Factors of the epidemiological triad that influence the persistence of human papilloma virus infection in women with systemic lupus erythematosus

We studied the epidemiologic triad-related factors influencing human papilloma virus (HPV) persistence in Mexican women with systemic lupus erythematosus (SLE). Patients aged ?18 years with SLE (American College of Rheumatology criteria), with and without HPV persistence, were selected. Groups were analyzed by (1) host: clinical disease characteristics; (2) agent: (I) infectious (prevalence, incidence, HPV genotype and co-infections (?2 HPV genotypes or mycoplasmas)), (II) chemical (contraceptives and immunosuppressive drugs) and (III) physical (vitamin D deficiency) and (3) environment. A total of 121 SLE patients were selected over a two-year period. (1) Host: mean age 45.8 years and disease duration 12.7 years. (2) Agent: (I) infectious. HPV infection prevalence in the second sample was 26.4%, high-risk HPV genotypes 21.5% and co-infections 7.4%. HPV infection incidence was 13.2%, persistence 13.2% and clearance 15.7%. (II) Chemical: use of oral hormonal contraceptives 5% and immunosuppressive treatment 97.5%. (III) Physical: Vitamin D levels were similar in both groups. (3) Environment: (I) natural. A total of 60.6% of patients were residents of Puebla City. (II) Social: The mean education level was 10.9. Poverty levels were: III degree 52.4%, IV degree 28% and II degree 17%. (III) Cultural behavioral: Onset of sexual life was 20.5 years, 10% had ?3 sexual partners and 51.2% were postmenopausal. In conclusion, no factor of the epidemiologic triad was associated with HPV infection prevalence. © The Author(s) 2018

Flares in patients with Systemic Lupus Erythematosus (SLE)

Objective: Systemic lupus erythematosus (SLE) is characterised by relapses and remissions. This study describes the frequency, type and time to flare in a cohort of SLE patients. Methods: SLE patients with one or more “A” or “B” BILAG2004 systems meeting flare criteria (“new” or ”worse” items) and requiring an increase in immunosuppression were recruited from nine UK centres and assessed at baseline and monthly for nine months. Subsequent flares were defined as: severe (any “A” irrespective of number of “Bs”), moderate (≥2 “Bs” without any “As”) and mild (one “B”). Results: Of the 100 patients, 94% were female, 61% white Caucasians, mean age (SD) was 40.7 years (12.7) and mean disease duration (SD) 9.3 years (8.1). A total of 195 flares re-occurred in 76 patients over 781 monthly assessments (flare rate of 0.25/patient-month). There were 37 severe flares, 32 moderate flares and 126 mild flares. By month one, 22% had a mild/moderate/severe flare and 22% had a severe flare by 7 months. The median time to any “A” or “B” flare was 4 months. Severe/moderate flares tend to be in the system/s affected at baseline whereas mild flares can affect any system. Conclusion: In a population with active SLE we observed an ongoing rate of flares from early in the follow-up period with moderate-severe flares being due to an inability to fully control the disease. This real-world population study demonstrates the limitations of current treatments and provides a useful reference population from which to inform future clinical trial design

Intervención educativa para estilo de vida saludable en discentes-pacientes con síndrome metabólico y lupus eritematoso sistémico.

"La investigación educativa tiene diversos ángulos, más allá del ámbito tradicionalmente escolar; uno muy importante y poco explorado es en el campo de la salud, especialmente al analizar el efecto de una intervención, donde los discentes son pacientes que aprenden. Un problema de salud pública destacado es el síndrome metabólico (SM), presente en las enfermedades autoinmunes como el lupus eritematoso sistémico (LES) donde tiene mayor incidencia, cuyos pacientes con ateroesclerosis y tratamientos farmacológicos, padecen en su calidad de vida y no suelen aprender acerca de sus condiciones. En ellos, es clave conocer su estilo de vida para fomentar su educación en hábitos alimentarios y de actividad física, entre otros, para disminuir complicaciones a corto y largo plazo. Mediante intervenciones educativas, el paciente es capaz de construir significados para aprender a incorporar esta información a su vida diaria y procurarse cambios en su estilo de vida más saludables.

