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Ítem Chronic joint pain 3 years after chikungunya virus infection largely characterized by relapsing-remitting symptoms(The Journal of Rheumatology Publishing, 2019) Tritsch, Sarah R.; Encinales, Liliana; Pacheco, Nelly; Cadena, Andres; Cure, Carlos; McMahon, Elizabeth; Watson, Hugh; Porras Ramirez, Alexandra; Rico Mendoza, Alejandro; Li, Guangzhao; Khurana, Kunal; Jaller-Radd, Juan Jose; Mejia Castillo, Stella; Barrios Taborda, Onaldo; Jaller Char, Alejandro; Jaller-Char, Juan Jose; Avendaño Echávez, Lil Geraldine ; Jiménez, Dennys; Gonzalez Coba, Andres; Alarcón Gómez, Magda; Ariza Orozco, Dores; Bravo, Eyda; Martinez, Victor; Guerra, Brenda; Simon, Gary; Firestein, Gary S.; Chang, Aileen Y.Objective. To determine the frequency of chronic joint pain and stiffness 3 years after infection with chikungunya virus in a Latin American cohort. Methods. A cross-sectional follow-up of 120 patients from an initial cohort of 500 patients who reported joint pain 2 years after infection from the Atlántico Department, Colombia. Patients were clinically diagnosed as having chikungunya virus during the 2014–2015 epidemic, and baseline and follow-up symptoms at 40 months were evaluated in serologically confirmed cases. Results. Of the initial 500 patients enrolled in the study, 482 had serologically confirmed chikungunya infection. From this group, 123 patients reported joint pain 20 months after infection, and 54% of those patients reported continued joint pain 40 months after infection. Therefore, 1 out of every 8 people who tested serologically positive for chikungunya infection had persistent joint pain 3 years after infection. Participants that followed up in-person were predominantly adult (mean ± SD age 51 ± 14 years) and female (86%). The most common type of pain reported in these patients at 40 months post-infection was pain with periods of relief and subsequent reoccurrence, and over 75% reported stiffness after immobility, with 39% experiencing morning stiffness. Conclusion. This is the first report to describe persistent joint pain and stiffness 40 months after viral infection. The high frequency of chronic disease highlights the need to develop prevention and treatment methods. Further studies should be conducted to understand the similarities between post-chikungunya joint pain and rheumatoid arthritis.Ítem Clinical and Immunological Factors Associated with the Progression of Lupus Nephritis in a Population from the Colombian Caribbean(MDPI, 2024) Vélez-Verbel, María; Aroca-Martinez, Gustavo; Vélez-Verbel, David; Domínguez-Vargas, Alex; Vallejo-Patino, Manuela; Sarmiento-Gutierrez, Joanny; Gómez-Escorcia, Lorena; Musso, Carlos G. ; González-Torres, Henry J.Lupus nephritis represents a significant immune-mediated glomerulonephritis, constituting the most important organ involvement induced by systemic lupus erythematosus (SLE), with variable epidemiology and clinical presentation among populations. Objective: to identify clinical and immunological factors associated with the progression of lupus nephritis in a population from the Colombian Caribbean. Methods: we evaluated 401 patients diagnosed with SLE and lupus nephritis, treated at a reference center in the Colombian Caribbean, gathering data recorded in medical records. Results: A proportion of 87% were female, with a median age of 42 years. Most patients presented with proliferative classes (90%), with class IV being the most common (70%). A proportion of 52% of patients did not respond to treatment, which is described as the lack of complete or partial response, while 28% had a complete response. A significant decrease in hemoglobin, glomerular filtration rate, and proteinuria was identified by the third follow-up (p < 0.001), along with an increase in creatinine, urea, and hematuria (p < 0.001). Patients with initial proteinuria > 2 g/day were found to be 27 times more likely to be non-responders (p < 0.001). Mortality was associated with the presence of serum creatinine >1.5 mg/dL (p = 0.01) (OR: 1.61 CI 95% 0.75–3.75) and thrombocytopenia (p = 0.01) (OR: 0.36; CI 95% 0.12–0.81). Conclusions: identifying factors of progression, non-response, and mortality provides an opportunity for more targeted and personalized intervention, thereby improving care and outcomes for patients with lupus nephritis.Ítem Infective endocarditis in the colombian caribbean region: clinical profile, microbiological insights, and risk factors for mortality(ACADEMIA NACIONAL DE MEDICINA, 2023) Solarte Bastidas, Gabriela; Herrera Calle, Pedro; Domínguez-Vargas, Alex; Iglesias Pertuz, Shirley; González-Torres, Henry J.Infective endocarditis (IE) is defined as the infectious and inflammatory process of the heart’s internal structures. It can be caused by a broad group of bacteria and, rarely, fungi, with potentially life-threatening consequences. Objective: To profile bacterial resistance and identify mortality risk factors in IE patients. Methods: This crosssectional study included clinically diagnosed IE patients. Sociodemographic, comorbidity, clinical, and microbiological data were recorded. Descriptive analyses, Chi-Square/Fisher’s exact tests, and Student’s t-tests examined variables in relation to IE outcomes (survival vs. mortality). Multivariate logistic regression calculated odds ratios and confidence intervals. Results: We enrolled 39 patients (mean age 51 ± 19.5 years, 54 % male). Common comorbidities included acute kidney injury (AKI) (46 %), heart failure (26 %), and ischemic stroke (21 %). Deceased patients had higher rates of fatigue (p=0.03), lower limb edema (p=0.01), and AKI (p=0.01) than survivors. Fifteen (38 %) patients had positive cultures; Staphylococcus aureus predominated in survivors (13 %) and deceased (13 %) patients (p=0.06). Multi-drug-resistant bacteria were found in six (15 %) patients, and one (2.6 %) had Extensively Drug-Resistant bacteria. Multivariate Logistic Regression indicated that lower limb edema (OR 8.6, 95 % CI 1.5–49, p=0.01), and AKI (OR 7.8, 95 % CI 1.65–37.2, p=0.01) increased mortality risk in IE patients. Conclusion: In this study, lower limb edema and AKI were significant predictors of mortality in IE patients, emphasizing their clinical importance in IE progression and resolution. Further research should explore additional variables and risk factors to enhance our ability to predict and manage outcomes in this population.