Policondritis recurrente. Estudio de 19 casos en Colombia

Resumen Objetivo: Describir el comportamiento clínico y paraclínico de la PR en la población colombiana y comparar nuestros resultados con otras series publicadas. Materiales y métodos: Estudio descriptivo observacional de 19 casos de PR presentados en 4 centros de reumatología del país durante los últimos 10 años. Los pacientes cumplieron con el diagnóstico de PR de acuerdo al parámetro establecido. Se obtuvo la frecuencia de todas las manifestaciones de la enfermedad y se compararon los hallazgos con 9 series de pacientes con PR publicadas en la literatura entre 1966 y 2007. Resultados: La edad promedio fue 46 años. Se observó una relación por género de 4:1 a favor del sexo femenino. El seguimiento se realizó por 4 años en promedio. La primera manifestación de la enfermedad fue condritis auricular en el 89%, y fue la manifestación más frecuente al presentarse en la totalidad de los casos. Respecto otras series publicadas, se encontró una menor frecuencia de artritis (21%), compromiso ocular (10%) y dermatológico (10%). El compromiso renal (10%), neurológico (5%) y la asociación con otras enfermedades autoinmunes (50%) tuvieron la frecuencia esperada. No se observó compromiso cardiovascular en esta serie. El 100% de los pacientes recibieron corticoides. Adicionalmente el 57% recibieron terapia inmunosupresora asociada. La mortalidad fue del 10% por complicaciones asociadas a la PR. Conclusiones: En este estudio, a diferencia de otras series de origen caucásico y oriental, observamos una clara predominancia del género femenino, el compromiso extracartilaginoso es menos frecuente y la condritis auricular es nuestra manifestación inicial más importante. Estos hallazgos podrían ser el reflejo de diferencias genéticas, inmunológicas o ambientales. Palabras claves: Policondritis recurrente, condritis, vasculitis, corticoides. Abstract Objective: To describe clinical and paraclinical involvement in RP in a Colombian population and compare it with another series previously published. Methods and materials: Retrospective review of 19 cases of RP presented in 4 rheumatology centers in our country in the last 10 years. All patients met diagnostic criteria previously established. In every case, each clinical feature was analized and then compared with another 9 series of RP previously published between 1966 y 2007. Results: Mean age at diagnosis was 46 years. A female predominance was observed in a relation 4:1. Mean follow-up was 4 years. Auricular condritis was the initial clinical feature in 89% of patients and finally was observed in the 100% of our report. Compared with other series, we found less frequently arthritis (21%), ocular (10%) and dermatologic involvement (10%). Renal and neurologic involvement and the association between RP and another autoimmune disorder were found in the expected frequency. We not observed any cardiovascular involvement in our serie. All of the patients received corticosteroids and 57% had had another immunosuppressive medication. Observed mortality was 10% by complications associated to RP. Conclusions: In contrast with another series from Caucasian and Oriental population, we observed a marked predominance of female sex, a minor frequency of systemic involvement and auricular condritis is our most frequent initial clinical feature. Probably, these findings are the result of a different genetic, immunological and environmental background. Key words: Relapsing polychondritis, chondritis, vasculitis, corticosteroids

The Changing Landscape for Stroke\ua0Prevention in AF: Findings From the GLORIA-AF Registry Phase 2

Background GLORIA-AF (Global Registry on Long-Term Oral Antithrombotic Treatment in Patients with Atrial Fibrillation) is a prospective, global registry program describing antithrombotic treatment patterns in patients with newly diagnosed nonvalvular atrial fibrillation at risk of stroke. Phase 2 began when dabigatran, the first non\u2013vitamin K antagonist oral anticoagulant (NOAC), became available. Objectives This study sought to describe phase 2 baseline data and compare these with the pre-NOAC era collected during phase 1. Methods During phase 2, 15,641 consenting patients were enrolled (November 2011 to December 2014); 15,092 were eligible. This pre-specified cross-sectional analysis describes eligible patients\u2019 baseline characteristics. Atrial fibrillation disease characteristics, medical outcomes, and concomitant diseases and medications were collected. Data were analyzed using descriptive statistics. Results Of the total patients, 45.5% were female; median age was 71 (interquartile range: 64, 78) years. Patients were from Europe (47.1%), North America (22.5%), Asia (20.3%), Latin America (6.0%), and the Middle East/Africa (4.0%). Most had high stroke risk (CHA2DS2-VASc [Congestive heart failure, Hypertension, Age  6575 years, Diabetes mellitus, previous Stroke, Vascular disease, Age 65 to 74 years, Sex category] score  652; 86.1%); 13.9% had moderate risk (CHA2DS2-VASc = 1). Overall, 79.9% received oral anticoagulants, of whom 47.6% received NOAC and 32.3% vitamin K antagonists (VKA); 12.1% received antiplatelet agents; 7.8% received no antithrombotic treatment. For comparison, the proportion of phase 1 patients (of N = 1,063 all eligible) prescribed VKA was 32.8%, acetylsalicylic acid 41.7%, and no therapy 20.2%. In Europe in phase 2, treatment with NOAC was more common than VKA (52.3% and 37.8%, respectively); 6.0% of patients received antiplatelet treatment; and 3.8% received no antithrombotic treatment. In North America, 52.1%, 26.2%, and 14.0% of patients received NOAC, VKA, and antiplatelet drugs, respectively; 7.5% received no antithrombotic treatment. NOAC use was less common in Asia (27.7%), where 27.5% of patients received VKA, 25.0% antiplatelet drugs, and 19.8% no antithrombotic treatment. Conclusions The baseline data from GLORIA-AF phase 2 demonstrate that in newly diagnosed nonvalvular atrial fibrillation patients, NOAC have been highly adopted into practice, becoming more frequently prescribed than VKA in Europe and North America. Worldwide, however, a large proportion of patients remain undertreated, particularly in Asia and North America. (Global Registry on Long-Term Oral Antithrombotic Treatment in Patients With Atrial Fibrillation [GLORIA-AF]; NCT01468701

