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La descripción del lupus eritematoso sistémico (LES) como una enfermedad capaz de afectar diferentes órganos y sistemas ha sido atribuida a Klemperer, Pollack y Bauehr en su (1)clásica comunicación de 1942. Hasta finales de esa década, el LES era reconocido como una enfermedad muy severa que afectaba principalmente a mujeres en edad reproductiva de la vida y que muchas veces solo era diagnosticada en la mesa de autopsia.

As part of field activities in Preventive Medicine for second and third year Medical Students, a 10% survey of the population has been done in a restricted area of Cueva and Ermitaño (marginal communities in the outskitts of Lima). The prevalence of Acarosis in these communities has been found to be 12.5% considering both communities as a whole. This infestation has been found to be more frequent in Cueva than in Ermitaño, in those under 15 years of age, and in women. Possible explanations for these differences are offered and future work is outlines. Emphasis is made on the educational value of the described experience. A combined effort of Cueva and Ermitaño's population and the UPCH Health team resulted in a single day massive treatment of Acarosis (Decenber the 9th, 1972). There were four working groups: Movilization of the community, Diagnosis, Treatment, and Complications. The g...

As part of field activities in Preventive Medicine for second and third year Medical Students, a 10% survey of the population has been done in a restricted area of Cueva and Ermitaño (marginal communities in the outskitts of Lima). The prevalence of Acarosis in these communities has been found to be 12.5% considering both communities as a whole. This infestation has been found to be more frequent in Cueva than in Ermitaño, in those under 15 years of age, and in women. Possible explanations for these differences are offered and future work is outlines. Emphasis is made on the educational value of the described experience. A combined effort of Cueva and Ermitaño's population and the UPCH Health team resulted in a single day massive treatment of Acarosis (Decenber the 9th, 1972). There were four working groups: Movilization of the community, Diagnosis, Treatment, and Complications. The g...

La presente Tesis titulada “Nivel de satisfacción del usuario externo, desde dimensiones de calidad, de la atención de enfermería del centro de salud Toribia Castro –Lambayeque noviembre 2015”; tuvo como objetivo determinar el nivel de satisfacción del usuario externo, desde dimensiones de calidad de la atención de enfermería en el Centro de Salud Toribia Castro Lambayeque 2015. Se realizó un estudio de tipo no experimental, descriptivo simple, se tuvo una muestra de 150 usuarios externos, a quienes se les aplicó la encuesta SERVQUAL. Los resultados mostraron el nivel global de satisfacción del usuario externo, en la atención de enfermería del Centro de Salud Toribia Castro – Lambayeque, fue de 45 % de satisfechos. Respecto al Nivel de satisfacción de los usuarios externos por dimensiones encontramos: en la dimensión FIABILIDAD (51.9% insatisfechos); CAPACIDAD DE RES...

The authors review methotrexate use in Rheumatic Diseases, specially in Rheumatoid arthritis. Pharmacokinetics, efficacy, toxicity, and treatment monitoring of methotrexate are presented.

Systemic lupus erythematosus (SLE) affects more severely non-White populations, which is also the case in Latin America; this is the result of a combination of genetic and non-genetic factors. Among the non-genetic factors, a limited income and a low educational level impact negatively on the course and outcome of the disease; in addition, lack of access to healthcare services deprives patients from the opportunity of being managed by specialists, making the availability of the newest drugs practically impossible. Taking together, these factors reduce the probability of patients achieving good outcomes, like remission, less damage accrual, a better survival and a better health-related quality of life, among others. Several strategies have been proposed to reduce these disparities, including peer education, educational activities for patients and primary care physicians, improving healthc...

Dentro de la enseñanza en nuestras escuelas de Medicina, existen muy pocas clases dedicadas a publicaciones científicas: cuándo, cómo, por qué, para qué; aúnmás, los futuros médicos tienen muy pocos modelos a seguir ya que la mayor parte del profesorado no publica el resultado de sus estudios en manuscritos completos sino solamente en resúmenes en congresos nacionales o regionales; estos si bien conllevan un momento de prestigio para el presentador, este es muy efímero y no es compartido con todos los miembros del grupo de investigación.

Twenty five patients meeting the Bohaq & Peter's criteria for the diagnosis of either Polymyositis or Dermatomyositis are presented. All but 2 of them were female.  Definitive Dermatomyositis and Polymyositis associated to Connective Tissye Disease were the two larger groups. There was no case of myositis associated with malignancy.  Eventhough muscle weakness was not the earliest complaint, it was the most common reason for the patients to seek medical consultation.  Results are discussed and compared with world literature, including factors regarding final outcome.  The need for an early diagnosis is stressed out in order to provide adequate therapy and improve prognosis in these patients. 

Twenty five patients meeting the Bohaq & Peter's criteria for the diagnosis of either Polymyositis or Dermatomyositis are presented. All but 2 of them were female.  Definitive Dermatomyositis and Polymyositis associated to Connective Tissye Disease were the two larger groups. There was no case of myositis associated with malignancy.  Eventhough muscle weakness was not the earliest complaint, it was the most common reason for the patients to seek medical consultation.  Results are discussed and compared with world literature, including factors regarding final outcome.  The need for an early diagnosis is stressed out in order to provide adequate therapy and improve prognosis in these patients. 

The case of a 49 years old man with ulcero necrotic lesions on areas of his body exposed to cold is presented. By inmunoelectrophoretic studies of his plasma and serum kept at 37°C, and of the precipitate and supernatant at 4°C it is concluded that this patient has a cryoglobulin. This cryoglobulin has shown to consist of two paraproteins, IgG type with kappalight chains. Cryofibrinogen has been detected in the precipitate as well. A clinical discussion is made emphazising the nosographic, etiopathogenic and therapeutic implications of the case being published. 

