This is a PDF file of an article that has undergone enhancements after acceptance, such as the ad... more This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.
RECIMUNDO: Revista Científica de la Investigación y el Conocimiento, 2019
Riesgos y cuidados a los pacientes diagnosticados con una meningitis bacteriana Risks and care fo... more Riesgos y cuidados a los pacientes diagnosticados con una meningitis bacteriana Risks and care for patients diagnosed with bacterial meningitis
El presente trabajo de titulacion tiene por objetivo dar a conocer los prototipos y estrategias a... more El presente trabajo de titulacion tiene por objetivo dar a conocer los prototipos y estrategias a seguir para la internacionalizacion de productos lacteos. La investigacion se desarrollo en la ciudad de Guayaquil con el apoyo de 39 empresas productoras de lacteos de dos potenciales provincias de Ecuador, Guayas y Pichincha, las mismas que fueron encuestadas con 8 preguntas con relacion al comercio lactifero. Se empleo un analisis de regresion lineal multiple correlacional para determinar si la elaboracion de un Plan de Marketing Estrategico incrementaria las exportaciones ecuatorianas de lacteos. De los resultados obtenidos en el modelo estadistico utilizado se determina nuestra hipotesis de investigacion como afirmativa, lo que nos lleva a concluir que las entidades comerciales que cuenten con caracteristicas expedidoras, deberian incluir dentro de su planificacion la elaboracion de un Plan de Marketing Estrategico que les permita tomar acciones e identificar estrategias y oportuni...
Background Rheumatology is considered a low-risk specialty, but studies have shown a prevalence o... more Background Rheumatology is considered a low-risk specialty, but studies have shown a prevalence of burnout between 42% and 51%. Objectives The aim was to determine the prevalence of burnout in rheumatologists in Latin America and the factors associated with it. Methods Cross-sectional study based on a survey completed through Google Forms platform that was sent by the national rheumatology associations of Latin America. Burnout was assessed with the Maslach Burnout Inventory. Data were analyzed using the statistical program SPSS v.22. Results Two hundred ninety-seven rheumatologists from 15 countries were included, mainly Argentina (28.3%), Brazil (26.3%), and Mexico (12.8%). The majority were women 62%, 42.4% worked in public hospitals with an average of 40.1 ± 14.2 hours per week; 31.3% did research, 13.1% clinical trials, 56.6% teaching, and 42.8% administrative work; 36% received an annual income less than $25,000; 56.6% had burnout in at least 1 dimension. Only 20.2% thought th...
The evolution of media has offered people easier access to information, which in turn has generat... more The evolution of media has offered people easier access to information, which in turn has generated a need for creating flexible content and providing a platform for expressing opinions. This trend especially impacts the food and beverage sector, which feels a constant pressure to meet the requirements of their influence groups and especially of consumers, who want to be informed about so-called healthy habits and dietary recommendations. This particular investigation focuses on evaluating the scientific precision that was applied in the publications of the digital newspapers El Mundo and El País during the months of February and March of 2019 in relation with the food and beverage sector and to what extent the number of these publications is an indication of the importance that is being attached to a scientific seal of approval. This scientific approval, in any case, should be demanded in any publication which is related to the health and certain consumer habits of readers.
Open Access Rheumatology: Research and Reviews, 2020
Introduction: Disability in RA is associated with loss of workdays, greater use of health resourc... more Introduction: Disability in RA is associated with loss of workdays, greater use of health resources and a higher prevalence of depression. The purpose of this study was to determine the prevalence of functional disability and the factors associated with it. Methods: A cross-sectional study was carried out during January-June 2019 at a rheumatology clinic in the city of Guayaquil. Patients with pre-established RA were included. Functional disability was measured using the HAQ-DI. Data were analyzed using the statistical program SPSS v22. We compared characteristics between patients with and without disability using Student's t-test and chi-square. A multiple logistic regression model for functional disability was made. Results: We included 395 patients, 87.8% female and 12.2% male with a mean age of 51.4±12 years and mean duration of disease 13.8±7 years. Most patients had extra-articular manifestations (80.8%) and comorbidities (81.3%). The mean HAQ-DI was 0.8±0.9, with a prevalence of disability of 26.6%. We found a statistically significant relationship between disability and female sex (p=0.018), age (p=0.020), presence of extra-articular manifestations (p=0.008), myalgia (p<0.001) and fatigue (p<0.001). In addition, patients with disabilities had a lower employment rate (26.7%) compared to those without disability (45.5%, p=0.001). In the multivariate logistic analysis, only depression (p=0.029), diabetes (p=0.003), SJC (p=0.001) and VAS of pain (p=0.004) were significantly related to functional disability. Conclusion: Disability affects a quarter of patients with RA. Among the determinants of disability, we found female sex, older age, grade of pain, inflammatory markers and the level of disease activity.