Photochemical and Photophysical Reactions of f ac -Rhenium(I) Tricarbonyl Complexes. Effects from Binucleating Spectator Ligands on Excited and Ground State Processes

Ground and excited state properties of the newly prepared complexes Re(CO)3(2,2¢-biquinoline) LS3(2,2¢-biquinoline) LSS +, LS ) pyrazine or 4,4¢-bipyridine, and Re(CO)3(2,2¢-bipy)(2-pyrazinecarboxylate) were investigated by steady state and time-resolved spectroscopy. The X-ray structure of the latter compound showed that the spectator ligand 2-pyrazinecarboxylate is coordinated through the carboxylate group to Re(I). A component of the complexes’ luminescence was associated with long-lived Re to ligand, 2,2¢-biquinoline or 2,2¢-bipy, charge transfer, while a fast component of the emission was associated with intraligand excited states. Quenching of the luminescence by CuCl2 involved energy transfer via dynamic and static mechanisms. The complexes in their excited states were reduced by 2,2¢,2¢¢-nitrilotriethanol with the formation of Re(I) ligand-radical species. Similar products were generated by the pulse radiolytic reduction of the complexes. The photochemical properties of the 2,2¢-biquinoline complexes and Re(CO)3(1,10-phen)4-nitrobenzoate are compared, and the mechanisms of their photochemical reactions are discussed., LS ) pyrazine or 4,4¢-bipyridine, and Re(CO)3(2,2¢-bipy)(2-pyrazinecarboxylate) were investigated by steady state and time-resolved spectroscopy. The X-ray structure of the latter compound showed that the spectator ligand 2-pyrazinecarboxylate is coordinated through the carboxylate group to Re(I). A component of the complexes’ luminescence was associated with long-lived Re to ligand, 2,2¢-biquinoline or 2,2¢-bipy, charge transfer, while a fast component of the emission was associated with intraligand excited states. Quenching of the luminescence by CuCl2 involved energy transfer via dynamic and static mechanisms. The complexes in their excited states were reduced by 2,2¢,2¢¢-nitrilotriethanol with the formation of Re(I) ligand-radical species. Similar products were generated by the pulse radiolytic reduction of the complexes. The photochemical properties of the 2,2¢-biquinoline complexes and Re(CO)3(1,10-phen)4-nitrobenzoate are compared, and the mechanisms of their photochemical reactions are discussed.¢-biquinoline or 2,2¢-bipy, charge transfer, while a fast component of the emission was associated with intraligand excited states. Quenching of the luminescence by CuCl2 involved energy transfer via dynamic and static mechanisms. The complexes in their excited states were reduced by 2,2¢,2¢¢-nitrilotriethanol with the formation of Re(I) ligand-radical species. Similar products were generated by the pulse radiolytic reduction of the complexes. The photochemical properties of the 2,2¢-biquinoline complexes and Re(CO)3(1,10-phen)4-nitrobenzoate are compared, and the mechanisms of their photochemical reactions are discussed.2 involved energy transfer via dynamic and static mechanisms. The complexes in their excited states were reduced by 2,2¢,2¢¢-nitrilotriethanol with the formation of Re(I) ligand-radical species. Similar products were generated by the pulse radiolytic reduction of the complexes. The photochemical properties of the 2,2¢-biquinoline complexes and Re(CO)3(1,10-phen)4-nitrobenzoate are compared, and the mechanisms of their photochemical reactions are discussed.¢,2¢¢-nitrilotriethanol with the formation of Re(I) ligand-radical species. Similar products were generated by the pulse radiolytic reduction of the complexes. The photochemical properties of the 2,2¢-biquinoline complexes and Re(CO)3(1,10-phen)4-nitrobenzoate are compared, and the mechanisms of their photochemical reactions are discussed.¢-biquinoline complexes and Re(CO)3(1,10-phen)4-nitrobenzoate are compared, and the mechanisms of their photochemical reactions are discussed.3(1,10-phen)4-nitrobenzoate are compared, and the mechanisms of their photochemical reactions are discussed.Fil: Guerrero, J.. Universidad de Santiago de Chile; ChileFil: Piro, Oscar Enrique. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - La Plata. Instituto de Física La Plata. Universidad Nacional de La Plata. Facultad de Ciencias Exactas. Instituto de Física La Plata; Argentina. Universidad Nacional de La Plata; ArgentinaFil: Wolcan, Ezequiel. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - La Plata. Instituto de Investigaciones Fisicoquímicas Teóricas y Aplicadas. Universidad Nacional de La Plata. Facultad de Ciencias Exactas. Instituto de Investigaciones Fisicoquímicas Teóricas y Aplicadas; ArgentinaFil: Feliz, Mario Ruben. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - La Plata. Instituto de Investigaciones Fisicoquímicas Teóricas y Aplicadas. Universidad Nacional de La Plata. Facultad de Ciencias Exactas. Instituto de Investigaciones Fisicoquímicas Teóricas y Aplicadas; ArgentinaFil: Ferraudi, G.. University of Notre Dame; Estados UnidosFil: Moya, S. A.. Universidad de Santiago de Chile; Chil

