Latin-American challenges and opportunities in rheumatology

Rocha, Francisco Airton Castro

doi:10.1186/s13075-017-1247-7

Cited by 12 publications

(5 citation statements)

References 15 publications

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“…Since some states exhibited a lower number of registries, we decided to look up the rheumatologists enrolled at the Mexican College of Rheumatology and observed a similar geographic distribution of rheumatologists than the registered participants (Supplementary Figure S1). In México, it has been calculated that there is 0.55 certified rheumatologist per 100,000 inhabitants, with a surfeit of specialists in the capital and metropolitan areas of the country, which is in line with the observed in other Latin American countries (Pineda et al, 2019;Rocha, 2017). The low proportion of rheumatologists per patient, along with the uneven distribution of these specialists across México, can lead to unequal access to health and medical services (Martínez-Martínez & Rodríguez-Brito, 2020).…”

Section: Discussionsupporting

confidence: 73%

Lupus RGMX: Social and Clinical Characteristics and their Contribution to Quality of Life in a Mexican Cohort with SLE

Hernández-Ledesma

Martínez

Fajardo-Brigido

et al. 2023

Preprint

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BACKGROUND. Although higher prevalence, disease activity, damage accumulation and mortality of systemic lupus erythematosus (SLE) are observed among Latin American, North American admixed population, African descendants and Native Americans, the information about SLE in Latin American countries, such as Mexico, is scarce. OBJECTIVES. To present Lupus RGMX, a multidisciplinary effort to generate a national digital patient registry to enrich the understanding of Mexican people with SLE. METHODS. Mexican patients with SLE registered between May 2021 and January 2023 in Lupus RGMX were included. Sociodemographic, socioeconomic and clinical characteristics, along with quality of life perception (QoL) were assessed using self-reported data. We compared the QoL obtained from patients with SLE with two groups of non-SLE Mexican subjects. Descriptive statistics, comparisons analyses and a multivariate nonparametric regression model were performed. RESULTS. A total of 1172 of lupus patients were included; of which 93.9% were women. The mean age±SD was 36.6±10.7 years, with 37.1% of the individuals between 41 and 50 years. The 24.9% reported a calculated monthly income of 430 USD (8,612 MXN). Lower QoL scores were observed in the SLE group, especially in subjects with lower socioeconomic level. Health perception, QoL perception and socioeconomic status were the variables with greater importance to predict total WHOQoL scores. CONCLUSION. The design and implementation of Lupus RGMX imply a pioneering approach to unraveling SLE in Mexicans. Further studies from Lupus RGMX will be focused on enriching the representation of the Mexican population and include other aspects that may allow us to improve our understanding of the disease in our population.

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Section: Discussionsupporting

confidence: 73%

Lupus RGMX: Social and Clinical Characteristics and their Contribution to Quality of Life in a Mexican Cohort with SLE

Hernández-Ledesma

Martínez

Fajardo-Brigido

et al. 2023

Preprint

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“…Although from the same country, Fortaleza and São Paulo display relevant differences, such as a 3000-km distance between both cities with a significantly higher mean GDP/capita in the later 11 . Notwithstanding, genetic issues may also influence given the relevant presence of European descendants in São Paulo, as compared with Fortaleza 12 …”

Section: Discussionmentioning

confidence: 99%

“…1 Although from the same country, Fortaleza and São Paulo display relevant differences, such as a 3000-km distance between both cities with a significantly higher mean GDP/capita in the later. 11 Notwithstanding, genetic issues may also influence given the 12 The harms imposed by exposure to cigarette smoke cannot be overemphasized. However, secondhand smoking influence in one's health is a very hard issue to define.…”

Section: Discussionmentioning

confidence: 99%

Parental Smoking Influence in Disease Activity in a Low-Income Juvenile Idiopathic Arthritis Cohort

Landim¹,

Rocha²,

Silva³

et al. 2021

J Clin Rheumatol

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“…Health inequities refer to differences among individuals related to socioeconomic issues, usually representing an additional burden to those living in unfavorable conditions since their work force is heavily compromised when sick [ 9 , 23 ]. A very recent population-base cohort study found that increased age, male gender, obesity and social inequities represented by a lower deprivation score and having blue-collar occupation was associated with an increased need for RCT surgery [ 14 ].…”

Section: Discussionmentioning

confidence: 99%

Surgical outcome following rotator cuff tear repair in a low-income population. Impact of obesity and smoking

Silva

Mourão

Rocha

et al. 2021

BMC Musculoskelet Disord

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Background Comorbidities and socioeconomic issues impact outcome of rotator cuff tear (RCT) repair. There are no data on RCT repair outcome from developing regions. We determined the impact of obesity and smoking following RCT repair in a low-income population. Methods This is a retrospective case series. Forty-seven shoulders of 42 patients subjected to open or arthroscopic repair of a RCT with a minimum of 2 years follow-up were cross-sectionally evaluated. Patients were seen in the Orthopaedic Service of the Hospital Geral de Fortaleza-CE, Brazil between March and September 2018. RCT were classified as partial or full-thickness lesions. Fatty infiltration (Goutallier) and tendon retraction (Patte) were recorded as well as obesity (BMI > 30), literacy [>/≤ 8 school years (SY)] and smoking status 6 months prior to surgery (present/absent). Outcomes included pain (visual analogue scale; VAS, 0–10 cm), range of motion [active forward flexion and external rotation (ER)], UCLA and ASES scoring. Results Patients were 59.9 ± 7.4 years-old, 35(74.4%) female with 19 (17.1–30.2 IQR) median of months from diagnosis to surgery and 25 median months of follow-up (26.9–34.0 IQR); over 90% declared < 900.00 US$ monthly family income and two-thirds had ≤8 SY. Forty patients (85.1%) had full-thickness tears, 7 (14.9%) had Goutallier ≥3 and over 80% had < Patte III stage. Outcomes were similar regardless of fatty infiltration or tendon retraction staging. There were 17 (36.1%) smokers and 13 (27.6%) obese patients. Outcome was similar when comparing obese vs non-obese patients. Smokers had more pain (P = 0.043) and less ER (P = 0.029) with a trend towards worse UCLA and ASES scores as compared to non-smokers though differences did not achieve minimal clinically important difference (MCID) proposed for surgical RCT treatment. After adjusting for obesity, VAS and ER values in smokers were no longer significant (P = 0.2474 and 0.4872, respectively). Conclusions Our data document outcomes following RCT repair in a low-income population. Smoking status but not obesity impacted RCT repair outcome though not reaching MCID for surgical treatment.

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Latin-American challenges and opportunities in rheumatology

Cited by 12 publications

References 15 publications

Lupus RGMX: Social and Clinical Characteristics and their Contribution to Quality of Life in a Mexican Cohort with SLE

Lupus RGMX: Social and Clinical Characteristics and their Contribution to Quality of Life in a Mexican Cohort with SLE

Parental Smoking Influence in Disease Activity in a Low-Income Juvenile Idiopathic Arthritis Cohort

Surgical outcome following rotator cuff tear repair in a low-income population. Impact of obesity and smoking

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