Browsing by Author "Ramirez-Cornejo, Cristian"

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    Can Ultrasound Examinations Generate Pain in Hidradenitis Suppurativa Patients? Results from a Multicentric Cross-Sectional Study
    (2023) Wortsman, Ximena; Reyes-Baraona, Francisco; Ramirez-Cornejo, Cristian; Ferreira-Wortsman, Camila; Caposiena Caro, Raffaele Dante; Molina-Leyva, Alejandro; Arias-Santiago, Salvador; Giavedoni, Priscila; Martorell, Antonio; Romani, Jorge; Gonzalez, Claudia; Alfageme, Fernando
    Background: Pain is not a trivial issue for hidradenitis suppurativa (HS) patients and has been considered a domain in the Core Outcome Set. To date, there is no evidence about pain caused by the ultrasound examinations. Objective: The aim of the study was to assess the presence of pain generated by the ultrasound examinations of HS patients. Methods: A multicentric cross-sectional study for detecting pain during the ultrasound examinations of HS patients using a validated verbal questionnaire immediately after the imaging studies. Statistical analysis included demographic data and possible associations with sex, age, location, clinical (Hurley), and ultrasonographic scoring (SOS-HS). The statistical tests were two proportions Z test, chi(2) test, Student's t test, and ANOVA. A p < 0.05 was considered significant. Results: 317 patients met the criteria. 77.3% of them did not present pain. Of cases with pain, 59.8% were mild, 16.7% moderate, and 23.6% severe. No significant association was found with sex, age, staging, location, or the number of affected regions. Although nonsignificant, severe pain cases were more frequent in the clinical Hurley III and ultrasonographic SOS-HS III stages. Conclusion: Pain generated by the ultrasound examination of HS patients is infrequent.
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    Low effectiveness of methotrexate in the management of localised scleroderma (morphea) based on an ultrasound activity score
    (2021) Vera-Kellet, Cristian; Meza-Romero, Rodrigo; Moll-Manzur, Catherina; Ramirez-Cornejo, Cristian; Wortsman, Ximena
    Background: The effectiveness of methotrexate (MTX), a first-line treatment for localised scleroderma (morphea), has not been assessed using colour Doppler ultrasonography (CDU). Objectives: We aimed to ultrasonographically monitor disease activity in patients with morphea treated with MTX, assessing its effectiveness using an Ultrasound Morphea Activity Score (US-MAS). Materials& Methods: Aretrospective cohort of 22 patients was studied between July 2014 and July 2019. The morphea of each patient, treated with MTX, was confirmed by histology and all patients had at least two CDU examinations. The US-MAS is based on published ultrasound signs of disease activity validated by histology. A weight-adjusted average MTX dose (mg/kg/wk) was used to standardize dosage, weight, and time between CDU examinations. The difference in US-MAS between two CDU examinations was determined. Statistical analyses includedWilcoxon and Fisher exact tests, the Spearman correlation coefficient, and risk ratios with 95% confidence intervals. To create two groups, we determined the median of the sample as the cut-off point for MTX dose (0.265 mg/kg/week). Significance was set at p <= 0.05; Results: In all cases, CDU examinations showed subclinical signs of activity beyond the visible lesional borders, either in the same or adjacent corporal segments. A negative correlation was found between the change in US-MAS andMTXdose (Spearman coefficient, -0.45; p = 0.035). The group dosed at >= 0.265 mg/kg/wk showed a non-significant change in US-MAS (2-point decrease). No case became inactive. Conclusion: MTX is a treatment with a low effectiveness for morphea, causing only slight decreases in ultrasound activity at higher doses.
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    Ultrasonographic subclinical signs of inflammation of the lacrimal, parotid, and submandibular glands in users of cosmetic fillers
    (2021) Wortsman, Ximena; Moll-Manzur, Catherina; Ramirez-Cornejo, Cristian; Alfaro-Sepulveda, Daniela; Mellado-Francisco, Gonzalo; Rezende, Juliana; Vera-Kellet, Cristian
    Objectives To detect ultrasonographic inflammatory signs in the lacrimal, parotid, and submandibular glands in cosmetic fillers (CFs) users.