Manifestaciones pulmonares de la artritis reumatoide. A propósito de un caso clínico

Rheumatoid arthritis is a systemic disease, which may be associated with respiratory involvement, the most fre- quent manifestations is interstitial lung disease and pleural effusion, which overshadows the prognosis of these patients. A clinical case of rheumatoid arthritis in the sequelae stage is presented, with pleural involvement in the form of pseudo-empyema, hydropneumothorax and tomographic findings compatible with lymphoid interstitial pneumonitis.La artritis reumatoide es una enfermedad sistémica, que puede asociar compromiso respiratorio siendo las manifestaciones más frecuentes la enfermedad pulmonar intersticial y el derrame pleural, lo que ensombrece el pronóstico de estos pacientes. Se presenta un caso clínico de artritis reumatoide en etapa secuelar, con compromiso pleural en forma de pseudoempiema, hidroneumotórax y hallazgos tomográficos compatibles con neumonitis intersticial linfoide

Mortality risk factors in primary Sjögren syndrome:a real-world, retrospective, cohort study

BACKGROUND: What baseline predictors would be involved in mortality in people with primary Sjögren syndrome (SjS) remains uncertain. This study aimed to investigate the baseline characteristics collected at the time of diagnosis of SjS associated with mortality and to identify mortality risk factors for all-cause death and deaths related to systemic SjS activity measured by the ESSDAI score.METHODS: In this international, real-world, retrospective, cohort study, we retrospectively collected data from 27 countries on mortality and causes of death from the Big Data Sjögren Registry. Inclusion criteria consisted of fulfilling 2002/2016 SjS classification criteria, and exclusion criteria included chronic HCV/HIV infections and associated systemic autoimmune diseases. A statistical approach based on a directed acyclic graph was used, with all-cause and Sjögren-related mortality as primary endpoints. The key determinants that defined the disease phenotype at diagnosis (glandular, systemic, and immunological) were analysed as independent variables.FINDINGS: Between January 1st, 2014 and December 31, 2023, data from 11,372 patients with primary SjS (93.5% women, 78.4% classified as White, mean age at diagnosis of 51.1 years) included in the Registry were analysed. 876 (7.7%) deaths were recorded after a mean follow-up of 8.6 years (SD 7.12). Univariate analysis of prognostic factors for all-cause death identified eight Sjögren-related variables (ocular and oral tests, salivary biopsy, ESSDAI, ANA, anti-Ro, anti-La, and cryoglobulins). The multivariate CPH model adjusted for these variables and the epidemiological features showed that DAS-ESSDAI (high vs no high: HR = 1.68; 95% CI, 1.27-2.22) and cryoglobulins (positive vs negative: HR = 1.72; 95% CI, 1.22-2.42) were independent predictors of all-cause death. Of the 640 deaths with available information detailing the specific cause of death, 14% were due to systemic SjS. Univariate analysis of prognostic factors for Sjögren-cause death identified five Sjögren-related variables (oral tests, clinESSDAI, DAS-ESSDAI, ANA, and cryoglobulins). The multivariate competing risks CPH model adjusted for these variables and the epidemiological features showed that oral tests (abnormal vs normal results: HR = 1.38; 95% CI, 1.01-1.87), DAS-ESSDAI (high vs no high: HR = 1.55; 95% CI, 1.22-1.96) and cryoglobulins (positive vs negative: HR = 1.52; 95% CI, 1.16-2) were independent predictors of SjS-related death.INTERPRETATION: The key mortality risk factors at the time of SjS diagnosis were positive cryoglobulins and a high systemic activity scored using the ESSDAI, conferring a 2-times increased risk of all-cause and SjS-related death. ESSDAI measurement and cryoglobulin testing should be considered mandatory when an individual is diagnosed with SjS.FUNDING: Novartis.</p

Educomunicação, Transformação Social e Desenvolvimento Sustentável

Esta publicação apresenta os principais trabalhos dos GTs do II Congresso Internacional de Comunicação e Educação nos temas&nbsp;Transformação social, com os artigos que abordam principalmente Educomunicação e/ou Mídia-Educação, no contexto de políticas de diversidade, inclusão e equidade; e, em Desenvolvimento Sustentável&nbsp;os artigos que abordam os avanços da relação comunicação/educação no contexto da educação ambiental e desenvolvimento sustentável

Educomunicação e suas áreas de intervenção: Novos paradigmas para o diálogo intercultural

oai:omp.abpeducom.org.br:publicationFormat/1O material aqui divulgado representa, em essência, a contribuição do VII Encontro Brasileiro de Educomunicação ao V Global MIL Week, da UNESCO, ocorrido na ECA/USP, entre 3&nbsp;e 5 de novembro de 2016. Estamos diante de um conjunto de 104 papers executivos, com uma média de entre 7 e 10 páginas, cada um. Com este rico e abundante material, chegamos ao sétimo e-book publicado pela ABPEducom, em seus seis primeiros anos de existência. A especificidade desta obra é a de trazer as “Áreas de Intervenção” do campo da Educomunicação, colocando-as a serviço de uma meta essencial ao agir educomunicativo: o diálogo intercultural, trabalhado na linha do tema geral do evento internacional: Media and Information Literacy: New Paradigms for Intercultural Dialogue

Glomerulonefritis de rápida progresión pauciinmunitaria negativa a ANCA en un paciente de 18 años: a propósito de un caso

La glomerulonefritis de rápida progresión (GNRP) pauciinmunitaria o de tipo III negativa a ANCA es infrecuente y representa tan sólo 10% a 20% del total de las GNRP pauciinmunitarias. Existen diferencias clínicas, analíticas y anatomopatológicas, entre las GNRP pauciinmunitarias negativas y positivas a ANCA. La sospecha de una GNRP pauciinmunitaria negativa a ANCA es elemental, ya que el pronóstico renal es tal vez peor en este subgrupo de pacientes. El tratamiento, al igual que en las GNRP de tipo III positivas a ANCA, se basa en la indicación de glucocorticoides y fármacos inmunosupresores

Phenotype of biopsy-proven patients with primary Sjögren syndrome lacking ro autoantibodies: high frequency of dryness symptoms with low systemic activity (big data Sjögren projct).

International audienc

Phenotype Of Biopsy-Proven Patients With Primary Sjogren Syndrome Lacking Ro Autoantibodies: High Frequency Of Dryness Symptoms With Low Systemic Activity (Big Data Sjogren Project)

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