Intervención educativa para estilo de vida saludable en discentes - pacientes con síndrome metabólico y lupus eritematoso sistémico

"La investigación educativa tiene diversos ángulos, más allá del ámbito tradicionalmente escolar; uno muy importante y poco explorado es en el campo de la salud, especialmente al analizar el efecto de una intervención, donde los discentes son pacientes que aprenden. Un problema de salud pública destacado es el síndrome metabólico (SM), presente en las enfermedades autoinmunes como el lupus eritematoso sistémico (LES) donde tiene mayor incidencia, cuyos pacientes con ateroesclerosis y tratamientos farmacológicos, padecen en su calidad de vida y no suelen aprender acerca de sus condiciones. En ellos, es clave conocer su estilo de vida para fomentar su educación en hábitos alimentarios y de actividad física, entre otros, para disminuir complicaciones a corto y largo plazo. Mediante intervenciones educativas, el paciente es capaz de construir significados para aprender a incorporar esta información a su vida diaria y procurarse cambios en su estilo de vida más saludables.

Differential item functioning for students with special educational needs in a primary education standardized test

Un aspecto fundamental en la evaluación de aprendizajes es la validez de los resultados de la prueba utilizada, que no solo supone medir lo que se dice sino considerar las implicaciones de esos resultados, porque a partir de ellos se toman variadas decisiones. La existencia de funcionamiento diferencial del ítem (DIF) indica que sujetos que tienen igual grado de habilidad presentan diferente probabilidad de responder correctamente a un ítem, lo que se relaciona con el sesgo, es decir, favorecer a un grupo sobre otro en la evaluación. En los últimos años, la integración y el aprendizaje de los alumnos con necesidades educativas especiales transitorias (NEET) han sido el foco de políticas educacionales especiales que involucran recursos, especialistas y nuevas formas de trabajar en las escuelas de Chile. Mediante un enfoque metodológico secuencial cuantitativo se exploró el funcionamiento diferencial del ítem de una prueba estandarizada aplicada por un centro de medición en educación (MIDE UC) a más de 100 establecimientos en Chile en las áreas de lenguaje y matemática en los niveles desde 4° a 8° Básico para niños con y sin NEET. Un primer análisis cuantitativo exploró el funcionamiento diferencial del ítem (DIF) obteniéndose similitudes en la habilidad promedio de los grupos y pocos ítems con DIF significativo (menos del 10%). Posteriormente, se exploró la forma en que los colegios operacionalizan la variable integración, observándose que el grupo de niños sin NEET usado en el análisis estadístico puede haber sido, en realidad, un grupo híbrido que incluía a algunos niños con NEETAn important aspect of learning assessment is the validity of the results of the test used because they are the basis for social, political or institutional decisions. The existence of differential item functioning (DIF) indicates that subjects having presented the same degree of skill, have different probability of correctly respond to an item, which strongly affect an aspect of the validity of the test, which relates to the bias, i.e. favor one group over another in the evaluation. In recent years, integration and learning of students with temporary special educational needs (NEET) have been the focus of special education policies involving resources, specialists and new ways of working in schools in Chile. Using a sequential quantitative methodological approach we explored the differential item functioning, aspect of the validity of the results, of a standardized test administered by measurement center (MIDE UC) to more than 100 schools in Chile in language and mathematics from 4th to 8th grade to children with and without NEET. An initial analysis of differential item functioning (DIF) showed similarities in the average group ability and few items with significant DIF (less than 10%). Later, we explored how schools operationalize the variable depicting NEET. Results suggest that the group of children without NEET used in the statistical analysis may have been, in fact, a hybrid group including some children with NEE

Diseño de un sistema de planeación estratégica en una empresa de la rama textil

"Generalmente cuando se habla de administración, se explica que la clave del éxito de una empresa es su competitividad y su alto desempeño organizacional, para lograr esto, es importante tener una visión estratégica, es decir se debe plantear de forma clara como es que se va a hacer que la planeación estratégica funcione de manera operativa, es decir no solo se tienen que elaborar planes y sistemas de control, sino que estos deben implantarse con la finalidad de que se lleven a cabo.

