La resonancia magnética en el estudio de lumbalgia. Un análisis de la oportunidad perdida para el diagnóstico de espondiloartritis axial

Objetivo: Describir las características de una población con lumbalgia estudiada por RM y analizar las características de los pacientes que cumplen criterios para ser derivados para estudio de EspA. Materiales y métodos: Estudio retrospectivo observacional, se incluyeron pacientes a quienes les fue solicitada RM para el estudio de lumbalgia. Se definió “población potencial para pesquisa de EspA” a los pacientes menores de 45 años con lumbalgia crónica. Análisis estadístico: se realizó el análisis descriptivo, test de Chi2 (categóricas) y test de Student o Mann Whitney (continuas). Análisis multivariado de regresión logística donde se consideró variable dependiente “Población potencial para pesquisa de EspA”

Lesiones destructivas de la línea media: diagnóstico diferencial con Vasculitis Asociada a ANCA

Presentamos los casos clínicos de tres pacientes adultos jóvenes de origen boliviano, que fueron hospitalizados en salas de clínica médica de un hospital de tercer nivel por manifestaciones de la vía aérea superior y lesiones de las estructuras de la línea media. Reumatología evaluó la posibilidad del diagnóstico de Vasculitis asociada a ANCA, la cual es un diagnóstico diferencial de la entidad conocida como “lesión destructiva de la línea media”. En todos los casos se arribó al diagnóstico definitivo de Linfoma T luego de un exhaustivo estudio histopatológico

Vasculitis cutáneas: etiología y características clínicas en pacientes adultos en un centro de tercer nivel

Introducción: diversas entidades clínicas, como enfermedades autoinmunes, infecciones, neoplasias y fármacos pueden manifestarse con lesiones vasculíticas en la piel. Debido a la heterogeneidad de las causas, suelen representar un desafío diagnóstico. El objetivo de este estudio es describir la etiología de las vasculitis cutáneas (VC) y evaluar las características clínicas, histológicas y de laboratorio halladas en estos pacientes. Material y métodos: se realizó un estudio retrospectivo con revisión de historias clínicas de pacientes mayores de 16 años con VC por diagnóstico clínico y/o histológico evaluados en el período 2010-2018. Resultados: se incluyeron 74 pacientes. El 69% son mujeres con una edad media al diagnóstico de 41 años (DE 16.5, rango 16 -75). Las causas más frecuentes asociadas a las VC fueron las enfermedades autoinmunes (EAI) en un 50% de los pacientes evaluados. En el 29.7% de los casos no pudo identificarse una causa subyacente. En el 2.7% de los casos se asoció a neoplasias, otro 2.7% a fármacos y un 12% a otras etiologías. El 76% de los pacientes presentaron formas clínicas no severas, predominando la púrpura palpable en el 65% de los casos. Entre los pacientes biopsiados, el 76% fueron vasculitis leucocitoclásticas (VLC). Como manifestaciones extracutáneas asociadas, predominó el compromiso articular (43,2%). En las vasculitis asociadas a EAI, el 33 % presentó compromiso renal, en tanto que éste no se observó en ninguno de los pacientes con vasculitis idiopáticas. El 78% de los pacientes recibieron glucocorticoides sistémicos. Conclusión: en nuestro centro, la etiología más común de VC fue la asociada a EAI. La mayoría de los pacientes eran mujeres. Clínicamente predominaron las manifestaciones cutáneas no severas y la VLC fue el hallazgo más frecuente en las biopsias

Cadaveric bone marrow mesenchymal stem cells: first experience treating a patient with large severe burns