Background/objective Latin America has scarce information related to rheumatologist's education, ... more Background/objective Latin America has scarce information related to rheumatologist's education, working conditions, productivity, and job satisfaction. The purpose of this survey was to describe the training and clinical practice characteristics of the rheumatology community in Latin America. Methods This is a cross-sectional study. A digital survey was created, approved, and endorsed by the scientific committee of the Pan-American League of Associations for Rheumatology (PANLAR) and later sent to the rheumatology associations of the region. The data was analyzed in the statistical program SPSS v.22. Results We included 600 surveys of rheumatologists from 19 Latin American countries. The majority were females (53%) and mestizos (58%). The mean age was 46.8 ± 11.7 years. The most frequent workplace was public/government hospitals 33.5% followed by private practice 28.8%, private hospital 20.8%, and university hospital 15.5%. The average number of weekly working hours was 37.8 ± 17.7. 87.5% worked in adult rheumatology, 12.7% pediatric rheumatology, and 23.5% internal medicine. Average satisfaction with practice as a rheumatologist was 5.3/7, career options 4.3/7, location 4.7/7, income 3.5/7, job security 3.7/7, and colleagues and co-workers 4.5/7. Finally, 69.7% had an annual compensation of < 50,000 US dollars. Conclusions The majority of the rheumatologists in the region who responded were women, worked in public hospitals, and were satisfied with their clinical practice. There was a low level of income for the region. Key Points • This is the first study that showed the demographic and clinical practice characteristics of rheumatologists in Latin America. • The challenges faced by Latin rheumatologists are like those faced by the region: ethnic diversity, gender differences, migration, difficult access to education, limited research, and low income. • Due to the high prevalence of rheumatic diseases and the shortage of professionals in this area, it is essential to analyze the current workforce and the projections of supply and demand in rheumatology that are expected in the future.
El control interno ha sido institucionalizado dentro las entidades públicas como disposición de... more El control interno ha sido institucionalizado dentro las entidades públicas como disposición de las entidades reguladoras, sin embargo esta situación no es la misma dentro del sector privado debido a que no es obligatorio el control interno en ocasiones no se le da la importancia que requiere y se desestima su utilidad, es por esta razón que dentro de esta investigación se ha partido de un estudio documental de los antecedentes del control interno como punto inicial, para luego hacer una investigación de campo donde se efectuaron entrevistas y encuestas a empresas del sector privado con la finalidad de conocer la aplicación que se le da al control interno, y con estos resultados realizar un análisis minucioso para determinar las causas y posibles soluciones de la poca aplicabilidad de estas técnicas en este sector; se puede resaltar el hecho que si bien no es aplicado si es conocido por la mayoría su existencia y por lo tanto se lo lleva a una práctica empírica que no es técni...