Funcionamiento diferencial del ítem en una evaluación estandarizada según necesidades educativas especiales transitorias

An important aspect of learning assessment is the validity of the results of the test used because they are the basis for social, political or institutional decisions. The existence of differential item functioning (DIF) indicates that subjects having presented the same degree of skill, have different probability of correctly respond to an item, which strongly affect an aspect of the validity of the test, which relates to the bias, i.e. favor one group over another in the evaluation. In recent years, integration and learning of students with temporary special educational needs (NEET) have been the focus of special education policies involving resources, specialists and new ways of working in schools in Chile. Using a sequential quantitative methodological approach we explored the differential item functioning, aspect of the validity of the results, of a standardized test administered by measurement center (MIDE UC) to more than 100 schools in Chile in language and mathematics from 4th to 8th grade to children with and without NEET. An initial analysis of differential item functioning (DIF) showed similarities in the average group ability and few items with significant DIF (less than 10%). Later, we explored how schools operationalize the variable depicting NEET. Results suggest that the group of children without NEET used in the statistical analysis may have been, in fact, a hybrid group including some children with NEET.Un aspecto fundamental en la evaluación de aprendizajes es la validez de los resultados de la prueba utilizada, que no solo supone medir lo que se dice sino considerar las implicaciones de esos resultados, porque a partir de ellos se toman variadas decisiones. La existencia de funcionamiento diferencial del ítem (DIF) indica que sujetos que tienen igual grado de habilidad presentan diferente probabilidad de responder correctamente a un ítem, lo que se relaciona con el sesgo, es decir, favorecer a un grupo sobre otro en la evaluación. En los últimos años, la integración y el aprendizaje de los alumnos con necesidades educativas especiales transitorias (NEET) han sido el foco de políticas educacionales especiales que involucran recursos, especialistas y nuevas formas de trabajar en las escuelas de Chile. Mediante un enfoque metodológico secuencial cuantitativo se exploró el funcionamiento diferencial del ítem de una prueba estandarizada aplicada por un centro de medición en educación (MIDE UC) a más de 100 establecimientos en Chile en las áreas de lenguaje y matemática en los niveles desde 4° a 8° Básico para niños con y sin NEET. Un primer análisis cuantitativo exploró el funcionamiento diferencial del ítem (DIF) obteniéndose similitudes en la habilidad promedio de los grupos y pocos ítems con DIF significativo (menos del 10%). Posteriormente, se exploró la forma en que los colegios operacionalizan la variable integración, observándose que el grupo de niños sin NEET usado en el análisis estadístico puede haber sido, en realidad, un grupo híbrido que incluía a algunos niños con NEET

Endothelial dysfunction and arterial stiffness in patients with systemic lupus erythematosus: A systematic review and meta-analysis

Background and aims: Non-invasive surrogates of cardiovascular (CV) disease such as endothelial dysfunction (ED) and peripheral arterial stiffness (AS) have been evaluated in systemic lupus erythematosus (SLE) patients. The aim of this study was to systematically review and meta-analyze reports of cardiovascular disease (CVD) in SLE patients, as measured by ED and AS. Methods: Studies analyzing the relationship of SLE with ED (flow-mediated dilatation [FMD], nitroglycerin-mediated dilatation [NMD] and peripheral arterial tonometry [PAT]) and AS (augmentation index [AIx], pulse wave velocity [PWV]) were systematically searched for in PubMed, Cochrane library, EMBASE, VHL, SciELO and Web of Science databases. Inclusion criteria included peer-review and English language. Mean differences (MD) and 95% confidence intervals (CIs) were estimated using the random effect model. The study was registered with PROSPERO, number CRD42019121068. Results: The meta-analysis included 49 studies. FMD data from 18 studies including 943 SLE subjects (mean age = 38.71 [95%CI 36.21, 41.21] years) and 644 unaffected controls (mean age = 38.63 [95%CI 36.11, 41.15] years) were included. When compared with unaffected controls, FMD in SLE subjects was decreased by 4.3% (95%CI: ?6.13%, ?2.47%): p less than 0.001). However, NMD did not significantly differ between SLE patients and controls (MD = ? 2.68%; 95% CI -6.00, 0.62; p = 0.11). A significantly increased AS between SLE patients and controls according to overall PWV (MD = 1.12 m/s; 95% CI 0.72–1.52; p less than 0.001) was observed, but not for the brachial-ankle PWV. AIx was also increased in SLE patients compared with healthy controls (MD = 4.55%; 95% CI 1.48–7.63; p = 0.003). Conclusions: Overall, SLE patients showed impaired FMD, an independent predictor of CV events. There was a higher degree of AS in SLE patients compared with controls. ED and AS in SLE should be considered when planning preventive strategies and therapies. © 2020 Elsevier B.V

