Roberto Muñoz-louis - Academia.edu (original) (raw)

Papers by Roberto Muñoz-louis

Research paper thumbnail of Prevalence and target attainment of traditional cardiovascular risk factors in patients with systemic lupus erythematosus: a cross-sectional study including 3401 individuals from 24 countries

˜The œLancet. Rheumatology, Jun 1, 2024

Research paper thumbnail of Chikungunya infection in the general population and in patients with rheumatoid arthritis on biological therapy

Clinical Rheumatology, May 28, 2015

Chikungunya infection is a febrile illness, which currently is afflicting the Caribbean islands i... more Chikungunya infection is a febrile illness, which currently is afflicting the Caribbean islands including the Dominican Republic. We would like to report our experience with Chikungunya-related musculoskeletal manifestations in our arthritis clinics in the Dominican Republic. A total of 514 patients presented for the first time to our arthritis clinic exhibiting musculoskeletal manifestations, 473/514 (92%) exhibiting symmetric polyarthralgias, 344/514 (67%) arthritis, and 385 (75%) skin rash. The great majority 457.46 (89%) exhibited very good clinical response to nonsteroidal anti-inflammatory drugs (NSAIDs), 370 (72%) require low-dose steroids, and only 5 patients (0.97%) required methotrexate therapy. In addition, of a total of 328 patients with rheumatoid arthritis on biological treatment, 53 exhibited Chikungunya-related musculoskeletal manifestations; 51/53 (96.2%) exhibited symmetric polyarthralgias, 25/53 (47.1%) arthritis, and 13/53 (24.5%) tendinopathy. Of most patients, 51/53 responded to NSAIDs, of which, 23 patients only responded partially, and in total 25 (47.1%) required low-dose steroids. Disease-modifying antirheumatic drug (DMARD) therapy including biologics remained unchanged in this population.

Research paper thumbnail of Ab0597 changes in the thyroid hormones in patients with sjogren’s syndrome in dominican republic

SLE, Sjögren’s and APS – clinical aspects (other than treatment), 2018

Research paper thumbnail of SAT0277 Cognitive dysfunction in patients with systemic lupus erythematosus in dominican republic

Poster Presentations, 2017

predictors of TAS-20 values were to be fibromyalgic and to have mild-to-severe depression accordi... more predictors of TAS-20 values were to be fibromyalgic and to have mild-to-severe depression according to BDI. In multiple logistic regression, alexithymia was significantly associated to BDI score (OR 1.2, 95% CI 1.0-1.4) and inversely associated to cognitive impairment (OR 0.1, 95% CI 0.02-0.8). Conclusions: SLE patients frequently present alexithymic tract. Alexithymia seems to be associated neither to disease feature, to disease course (activity and damage) and to SLE therapy, nor to HR-QoL expressed by SF-36. Nevertheless, alexithymia could be tightly related to QoL-associated factors as depression and fibromyalgia Disclosure of Interest: None declared

Research paper thumbnail of SAT0276 Eye toxicity in patients with systemic lupus erithematosus treated with antimalarics in dominican republic

Poster Presentations, 2017

predictors of TAS-20 values were to be fibromyalgic and to have mild-to-severe depression accordi... more predictors of TAS-20 values were to be fibromyalgic and to have mild-to-severe depression according to BDI. In multiple logistic regression, alexithymia was significantly associated to BDI score (OR 1.2, 95% CI 1.0-1.4) and inversely associated to cognitive impairment (OR 0.1, 95% CI 0.02-0.8). Conclusions: SLE patients frequently present alexithymic tract. Alexithymia seems to be associated neither to disease feature, to disease course (activity and damage) and to SLE therapy, nor to HR-QoL expressed by SF-36. Nevertheless, alexithymia could be tightly related to QoL-associated factors as depression and fibromyalgia Disclosure of Interest: None declared

Research paper thumbnail of Rheumatoid arthritis in Latin America: challenges and solutions to improve its diagnosis and treatment training for medical professionals

Clinical Rheumatology, 2015

Rheumatoid arthritis (RA) is a disease with multiple clinical manifestations and chronic complica... more Rheumatoid arthritis (RA) is a disease with multiple clinical manifestations and chronic complications that requires a multidisciplinary team to treat and monitor patients. This understanding between the different medical and health professionals is essential in obtaining patient well-being. This is the reason behind the assessment of the difficulties and limitations seen in Latin America in the field of rheumatology. The aim is to suggest possible mechanisms and solutions to strengthen the knowledge and understanding of the way the disease behaves and how it can be handled by doctors and medical professionals.

Research paper thumbnail of LP-149 Latin-American systemic lupus erythematosus clusters

Research paper thumbnail of LSO-086 Pregnancy outcomes in systemic lupus erythematosus: data from a multiethnic, multinational Latin American cohort

Research paper thumbnail of Sonoanatomía de la mano y la muñeca

Rev. chil. reumatol, 2011

Research paper thumbnail of Comorbidities And Occupation According To The Degree Of Radiological Compromise And The Kellgren And Lawrence Scale In Oa Patients In 13 Latin America Countries

Research paper thumbnail of Cost-Effectiveness Analysis Of Etanercept Versus Other Available