SummaryDual-energy X-ray absorptiometry is recognized for measuring bone mineral density. The lac... more SummaryDual-energy X-ray absorptiometry is recognized for measuring bone mineral density. The lack of knowledge can lead to errors both in the acquisition of information and in its analysis and subsequent interpretation. The main errors in Ecuadorian Centers were positioning of the patient to the equipment and incorrect analyzed area.Purpose/introductionDual-energy X-ray absorptiometry (DXA) is recognized as the gold standard for measuring bone mineral density (BMD) with acceptable errors, good precision, and reproducibility. However, the training of operators in different centers and countries is not standardized, and the lack of knowledge can lead to errors both in the acquisition of information and in its analysis and subsequent interpretation. The purpose was to determine the most common errors in the performance of bone densitometry from different imaging centers in Ecuador.MethodsCross-sectional descriptive study. We collected DXA scans from different imaging centers in Ecuador. Data from the DXA scan included city of origin, type of specialist that requested it, and densitometry diagnosis. The DXA images provided were analyzed double blind by experts in the field from Argentina.ResultsFrom a total of 141 patients with a mean age of 61 ± 10 years, 93.6% were women. About 78% of the DXA scans came from private imaging centers and 22% from public centers, 95% of all came from the city of Guayaquil. The machines used were Hologic 50.4% and Lunar 49.6%. The densitometric diagnosis was 16.3% normal, 46.1% osteoporosis, and 37.6% osteopenia. A total of 112 left hip and 49 right hip scans were analyzed from which 31.2% and 22.4% had errors in patient positioning, respectively, mainly internal or external rotation. About 140 lumbar scans were analyzed from which 21.4% had patient positioning errors (not centered or not straight). Also in 38.5% the vertebral area did not correspond to L1-L4. About 3.5% had artifacts such as a metal bar or implant. The region of interest was misplaced in 24.1% of the lumbar scans and 19.9% of the femur.ConclusionsDXA quality standards exist but are often not implemented in clinical practice. When studies are performed incorrectly, it can lead to important errors in diagnosis and therapy. Physicians interested in the management of osteoporosis, although not directly involved in the performance and interpretation of DXA, should be familiar with the protocols to minimize errors and allow the proper use of bone densitometry.
Open Access Rheumatology: Research and Reviews, 2019
Purpose: To evaluate quality of life in patients with established rheumatoid arthritis (RA) and i... more Purpose: To evaluate quality of life in patients with established rheumatoid arthritis (RA) and identify the factors that negatively affect it. Methods: This was a cross-sectional study with patients with established RA from a rheumatology center in Ecuador. The RA Quality of Life (RAQoL) questionnaire was used to assess QoL and the Health Assessment Questionnairedisability index (HAQ-DI) questionnaire for functional capacity. In addition, demographics, clinical characteristics, and markers of disease activity were included. Data were analyzed using SPSS 22. Results: Of 186 patients, 89.8% were women, with a mean age of 51 years, 86.6% had symmetrical polyarticular involvement, 40.3% erosions, 46.8% morning stiffness, 46.8% xerophthalmia, and 39.2% fatigue. Depression was the most frequent comorbidity-42.5%. The mean HAQ-DI score was 0.8, and 26.9% had functional disability. The mean RAQoL score was 7.2. Xerophthalmia, xerostomia, fatigue, morning stiffness, and depression were related to higher scores in the RAQoL (p<0.05). The mean RAQoL was higher in patients with more disease activity and comorbidities (p<0.05). Likewise, patients with functional disability had a mean RAQoL score of 15.6 versus 4.1 in patients without disability (p<0.05). There were positive correlations between RAQoL and ESR, CRP, painful-joint count, swollen-joint count, VAS of pain, and physician assessment (p<0.05). Conclusion: QoL is severely affected in patients with RA. Depression, fatigue, morning stiffness, pain, high disease activity, and disability have a negative effect on QoL in RA. Likewise, patients with more comorbidities and extraarticular manifestations show worse QoL.
Revista Colombiana de Reumatología (English Edition), 2017
Introducción: La depresión es una importante comorbilidad en pacientes con artritis reumatoide; d... more Introducción: La depresión es una importante comorbilidad en pacientes con artritis reumatoide; diversos factores como la actividad de la enfermedad, el dolor y la discapacidad contribuyen a su desarrollo. Materiales y métodos: Se realizó un estudio transversal en pacientes con artritis reumatoide para determinar la prevalencia de depresión, utilizando el cuestionario Patient health questionnaire (PHQ-9) y su relación con la actividad de la enfermedad mediante DAS-28 y la discapacidad funcional mediante HAQ-DI. Resultados: El 42,9% de los pacientes presentaron depresión. Se encontró una asociación entre depresión con DAS-28 y HAQ-DI, ya que el 70% de los pacientes con alta actividad de la enfermedad y el 38% de los pacientes con discapacidad funcional presentaron depresión de moderada a grave. El número de articulaciones dolorosas y tumefactas fue mayor en los pacientes con depresión grave que en aquellos con depresión leve. Los pacientes con mayor depresión referían un dolor más intenso según la escala visual del dolor.
