Radiografía de Mano, su valor clínico

A través de una revisión bibliográfica se determina la imperiosa necesidad, en algunos casos de utilizar como elemento auxiliar de diagnóstico la radiografía de mano. Para ello se ha recopilado información básica sobre anatomía, técnicas radiográficas e interpretación de las mismas. Se establecen los índices de maduración que nos permiten evaluar el estado de desarrollo del individuo, lo que condiciona nuestro diagnóstico, pronóstico y plan de tratamiento

Comparison of the clinical expression of patients with ankylosing spondylitis from Europe and Latin America.

To compare the clinical, demographic, and serologic characteristics and the treatment of patients diagnosed with ankylosing spondylitis (AS) from Europe (EU) and Latin America (LA).Comparative StudyJournal ArticleMulticenter StudyRESPONDIA group ;ASPECT study group ;REGISPONSER study groupinfo:eu-repo/semantics/publishe

Homenaje a Ana María Barrenechea

Este número de Cuadernos LIRICO está dedicado a Ana María Barrenechea, destacada profesora e investigadora argentina que fue maestra de varias generaciones de críticos de las literaturas hispánicas y de estudiosos de la lengua. Nuestro volumen se propone recordar la importancia de su obra escrita y el aura de su magisterio y de su personalidad excepcional, evocando su figura y recorriendo algunos de entre los tantos caminos críticos abiertos por ella. De esta manera, el Homenaje pretende ser a la vez un recordatorio de su presencia y una puesta en perspectiva de la amplitud y la persistencia de sus aportes, de la fertilidad y los desafíos de su trabajo. Colaboran en él tanto una serie de especialistas que trabajó con ella o recibió directamente su estímulo y su influencia, como un grupo de otros que se abocó ulteriormente a sus temas dentro de las líneas de lectura que ella contribuyó a enriquecer. El número incluye una Introducción dedicada a su memoria y una serie de veinticuatro artículos, que abarcan estudios sobre prosa y poesía ríoplatense y literaturas extranjeras, historia y literatura del siglo XIX hispanoamericano, poética y teoría literaria, así como de crítica genética

Gender differences among patients with primary ankylosing spondylitis and spondylitis associated with psoriasis and inflammatory bowel disease in an iberoamerican spondyloarthritis cohort.

The aim of the study was to compare clinical manifestations, disease activity, functional capacity, spinal mobility, and radiological findings between men and women from a multicenter, multiethnic Ibero-American cohort of patients with Spondyloarthritis (SpA).This observational cross-section study included 1264 consecutive SpA patients who fulfilled the modified New York criteria for ankylosing spondylitis (AS). Demographic, clinical, and radiologic data were evaluated. Categorical data were compared by X or Fisher's exact tests and continuous variables by ANOVA with post-hoc tests.Primary AS was diagnosed in 1072 patients, psoriatic spondylitis in 147, and spondylitis associated to inflammatory bowel disease (IBD) in 45 patients. Overall, male patients were significantly younger, had longer diagnostic delay, lower disease activity, worse spinal mobility, better quality of life, and more severe radiologic damage. Dactylitis and enthesitis, as well as swollen joint count, were significantly more common among women. In primary AS, there was a marked male predominance (76.2%). Among patients with psoriatic spondylitis, male predominance was lower (57.8%), but was also associated with worse spinal mobility and more severe radiologic damage. In the total population, male patients with primary AS referred higher permanent work disability (13.2% vs 6.9%; P

Design of an algorithm for the diagnostic approach of patients with joint pain

Background Rheumatic diseases are a reason for frequent consultation with primary care doctors. Unfortunately, there is a high percentage of misdiagnosis. Objective To design an algorithm to be used by primary care physicians to improve the diagnostic approach of the patient with joint pain, and thus improve the diagnostic capacity in four rheumatic diseases. Methods Based on the information obtained from a literature review, we identified the main symptoms, signs, and paraclinical tests related to the diagnosis of rheumatoid arthritis, spondyloarthritis with peripheral involvement, systemic lupus erythematosus with joint involvement, and osteoarthritis. We conducted 3 consultations with a group of expert rheumatologists, using the Delphi technique, to design a diagnostic algorithm that has as a starting point “joint pain” as a common symptom for the four diseases. Results Thirty-nine rheumatologists from 18 countries of Ibero-America participated in the Delphi exercise. In the first consultation, we presented 94 items to the experts (35 symptoms, 31 signs, and 28 paraclinical tests) candidates to be part of the algorithm; 74 items (25 symptoms, 27 signs, and 22 paraclinical tests) were chosen. In the second consultation, the decision nodes of the algorithm were chosen, and in the third, its final structure was defined. The Delphi exercise lasted 8 months; 100% of the experts participated in the three consultations. Conclusion We present an algorithm designed through an international consensus of experts, in which Delphi methodology was used, to support primary care physicians in the clinical approach to patients with joint pain