Endothelial dysfunction and arterial stiffness in patients with systemic lupus erythematosus: A systematic review and meta-analysis

Background and aims: Non-invasive surrogates of cardiovascular (CV) disease such as endothelial dysfunction (ED) and peripheral arterial stiffness (AS) have been evaluated in systemic lupus erythematosus (SLE) patients. The aim of this study was to systematically review and meta-analyze reports of cardiovascular disease (CVD) in SLE patients, as measured by ED and AS. Methods: Studies analyzing the relationship of SLE with ED (flow-mediated dilatation [FMD], nitroglycerin-mediated dilatation [NMD] and peripheral arterial tonometry [PAT]) and AS (augmentation index [AIx], pulse wave velocity [PWV]) were systematically searched for in PubMed, Cochrane library, EMBASE, VHL, SciELO and Web of Science databases. Inclusion criteria included peer-review and English language. Mean differences (MD) and 95% confidence intervals (CIs) were estimated using the random effect model. The study was registered with PROSPERO, number CRD42019121068. Results: The meta-analysis included 49 studies. FMD data from 18 studies including 943 SLE subjects (mean age = 38.71 [95%CI 36.21, 41.21] years) and 644 unaffected controls (mean age = 38.63 [95%CI 36.11, 41.15] years) were included. When compared with unaffected controls, FMD in SLE subjects was decreased by 4.3% (95%CI: ?6.13%, ?2.47%): p less than 0.001). However, NMD did not significantly differ between SLE patients and controls (MD = ? 2.68%; 95% CI -6.00, 0.62; p = 0.11). A significantly increased AS between SLE patients and controls according to overall PWV (MD = 1.12 m/s; 95% CI 0.72–1.52; p less than 0.001) was observed, but not for the brachial-ankle PWV. AIx was also increased in SLE patients compared with healthy controls (MD = 4.55%; 95% CI 1.48–7.63; p = 0.003). Conclusions: Overall, SLE patients showed impaired FMD, an independent predictor of CV events. There was a higher degree of AS in SLE patients compared with controls. ED and AS in SLE should be considered when planning preventive strategies and therapies. © 2020 Elsevier B.V

Factors Associated with Health-Related Quality of Life in Mexican Lupus Patients Using the LupusQol.

Health-related quality of life (HRQOL) is affected by numerous clinical variables, including disease activity, damage, fibromyalgia, depression and anxiety. However, these associations have not yet been described in Mexican patients with systemic lupus erythematosus (SLE).To evaluate the relationship between disease activity, damage, depression and fibromyalgia and HRQOL measured by the LupusQoL-instrument in Mexican patients with SLE.A cross-sectional study was conducted in women fulfilling the 1997 ACR classification criteria for SLE. HRQOL was evaluated using a disease-specific instrument for SLE, the LupusQoL (validated for the Spanish-speaking population). Patients were evaluated clinically to determine the degree of disease activity and damage using the Mexican Systemic Lupus Erythematosus Disease Activity Index (Mex-SLEDAI) and Systemic Lupus International Collaborating Clinics-Damage Index (SLICC), respectively. Fibromyalgia and depression were assessed using the ACR criteria and the CES-D scale, respectively. The relationship between HRQOL and these variables was measured using Spearman's rank correlation coefficient and linear regression analysis.A total of 138 women with SLE, age 40.3±11 years, disease duration 8.8±6.4 years, with disease activity in 51.4%, depression in 50%, damage in 43% and fibromyalgia in 19.6% were included. Poorer HRQOL correlated with depression (r = -0.61; p< 0.005), fibromyalgia (r = -0.42; p< 0.005), disease activity (r = -0.37; p < 0.005) and damage (r = -0.31; p < 0.005). In the multivariate linear regression analysis, damage (β = -3.756, p<0.005), fibromyalgia (β = -0.920, p<0.005), depression (β = -0.911, p<0.005) and disease activity (β = -0.911, p<0.005) were associated with poor HRQOL.SLE disease activity, damage, fibromyalgia and depression were associated with poor HRQOL in our sample of Mexican SLE patients