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...

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...

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.

En Perú se ha estado trabajando en genética y genómica a pesar de la ausencia de inversión nacional. Proveedores multidisciplinarios en el cuidado de la salud han contribuido en el área de la genética en Perú. Se destaca varios ejemplos de logros en áreas clínicas y de investigación. El número de profesionales bien entrenados está aumentando, contribuyendo con colaboraciones nacionales e internacionales, investigación y experiencia clínica, que se incrementa en calidad y extensión. En estos tiempos donde mucha tecnología externa y estandarizada está emergiendo, la colaboración es muy importante para la investigación y se traduce en la implementación de medicina precisa para el sistema de salud pública.

El Lupus eritematoso sistémico es una enfermedad autoinmune compleja y heterogenea, que representa un desafío significativo en su diagnóstico y tratamiento. El objetivo de este estudio es desarrollar una guía práctica clínica para los pacientes con lupus en América Latina.

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...

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.

Objetivo: identificar el nivel de conocimiento de los criterios diagnósticos de fibromialgia en los médicos reumatólogos del Perú. Materiales y métodos: estudio descriptivo transversal. Al XX Congreso Peruano de Reumatología realizado del 22 al 24 de noviembre de 2018 en Lima, Perú, asistieron 150 médicos reumatólogos peruanos de los cuales se encuestaron a 96 médicos. Se aplicó un cuestionario previamente elaborado y validado teniendo en cuenta los criterios de fibromialgia del Colegio Americano de Reumatología de 2010. El análisis estadístico descriptivo se realizó con el paquete estadístico SPSS. Resultados: la mayoría de reumatólogos fueron varones (58,3%) de 25 a 40 años de edad (47,9%). El 33,3% tenía más de 20 años de egresado, el 43,8% refirió que asiste una vez por año a congresos de reumatología, el 27,1% ejerce la docencia en algún centro de estudios ...

Objective: to identify knowledge levels of diagnostic criteria for fibromyalgia by Peruvian rheumatologists. Materials and methods: this is a cross-sectional descriptive study. One-hundred and fifty Peruvian rheumatologists attended the XX Peruvian Rheumatology Congress, which took place in November 22-24, 2018 in Lima, Peru. Ninety six of these 150 physicians were surveyed. A previously developed and validated questionnaire was administered to them taking into account the 2010 fibromyalgia criteria issued by the American College of Rheumatology. The statistical analysis was performed using the SPSS statistical package. Results: most rheumatologists were male (58.3%), aged 25 to 40 years (47.9%). One-third (33.3%) had more than 20 years experience, 43.8% reported that they attend rheumatology conferences once a year, 27.1% are medicine school instructors, and 40.6% declared identifying o...

Objective: to identify knowledge levels of diagnostic criteria for fibromyalgia by Peruvian rheumatologists. Materials and methods: this is a cross-sectional descriptive study. One-hundred and fifty Peruvian rheumatologists attended the XX Peruvian Rheumatology Congress, which took place in November 22-24, 2018 in Lima, Peru. Ninety six of these 150 physicians were surveyed. A previously developed and validated questionnaire was administered to them taking into account the 2010 fibromyalgia criteria issued by the American College of Rheumatology. The statistical analysis was performed using the SPSS statistical package. Results: most rheumatologists were male (58.3%), aged 25 to 40 years (47.9%). One-third (33.3%) had more than 20 years experience, 43.8% reported that they attend rheumatology conferences once a year, 27.1% are medicine school instructors, and 40.6% declared identifying o...

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.

Peruvians currently preserve in their DNA the history of 2.5 million years of human evolution and 150,000 years of migration from Africa to Peru or the Americas. The development of Genetics and Genomics in the clinical and academic field is shown in this review.

Objective: To determine the impact of homocysteine levels on damage accrual in systemic lupus erythematosus (SLE) patients. Methods: This longitudinal study was conducted in consecutive patients seen every 6 months at our Rheumatology Department since 2012. Patients with available homocysteine levels and who had at least one subsequent visit were included. Univariable and multivariable Cox regression models were done to determine if homocysteine levels were predictive of damage accrual as per the SLICC Damage Index (SDI). The multivariable model was adjusted for pertinent variables (age at diagnosis, gender, socioeconomic status, disease duration, disease activity (SLEDAI), Framingham score, antimalarial and immunosuppressive drug use, average daily dose, and exposure time to prednisone (PDN)). Results: One hundred forty-five patients were included; their mean (SD) age at diagnosis was 4...

Objective: To determine the impact of homocysteine levels on damage accrual in systemic lupus erythematosus (SLE) patients. Methods: This longitudinal study was conducted in consecutive patients seen every 6 months at our Rheumatology Department since 2012. Patients with available homocysteine levels and who had at least one subsequent visit were included. Univariable and multivariable Cox regression models were done to determine if homocysteine levels were predictive of damage accrual as per the SLICC Damage Index (SDI). The multivariable model was adjusted for pertinent variables (age at diagnosis, gender, socioeconomic status, disease duration, disease activity (SLEDAI), Framingham score, antimalarial and immunosuppressive drug use, average daily dose, and exposure time to prednisone (PDN)). Results: One hundred forty-five patients were included; their mean (SD) age at diagnosis was 4...