Policondritis recurrente. Estudio de 19 casos en Colombia

Resumen Objetivo: Describir el comportamiento clínico y paraclínico de la PR en la población colombiana y comparar nuestros resultados con otras series publicadas. Materiales y métodos: Estudio descriptivo observacional de 19 casos de PR presentados en 4 centros de reumatología del país durante los últimos 10 años. Los pacientes cumplieron con el diagnóstico de PR de acuerdo al parámetro establecido. Se obtuvo la frecuencia de todas las manifestaciones de la enfermedad y se compararon los hallazgos con 9 series de pacientes con PR publicadas en la literatura entre 1966 y 2007. Resultados: La edad promedio fue 46 años. Se observó una relación por género de 4:1 a favor del sexo femenino. El seguimiento se realizó por 4 años en promedio. La primera manifestación de la enfermedad fue condritis auricular en el 89%, y fue la manifestación más frecuente al presentarse en la totalidad de los casos. Respecto otras series publicadas, se encontró una menor frecuencia de artritis (21%), compromiso ocular (10%) y dermatológico (10%). El compromiso renal (10%), neurológico (5%) y la asociación con otras enfermedades autoinmunes (50%) tuvieron la frecuencia esperada. No se observó compromiso cardiovascular en esta serie. El 100% de los pacientes recibieron corticoides. Adicionalmente el 57% recibieron terapia inmunosupresora asociada. La mortalidad fue del 10% por complicaciones asociadas a la PR. Conclusiones: En este estudio, a diferencia de otras series de origen caucásico y oriental, observamos una clara predominancia del género femenino, el compromiso extracartilaginoso es menos frecuente y la condritis auricular es nuestra manifestación inicial más importante. Estos hallazgos podrían ser el reflejo de diferencias genéticas, inmunológicas o ambientales. Palabras claves: Policondritis recurrente, condritis, vasculitis, corticoides. Abstract Objective: To describe clinical and paraclinical involvement in RP in a Colombian population and compare it with another series previously published. Methods and materials: Retrospective review of 19 cases of RP presented in 4 rheumatology centers in our country in the last 10 years. All patients met diagnostic criteria previously established. In every case, each clinical feature was analized and then compared with another 9 series of RP previously published between 1966 y 2007. Results: Mean age at diagnosis was 46 years. A female predominance was observed in a relation 4:1. Mean follow-up was 4 years. Auricular condritis was the initial clinical feature in 89% of patients and finally was observed in the 100% of our report. Compared with other series, we found less frequently arthritis (21%), ocular (10%) and dermatologic involvement (10%). Renal and neurologic involvement and the association between RP and another autoimmune disorder were found in the expected frequency. We not observed any cardiovascular involvement in our serie. All of the patients received corticosteroids and 57% had had another immunosuppressive medication. Observed mortality was 10% by complications associated to RP. Conclusions: In contrast with another series from Caucasian and Oriental population, we observed a marked predominance of female sex, a minor frequency of systemic involvement and auricular condritis is our most frequent initial clinical feature. Probably, these findings are the result of a different genetic, immunological and environmental background. Key words: Relapsing polychondritis, chondritis, vasculitis, corticosteroids