Browsing by Author "Soriano, Enrique R."
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- ItemCurrent status of the rheumatologists' workforce in Latin America: a PANLAR collaborative study(2021) Gerardo Fernandez-Avila, Daniel; Patino-Hernandez, Daniela; Kowalskii, Sergio; Vargas-Caselles, Alfredo; Sapag, Ana Maria; Cachafeiro-Vilar, Antonio; Melendez-Munoz, Lucia; Santiago-Pastelin, Carlos; Graf, Cesar; Rossetto, Chayanne; Palleiro, Daniel; Trincado, Daniela; Fernandez-Avila, Diana; Arrieta, Dina; Reyes, Gil; Baez, Jossiel Then; Ugarte-Gil, Manuel F.; Cardiel, Mario; Colman, Nelly; Chavez, Nilmo; Burgos, Paula, I; Montufar, Ruben; Sandino, Sayonara; Fuentes-Silva, Yurilis; Soriano, Enrique R.Introduction Studies conducted by various scientific societies have shown that the demand for specialized rheumatology care is greater than the projected growth of the workforce. Our research aims to assess the current status of the rheumatology workforce in Latin America.
- ItemEarly Rheumatoid Arthritis in Latin America: Low Socioeconomic Status Related to High Disease Activity at Baseline(2012) Massardo Vega, Loreto; Pons-Estel, Bernardo A.; Wojdyla, Daniel; Cardiel, Mario H.; Galarza Maldonado, Claudio M.; Padilla Pérez, Oslando; Sacnun, Mónica P.; Soriano, Enrique R.; Laurindo, Leda M.; Acevedo Vásquez, Eduardo M.; Caballero Uribe, Carlo V.; Guibert Toledano, Zoila M.; Mota, Licia M. da; Montufar, Rubén A.; Lino Pérez, Leticia; Díaz Coto, José F.; Achurra Castillo, Angel F.; Hernández, Jaime A.; Esteva-Spinetti, María H.; Ramírez, Luis A.; Pineda, Carlos; Furst, Daniel E.
- ItemFactors predictive of serious infections over time in systemic lupus erythematosus patients: data from a multi-ethnic, multi-national, Latin American lupus cohort(2019) Pimentel-Quiroz, V. R.; Ugarte-Gil, M. F.; Harvey, G. B.; Wojdyla, D.; Pons-Estel, G. J.; Quintana, R.; Esposto, A.; Garcia, M. A.; Catoggio, L. J.; Cardiel, M. H.; Barile, L. A.; Amigo, M-C; Sato, E., I; Bonfa, E.; Borba, E.; Lavras Costallat, L. T.; Neira, O. J.; Massardo, L.; Guibert-Toledano, M.; Chacon-Diaz, R.; Alarcon, G. S.; Pons-Estel, B. A.; Soriano, Enrique R.; Ceballos Recalde, Maria Flavia; Velozo, Edson; Manni, Jorge A.; Grimaudo, Sebastian; Sarano, Judith; Maldonado-Cocco, Jose A.; Arriola, Maria S.; Gomez, Graciela; Ines Marcos, Ana; Carlos Marcos, Juan; Scherbarth, Hugo R.; Lopez, Jorge A.; Motta, Estela L.; Drenkard, Cristina; Gamron, Susana; Buliubasich, Sandra; Onetti, Laura; Caeiro, Francisco; Alvarellos, Alejandro; Saurit, Veronica; Gentiletti, Silvana; Quagliatto, Norberto; Gentiletti, Alberto A.; Machado, Daniel; Abdala, Marcelo; Palatnik, Simon; Berbotto, Guillermo A.; Battagliotti, Carlos A.; Souza, Alexandre Wagner S.; Bertolo, Manoel Barros; Coimbra, Ibsen Bellini; Tavares Brenol, Joao C.; Monticielo, Odirlei; Xavier, Ricardo; Cavalcanti, Fernando de Souza; Branco Duarte, Angela Luzia; Lopes Marques, Claudia Diniz; da Silva, Nilzio