Value in Health, 2014

Objectives: To evaluate the cost-effectiveness of denosumab (Prolia®, 60 mg every 6 month) compar... more Objectives: To evaluate the cost-effectiveness of denosumab (Prolia®, 60 mg every 6 month) compared to generic zoledronic acid (5 mg once yearly) in the treatment of postmenopausal osteoporosis in the U.S. societal perspective. MethOds: Comprehensive literature and online search was employed to obtain data on the clinical effectiveness of drugs, health-related quality of life (HRQoL) of disease states and costs. Databases searched were PubMed and Google Scholar engine. A Markov cohort model was constructed within the framework of incremental cost effectiveness ratios (ICERs) and net monetary benefit analyses. Given that generic zoledronic acid dominates denosumab in the base-case scenario, only one-way sensitivity analyses were performed to evaluate the sensitivity of results to model parameters. Finally, threshold analyses were used to determine the price at which denosumab would be as cost-effective as generic zoledronic acid. Results: In the base-case scenario, generic zoledronic acid increased 0.003 QALYs and decreased 227costsincrementallycomparedtodenosumab.Assumingawillingness−to−paythresholdof227 costs incrementally compared to denosumab. Assuming a willingness-to-pay threshold of 227costsincrementallycomparedtodenosumab.Assumingawillingness−to−paythresholdof150,000 per QALY, the NMB value of generic zoledronic acid compared to denosumab was $679. In the one-way sensitivity analyses, generic zoledronic acid dominated denosumab in all scenarios when model parameters were varied within a range of 10%-15%. The threshold analyses indicated that even at a zero price, denosumab would not be cost effective relative to generic zoledronic acid. cOnclusiOns: Based on a U.S. societal perspective, generic zoledronic acid is more cost-effective than denosumab in the treatment of high-risk patients with postmenopausal osteoporosis.

Research paper thumbnail of AB0569 Relationship between the levels of vitamin d and the activity in systemic lupus erythematosus in dominican republic

SLE, Sjögren’s and APS – clinical aspects (other than treatment), 2018

Background: Associations between clinical manifestations of systemic lupus erythematosus (SLE), p... more Background: Associations between clinical manifestations of systemic lupus erythematosus (SLE), presence of antiphospholipid antibodies (aPL) and HLA-DRB1 alleles have been established, these associations however need clarification. Objectives: Clarify the associations between clinical features of APS in patients with SLE and the presence of aPL and the HLA-DRB1 alleles. Methods: 79 SLE patients were enrolled in the study (M/F 7/72; mean age 11.0 years, range (18,0;78,0). The main group consisted of 41 aPL carriers (28 of them with antiphospholipid syndrome (APS), a comparison group consisted of 38 aPLnegative SLE patients. The groups were comparable in age, duration and SLE activity. ELISA was used to test for aPL. Lupus anticoagulant (LA) was evaluated using the DRVV test method. The HLA-DRB1 alleles were identified using HLA-typing. Results: While comparing both groups, HLA-DRB1*03 allele was found significantly less frequently in aPL-carriers group (p=0.04). In APS group HLA-DRB1*08 allele was present significantly more often (p=0.002), both HLA-DRB1*03 and *15 alleles were found significantly less often (p=0.008) in comparison with the aPL-negative group. SLE patients with HLA-DRB1*16 allele were more likely to develop an early pregnancy loss (OR=19, p=0.04), patient with HLA-DRB1*11 allelemore likely to develop a fetal loss (OR=4.9, p=0.04) in comparison with other alleles; in patients with HLA-DRB1*01 allele both early pregnancy loss and fetal loss occurred less often (OR=0.18, p=0.04; OR=0.29, p=0.04) compared with other alleles. The highest level of anti-double-stranded DNA was found in patients with HLA-DRB1*13 allele (Me=54, [17.0, 290.0 IU/ml], p=0.005), and lowest levelin patients with HLA-DRB1*04 (Me=0.15, [0.0; 14.2 IU/ml], p=0.005). In the group of aPL carriers significant correlations between the HLA-DRB1*08 allele and elevated level of anticardiolipin antibodies (aCL) IgM (r=À0.42, p=0.005) and anti-annexin V antibodies IgG (r=0.3, p=0, 01), between HLA-DRB1 * 04 allele and elevated level of aCL IgG (r=0.31, p=0.008), between the HLA-DRB1*12 allele and an elevated level of anti-annexin V antibodies IgM (r=0.31, p=0.01) were found. Correlations between HLA-DRB1*16 allele and early pregnancy loss (r=0.37, p<0.001), between HLA-DRB1*11 allele and fetal loss (r=0.30, p<0.001) were observed. Conclusions: 1. HLA-DRB1*08 allele is a risk factor for the development of APS in SLE patients. 2. HLA-DRB1*03 and *15 alleles were more often detected in aPL-negative SLE patients. 3. The presence of HLA-DRB1*16 and *11 alleles in SLE patients is a risk factor for the development of obstetric complications. 4. In the group of aPL carriers significant correlations between HLA-DRB1 alleles and elevated levels of aPL were found. 5. SLE patients with HLA-DRB1*01 were less likely to develop any obstetric complications.

