Objectives:To describe 2 patients with the coexistence of SLE and Myasthenia Gravis (MG). Case 1: This is a 14-year-old girl with a diagnosis of MG since she was twelve. At that time a thymectomy was performed and the patient was treated with pyridostigmine and prednisone, with good clinical response. The dose of prednisone could be tapered off and the patient remained clinically stable for 2 years. Then she developed thrombocytopenic purpura, cutaneous lesions, polyarthralgias and a positive ANA 1: 640. With a diagnosis of SLE she is now on prednisone, hydroxychloroquine and ASS. Her MG remains stable. Case 2: This is a 25-year-old woman with a history of IPT 10 years ago. In 2003 she developed nephritis, polyarthritis, cutaneous lesions, muscular weakness and a secondary antiphospholipid syndrome. A simultaneous diagnosis of SLE and MG was made based on positive ANA and DNA, low complement and a positive test for anti-AChRs. The patient was treated with prednisone and azathioprine with good clinical response. Conclusions: The coexistence of SLE and MG is considered occasional. MG can precede the development of LES in 75% of cases and thymectomy may be a precipitating factor en some patients, as in case 1. The assessment for MG is suggested in every SLE patients with unexplained muscular weakness. Objectives:To study clinical and laboratory manifestations in 120 patients with SLE. Materials and Methods: 120 patients with Systemic Lupus Erythematosus (ACR criteria) were included. They were attended at Hospital Luis Vernaza (Guayaquil, Ecuador) in the past 3 years. We revised the clinical histories, laboratory results. Results: 120 SLE patients were seen in the past 36 months. 110 (92%) were women. Mean age 34.3 years (13-68), mean age at diagnosis 30.4 years (12-67), mean evolution time was 57.8 m (5-390) and mean delay at diagnosis was 14.3 m (0 -276). 11 patients (9%) were lost during the follow up. Clinical manifestations: systemic symptoms 95%, dermato-logical involvement 85%, arthritis 76%, hematologic 70%, nephritis 51%, pleural effusion 23%. Laboratory results: ANA positive 96%, DNA 73% m low C3 68%, low C4 75%, Anti Ro 26%, Anti La 9%, Anti SM 31%, Anti RNP 31%. Actual treatment: steroids 90%, inmunosuppresors 40%, antimalarials 68%. 9 patients (7.5%) died. Significative association was found between nephritis and low complement (P ϭ 0.001), nephritis and dead pts (P ϭ 0.01), thrombosis and antiphospholipids (P ϭ 0.02), hemolytic anemia and anticardiolipins IgM (P ϭ 0.03). Conclusions: Clinical and laboratory manifestations are similar to other series. High mortality rate was found. Objectives:To describe morbility and mortality on a lupus cohort of 120 patient followed at 3 years. Materials and Methods: 120 patients with Systemic Lupus Erythematosus (ACR criteria) were included. They were attended at Hospital Luis Vernaza (Guayaquil, Ecuador) in the past 3 years. We revised the clinical histories, laboratory results, searching for complications and mortality. Patients with and without complications were ...
Objective: Determine average time of delivery of childbirth in pregnants with joint hypermobility and compare with the average time of delivery of childbirth in pregnants without it. Patients and Methods: One hundred ninety-one pregnants distributed in 2 groups were studied, a group included 64 pregnants with joint hypermobility (exposed group) and other of 127 pregnants without it (non exposed group), assisted in the Obstetrician service from Hospital Regional Docente de Trujillo. We applied Beighton's Test to determine joint hypermobility. T-student Test was used, assuming that the difference is significant among the groups (P Ͻ 0.05). Results: The average time of delivery total childbirth in exposed group was 7.01 Ϯ 2.15 and the non exposed group was 8.89 hours Ϯ 3.5 (P Ͻ 0.001). The average time delivery of the childbirth in active stage in the exposed group was 4.05 hours Ϯ 2.15 and in the non exposed group was 5.94 Ϯ 3.46 (P Ͻ 0.001). Conclusions:The time of childbirth work is smaller in pregnants, with joint hypermobility that in those pregnants without it, with difference highly significant statistic.Objetivos: Demostrar a través de un análisis de los costos que realizan durante el primer mes en su tratamiento, los pacientes con A.R, OAD, y RPB, el potencial encarecimiento de su presupuesto, y de la marcada disminución en la capacidad adquisitiva de servicios básicos, de salud, vivienda, alimentación, vestido, trasporte y recreación, al compararlos con el estimado gubernamental para la canasta básica mensual, que dichos costos representan en Guatemala. Metodología: Se analizan 3 grupos de pacientes con los padecimientos reumáticos más frecuentes: Artritis Reumatoide (AR), Osteo-artritis Degenerativa (OAD) y Reumatismo de partes blandas (RPB), cada grupo compuesto de 30 pacientes, de una clínica priada, clínicas AGAR y consulta externa de un hospital local.Para tal objeto se diseñó un instrumento de recolección de datos, las respuestas de los gastos realizados fueron divididas entre. Gastos Directos: todos aquellos que se relacionan propiamente con el diagnóstico y tratamiento de la patología articular. Indirectos: los que se relacionan con la vida diaria y las adaptaciones que el paciente realiza a la misma como consecuencia de la enfermedad. El sueldo mínimo fijado por el gobierno para este año para el área agrícola es de Q957.00 ($119.62) y para el área no agrícola de Q1,026.00 ($128.25); es decir $1435.44 years $1539.00 respectivamente al año (Fuente: ACUERDO GUBERNATIVO No. 459-2002 Departamento Nacional del Salario, Ministerio de Trabajo y Previsión social de Guatemala). Resultados: El 85% de los pacientes no cuentan con la capacidad económica para un adecuado control y seguimiento de su enfermedad. La dependencia familiar corresponde a 58% hijos, cónyuges 30%, padres 3%, hermanos 5%. Mensualmente los Guatemaltecos, en base a su salario pueden realizar una inversión del 5.48% en salud (Instituto Nacional de Estadística, Indice de precios al consumidor, Boletín Marzo 2004) es decir Q69.92 ($8.75) resu...
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