The Argentine version of LupusQoL is a valid, reliable and reproducible instrument to assess quality of life. In this study, cut-off points that allow the classification of patients regarding whether they have good or bad quality of life are established for the first time.

No abstract

The aim of this study was to determine the prevalence and incidence of Systemic Lupus Erythematosus (SLE) in Tucumán, Argentina. Methods: The study included inpatient and outpatient charts from four public hospitals and private practice rheumatology clinics, all of them members of the Tucumán Rheumatology Society. Patients older than 16 years with diagnosis of SLE between January 2005 and December 2012 were included. Prevalence and annual incidence were calculated as the number of cases per 100.000 inhabitants during the period 2005 to 2012. Results: Three hundred fifty-three patients were identified. The mean age at diagnosis was 30.5 ± 11.7 years, 93.5% women, 83% mestizos. Prevalence was 24.3 cases/100.000 inhabitants (CI 95% 22.6–28.8) and age-adjusted (≥16 years) of 34.9 cases/100.000 inhabitants (CI 95% 32.8–41.1). The annual incidence in 2005 was 1.8 cases/100.000 inhabitants (95% CI 1–2.9) and 2012 of 4.2 cases/100.000 inhabitants (95% CI 2.9–5.8). Mortality was 9.1%, with infections being the most frequent cause (14/32). Conclusion: The prevalence of SLE in the province of Tucumán was 34.9 cases/100.000 inhabitants.

We evaluated species richness, abundance, alpha diversity, and true diversity of Phlebotominae sand fl ies temporal changes in domiciles within the northern Argentina city of Corrientes. A total of 16 sampling nights were conducted seasonally throughout the years 2012-2014 through light traps supplemented with CO 2 . Meteorological and remote sensing environmental factors were used to assessed for vectors implications in disease transmission through Generalized Mixt Models. Lutzomyia longipalpis was the most abundant and common species, followed by Nyssomyia neivai and Migonemyia migonei. Lutzomyia longipalpis was more abundant in urban areas, Ny. neivai was associated with vegetation in periurban areas, both were found all sampling years with higher abundance during the rainy season. Positive association of Lu. longipalpis with precipitation and relative humidity and negative association with temperature were observed. Models showed humidity and vegetation as making effects on Lu. longipalpis abundance. Precipitation was signifi cant for Mg. migonei models, with higher abundance in periurban and periurban-rural environments. For Ny. neivai models, relative humidity was the most important variable, followed by precipitation frequency. Our fi ndings led to identify high risk areas and develop predictive models. These are useful for public health stakeholders giving tolls to optimized resources aim to prevent leshmaniasis transmission on the area.

Background:The mortality rate in patients with systemic lupus erythematosus (SLE) is 2–3 times higher than in the general population. However, survival in these patients has improved significantly and is currently 95% at 5 years according to different studies. Since the last 20 years, there are no new reports on this issue in Argentina.Objectives:To analyze the factors associated with mortality, survival and causes of death in patients with SLE.Methods:Longitudinal - multicenter study, in which 10 rheumatology centers of Argentina participated. Patients with SLE (ACR 1997 and / or SLICC 2012 criteria) with a minimum follow-up of 6 months monitored between January 2008 and December 2018 were included. Demographic, clinical, laboratory, therapeutic variables (treatments received during the evolution of the disease and within 60 days prior to death or last control); mortality, causes of death and survival at 5, 10 and 20 years were evaluated. Statistical analysis: descriptive statistics, Kaplan-Meier survival curves and Cox regression model.Results:Three hundred and eighty two patients were included; 90% women and 82% mestizos. The mean of evolution time of SLE was 4.1 ± 6.7 years. The mean age at the last control or death was 37.2 ± 12.7 years, SLEDAI 3.2 ± 4.2 and SLICC 1.2 ± 1.9.Mortality was 12% (95% CI [8-15]) and the causes of death were: Infections (27), cardiovascular disease (6), SLE activity (3), catastrophic antiphospholipid syndrome (2) and other causes (8). Using the variables associated with mortality in different Cox regression models, the variables that increased the risk of death significantly were: renal involvement (RR 3.3), cardiac involvement (RR 2.7), central nervous system involvement (RR 2.1), arterial thrombosis (RR 2.3), hyperlipemia (RR 2.4), number of infections (RR 1.2) and last SLEDAI (1.1).The time of HCQ use greater than 36 months decreased the risk of death in this cohort by 40% (p 0.03). Prednisone (maximum dose and time) was not associated with mortality (p NS). When analyzing the last treatment and adjusting it for final SLEDAI, HCQ was a mortality protection factor (RR 0.4) while the use of cyclophosphamide alone or associated with prednisone was a risk factor for death (RR 5.2).Significant differences were found when analyzing the causes of death according to the SLE evolution time (p 0.017): patients who died from infection had less evolution time (Me 2.25 years), than those who died due to cardiovascular causes (Me 10 years) or SLE activity (Me 15 years). In this cohort of patients, survival was 93% at 5 years, 88% at 10 years and 72% at 20 years.Conclusion:Mortality in this series of patients was 12% and infection was the leading cause of death. The use of HCQ for a period greater than 36 months, decreased the risk of death 40%.Disclosure of Interests:None declared

Introduction: sexual dysfunction is the alteration in one or several phases of sexual activity. It can culminate in frustration, pain and a decrease in the frequency of sexual intercourse. Objectives: determine the frequency of sexual dysfunction and analyze associated factors in patients with SLE. Materials and methods: a descriptive cross-sectional study was conducted. We included patients with SLE, between 18 and 50 years of age, Secondary Sjogren’s syndrome, menopause, severe depression and illiterate patients were excluded. Demographic and disease-related variables were studied. The Depression Anxiety Stress Scale (DASS-21), and the Female Sexual Function Index (FSFI) were applied. Results: sixty women with SLE and 63 controls were evaluated. The prevalence of SD in SLE was 71.7% and there were significant differences in all domains of sexual function. The total FSFI score in patients with SLE was lower when compared to controls. According to the DASS-21 scale, stress, anxiety and depression were observed in at least half of lupus women, however no association was found between these variables and SD. Conclusions: the prevalence of SD in patients with SLE was high. Depression, Anxiety, and Stress were not determinants in the presence of SD.