Resumen Introduccion La depresion es una importante comorbilidad en pacientes con artritis reumat... more Resumen Introduccion La depresion es una importante comorbilidad en pacientes con artritis reumatoide; diversos factores como la actividad de la enfermedad, el dolor y la discapacidad contribuyen a su desarrollo. Materiales y metodos Se realizo un estudio transversal en pacientes con artritis reumatoide para determinar la prevalencia de depresion, utilizando el cuestionario Patient health questionnaire (PHQ-9) y su relacion con la actividad de la enfermedad mediante DAS-28 y la discapacidad funcional mediante HAQ-DI. Resultados El 42,9% de los pacientes presentaron depresion. Se encontro una asociacion entre depresion con DAS-28 y HAQ-DI, ya que el 70% de los pacientes con alta actividad de la enfermedad y el 38% de los pacientes con discapacidad funcional presentaron depresion de moderada a grave. El numero de articulaciones dolorosas y tumefactas fue mayor en los pacientes con depresion grave que en aquellos con depresion leve. Los pacientes con mayor depresion referian un dolor mas intenso segun la escala visual del dolor.
El presente trabajo de graduación presenta el desarrollo práctico de una serie de análisis tribut... more El presente trabajo de graduación presenta el desarrollo práctico de una serie de análisis tributarios y estadísticos que permitan evidenciar el manejo de gastos deducibles en una empresa dedicada a la construcción y remodelación de espacios o locales comerciales en el Ecuador. Cuenta en primera instancia con una sólida base teórica que permite entender claramente el objetivo de la información a preparar para el cumplimiento de la legislación tributaria vigente para el periodo 2008. Luego se presenta una breve reseña que permita al lector entender el manejo del negocio y su diferenciación de los métodos constructivos clásicos, datos que son muy importantes para la comprensión de ciertos tratamientos contables y tributarios. Todos estos datos fueron analizados muy detalladamente dada las oportunidades de nuestro trabajo en la empresa y del conocimiento del negocio que nos brinda el tiempo de labores.
This is a PDF file of an article that has undergone enhancements after acceptance, such as the ad... more This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.
RECIMUNDO: Revista Científica de la Investigación y el Conocimiento, 2019
Riesgos y cuidados a los pacientes diagnosticados con una meningitis bacteriana Risks and care fo... more Riesgos y cuidados a los pacientes diagnosticados con una meningitis bacteriana Risks and care for patients diagnosed with bacterial meningitis
El presente trabajo de titulacion tiene por objetivo dar a conocer los prototipos y estrategias a... more El presente trabajo de titulacion tiene por objetivo dar a conocer los prototipos y estrategias a seguir para la internacionalizacion de productos lacteos. La investigacion se desarrollo en la ciudad de Guayaquil con el apoyo de 39 empresas productoras de lacteos de dos potenciales provincias de Ecuador, Guayas y Pichincha, las mismas que fueron encuestadas con 8 preguntas con relacion al comercio lactifero. Se empleo un analisis de regresion lineal multiple correlacional para determinar si la elaboracion de un Plan de Marketing Estrategico incrementaria las exportaciones ecuatorianas de lacteos. De los resultados obtenidos en el modelo estadistico utilizado se determina nuestra hipotesis de investigacion como afirmativa, lo que nos lleva a concluir que las entidades comerciales que cuenten con caracteristicas expedidoras, deberian incluir dentro de su planificacion la elaboracion de un Plan de Marketing Estrategico que les permita tomar acciones e identificar estrategias y oportuni...