Antonio; de O e Silva, Ana Carolina; Pacheco, Tatiana Ferracine; Fernando Molina-Restrepo, Jose; Molina-Lopez, Javier; Vasquez, Gloria; Ramirez, Luis A.; Uribe, Oscar; Iglesias-Gamarra, Antonio; Iglesias-Rodriguez, Antonio; Egea-Bermejo, Eduardo; Guzman-Moreno, Renato A.; Restrepo-Suarez, Jose F.; Alberto Reyes-Llerena, Gil; Hernandez-Martinez, Alfredo; Jacobelli, Sergio; Guzman, Leonardo R.; Garcia-Kutzbach, Abraham; Castellanos, Claudia; Cajas, Erwin; Pascual-Ramos, Virginia; Silveira, Luis H.; Garcia De La Torre, Ignacio; Orozco-Barocio, Gerardo; Estrada-Contreras, Magali L.; Sauza del Pozo, Maria Josefina; Aranda Baca, Laura E.; Urenda Quezada, Adelfia; Huerta-Yanez, Guillermo F.; Acevedo-Vazquez, Eduardo M.; Luis Alfaro-Lozano, Jose; Cucho-Venegas, Jorge M.; Ines Segami, Maria; Chung, Cecilia P.; Alva-Linares, Magaly; Abadi, Isaac; Rangel, Neriza; Al Snih Al Snih, Soham; Esteva-Spinetti, Maria H.; Vivas, JorgeAim The aim of this study was to identify factors predictive of serious infections over time in patients with systemic lupus erythematosus (SLE). Methods A multi-ethnic, multi-national Latin American SLE cohort was studied. Serious infection was defined as one that required hospitalization, occurred during a hospitalization or led to death. Potential predictors included were sociodemographic factors, clinical manifestations (per organ involved, lymphopenia and leukopenia, independently) and previous infections at baseline. Disease activity (SLEDAI), damage (SLICC/ACR Damage Index), non-serious infections, glucocorticoids, antimalarials (users and non-users), and immunosuppressive drugs use; the last six variables were examined as time-dependent covariates. Cox regression models were used to evaluate the predictors of serious infections using a backward elimination procedure. Univariable and multivariable analyses were performed. Results Of the 1243 patients included, 1116 (89.8%) were female. The median (interquartile range) age at diagnosis and follow-up time were 27 (20-37) years and 47.8 (17.9-68.6) months, respectively. The incidence rate of serious infections was 3.8 cases per 100 person-years. Antimalarial use (hazard ratio: 0.69; 95% confidence interval (CI): 0.48-0.99; p = 0.0440) was protective, while doses of prednisone >15 and <= 60 mg/day (hazard ratio: 4.18; 95 %CI: 1.69-10.31; p = 0.0019) and >60 mg/day (hazard ratio: 4.71; 95% CI: 1.35-16.49; p = 0.0153), use of methylprednisolone pulses (hazard ratio: 1.53; 95% CI: 1.10-2.13; p = 0.0124), increase in disease activity (hazard ratio: 1.03; 95% CI: 1.01-1.04; p = 0.0016) and damage accrual (hazard ratio: 1.22; 95% CI: 1.11-1.34; p < 0.0001) were predictive factors of serious infections. Conclusions Over time, prednisone doses higher than 15 mg/day, use of methylprednisolone pulses, increase in disease activity and damage accrual were predictive of infections, whereas antimalarial use was protective against them in SLE patients.