Research paper thumbnail of PANLAR Consensus Recommendations for the Management in Osteoarthritis of Hand, Hip, and Knee

JCR: Journal of Clinical Rheumatology, 2016

Research paper thumbnail of Efficacité à court terme des infiltrations locales de corticoïdes réalisées « à l’aveugle » versus « sous contrôle échographique » dans le traitement de la ténosynovite chez les patients atteints d’arthrite inflammatoire chronique : étude comparative randomisée

Revue du Rhumatisme, 2016

Resume Objectif Comparer les benefices a court terme des infiltrations de corticoides realisees «... more Resume Objectif Comparer les benefices a court terme des infiltrations de corticoides realisees « a l’aveugle » versus « sous controle echographique », dans le traitement de la tenosynovite chez les patients atteints d’arthrite chronique et determiner si l’infiltration echoguidee est un geste moins douloureux et si des differences existent en termes de modifications de l’aspect echographique au cours du suivi post-injection. Methodes Ont ete inclus dans cette etude des patients qui presentaient une tenosynovite justifiant un traitement par corticoides injectables. Apres l’evaluation clinique et l’etude echographique prealables, les patients ont ete randomises pour faire l’objet d’une infiltration dite « a l’aveugle » ou d’un geste echoguide. L’efficacite de la procedure avait pour critere l’amelioration des scores Health Assessment Questionnaire (HAQ) et des scores echelle visuelle analogique (EVA) douleur qui incluaient le score EVA douleur procedure, EVA douleur globale et EVA douleur locale, mesures a la 1re et la 4e semaine post-injection. Les observations rapportees durant la surveillance echographique en mode Doppler puissance (DP) et en mode B ont egalement fait l’objet du suivi. Les infiltrations a l’aveugle et echoguidees d’une solution contenant 20 mg d’acetate de methylprednisolone ont ete realisees dans des conditions d’asepsie rigoureuses et conformement aux recommandations locales. Resultats Au total, 114 patients ont ete assignes de maniere aleatoire au groupe des infiltrations a l’aveugle (54 patients) ou celui des infiltrations echoguidees (60 patients). Il n’existait initialement aucune difference significative en termes de sexe, d’âge et de duree de la douleur entre les deux groupes. L’infiltration sous controle echographique s’est averee nettement moins douloureuse que le geste realise a l’aveugle (p = 0,0001). L’analyse de l’aire sous la courbe (ASC) a retrouve une meilleure reponse therapeutique au cours du suivi sur la base des scores HAQ, EVA douleur locale et EVA douleur globale (respectivement p = 0,0001, p = 0,012 et p = 0,0001) dans le groupe des infiltrations echoguidees par rapport au geste realise a l’aveugle. Pendant la duree du suivi, une reduction plus marquee des scores en mode DP a ete observee dans le groupe echoguide compare au groupe a l’aveugle (p = 0,0002) sans qu’il y ait de difference statistique constatee entre les deux gestes en mode B (p = 0,5627). Conclusion Notre etude a mis en evidence l’apport benefique significativement superieur des infiltrations echoguidees par rapport aux gestes realises a l’aveugle dans la prise en charge des tenosynovites douloureuses, comme l’indiquent les meilleurs resultats obtenus a court terme et mesures par les scores fonctionnels, cliniques et echographiques. Ces donnees confirment l’interet des infiltrations echoguidees dans le traitement de la tenosynovite en pratique rhumatologique hospitaliere et/ou privee.

Research paper thumbnail of Pan-American League of Associations for Rheumatology (PANLAR) recommendations and guidelines for musculoskeletal ultrasound training in the Americas for rheumatologists

Journal of clinical rheumatology : practical reports on rheumatic & musculoskeletal diseases, 2010

To develop guidelines for Musculoskeletal Ultrasound (MSKUS) training for rheumatologists in the ... more To develop guidelines for Musculoskeletal Ultrasound (MSKUS) training for rheumatologists in the Americas.

Research paper thumbnail of How is the ultrasound in rheumatology used, implemented, and applied in Latin American centers? Results from a multicenter study

Clinical Rheumatology, 2016

This study aimed to perform an overview of how ultrasound (US) is being used, implemented, and ap... more This study aimed to perform an overview of how ultrasound (US) is being used, implemented, and applied in rheumatologic centers in Latin America (LA). A retrospective, multicenter 1-year experience study was undertaken. Eighteen centers from eight countries were involved. The following information were collected: demographic data, indication to perform an US examination, physician that required the examination, and the anatomical region required for the examination. A total of 7167 patients underwent an US examination. The request for US examinations came most frequently from their own institution (5981 (83.45 %)) than from external referral (1186 (16.55 %)). The services that more frequently requested an US examination were rheumatology 5154 (71.91 %), followed by orthopedic 1016 (14.18 %), and rehabilitation 375 (5.23 %). The most frequently scanned area was the shoulder in 1908 cases (26.62 %), followed by hand 1754 (24.47 %), knee 1518 (21.18 %), ankle 574 (8.01 %), and wrist 394 (5.50 %). Osteoarthritis was the most common disease assessed (2279 patients (31.8 %)), followed by rheumatoid arthritis (2125 patients (29.65 %)), psoriatic arthritis (869 patients (12.1 %)), painful shoulder syndrome (545 (7.6 %)), connective tissue disorders (systemic sclerosis 339 (4.7 %), polymyositis/dermatomyositis 107 (1.4 %), Sjögren&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s syndrome 60 (0.8 %), and systemic lupus erythematosus 57 (0.8 %)). US evaluation was more frequently requested for diagnostic purposes (3981 (55.5 %)) compared to follow-up studies (2649 (36.9 %)), research protocols (339 (4.73 %)), and invasive guided procedures (198 (2.76 %)). US registered increasing applications in rheumatology and highlighted its positive impact in daily clinical practice. US increases the accuracy of the musculoskeletal clinical examination, influence the diagnosis, and the disease management.

