Browsing by Author "Ugarte-Gil, Manuel F."

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    Current 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.
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    Impact 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.
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    Impact 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.
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    Performance of the 2019 American College of Rheumatology/European League Against Rheumatism Classification Criteria for IgG4-Related Disease in a Latin American Cohort
    (2024) Martin-Nares, Eduardo; Hernandez-Molina, Gabriela; Baenas, Diego Federico; Delgado de la Mora, Jesus; Caeiro, Francisco; Wurmann Kiblisky, Pamela; Pimentel-Quiroz, Victor R.; Ascuna Valdivia, Valery; Faz-Munoz, David; Saad, Emanuel Jose; Cairoli, Ernesto; Elgueta Pinochet, Sergio; Madariaga Charaja, Hugo; Montante-Montes de Oca, Daniel; Gallo, Jesica Romina; Ugarte-Gil, Manuel F.; Neira, Oscar; Burgos, Paula I.; Paira, Sergio
    Background/ObjectiveThe 2019 American College of Rheumatology/European League Against Rheumatism Classification Criteria (2019 AECC) for IgG4-related disease (IgG4-RD) is considered a significant advancement in the study of this condition. Most studies evaluating their performance have focused on White and Asian patients, leaving a knowledge gap regarding Latin American populations. Therefore, this study aimed to assess the performance of the 2019 AECC for IgG4-RD in a cohort of Latin American patients.MethodsA multicenter medical records review study was conducted, involving centers from Argentina, Chile, Mexico, Peru, and Uruguay. Data on IgG4-RD patients and mimicker conditions were collected through a standardized online form. The criterion standard for diagnosing IgG4-RD was based on the fulfillment of the Comprehensive Diagnostic Criteria for IgG4-RD and/or the Consensus Statement on Pathology. The 2019 AECC was retrospectively applied.ResultsWe included 300 patients, with 180 (60%) having IgG4-RD and 120 (40%) having mimicker conditions. The 2019 AECC had a sensitivity of 66.7% and a specificity of 100%. Sensitivity increased to 73.3% when disease-specific autoantibody items were removed, without affecting specificity. The true-positive cases had more involved organs, a higher availability of biopsy results, and were more likely to belong to the Mikulicz/systemic and proliferative phenotypes.ConclusionsThe use of the 2019 AECC for IgG4-RD in a Latin American population confirms its high specificity in excluding those without the disease. The presence of concomitant autoimmune diseases and clinically nonsignificant disease-specific autoantibodies excludes a significant number of patients from fulfilling the criteria.
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    Rheumatology 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.
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    The 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