- ItemFirst Latin American clinical practice guidelines for the treatment of systemic lupus erythematosus : Latin American Group for the Study of Lupus (GLADEL, Grupo Latino Americano de Estudio del Lupus)-Pan-American League of Associations of Rheumatology (PANLAR)(2018) Pons-Estel, Bernardo A.; Bonfa, Eloisa; Soriano, Enrique R.; Cardiel, Mario H.; Izcovich, Ariel; Popoff, Federico; Criniti, Juan M.; Vásquez, Gloria; Burgos, Paula I.; Llanos Muñoz, Carolina
- ItemImpact of COVID-19 pandemic on patients with rheumatic diseases in Latin America(2022) Fernandez-Avila, Daniel G.; Barahona-Correa, Julian; Romero-Alvernia, Diana; Kowalski, Sergio; Sapag, Ana; Cachafeiro-Vilar, Antonio; Melendez, Belia; Pastelin, Carlos; Palleiro, Daniel; Arrieta, Dina; Reyes, Gil; Pons-Estel, Guillermo J.; Then-Baez, Jossiell; Ugarte-Gil, Manuel F.; Cardiel, Mario H.; Colman, Nelly; Chavez, Nilmo; Burgos, Paula, I; Montufar, Ruben; Sandino, Sayonara; Fuentes-Silva, Yurilis J.; Soriano, Enrique R.The objective of our study was to describe knowledge, attitudes and practices of Latin-American rheumatology patients regarding management and follow-up of their disease during COVID-19 pandemic. A cross-sectional observational study was conducted using a digital anonymous survey. Rheumatic patients >= 18 years from non-English-speaking PANLAR countries were included. Our survey included 3502 rheumatic patients living in more than 19 Latin-American countries. Median age of patients was 45.8(36-55) years and the majority (88.9%) was female. Most frequently self-reported disease was rheumatoid arthritis (48.4%). At least one anti-rheumatic treatment was suspended by 23.4% of patients. Fear of contracting SARS-Cov2 (27.7%) and economic issues (25%) were the most common reasons for drug discontinuation. Self-rated disease activity increased from 30 (7-50) to 45 (10-70) points during the pandemic. Communication with their rheumatologist during the pandemic was required by 55.6% of patients, mainly by telephone calls (50.2%) and social network messages (47.8%). An adequate knowledge about COVID-19 was observed in 43% of patients. Patients with rheumatic diseases in Latin America were negatively affected by the COVID-19 pandemic. An increase in self-rated disease activity, a reduction in medication adherence, and hurdles for medical follow-up were reported. Teleconsultation was perceived as a valid alternative to in-person visits during the pandemic.
- ItemImpact of COVID-19 Pandemic on Rheumatology Practice in Latin America(2021) Fernandez-Avila, Daniel G.; Barahona-Correa, Julian; Romero-Alvernia, Diana; Kowalski, Sergio; Sapag, Ana; Cachafeiro-Vilar, Antonio; Melendez, Belia; Santiago-Pastelin, Carlos; Palleiro, Daniel; Arrieta, Dina; Reyes, Gil; Pons-Estel, Guillermo J.; Then-Baez, Jossiell; Ugarte-Gil, Manuel F.; Cardiel, Mario H.; Colman, Nelly; Chavez, Nilmo; Burgos, Paula, I; Montufar, Ruben; Sandino, Sayonara; Fuentes-Silva, Yurilis J.; Soriano, Enrique R.Objective. To describe the effect of the coronavirus disease 2019 (COVID-19) pandemic on Latin American rheumatologists from a professional, economic, and occupational point of view. Methods. We conducted an observational cross-sectional study using an online survey sent to rheuma-tologists of each non-English-speaking country member of the Pan American League of Rheumatology Associations (PANLAR). A specific questionnaire was developed. Results. Our survey included 1097 rheumatologists from 19 Latin American countries. Median (IQR) age of respondents was 48 (40-59) years and 618 (56.3%) were female. Duration of practice since graduation as a rheumatologist was 17 years, and 585 (53.3%) were aged < 50 years. Most rheumatologists worked in private practice (81.8%) and almost half worked in institutional outpatient centers (55%) and inpatient care (49.9%). The median number of weekly hours (IQR) of face-to-face practice before the pandemic was 27 (15-40) hours, but was reduced to 10 (5-20) hours during the pandemic. Telehealth was used by 866 (78.9%) respondents during the pandemic. Most common methods of communication were video calls (555; 50.6%), telephone calls (499; 45.5%), and WhatsApp voice calls (423; 38.6%). A reduction in monthly wages was reported by 946 (86.2%) respondents. Consultation fees also were reduced and 88 (8%) rheumatologists stated they had lost their jobs. A reduction in patient adherence to medication was reported by nearly 50% of respondents. Eighty-one (7.4%) rheumatologists received a COVID-19 diagnosis and 7 (8.6%) of them were hospitalized. Conclusion. The COVID-19 pandemic has reshaped rheumatology practice in Latin America and has had a profound effect on rheumatologists' behaviors and clinical practice.