Research paper thumbnail of sj-xlsx-1-lup-10.1177_0961203320988586 - Supplemental material for A longitudinal multiethnic study of biomarkers in systemic lupus erythematosus: Launching the GLADEL 2.0 Study Group

Supplemental material, sj-xlsx-1-lup-10.1177_0961203320988586 for A longitudinal multiethnic stud... more Supplemental material, sj-xlsx-1-lup-10.1177_0961203320988586 for A longitudinal multiethnic study of biomarkers in systemic lupus erythematosus: Launching the GLADEL 2.0 Study Group by José A Gómez-Puerta, Guillermo J Pons-Estel, Rosana Quintana, Romina Nieto, Rosa M Serrano Morales, Guillermina B Harvey, Daniel Wojdyla, Marina Scolnik, Carmen Funes Soaje, Paula Alba Moreyra, Elisa Novatti, Fernando Arizpe, Guillermo A Berbotto, Luciana González Lucero, Sabrina Porta, Nicolás Pérez, Anabella M Rodriguez, Simone Appenzeller, Ana Carolina de Oliveira e Silva Montadon, Odirlei Andre Monticielo, Fernando S Cavalcanti, Francinne Machado Ribeiro, Eduardo F Borba, Edgard Torres dos Reis-Neto, Oscar Neira, José Miguel Chahuán, Milena Mimica, Gustavo Aroca Martínez, Gabriel J Tobón, Gloria Vásquez, Gerardo Quintana-Lopez, Mario J. Moreno Alvarez, Miguel Ángel Saavedra, Mario Pérez Cristobal, Hilda Fragoso-Loyo, Luis M Amezcua-Guerra, Yelitza C González-Bello, Carlos Abud-Mendoza, Jorge A Es...

Research paper thumbnail of Panlar Consensus on Knee OA

Jcr-journal of Clinical Rheumatology, 2016

de reunión: 3286956 Fecha de publicación: APR 2016 Ver información de revista Información del aut... more de reunión: 3286956 Fecha de publicación: APR 2016 Ver información de revista Información del autor Direcciones: [ 1 ] Univ Los Andes, Hosp Univ Los Andes, Inst Autonomo, Unidad Reumatol, Bogota, Colombia [ 2 ] Inst Nacl Rehabil, Dept Reumatol, Mexico City, DF, Mexico [ 3 ] Hosp Univ Ruiz y Paez, Ciudad Bolivar, Bolivar, Venezuela [ 4 ] Clin Roosevelt, Caracas, Venezuela [ 5 ] Hosp Perez Carreno, Caracas, Venezuela [ 6 ] Clin Colinas, Anzoategui, Venezuela [ 7 ] Univ Los Andes, Traumatol, Inst Autonomo Hosp, Merida, Venezuela [ 8 ] Inst Docente Urol, Carabobo, Venezuela [ 9 ] Ctr Clin La Isabel, Carabobo, Venezuela [ 10 ] Hosp Cent Dr Urquinaona, Maracaibo, Venezuela [ 11 ] Hosp Gen Agudos Dr E Tornu, Serv Reumatol, Buenos Aires, DF, Argentina [ 12 ] Univ Los Andes, LabMice, Inst Autonomo Hosp, Bogota, Colombia [ 13 ] Univ Autonoma Nuevo Leon, Mexico City, DF, Mexico [ 14 ] Univ Montevideo, Fac Med, Catedra Reumatol, Montevideo, Uruguay [ 15 ] Ctr Integral Reumatol Reumalab, Medelli...

Research paper thumbnail of Vitamin D supplementation: position Statement of the Iberoamerican Society of Osteoporosis and Mineral Metabolism (SIBOMM)

Gynecological Endocrinology, 2020

Background Vitamin D (VD) deficiency is a global pandemic that affects more than a third of the p... more Background Vitamin D (VD) deficiency is a global pandemic that affects more than a third of the population worldwide. The population of Latin America and the Caribbean exceeds 620 million inhabitants with diverse ethnic origins and different latitudes and altitudes, which make comparisons and generalizations difficult. Aim and method We sought to establish an expert consensus regarding the recommendations for VD supplementation in Latin America by means of the Delphi methodology. Results The prophylactic dosage of VD in the general population should be individualized according to age, race, body weight, sun exposure of an individual, altitude, and dietary and exercise habits, without ruling out existing chronic diseases. Conclusion The importance of VD has been widely documented and its deficiency is a pandemic. Many individuals have difficulty meeting daily VD requirements through food and the sun. The population of Latin America and the Caribbean has diverse ethnics, cultures, in ...

Research paper thumbnail of Subclinical interstitial lung disease in patients with systemic sclerosis. A pilot study on the role of ultrasound

Reumatología Clínica, 2021

Introduction Interstitial lung disease (ILD) is a common comorbidity present in patients with sys... more Introduction Interstitial lung disease (ILD) is a common comorbidity present in patients with systemic sclerosis (SSc). Employment of high-resolution computed tomography (HRCT) is very limited and lung ultrasound (LUS) can be an alternative tool for the early evaluation of ILD. Objective To determine the validity of LUS in the early detection of ILD in patients with SSc. Materials and Methods Sixty-eight patients with SSc ≥18 years without respiratory symptoms were included. A rheumatologist rated the subclinical respiratory condition, another rheumatologist blinded to the clinical assessment performed the LUS. To determine validity HRCT was performed as well. Results Prevalence of LID in SSc patients was 41.2% in contrast to the 4.8% healthy controls (P = .0001). Variables associated with LUS and HRCT findings were anti-centromere antibodies (P = .005) and the Rodnan skin score (P = .004). A positive correlation was present between the findings of HRCT and LUS (P = .001). Sensitivi...

