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Ramirez P, Giglio A, Verdugo J, Gutierrez F. Induction treatment for lupus nephritis at a high-complexity hospital in Chile. Lupus 2024:9612033241249574. [PMID: 38652826 DOI: 10.1177/09612033241249574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/25/2024]
Abstract
INTRODUCTION Systemic lupus erythematosus (SLE) causes kidney compromise in up to 40% of patients, contributing significantly to morbidity. Lupus nephritis (LN), an early onset manifestation in most patients, is histologically classified into six types, with types III, IV, and V requiring treatment with induction therapies, usually glucocorticoids with mycophenolate mofetil (MMF) or intravenous cyclophosphamide (IVC). However, up to 60% of patients fail to achieve complete remission, and 27%-66% have subsequent flares. There is scarce literature on the superiority of IVC or MMF in the Latin population. METHODOLOGY A retrospective cohort study of 72 LN patients at a high-complexity hospital in Chile between 2016 and 2021 was conducted. Demographics, urine studies, creatinine levels, complement levels, antibody profiles, biopsy results, and response to treatment were analysed. RESULTS The median age of the cohort was 29 years, with women representing 90% of patients. At diagnosis, 87.5% of the patients presented with proteinuria, 55% had haematuria, and 49% had acute kidney injury. The most common LN type was type IV. For induction therapy, half of the patients were treated with IVC, and the other half with MMF. The response to treatment did not differ significantly between the two. DISCUSSION This is one of the few studies to focus on the Latin American population, specifically Chile. These results are consistent with the current understanding of LN treatment. Despite its limitations, this study provides valuable insights into the treatment effectiveness of IVC and MMF in this population. CONCLUSION This study did not find significant differences in the clinical response to IVC or MMF at 6 months. Future prospective studies are required to determine the optimal induction therapy for LN, especially in Latin populations.
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Affiliation(s)
- Paulina Ramirez
- Rheumatology Unit, Complejo Asistencial Dr Sótero del Río, Puente Alto, Chile
- Internal Medicine Department, Complejo Asistencial, Dr Sótero del Río, Puente Alto, Chile
| | - Andres Giglio
- Critical Care Department, Finis Terrae University, Santiago, Chile
- Critical Care Department, Clínica Las Condes Hospital, Las Condes, Chile
| | - Jorge Verdugo
- Internal Medicine Department, Complejo Asistencial, Dr Sótero del Río, Puente Alto, Chile
| | - Francisco Gutierrez
- Rheumatology Unit, Complejo Asistencial Dr Sótero del Río, Puente Alto, Chile
- Internal Medicine Department, Complejo Asistencial, Dr Sótero del Río, Puente Alto, Chile
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Espino A, Vargas JI, Mancilla C, Muñoz P, Martínez W, Menéndez A, Jara D, Mansilla R, Schiappacasse G, Santamarina M, Huete Á, Candia R, Silva F, Castillo C, Richter H, Mejía R, Vial P, Robles I, Martínez J, Jarufe N, Briceño E, Lembach H, Zoroquiain P, Roa JC, Walker K, Torres J, Carreño L, Castiblanco A, Fernández W, Ríos Á, Chandia J, Ayala MJ, Rojas T, Verdugo J, Berger Z. [Chilean consensus on diagnosis and management of pancreatic cystic neoplasms]. Rev Med Chil 2021; 149:1773-1786. [PMID: 35735345 DOI: 10.4067/s0034-98872021001201773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Accepted: 12/15/2021] [Indexed: 12/29/2022]
Abstract
Pancreatic cystic neoplasms (PCN) are frequently detected on abdominal images performed for non-pancreatic indications. Their prevalence in asymptomatic population ranges from 2.7 to 24.8%, and increases with age. There are several types of pancreatic cysts. Some may contain cancer or have malignant potential, such as mucinous cystic neoplasms, including mucinous cystadenoma (MCN) and intraductal papillary mucinous neoplasms (IPMN). In contrast, others are benign, such as serous cystadenoma (SCA). However, even those cysts with malignant potential rarely progress to cancer. Currently, the only treatment for pancreatic cysts is surgery, which is associated with high morbidity and occasional mortality. The Board of the Chilean Pancreas Club of the Chilean Gastroenterology Society developed the first Chilean multidisciplinary consensus for diagnosis, management, and surveillance of PCN. Thirty experts were invited and answered 21 statements with five possible alternatives: 1) fully agree; 2) partially agree; 3) undecided; 4) disagree and 5) strongly disagree. A consensus was adopted when at least 80% of the sum of the answers "fully agree" and "partially agree" was reached. The consensus was approved by the Board of Directors of the Chilean Pancreas Club for publication.
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Affiliation(s)
- Alberto Espino
- Departamento de Gastroenterología, Hospital Clínico UC-Christus, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - José Ignacio Vargas
- Departamento de Gastroenterología, Hospital Clínico UC-Christus, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Carla Mancilla
- Departamento de Medicina, Hospital Clínico, Universidad de Chile, Santiago, Chile
| | - Pablo Muñoz
- Departamento de Medicina, Hospital Clínico, Universidad de Chile, Santiago, Chile
| | - Waldo Martínez
- Cirugía Digestiva, Clínica Colonial, Huechuraba, Santiago, Chile
| | | | | | - Rodrigo Mansilla
- Facultad de Medicina y Ciencia, Universidad San Sebastián, Puerto Montt, Chile
| | - Giancarlo Schiappacasse
- Departamento de Radiología, Facultad de Medicina, Universidad de Desarrollo, Santiago, Chile
| | - Mario Santamarina
- Departamento de Radiología, Hospital Naval Almirante Nef, Viña del Mar, Valparaíso, Chile
| | - Álvaro Huete
- Departamento de Radiología, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Roberto Candia
- Departamento de Gastroenterología, Hospital Clínico UC-Christus, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Felipe Silva
- Hospital Regional de Coyhaique, Coyhaique, Chile
| | - Cecilia Castillo
- Cirugía Endoscópica, Hospital Clínico San Borja Arriarán; Endoscopía, Clínica Alemana de Santiago, Santiago, Chile
| | - Hugo Richter
- Departamento de Cirugía Digestiva, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Ricardo Mejía
- Departamento de Cirugía Digestiva, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Paula Vial
- Departamento de Gastroenterología, Clínica Alemana de Santiago, Santiago, Chile
| | | | - Jorge Martínez
- Departamento de Cirugía Digestiva, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
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Verdugo J, Mena A, Cavada G, Silva C, Ramos C, Varela C, Diaz J, Alegria J. Correlation Between Non-contrast Chest CT Findings And Clinical Outcomes In Hospitalized Patients With Covid-19 Pneumonia With Positive PCR For SARS-Cov-2 During The First Wave. J Cardiovasc Comput Tomogr 2021. [PMCID: PMC8280283 DOI: 10.1016/j.jcct.2021.06.233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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