Background:Sexual dysfunction is the alteration in one or several phases of sexual activity (desire, excitement, plateau, orgasm and resolution), which can culminate in frustration, pain and a decrease in the frequency of sexual intercourse. There are few studies that associate sexual dysfunction with Systemic Lupus Erythematosus (SLE) due to the difficulty in assessing it and its multifactorial cause.Objectives:Determine the frequency of sexual dysfunction and analyze associated factors in patients with SLE.Methods:A descriptive cross-sectional study was conducted. We included patients who attended the Rheumatology unit between May and July 2019; over 18 years of age, with a diagnosis of SLE according to the ACR 1997 and / or SLICC 2012 criteria, and healthy patients matched by age as control. Demographic and disease-related variables were studied. The DASS-21 (Depression Anxiety Stress Scale) scale that evaluates depression, anxiety and stress, and the Female Sexual Function Index (FSFI) that assesses 6 domains (desire, excitement, lubrication, orgasms, satisfaction and pain) were applied with a cut-off point ≤ 26.5 to define sexual dysfunction. Women over 50 years old, with secondary Sjogren’s syndrome, menopause, severe depression and illiterate patients were excluded.Results:One hundred and twenty three women were included (60 with SLE and 63 controls), with a mean age of 34.3 ± 8.3 and 31.7 ± 4.4 years respectively. The prevalence of sexual dysfunction in the SLE group was 71.7%; 95% CI = [58.5 – 82.5], and 23.8%, 95% CI = [13.9 – 36.2] in healthy patients. There were significant differences in all domains of sexual function between women with SLE and healthy group. In the desire, excitement and pain domains the differences were notable. The total FSFI score in patients with SLE was 18.2 ± 11.2 and in healthy women 28.3 ± 6.9 (p=0.001). Stress, anxiety and depression were observed in 58.4%, 58.3% and 50% of women with SLE and 19%, 20.6% and 28.5% of healthy women respectively (p=0.001). No association was found between sexual dysfunction and age, age at diagnosis, disease activity or treatment (pNS). No association was found in patients with SLE when analyzing the effect of sexual dysfunction in stress, depression and anxiety variables, in opposition to the healthy group (p<0.05).Conclusion:The prevalence of sexual dysfunction in patients with SLE was high (71.7%). Depression, Anxiety, and Stress were not decisive variables in Sexual Dysfunction.Disclosure of Interests:None declared

Background:Systemic lupus erythematosus (SLE) is a systemic, chronic, autoimmune disease of unknown cause characterized by a wide variety of clinical manifestations and autoantibody production. The complement is useful in the initial diagnosis, as an activity marker and for the follow-up of patients with SLE. Individual components may fluctuate only slightly with disease activity and C4 may even remain low during remission. Hypocomplementemia is associated with renal involvement, cutaneous vasculitis, diffuse alveolar hemorrhage, however, patients with persistent hypocomplementemia are not characterized yet.Objectives:1) Determine the prevalence of persistent hypocomplementemia in patients with SLE.2) Identify clinical characteristics, disease activity and accumulated damage in these patients.Methods:A longitudinal study was conducted with a review of the medical records of patients diagnosed with SLE (ACR criteria 82/97) who attended the Rheumatology Service between January 2000 and December 2015. Patients with a minimum evolution time of 6 months from the diagnosis of SLE with quarterly controls and monitoring for 2 years. Persistent Hypocomplementemia (PHC) was defined at C3 and / or C4 values below the normal range of the reference laboratory in a sustained form for at least 24 months. Demographic variables, clinical manifestations, disease activity by SLEDAI 2k, flare by SELENA SLEDAI and accumulated damage by SLICC / SDI were analyzed.Results:Clinical records of 254 patients with SLE were reviewed and 144 were included; 96% were women, with a mean age at diagnosis of SLE of 30.5 ± 11.2 years and a time of evolution of the disease at the last control 11.85 ± 7.8 years. Forty-one patients had PHC (28.5%; 95% CI 21.1, 35.8). The median of evolution time disease at the moment of PHC was 1 year (0-24) and the mean time of persistence of hypocomplementemia was 56 ± 46 months. In the univariate analysis, PHC was associated with hematological involvement during the course of the disease (p=0.01). Patients with PHC had a higher frequency of severe flare during follow-up (p=0.02). PHC was not associated with age of onset of SLE, disease activity (maximum SLEDAI reached), accumulated damage or death. Applying Logistic Regression Model with dependent variables with a level of significance <0.25, PHC was associated independently with hematological compromise (OR 3.2).Conclusion:In this cohort of patients, the prevalence of PHC was 28.5%. PHC was associated with severe flare and hematological compromise.Disclosure of Interests:None declared