Research paper thumbnail of Prevalence and target attainment of traditional cardiovascular risk factors in patients with systemic lupus erythematosus: a cross-sectional study including 3401 individuals from 24 countries

˜The œLancet. Rheumatology, Jun 1, 2024

Research paper thumbnail of Chikungunya infection in the general population and in patients with rheumatoid arthritis on biological therapy

Clinical Rheumatology, May 28, 2015

Chikungunya infection is a febrile illness, which currently is afflicting the Caribbean islands i... more Chikungunya infection is a febrile illness, which currently is afflicting the Caribbean islands including the Dominican Republic. We would like to report our experience with Chikungunya-related musculoskeletal manifestations in our arthritis clinics in the Dominican Republic. A total of 514 patients presented for the first time to our arthritis clinic exhibiting musculoskeletal manifestations, 473/514 (92%) exhibiting symmetric polyarthralgias, 344/514 (67%) arthritis, and 385 (75%) skin rash. The great majority 457.46 (89%) exhibited very good clinical response to nonsteroidal anti-inflammatory drugs (NSAIDs), 370 (72%) require low-dose steroids, and only 5 patients (0.97%) required methotrexate therapy. In addition, of a total of 328 patients with rheumatoid arthritis on biological treatment, 53 exhibited Chikungunya-related musculoskeletal manifestations; 51/53 (96.2%) exhibited symmetric polyarthralgias, 25/53 (47.1%) arthritis, and 13/53 (24.5%) tendinopathy. Of most patients, 51/53 responded to NSAIDs, of which, 23 patients only responded partially, and in total 25 (47.1%) required low-dose steroids. Disease-modifying antirheumatic drug (DMARD) therapy including biologics remained unchanged in this population.

Research paper thumbnail of Ab0597 changes in the thyroid hormones in patients with sjogren’s syndrome in dominican republic

SLE, Sjögren’s and APS – clinical aspects (other than treatment), 2018

Research paper thumbnail of SAT0277 Cognitive dysfunction in patients with systemic lupus erythematosus in dominican republic

Poster Presentations, 2017

predictors of TAS-20 values were to be fibromyalgic and to have mild-to-severe depression accordi... more predictors of TAS-20 values were to be fibromyalgic and to have mild-to-severe depression according to BDI. In multiple logistic regression, alexithymia was significantly associated to BDI score (OR 1.2, 95% CI 1.0-1.4) and inversely associated to cognitive impairment (OR 0.1, 95% CI 0.02-0.8). Conclusions: SLE patients frequently present alexithymic tract. Alexithymia seems to be associated neither to disease feature, to disease course (activity and damage) and to SLE therapy, nor to HR-QoL expressed by SF-36. Nevertheless, alexithymia could be tightly related to QoL-associated factors as depression and fibromyalgia Disclosure of Interest: None declared

Research paper thumbnail of SAT0276 Eye toxicity in patients with systemic lupus erithematosus treated with antimalarics in dominican republic

Poster Presentations, 2017

predictors of TAS-20 values were to be fibromyalgic and to have mild-to-severe depression accordi... more predictors of TAS-20 values were to be fibromyalgic and to have mild-to-severe depression according to BDI. In multiple logistic regression, alexithymia was significantly associated to BDI score (OR 1.2, 95% CI 1.0-1.4) and inversely associated to cognitive impairment (OR 0.1, 95% CI 0.02-0.8). Conclusions: SLE patients frequently present alexithymic tract. Alexithymia seems to be associated neither to disease feature, to disease course (activity and damage) and to SLE therapy, nor to HR-QoL expressed by SF-36. Nevertheless, alexithymia could be tightly related to QoL-associated factors as depression and fibromyalgia Disclosure of Interest: None declared

Research paper thumbnail of Rheumatoid arthritis in Latin America: challenges and solutions to improve its diagnosis and treatment training for medical professionals

Clinical Rheumatology, 2015

Rheumatoid arthritis (RA) is a disease with multiple clinical manifestations and chronic complica... more Rheumatoid arthritis (RA) is a disease with multiple clinical manifestations and chronic complications that requires a multidisciplinary team to treat and monitor patients. This understanding between the different medical and health professionals is essential in obtaining patient well-being. This is the reason behind the assessment of the difficulties and limitations seen in Latin America in the field of rheumatology. The aim is to suggest possible mechanisms and solutions to strengthen the knowledge and understanding of the way the disease behaves and how it can be handled by doctors and medical professionals.

Research paper thumbnail of LP-149 Latin-American systemic lupus erythematosus clusters

Research paper thumbnail of LSO-086 Pregnancy outcomes in systemic lupus erythematosus: data from a multiethnic, multinational Latin American cohort

Research paper thumbnail of Sonoanatomía de la mano y la muñeca

Rev. chil. reumatol, 2011

Research paper thumbnail of Comorbidities And Occupation According To The Degree Of Radiological Compromise And The Kellgren And Lawrence Scale In Oa Patients In 13 Latin America Countries

Research paper thumbnail of Cost-Effectiveness Analysis Of Etanercept Versus Other Available

