BackgroundRheumatoid Arthritis (RA) is a systemic, inflammatory, chronic, autoimmune disease that predominantly affects the joints.1 In the last decade new drugs have been introduced, including biological drugs that act on different targets implicated in the pathogenesis of the disease.2 Within this group of drugs is tocilizumab (TCZ), a humanized monoclonal antibody anti IL-6r, key cytokine involved in the pathogenesis of RA and the disease activity.3 TCZ use has been associated with abnormalities in transaminases (AST, ALT).2ObjectivesTo determine the frequency of transaminases abnormalities in patients with RA treated with TCZ in Santo Domingo, Dominican Republic.MethodsWe performed a longitudinal, observational, prospective study. The records of patients diagnosed with RA who fulfilled the 1987 ACR criteria and ACR/EULAR 2010, which use biological therapy with TCZ in HDPB and HFMP in July 2013 until August 2014 were reviewed. All patients signed informed consent. We reviewed a total of 56 records from which we selected patients who had at least 2 follow-up visits after the start of treatment (40 patients) taking into account the transaminases baseline values to compare changes. Visits were conducted every three months, mild and moderate levels were considered between (>1xUI/L, >2xUI/L) and severe (>3xUI/L) over the normal value. The patients whose records were found incomplete during the first 3 visits were excluded. The frequency of continuous variables was analyzed using the SPSS statistical program (V20.x86).ResultsOf 40 patients who met the inclusion criteria, 45% (18) elevated transaminases levels. For AST elevations 33.3% (6) elevated from mild to moderate, only 5.6% (1) severely and 61.1% (11) did not alter the levels. As for ALT, 50% (9) presented increased mild to moderate, 5.6% (1) course with severe elevation and the remaining 44.4% (8) did not alter the normal parameters. On the third visit 50% (9) presented elevated AST from mild to moderate, not severe elevations were reported and 50% (9) remained within normal parameters. Elevations of ALT were higher during the third visit in 72.2% (13) of mild to moderate, only 5.6% (1) course with severe elevation and 22.2% (4) was found within normal values. Of the 18 patients who were enrolled with alterations, 83.33% (15) were using simultaneously therapy with sDMARD.ConclusionsThe results of monitoring of a population of Dominican Republic showed that treatment with TCZ was associated with increased levels of transaminases.ReferencesAnn Rheum Dis 2014; 73:1607-1615.Ann Rheum Dis 2010; 69:88-96.Reumatol Clin.2011, 6 (S3). S29-S32.Disclosure of InterestNone declared
Objectives: To determine the sociodemographic and clinical variables associated with hip fracture and its complications on ambulation, functionality and survival in a population of older adults in Caldas, Colombia. Methods: Descriptive study. Adults of any sex over 65 years who entered the emergency department at SES Hospital de Caldas with a diagnosis of hip fracture, between January/2016-February/2018 were included. The information was obtained from the clinical records. Sociodemographic and clinical variables regarding the mechanism of fall, type of fracture and outcomes (complications, gait status and survival) were obtained. Results: A total of 229 patients were identified, with a mean age of 80.467.8 years and female predominance (n=151, 65.9%). The main cause of falls during everyday activities (82.5%) mainly by slip or stumble and 29.7% had a previous diagnosis of osteoporosis. The main comorbidity was hypertension (68.6%). The average Barthel score at admission was 37.5618.5. In addition, 95.6% of the patients were admitted to osteosynthesis or hip replacement surgery, with a mean of days from admission to procedure of 6.2 6 25.2 days. When evaluating in-hospital complications, 37.6% of the patients presented hydroelectrolytic alterations, 31.0% delirium and 10.0% pneumonia. Among the outcomes evaluated, it was found that 44.5% of the patients had stood up at 48 hours and 69.4% were already walking at hospital discharge. It was possible to follow up 90 patients at 90 days, of those 67.8% were alive. Conclusions: Hip fractures in the elderly are a major public health problem. The timing of surgical intervention was prolonged and only two thirds of patients could walk at discharge. Research in this area is essential to identify and formulate strategies aimed to achieve the best health outcomes in this population.
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