Background Rheumatology is considered a low-risk specialty, but studies have shown a prevalence o... more Background Rheumatology is considered a low-risk specialty, but studies have shown a prevalence of burnout between 42% and 51%. Objectives The aim was to determine the prevalence of burnout in rheumatologists in Latin America and the factors associated with it. Methods Cross-sectional study based on a survey completed through Google Forms platform that was sent by the national rheumatology associations of Latin America. Burnout was assessed with the Maslach Burnout Inventory. Data were analyzed using the statistical program SPSS v.22. Results Two hundred ninety-seven rheumatologists from 15 countries were included, mainly Argentina (28.3%), Brazil (26.3%), and Mexico (12.8%). The majority were women 62%, 42.4% worked in public hospitals with an average of 40.1 ± 14.2 hours per week; 31.3% did research, 13.1% clinical trials, 56.6% teaching, and 42.8% administrative work; 36% received an annual income less than $25,000; 56.6% had burnout in at least 1 dimension. Only 20.2% thought th...
The evolution of media has offered people easier access to information, which in turn has generat... more The evolution of media has offered people easier access to information, which in turn has generated a need for creating flexible content and providing a platform for expressing opinions. This trend especially impacts the food and beverage sector, which feels a constant pressure to meet the requirements of their influence groups and especially of consumers, who want to be informed about so-called healthy habits and dietary recommendations. This particular investigation focuses on evaluating the scientific precision that was applied in the publications of the digital newspapers El Mundo and El País during the months of February and March of 2019 in relation with the food and beverage sector and to what extent the number of these publications is an indication of the importance that is being attached to a scientific seal of approval. This scientific approval, in any case, should be demanded in any publication which is related to the health and certain consumer habits of readers.
Open Access Rheumatology: Research and Reviews, 2020
Introduction: Disability in RA is associated with loss of workdays, greater use of health resourc... more Introduction: Disability in RA is associated with loss of workdays, greater use of health resources and a higher prevalence of depression. The purpose of this study was to determine the prevalence of functional disability and the factors associated with it. Methods: A cross-sectional study was carried out during January-June 2019 at a rheumatology clinic in the city of Guayaquil. Patients with pre-established RA were included. Functional disability was measured using the HAQ-DI. Data were analyzed using the statistical program SPSS v22. We compared characteristics between patients with and without disability using Student's t-test and chi-square. A multiple logistic regression model for functional disability was made. Results: We included 395 patients, 87.8% female and 12.2% male with a mean age of 51.4±12 years and mean duration of disease 13.8±7 years. Most patients had extra-articular manifestations (80.8%) and comorbidities (81.3%). The mean HAQ-DI was 0.8±0.9, with a prevalence of disability of 26.6%. We found a statistically significant relationship between disability and female sex (p=0.018), age (p=0.020), presence of extra-articular manifestations (p=0.008), myalgia (p<0.001) and fatigue (p<0.001). In addition, patients with disabilities had a lower employment rate (26.7%) compared to those without disability (45.5%, p=0.001). In the multivariate logistic analysis, only depression (p=0.029), diabetes (p=0.003), SJC (p=0.001) and VAS of pain (p=0.004) were significantly related to functional disability. Conclusion: Disability affects a quarter of patients with RA. Among the determinants of disability, we found female sex, older age, grade of pain, inflammatory markers and the level of disease activity.