Value in Health, 2014

Objectives: To evaluate the cost-effectiveness of denosumab (Prolia®, 60 mg every 6 month) compar... more Objectives: To evaluate the cost-effectiveness of denosumab (Prolia®, 60 mg every 6 month) compared to generic zoledronic acid (5 mg once yearly) in the treatment of postmenopausal osteoporosis in the U.S. societal perspective. MethOds: Comprehensive literature and online search was employed to obtain data on the clinical effectiveness of drugs, health-related quality of life (HRQoL) of disease states and costs. Databases searched were PubMed and Google Scholar engine. A Markov cohort model was constructed within the framework of incremental cost effectiveness ratios (ICERs) and net monetary benefit analyses. Given that generic zoledronic acid dominates denosumab in the base-case scenario, only one-way sensitivity analyses were performed to evaluate the sensitivity of results to model parameters. Finally, threshold analyses were used to determine the price at which denosumab would be as cost-effective as generic zoledronic acid. Results: In the base-case scenario, generic zoledronic acid increased 0.003 QALYs and decreased 227costsincrementallycomparedtodenosumab.Assumingawillingness−to−paythresholdof227 costs incrementally compared to denosumab. Assuming a willingness-to-pay threshold of 227costsincrementallycomparedtodenosumab.Assumingawillingness−to−paythresholdof150,000 per QALY, the NMB value of generic zoledronic acid compared to denosumab was $679. In the one-way sensitivity analyses, generic zoledronic acid dominated denosumab in all scenarios when model parameters were varied within a range of 10%-15%. The threshold analyses indicated that even at a zero price, denosumab would not be cost effective relative to generic zoledronic acid. cOnclusiOns: Based on a U.S. societal perspective, generic zoledronic acid is more cost-effective than denosumab in the treatment of high-risk patients with postmenopausal osteoporosis.

Research paper thumbnail of AB0569 Relationship between the levels of vitamin d and the activity in systemic lupus erythematosus in dominican republic

SLE, Sjögren’s and APS – clinical aspects (other than treatment), 2018

Background: Associations between clinical manifestations of systemic lupus erythematosus (SLE), p... more Background: Associations between clinical manifestations of systemic lupus erythematosus (SLE), presence of antiphospholipid antibodies (aPL) and HLA-DRB1 alleles have been established, these associations however need clarification. Objectives: Clarify the associations between clinical features of APS in patients with SLE and the presence of aPL and the HLA-DRB1 alleles. Methods: 79 SLE patients were enrolled in the study (M/F 7/72; mean age 11.0 years, range (18,0;78,0). The main group consisted of 41 aPL carriers (28 of them with antiphospholipid syndrome (APS), a comparison group consisted of 38 aPLnegative SLE patients. The groups were comparable in age, duration and SLE activity. ELISA was used to test for aPL. Lupus anticoagulant (LA) was evaluated using the DRVV test method. The HLA-DRB1 alleles were identified using HLA-typing. Results: While comparing both groups, HLA-DRB1*03 allele was found significantly less frequently in aPL-carriers group (p=0.04). In APS group HLA-DRB1*08 allele was present significantly more often (p=0.002), both HLA-DRB1*03 and *15 alleles were found significantly less often (p=0.008) in comparison with the aPL-negative group. SLE patients with HLA-DRB1*16 allele were more likely to develop an early pregnancy loss (OR=19, p=0.04), patient with HLA-DRB1*11 allelemore likely to develop a fetal loss (OR=4.9, p=0.04) in comparison with other alleles; in patients with HLA-DRB1*01 allele both early pregnancy loss and fetal loss occurred less often (OR=0.18, p=0.04; OR=0.29, p=0.04) compared with other alleles. The highest level of anti-double-stranded DNA was found in patients with HLA-DRB1*13 allele (Me=54, [17.0, 290.0 IU/ml], p=0.005), and lowest levelin patients with HLA-DRB1*04 (Me=0.15, [0.0; 14.2 IU/ml], p=0.005). In the group of aPL carriers significant correlations between the HLA-DRB1*08 allele and elevated level of anticardiolipin antibodies (aCL) IgM (r=À0.42, p=0.005) and anti-annexin V antibodies IgG (r=0.3, p=0, 01), between HLA-DRB1 * 04 allele and elevated level of aCL IgG (r=0.31, p=0.008), between the HLA-DRB1*12 allele and an elevated level of anti-annexin V antibodies IgM (r=0.31, p=0.01) were found. Correlations between HLA-DRB1*16 allele and early pregnancy loss (r=0.37, p<0.001), between HLA-DRB1*11 allele and fetal loss (r=0.30, p<0.001) were observed. Conclusions: 1. HLA-DRB1*08 allele is a risk factor for the development of APS in SLE patients. 2. HLA-DRB1*03 and *15 alleles were more often detected in aPL-negative SLE patients. 3. The presence of HLA-DRB1*16 and *11 alleles in SLE patients is a risk factor for the development of obstetric complications. 4. In the group of aPL carriers significant correlations between HLA-DRB1 alleles and elevated levels of aPL were found. 5. SLE patients with HLA-DRB1*01 were less likely to develop any obstetric complications.

Research paper thumbnail of PANLAR Consensus Recommendations for the Management in Osteoarthritis of Hand, Hip, and Knee

JCR: Journal of Clinical Rheumatology, 2016

Research paper thumbnail of Efficacité à court terme des infiltrations locales de corticoïdes réalisées « à l’aveugle » versus « sous contrôle échographique » dans le traitement de la ténosynovite chez les patients atteints d’arthrite inflammatoire chronique : étude comparative randomisée

