and only one had capillary hemorrhage. In contrast, none of the controls presented these alterations. (p 0.0).According to the 3 NVC patterns the following averages were observed in the LVC: Early Pattern (n: 8): diameter 36.93±10.84 μm; Long 191.21±47.58 μm; Density 18.12±5.33 μm. Active Pattern (n: 11): diameter 48.80±14.80 μm; Length 184.11±29.91 μm; Density 16.72±3.25 μm. Late Pattern (n: 3): diameter 36.27±10; Long 178.03±28.8 μm, density 19.33±4.16 μm.ConclusionsWe found that LVC in SCL patients show significant microvascular changes with respect to HC. In addition, all NVC patterns described in SCL showed similar alterations in LVC. Therefore, LVC could be a complementary or alternative method to ...
BackgroundSystemic lupus erythematous (SLE) have an increase cardiovascular risk, worsened by overweight and obesity. Increased BMI is associated with other severe complications and comorbidities as lupus nephritis, hypertension, insulin resistance and dyslipemia. Body weight is a modifiable risk factor.ObjectivesTo determine the frequency of overweight and obesity in patients with SLE and their impact on this diseaseMethodsDescriptive, cross-sectional study. We reviewed the medical records of outpatients with SLE (ACR 1997) who were seen since 2014 to 2016 in the Clinical Hospital of Buenos Aires, Argentina.We evaluated sex, age, disease duration, obstetric history, use and doses of oral corticosteroids, BMI, 25 OH vitamin D and educational level. Disease activity was scored by SLEDAI. Scores ≥4 were classified as active.The patients were classified into 2 groups, according to BMI: normal weight (NW) (19–25), overweight and obesity (≥25).ResultsOne hundred and sixty two of 230 were evaluated. Sixty-eight patients were excluded due to lack of data. 157 (97%) were women. Mean age for both sexes was 40.6±14.3 years (p 0.70). Means of: SLEDAI 4.3±4.47 (54.9% had SLEDAI ≥4), IMC: 27.04±5.22 (56% had a BMI ≥25) and 25-hidroxivitamin D was 25.15±9.0. Relation between 2 groups, according to BMI: 84.5% whom were in NW group have received steroids at some point vs 95.6% in BMI≥25 group (p 0.02). Mean steroids doses: BMI ≥25: 9.53±10.98 vs 5.0±7.2 in NW group (p 0.04). Multivariate analysis showed that BMI ≥25 continued significantly associated with SLE duration, independently of the steroids use and other variables.25 OH vitamin D tended to be lower in BMI ≥25 vs NW, but no significant differences (24.53±9.91 vs 25.50±9.85) (p=0.071)Table 1.In the multivariate analysis, Number of pregnancies was the only one variable remained significant (OR: 0.78, IC 95%: 0.63–0.98) (p=0.03)VariableIMC ? 25 (n: 71)IMC ≥25 (n: 91)P Duration (months) Median (rank)60 (1–384)84 (2–480)0,02Pregnancies mean (SD)1,20±1,622,64±2,840,0Menopause (%)27 (38,5)51 (58,6)0,009Abdominal perimeter mean (SD)88±8,399±11,90,0Depression (%)9 (12,5)24 (26,6)0,02Chronic renal failure (%)2 (2,7)9 (10)0,03SLEDAI ≥4 (%)33 (45,8)56 (62,2)0,02SLICC mean (SD)0,30±0.551,3±1,30,0SLICC ≥1 (%)18 (25)64 (71,1)0,0Arterial hypertension (%)12 (16,6)32 (35,5)0,003Grade and University Studies (%)32 (45)19 (20)0,004ConclusionsOver a half of our cohort had BMI ≥25 and was characterized by older age, more frequent menopause, longer course of the disease, increased steroid use and lower educational level. Depression and hypertension were the statistically more frequent comorbidities found. Obesity was associated with more activity and accrual damage including chronic renal disease.Disclosure of InterestNone declared
Background and AimsSystemic Lupus Erythematosus (SLE) and its treatment predispose to infections such as human papillomavirus (HPV) that is a risk factor for the development of lower genital tract (LGT) and anal cancers.To assess LGT- anal lesions, frequency of HPV lesions and premalignant and malignant lesions.MethodsDescriptive, cross-sectional design. Women with SLE (ACR 1997) of Argentina were consecutively sent to examination of the LGT and high-resolution anoscopy (2010–2015). Biopsies were performed according to gynaecological criteria and patient consent (Bethesda). Koilocytic cells were associated with HPV. Three Socioeconomic status (SES) groups were established (Graffar).EditorResults73 SLE patients and 104 healthy control were included. Table 1: Demographics characteristics.SLE patients 25/73 (34.3%) had HPV versus 6/104 (5.8%) in the control group (p=0.00).In the SLE-HPV were found statistically significant differences in: low SES, sexual partners≥5, antiDNA+ and low complement and a trend to low educational level (p=0,07).At check data the average dose of steroids was 10.8 Mg/d (SLE-HPV) vs 2.9 Mg/d in without HPV (p=0.00) while 61% (HPV group) vs 29% (without HPV) were receiving immunosupressors (IS) (Table 2)Abstract 151 Table 1Abstract 151 Table 2Non-differences were found related to duration of SLE, smoking, beginning of sexual intercourse, condom use and anal or oral intercourse.Abstract 151 Table 3gynecological abnormalitiesConclusionsThe frequency of HPV was high in women with SLE. We remark oligo/asymptomatic HPV and its association with low SES, serological activity and treatment.As we detected a high frequency of sole anal lesions we highlight the anoscopy regardless of symptoms.
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