Background/objective Latin America has scarce information related to rheumatologist's education, ... more Background/objective Latin America has scarce information related to rheumatologist's education, working conditions, productivity, and job satisfaction. The purpose of this survey was to describe the training and clinical practice characteristics of the rheumatology community in Latin America. Methods This is a cross-sectional study. A digital survey was created, approved, and endorsed by the scientific committee of the Pan-American League of Associations for Rheumatology (PANLAR) and later sent to the rheumatology associations of the region. The data was analyzed in the statistical program SPSS v.22. Results We included 600 surveys of rheumatologists from 19 Latin American countries. The majority were females (53%) and mestizos (58%). The mean age was 46.8 ± 11.7 years. The most frequent workplace was public/government hospitals 33.5% followed by private practice 28.8%, private hospital 20.8%, and university hospital 15.5%. The average number of weekly working hours was 37.8 ± 17.7. 87.5% worked in adult rheumatology, 12.7% pediatric rheumatology, and 23.5% internal medicine. Average satisfaction with practice as a rheumatologist was 5.3/7, career options 4.3/7, location 4.7/7, income 3.5/7, job security 3.7/7, and colleagues and co-workers 4.5/7. Finally, 69.7% had an annual compensation of < 50,000 US dollars. Conclusions The majority of the rheumatologists in the region who responded were women, worked in public hospitals, and were satisfied with their clinical practice. There was a low level of income for the region. Key Points • This is the first study that showed the demographic and clinical practice characteristics of rheumatologists in Latin America. • The challenges faced by Latin rheumatologists are like those faced by the region: ethnic diversity, gender differences, migration, difficult access to education, limited research, and low income. • Due to the high prevalence of rheumatic diseases and the shortage of professionals in this area, it is essential to analyze the current workforce and the projections of supply and demand in rheumatology that are expected in the future.
El control interno ha sido institucionalizado dentro las entidades públicas como disposición de... more El control interno ha sido institucionalizado dentro las entidades públicas como disposición de las entidades reguladoras, sin embargo esta situación no es la misma dentro del sector privado debido a que no es obligatorio el control interno en ocasiones no se le da la importancia que requiere y se desestima su utilidad, es por esta razón que dentro de esta investigación se ha partido de un estudio documental de los antecedentes del control interno como punto inicial, para luego hacer una investigación de campo donde se efectuaron entrevistas y encuestas a empresas del sector privado con la finalidad de conocer la aplicación que se le da al control interno, y con estos resultados realizar un análisis minucioso para determinar las causas y posibles soluciones de la poca aplicabilidad de estas técnicas en este sector; se puede resaltar el hecho que si bien no es aplicado si es conocido por la mayoría su existencia y por lo tanto se lo lleva a una práctica empírica que no es técni...
SummaryDual-energy X-ray absorptiometry is recognized for measuring bone mineral density. The lac... more SummaryDual-energy X-ray absorptiometry is recognized for measuring bone mineral density. The lack of knowledge can lead to errors both in the acquisition of information and in its analysis and subsequent interpretation. The main errors in Ecuadorian Centers were positioning of the patient to the equipment and incorrect analyzed area.Purpose/introductionDual-energy X-ray absorptiometry (DXA) is recognized as the gold standard for measuring bone mineral density (BMD) with acceptable errors, good precision, and reproducibility. However, the training of operators in different centers and countries is not standardized, and the lack of knowledge can lead to errors both in the acquisition of information and in its analysis and subsequent interpretation. The purpose was to determine the most common errors in the performance of bone densitometry from different imaging centers in Ecuador.MethodsCross-sectional descriptive study. We collected DXA scans from different imaging centers in Ecuador. Data from the DXA scan included city of origin, type of specialist that requested it, and densitometry diagnosis. The DXA images provided were analyzed double blind by experts in the field from Argentina.ResultsFrom a total of 141 patients with a mean age of 61 ± 10 years, 93.6% were women. About 78% of the DXA scans came from private imaging centers and 22% from public centers, 95% of all came from the city of Guayaquil. The machines used were Hologic 50.4% and Lunar 49.6%. The densitometric diagnosis was 16.3% normal, 46.1% osteoporosis, and 37.6% osteopenia. A total of 112 left hip and 49 right hip scans were analyzed from which 31.2% and 22.4% had errors in patient positioning, respectively, mainly internal or external rotation. About 140 lumbar scans were analyzed from which 21.4% had patient positioning errors (not centered or not straight). Also in 38.5% the vertebral area did not correspond to L1-L4. About 3.5% had artifacts such as a metal bar or implant. The region of interest was misplaced in 24.1% of the lumbar scans and 19.9% of the femur.ConclusionsDXA quality standards exist but are often not implemented in clinical practice. When studies are performed incorrectly, it can lead to important errors in diagnosis and therapy. Physicians interested in the management of osteoporosis, although not directly involved in the performance and interpretation of DXA, should be familiar with the protocols to minimize errors and allow the proper use of bone densitometry.