Background: In January 2005, Rasulov et al. originally published ?First experience in the use of bone marrowmesenchymal stem cells (MSCs) for the treatment of a patient with deep skin burns. Here, we present the firstever treated patient with cadaveric bone marrow mesenchymal stem cells (CMSCs) in the history of Medicine.Methods: A young man, who severely burned 60 % of his total body surface with 30 % of full-thickness burns whileworking with a grass trimmer that exploded, was involved in the study. MSCs were obtained from the bone marrow ofa cadaver donor in a routine procurement procedure of CUCAIBA, the Province of Buenos Aires, Argentina, Ministry ofHealth, Transplantation Agency, cultured, expanded, and applied on the burned surfaces using a fibrin spray after earlyescharotomy.Results: So far, our preliminary experience and our early results have been very impressive showing an outstandingsafety data as well as some impressive good results in the use of CMSCs.Conclusions: Based on all this, we think that improvements in the use of stem cells for burns might be possible in thenear future and a lot of time as well as many lives could be saved by many other research teams all over the world.CMSCs will probably be a real scientific opportunity in Regenerative Medicine as well as in Transplantation.Fil: Mansilla, Eduardo. No especifíca;Fil: Marin, Gustavo Horacio. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - La Plata; ArgentinaFil: Berges, Mirta. Hospital San Martin; ArgentinaFil: Scafatti, Silvia. Hospital San Martin; ArgentinaFil: Rivas, Jaime. Hospital San Martin; ArgentinaFil: Núñez, Andrea. Hospital San Martin; ArgentinaFil: Menvielle, Martin. Hospital San Martin; ArgentinaFil: Lamonega, Roberto. Hospital San Martin; ArgentinaFil: Gardiner, Cecilia. Hospital San Martin; ArgentinaFil: Drago, Hugo. Hospital Burns; ArgentinaFil: Sturla, Flavio. Hospital Burns; ArgentinaFil: Portas, Mercedes. Hospital Burns; ArgentinaFil: Bossi, Silvia. Hospital Burns; ArgentinaFil: Castuma, Maria Victoria. No especifíca;Fil: Peña Luengas, Sandra. Universidad de Puerto Rico; Puerto RicoFil: Roque, Gustavo. No especifíca;Fil: Martire, Karina. No especifíca;Fil: Taulamet, María José. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - La Plata; ArgentinaFil: Orlandi, Gabriel. No especifíca;Fil: Tarditti, Adrian. No especifíca

Cadaveric bone marrow mesenchymal stem cells: first experience treating a patient with large severe burns

Background: In January 2005, Rasulov et al. originally published ?First experience in the use of bone marrowmesenchymal stem cells (MSCs) for the treatment of a patient with deep skin burns. Here, we present the firstever treated patient with cadaveric bone marrow mesenchymal stem cells (CMSCs) in the history of Medicine.Methods: A young man, who severely burned 60 % of his total body surface with 30 % of full-thickness burns whileworking with a grass trimmer that exploded, was involved in the study. MSCs were obtained from the bone marrow ofa cadaver donor in a routine procurement procedure of CUCAIBA, the Province of Buenos Aires, Argentina, Ministry ofHealth, Transplantation Agency, cultured, expanded, and applied on the burned surfaces using a fibrin spray after earlyescharotomy.Results: So far, our preliminary experience and our early results have been very impressive showing an outstandingsafety data as well as some impressive good results in the use of CMSCs.Conclusions: Based on all this, we think that improvements in the use of stem cells for burns might be possible in thenear future and a lot of time as well as many lives could be saved by many other research teams all over the world.CMSCs will probably be a real scientific opportunity in Regenerative Medicine as well as in Transplantation.Fil: Mansilla, Eduardo. No especifíca;Fil: Marin, Gustavo Horacio. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - La Plata; ArgentinaFil: Berges, Mirta. Hospital San Martin; ArgentinaFil: Scafatti, Silvia. Hospital San Martin; ArgentinaFil: Rivas, Jaime. Hospital San Martin; ArgentinaFil: Núñez, Andrea. Hospital San Martin; ArgentinaFil: Menvielle, Martin. Hospital San Martin; ArgentinaFil: Lamonega, Roberto. Hospital San Martin; ArgentinaFil: Gardiner, Cecilia. Hospital San Martin; ArgentinaFil: Drago, Hugo. Hospital Burns; ArgentinaFil: Sturla, Flavio. Hospital Burns; ArgentinaFil: Portas, Mercedes. Hospital Burns; ArgentinaFil: Bossi, Silvia. Hospital Burns; ArgentinaFil: Castuma, Maria Victoria. No especifíca;Fil: Peña Luengas, Sandra. Universidad de Puerto Rico; Puerto RicoFil: Roque, Gustavo. No especifíca;Fil: Martire, Karina. No especifíca;Fil: Taulamet, María José. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - La Plata; ArgentinaFil: Orlandi, Gabriel. No especifíca;Fil: Tarditti, Adrian. No especifíca