Revue du Rhumatisme, 2016

Resume Objectif Comparer les benefices a court terme des infiltrations de corticoides realisees «... more Resume Objectif Comparer les benefices a court terme des infiltrations de corticoides realisees « a l’aveugle » versus « sous controle echographique », dans le traitement de la tenosynovite chez les patients atteints d’arthrite chronique et determiner si l’infiltration echoguidee est un geste moins douloureux et si des differences existent en termes de modifications de l’aspect echographique au cours du suivi post-injection. Methodes Ont ete inclus dans cette etude des patients qui presentaient une tenosynovite justifiant un traitement par corticoides injectables. Apres l’evaluation clinique et l’etude echographique prealables, les patients ont ete randomises pour faire l’objet d’une infiltration dite « a l’aveugle » ou d’un geste echoguide. L’efficacite de la procedure avait pour critere l’amelioration des scores Health Assessment Questionnaire (HAQ) et des scores echelle visuelle analogique (EVA) douleur qui incluaient le score EVA douleur procedure, EVA douleur globale et EVA douleur locale, mesures a la 1re et la 4e semaine post-injection. Les observations rapportees durant la surveillance echographique en mode Doppler puissance (DP) et en mode B ont egalement fait l’objet du suivi. Les infiltrations a l’aveugle et echoguidees d’une solution contenant 20 mg d’acetate de methylprednisolone ont ete realisees dans des conditions d’asepsie rigoureuses et conformement aux recommandations locales. Resultats Au total, 114 patients ont ete assignes de maniere aleatoire au groupe des infiltrations a l’aveugle (54 patients) ou celui des infiltrations echoguidees (60 patients). Il n’existait initialement aucune difference significative en termes de sexe, d’âge et de duree de la douleur entre les deux groupes. L’infiltration sous controle echographique s’est averee nettement moins douloureuse que le geste realise a l’aveugle (p = 0,0001). L’analyse de l’aire sous la courbe (ASC) a retrouve une meilleure reponse therapeutique au cours du suivi sur la base des scores HAQ, EVA douleur locale et EVA douleur globale (respectivement p = 0,0001, p = 0,012 et p = 0,0001) dans le groupe des infiltrations echoguidees par rapport au geste realise a l’aveugle. Pendant la duree du suivi, une reduction plus marquee des scores en mode DP a ete observee dans le groupe echoguide compare au groupe a l’aveugle (p = 0,0002) sans qu’il y ait de difference statistique constatee entre les deux gestes en mode B (p = 0,5627). Conclusion Notre etude a mis en evidence l’apport benefique significativement superieur des infiltrations echoguidees par rapport aux gestes realises a l’aveugle dans la prise en charge des tenosynovites douloureuses, comme l’indiquent les meilleurs resultats obtenus a court terme et mesures par les scores fonctionnels, cliniques et echographiques. Ces donnees confirment l’interet des infiltrations echoguidees dans le traitement de la tenosynovite en pratique rhumatologique hospitaliere et/ou privee.

Research paper thumbnail of Pan-American League of Associations for Rheumatology (PANLAR) recommendations and guidelines for musculoskeletal ultrasound training in the Americas for rheumatologists

Journal of clinical rheumatology : practical reports on rheumatic & musculoskeletal diseases, 2010

To develop guidelines for Musculoskeletal Ultrasound (MSKUS) training for rheumatologists in the ... more To develop guidelines for Musculoskeletal Ultrasound (MSKUS) training for rheumatologists in the Americas.

Research paper thumbnail of How is the ultrasound in rheumatology used, implemented, and applied in Latin American centers? Results from a multicenter study

Clinical Rheumatology, 2016

This study aimed to perform an overview of how ultrasound (US) is being used, implemented, and ap... more This study aimed to perform an overview of how ultrasound (US) is being used, implemented, and applied in rheumatologic centers in Latin America (LA). A retrospective, multicenter 1-year experience study was undertaken. Eighteen centers from eight countries were involved. The following information were collected: demographic data, indication to perform an US examination, physician that required the examination, and the anatomical region required for the examination. A total of 7167 patients underwent an US examination. The request for US examinations came most frequently from their own institution (5981 (83.45 %)) than from external referral (1186 (16.55 %)). The services that more frequently requested an US examination were rheumatology 5154 (71.91 %), followed by orthopedic 1016 (14.18 %), and rehabilitation 375 (5.23 %). The most frequently scanned area was the shoulder in 1908 cases (26.62 %), followed by hand 1754 (24.47 %), knee 1518 (21.18 %), ankle 574 (8.01 %), and wrist 394 (5.50 %). Osteoarthritis was the most common disease assessed (2279 patients (31.8 %)), followed by rheumatoid arthritis (2125 patients (29.65 %)), psoriatic arthritis (869 patients (12.1 %)), painful shoulder syndrome (545 (7.6 %)), connective tissue disorders (systemic sclerosis 339 (4.7 %), polymyositis/dermatomyositis 107 (1.4 %), Sjögren&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s syndrome 60 (0.8 %), and systemic lupus erythematosus 57 (0.8 %)). US evaluation was more frequently requested for diagnostic purposes (3981 (55.5 %)) compared to follow-up studies (2649 (36.9 %)), research protocols (339 (4.73 %)), and invasive guided procedures (198 (2.76 %)). US registered increasing applications in rheumatology and highlighted its positive impact in daily clinical practice. US increases the accuracy of the musculoskeletal clinical examination, influence the diagnosis, and the disease management.