- ItemManagement of Patients With Rheumatoid Arthritis in Latin America A Consensus Position Paper From Pan-American League of Associations of Rheumatology and Grupo Latino Americano De Estudio de Artritis Reumatoide(LIPPINCOTT WILLIAMS & WILKINS, 2009) Massardo, Loreto; Suarez Almazor, Maria E.; Cardiel, Mario H.; Nava, Arnulfo; Levy, Roger A.; Laurindo, Ieda; Soriano, Enrique R.; Acevedo Vazquez, Eduardo; Millan, Alberto; Pineda Villasenor, Carlos; Galarza Maldonado, Claudio; Caballero Uribe, Carlo V.; Espinosa Morales, Rolando; Pons Estel, Bernardo A.Objective: A consensus meeting of representatives of 18 Latin-American and Caribbean countries gathered in Renaca, Chile, for 2 days to identify problems and provide recommendations for the care of patients with rheumatoid arthritis (RA) in Latin America, a region where poverty and other health priorities make the efforts to provide effective and high quality care difficult. This report includes recommendations for health professionals, patients, and health authorities in Latin America, with an emphasis oil education and therapeutic issues.
- ItemRheumatology Training in Latin America A Collaborative Study by the Pan American League of Associations for Rheumatology(2022) Fernandez-Avila, Daniel G.; Patino-Hernandez, Daniela; Kowalskii, Sergio; Vargas-Caselles, Alfredo; Sapag, Ana Maria; Cachafeiro-Vilar, Antonio; Melendez, Belia; Santiago-Pastelin, Carlos; Graf, Cesar; Rossetto, Chayanne; Palleiro, Daniel; Trincado, Daniela; Fernandez-Avila, Diana Carolina; Arrieta, Dina; Reyes, Gil; Baez, Jossiel Then; Ugarte-Gil, Manuel F.; Cardiel, Mario; Colman, Nelly; Chavez, Nilmo; Burgos, Paula, I; Montufar, Ruben; Sandino, Sayonara; Fuentes-Silva, Yurilis; Soriano, Enrique R.Background/Objective Demand for rheumatology care has steadily increased in recent years. The number of specialists in this field, however, seems insufficient. No recent studies have diagnosed the attributes of rheumatology training in Latin America. Methods This is a descriptive cross-sectional study. We obtained data on each country through local rheumatologists of the Pan-American League Against Rheumatism, who acted as principal investigators for participating countries. Our sample was analyzed and described through means and standard deviations or through frequencies and percentages, depending on the variable. Results Countries with the most rheumatology-training programs were Brazil (n = 50), Argentina (n = 18), and Mexico (n = 15). Ecuador, Honduras, and Nicaragua do not have rheumatology-training programs. The countries with the most available slots for rheumatology residents were Brazil (n = 126) and Argentina (n = 36). To be admitted into rheumatology training, candidates were required to have completed graduate studies in internal medicine in 42.1% of the programs. In 8 countries (42.1%), residents are not required to pay tuition; the median cost of tuition in the remaining countries is US $528 (interquartile range, US $2153). Conclusions Conditions associated with rheumatology training in Latin America vary. Significant differences exist in income and tuition fees for residents, for example, and 4 countries in Latin America do not currently offer programs. Information collected in this study will be useful when comparing the status of rheumatology services offered in Latin America with those in other countries. Most countries require a wider offering of rheumatology-training programs, as well as more available slots.
- ItemSystematic and progressive implementation of the centers of excellence for rheumatoid arthritis: a methodological proposal(2017) Santos Moreno, Pedro; Caballero Uribe, Carlo V.; Massardo Vega, Loreto; Galarza Maldonado, Claudio; Soriano, Enrique R.; Pineda, Carlos; Cardiel, Mario; Benavides, Juan Alberto; Beltrán, Paula Andrea
- ItemThe number of flares patients experience impacts on damage accrual in systemic lupus erythematosus: data from a multiethnic Latin American cohort(2015) Ugarte-Gil, Manuel F.; Acevedo-Vásquez, Eduardo; Alarcón, Graciela S.; Pastor-Asurza, Cesar A.; Alfaro-Lozano, José L.; Cucho-Venegas, Jorge M.; Segami, Maria I.; Wojdyla, Daniel; Soriano, Enrique R.; Massardo Vega, Loreto
- ItemTherapeutic Guidelines for Latin American Lupus Patients Methodology(2018) Cardiel, Mario H.; Soriano, Enrique R.; Dutra de Oliveira Bonfa, Eloisa Silva; Alarcon, Graciela S.; Izcovich, Ariel; Amigo Castaneda, Mary Carmen; Barile-Fabris, Leonor A.; Duarte, Margarita; Espada, Graciela; Garcia, Mercedes A.; Levy, Roger A