Cadaveric bone marrow mesenchymal stem cells: first experience treating a patient with large severe burns

Background: In January 2005, Rasulov et al. originally published “First experience in the use of bone marrow mesenchymal stem cells (MSCs) for the treatment of a patient with deep skin burns”. Here, we present the first ever treated patient with cadaveric bone marrow mesenchymal stem cells (CMSCs) in the history of Medicine. Methods: A young man, who severely burned 60 % of his total body surface with 30 % of full-thickness burns while working with a grass trimmer that exploded, was involved in the study. MSCs were obtained from the bone marrow of a cadaver donor in a routine procurement procedure of CUCAIBA, the Province of Buenos Aires, Argentina, Ministry of Health, Transplantation Agency, cultured, expanded, and applied on the burned surfaces using a fibrin spray after early escharotomy. Results: So far, our preliminary experience and our early results have been very impressive showing an outstanding safety data as well as some impressive good results in the use of CMSCs. Conclusions: Based on all this, we think that improvements in the use of stem cells for burns might be possible in the near future and a lot of time as well as many lives could be saved by many other research teams all over the world. CMSCs will probably be a real scientific opportunity in Regenerative Medicine as well as in Transplantation.Facultad de Ciencias Médica

Participación laboral en espondiloartritis axial radiográfica y no radiográfica

Introducción: las limitaciones laborales son un punto importante a considerar en el tratamiento de la espondiloartritis axial (EspAax) dado que esta enfermedad afecta a las personas en la etapa más productiva de la vida. Objetivos: describir la situación laboral en pacientes con EspAax de Argentina, incluyendo la espondilitis anquilosante (EA) y la espondiloartritis axial no radiográfica (EspAax-nr), y evaluar los factores asociados a la pérdida de productividad laboral (PPL) en esta cohorte nacional y los factores asociados a estar empleado

Does the Use of Immunosuppressive Drugs Impact on SARS-CoV-2 Infection Outcome? Data From A National Cohort of Patients With Immune-Mediated Inflammatory Diseases (SAR-COVID Registry)

Background/objectiveThis study describes the impact of immunomodulatory and/or immunosuppressive (IM/IS) drugs in the outcomes of COVID-19 infection in a cohort of patients with immune-mediated inflammatory diseases (IMIDs).MethodsAdult patients with IMIDs with a confirmed SARS-CoV-2 infection were included. Data were reported by the treating physician between August 13, 2020 and July 31, 2021. Sociodemographic data, comorbidities, and DMARDs, as well as clinical characteristics, complications, and treatment of the SARS-CoV-2 infection, were recorded. Descriptive analysis and multivariable logistic regression models were carried out.ResultsA total of 1672 patients with IMIDs were included, of whom 1402 were treated with IM/IS drugs. The most frequent diseases were rheumatoid arthritis (47.7%) and systemic lupus erythematosus (18.4%). COVID-19 symptoms were present in 95.2% of the patients. A total of 461 (27.6%) patients were hospitalized, 8.2% were admitted to the intensive care unit, and 4.4% died due to COVID-19.Patients without IM/IS treatment used glucocorticoids less frequently but at higher doses, had higher levels of disease activity, were significantly older, were more frequently hospitalized, admitted to the intensive care unit, and died due to COVID-19. After adjusting for these factors, treatment with IM/IS drugs was not associated with a worse COVID-19 outcome (World Health Organization-Ordinal Scale ≥5) (odds ratio, 1.24; 95% confidence interval, 0.73-2.06).ConclusionsSAR-COVID is the first multicenter Argentine registry collecting data from patients with rheumatic diseases and SARS-CoV-2 infection. After adjusting for relevant covariates, treatment with IM/IS drugs was not associated with severe COVID-19 in patients with IMIDs.Study registrationThis study has been registered in ClinicalTrials.gov under the number NCT04568421