Research paper thumbnail of sj-xlsx-1-lup-10.1177_0961203320988586 - Supplemental material for A longitudinal multiethnic study of biomarkers in systemic lupus erythematosus: Launching the GLADEL 2.0 Study Group

Supplemental material, sj-xlsx-1-lup-10.1177_0961203320988586 for A longitudinal multiethnic stud... more Supplemental material, sj-xlsx-1-lup-10.1177_0961203320988586 for A longitudinal multiethnic study of biomarkers in systemic lupus erythematosus: Launching the GLADEL 2.0 Study Group by José A Gómez-Puerta, Guillermo J Pons-Estel, Rosana Quintana, Romina Nieto, Rosa M Serrano Morales, Guillermina B Harvey, Daniel Wojdyla, Marina Scolnik, Carmen Funes Soaje, Paula Alba Moreyra, Elisa Novatti, Fernando Arizpe, Guillermo A Berbotto, Luciana González Lucero, Sabrina Porta, Nicolás Pérez, Anabella M Rodriguez, Simone Appenzeller, Ana Carolina de Oliveira e Silva Montadon, Odirlei Andre Monticielo, Fernando S Cavalcanti, Francinne Machado Ribeiro, Eduardo F Borba, Edgard Torres dos Reis-Neto, Oscar Neira, José Miguel Chahuán, Milena Mimica, Gustavo Aroca Martínez, Gabriel J Tobón, Gloria Vásquez, Gerardo Quintana-Lopez, Mario J. Moreno Alvarez, Miguel Ángel Saavedra, Mario Pérez Cristobal, Hilda Fragoso-Loyo, Luis M Amezcua-Guerra, Yelitza C González-Bello, Carlos Abud-Mendoza, Jorge A Es...

Research paper thumbnail of Panlar Consensus on Knee OA

Jcr-journal of Clinical Rheumatology, 2016

de reunión: 3286956 Fecha de publicación: APR 2016 Ver información de revista Información del aut... more de reunión: 3286956 Fecha de publicación: APR 2016 Ver información de revista Información del autor Direcciones: [ 1 ] Univ Los Andes, Hosp Univ Los Andes, Inst Autonomo, Unidad Reumatol, Bogota, Colombia [ 2 ] Inst Nacl Rehabil, Dept Reumatol, Mexico City, DF, Mexico [ 3 ] Hosp Univ Ruiz y Paez, Ciudad Bolivar, Bolivar, Venezuela [ 4 ] Clin Roosevelt, Caracas, Venezuela [ 5 ] Hosp Perez Carreno, Caracas, Venezuela [ 6 ] Clin Colinas, Anzoategui, Venezuela [ 7 ] Univ Los Andes, Traumatol, Inst Autonomo Hosp, Merida, Venezuela [ 8 ] Inst Docente Urol, Carabobo, Venezuela [ 9 ] Ctr Clin La Isabel, Carabobo, Venezuela [ 10 ] Hosp Cent Dr Urquinaona, Maracaibo, Venezuela [ 11 ] Hosp Gen Agudos Dr E Tornu, Serv Reumatol, Buenos Aires, DF, Argentina [ 12 ] Univ Los Andes, LabMice, Inst Autonomo Hosp, Bogota, Colombia [ 13 ] Univ Autonoma Nuevo Leon, Mexico City, DF, Mexico [ 14 ] Univ Montevideo, Fac Med, Catedra Reumatol, Montevideo, Uruguay [ 15 ] Ctr Integral Reumatol Reumalab, Medelli...

Research paper thumbnail of Vitamin D supplementation: position Statement of the Iberoamerican Society of Osteoporosis and Mineral Metabolism (SIBOMM)

Gynecological Endocrinology, 2020

Background Vitamin D (VD) deficiency is a global pandemic that affects more than a third of the p... more Background Vitamin D (VD) deficiency is a global pandemic that affects more than a third of the population worldwide. The population of Latin America and the Caribbean exceeds 620 million inhabitants with diverse ethnic origins and different latitudes and altitudes, which make comparisons and generalizations difficult. Aim and method We sought to establish an expert consensus regarding the recommendations for VD supplementation in Latin America by means of the Delphi methodology. Results The prophylactic dosage of VD in the general population should be individualized according to age, race, body weight, sun exposure of an individual, altitude, and dietary and exercise habits, without ruling out existing chronic diseases. Conclusion The importance of VD has been widely documented and its deficiency is a pandemic. Many individuals have difficulty meeting daily VD requirements through food and the sun. The population of Latin America and the Caribbean has diverse ethnics, cultures, in ...

Research paper thumbnail of Subclinical interstitial lung disease in patients with systemic sclerosis. A pilot study on the role of ultrasound

Reumatología Clínica, 2021

Introduction Interstitial lung disease (ILD) is a common comorbidity present in patients with sys... more Introduction Interstitial lung disease (ILD) is a common comorbidity present in patients with systemic sclerosis (SSc). Employment of high-resolution computed tomography (HRCT) is very limited and lung ultrasound (LUS) can be an alternative tool for the early evaluation of ILD. Objective To determine the validity of LUS in the early detection of ILD in patients with SSc. Materials and Methods Sixty-eight patients with SSc ≥18 years without respiratory symptoms were included. A rheumatologist rated the subclinical respiratory condition, another rheumatologist blinded to the clinical assessment performed the LUS. To determine validity HRCT was performed as well. Results Prevalence of LID in SSc patients was 41.2% in contrast to the 4.8% healthy controls (P = .0001). Variables associated with LUS and HRCT findings were anti-centromere antibodies (P = .005) and the Rodnan skin score (P = .004). A positive correlation was present between the findings of HRCT and LUS (P = .001). Sensitivi...

Research paper thumbnail of Libro Texto Artritis Psoriásica

Libro Texto Artritis Psoriática, 2019

Psoriasis, dactilitis Todas las imágenes de Thinkstock incluyen una licencia libre de derechos Di... more Psoriasis, dactilitis Todas las imágenes de Thinkstock incluyen una licencia libre de derechos Diagramación e ilustración: Cristopher Chan Bueno 260 páginas Incluye referencias ISBN Obra Independiente: 978-9945-8-0396-9