El advenimiento del uso de terapias biológicas en Reumatología ha modificado significativamente el pronóstico de pacientes portadores de artritis reumatoide (AR), artritis juvenil (AJ), espondilitis anquilosante (EA), entre otras enfermedades. A diferencia de las terapias convencionales estos productos biológicos se dirigen a los llamados blancos terapéuticos ya sea estas una línea celular, un mediador inflamatorio o un receptor de superficie. Estos compuestos son producidos por células vivas mediante la tecnología del ADN recombinante. Estos compuestos pueden tener componentes humano y animal [quiméricos (Xi), humanizados (Zu)], o completamente humanos (H) lo cual se reconoce por las letras que se incluyen en el nombre de cada uno. En el campo de la Reumatología, el primer compuesto utilizado fue el etanercept (anti-factor de necrosis tumoral o anti-TNF) aprobado en 1998, pero...

The case of a 49 years old man with ulcero necrotic lesions on areas of his body exposed to cold is presented. By inmunoelectrophoretic studies of his plasma and serum kept at 37°C, and of the precipitate and supernatant at 4°C it is concluded that this patient has a cryoglobulin. This cryoglobulin has shown to consist of two paraproteins, IgG type with kappalight chains. Cryofibrinogen has been detected in the precipitate as well. A clinical discussion is made emphazising the nosographic, etiopathogenic and therapeutic implications of the case being published. 

Objective: To examine the possible role of medications in the occurrence of neuropsychiatric damage in patientswith systemic lupus erythematosus (SLE). Material and methods: SLE patients from the LUMINA (Lupus inMinorities: Nature vs. Nurture) cohort (ACR criteria, ≥ 16 years of age at enrollment and ≤5 years of diseaseduration) were studied. Time-to-neuropsychiatric damage [defined according with the Systemic Lupus CollaboratingClinics (SLICC) Damage Index (SDI): neurocognitive impairment or psychosis, seizures, cranial or peripheralneuropathy, stroke or surgical resection not due to malignancies and transverse myelitis] was examined by univariableand multivariable Cox regression analyses. Propensity score analyses were done to further determine the possibleprotective role of hydroxychloroquine in neuropsychiatric damage occurrence. Results: Six-hundred and thirtytwopatients were st...

Se comenta un estudio sobre el estado de baja actividad de la enfermedad del lupus está asociado con la disminución de la progresión del daño en pacientes caucásicos con Lupus Eritematoso Sistémico.

Objective. To evaluate disease features and outcomes in two populations with significant Amerindian ancestry. Methods. Hispanic patients (from Texas) from the Lupus in Minorities: Nature versus Nurture (LUMINA) cohort and Mestizo patients from the Grupo Latino Americano De Estudio del Lupus or Latin American Group for the Study of Lupus (GLADEL) cohort were included. Disease features and outcomes were evaluated at baseline and last visit. Admixture informative markers of Mestizo Genoma de Lupus Eritematoso Siste´ mico Network consortium (GENLES) patients and Hispanic LUMINA patients were compared. Univariable analyses were performed using Chi square or Student’s t test as appropriate. Multivariable analyses adjusting for possible confounders were carried out using Poisson, logistic or Cox regression models as appropriate. Results. A total of 114 LUMINA and 619 GLADEL patients were inc...

Background: Self-efficacy for managing chronic conditions assesses the confidence a person has on the ability of successfully perform specific tasks related to a chronic condition in several different situations. Self-efficacy is considered one of the most important modifiable factors in educational interventions that enhance Systemic Lupus Erythematosus (SLE) patients’ mental health status. Low disease self-efficacy is associated with SLE morbidity. Objectives: To determine the association of several domains of self-efficacy for managing chronic conditions and health-related quality of life (HRQoL) in SLE patients.

Background: Self-efficacy for managing chronic conditions assesses the confidence a person has on the ability of successfully perform specific tasks related to a chronic condition in several different situations. Self-efficacy is considered one of the most important modifiable factors in educational interventions that enhance Systemic Lupus Erythematosus (SLE) patients’ mental health status. Low disease self-efficacy is associated with SLE morbidity. Objectives: To determine the association of several domains of self-efficacy for managing chronic conditions and health-related quality of life (HRQoL) in SLE patients.

Background: Because most patients with SLE are in their productive-age years, the ability to maintain a gainful employment is fundamental for both, the patient and society at large. It is thus quite important to determine the work and non-work factors that are associated with work productivity impairment in these patients. Objectives: To determine the factors associated with absenteeism (percentage of the time missed from scheduled work-time over the preceding 7 days, due to SLE), presenteeism (percentage of time from scheduled work-time where productivity was impaired while patient was at work, over the preceding 7 days, due to SLE) and overall work impairment (combination of absenteeism and presenteeism) in patients with SLE.

Background: Because most patients with SLE are in their productive-age years, the ability to maintain a gainful employment is fundamental for both, the patient and society at large. It is thus quite important to determine the work and non-work factors that are associated with work productivity impairment in these patients. Objectives: To determine the factors associated with absenteeism (percentage of the time missed from scheduled work-time over the preceding 7 days, due to SLE), presenteeism (percentage of time from scheduled work-time where productivity was impaired while patient was at work, over the preceding 7 days, due to SLE) and overall work impairment (combination of absenteeism and presenteeism) in patients with SLE.