Open Access Rheumatology: Research and Reviews, 2019
Purpose: To evaluate quality of life in patients with established rheumatoid arthritis (RA) and i... more Purpose: To evaluate quality of life in patients with established rheumatoid arthritis (RA) and identify the factors that negatively affect it. Methods: This was a cross-sectional study with patients with established RA from a rheumatology center in Ecuador. The RA Quality of Life (RAQoL) questionnaire was used to assess QoL and the Health Assessment Questionnairedisability index (HAQ-DI) questionnaire for functional capacity. In addition, demographics, clinical characteristics, and markers of disease activity were included. Data were analyzed using SPSS 22. Results: Of 186 patients, 89.8% were women, with a mean age of 51 years, 86.6% had symmetrical polyarticular involvement, 40.3% erosions, 46.8% morning stiffness, 46.8% xerophthalmia, and 39.2% fatigue. Depression was the most frequent comorbidity-42.5%. The mean HAQ-DI score was 0.8, and 26.9% had functional disability. The mean RAQoL score was 7.2. Xerophthalmia, xerostomia, fatigue, morning stiffness, and depression were related to higher scores in the RAQoL (p<0.05). The mean RAQoL was higher in patients with more disease activity and comorbidities (p<0.05). Likewise, patients with functional disability had a mean RAQoL score of 15.6 versus 4.1 in patients without disability (p<0.05). There were positive correlations between RAQoL and ESR, CRP, painful-joint count, swollen-joint count, VAS of pain, and physician assessment (p<0.05). Conclusion: QoL is severely affected in patients with RA. Depression, fatigue, morning stiffness, pain, high disease activity, and disability have a negative effect on QoL in RA. Likewise, patients with more comorbidities and extraarticular manifestations show worse QoL.
Revista Colombiana de Reumatología (English Edition), 2017
Introducción: La depresión es una importante comorbilidad en pacientes con artritis reumatoide; d... more Introducción: La depresión es una importante comorbilidad en pacientes con artritis reumatoide; diversos factores como la actividad de la enfermedad, el dolor y la discapacidad contribuyen a su desarrollo. Materiales y métodos: Se realizó un estudio transversal en pacientes con artritis reumatoide para determinar la prevalencia de depresión, utilizando el cuestionario Patient health questionnaire (PHQ-9) y su relación con la actividad de la enfermedad mediante DAS-28 y la discapacidad funcional mediante HAQ-DI. Resultados: El 42,9% de los pacientes presentaron depresión. Se encontró una asociación entre depresión con DAS-28 y HAQ-DI, ya que el 70% de los pacientes con alta actividad de la enfermedad y el 38% de los pacientes con discapacidad funcional presentaron depresión de moderada a grave. El número de articulaciones dolorosas y tumefactas fue mayor en los pacientes con depresión grave que en aquellos con depresión leve. Los pacientes con mayor depresión referían un dolor más intenso según la escala visual del dolor.
Resumen Introduccion La depresion es una importante comorbilidad en pacientes con artritis reumat... more Resumen Introduccion La depresion es una importante comorbilidad en pacientes con artritis reumatoide; diversos factores como la actividad de la enfermedad, el dolor y la discapacidad contribuyen a su desarrollo. Materiales y metodos Se realizo un estudio transversal en pacientes con artritis reumatoide para determinar la prevalencia de depresion, utilizando el cuestionario Patient health questionnaire (PHQ-9) y su relacion con la actividad de la enfermedad mediante DAS-28 y la discapacidad funcional mediante HAQ-DI. Resultados El 42,9% de los pacientes presentaron depresion. Se encontro una asociacion entre depresion con DAS-28 y HAQ-DI, ya que el 70% de los pacientes con alta actividad de la enfermedad y el 38% de los pacientes con discapacidad funcional presentaron depresion de moderada a grave. El numero de articulaciones dolorosas y tumefactas fue mayor en los pacientes con depresion grave que en aquellos con depresion leve. Los pacientes con mayor depresion referian un dolor mas intenso segun la escala visual del dolor.
El presente trabajo de graduación presenta el desarrollo práctico de una serie de análisis tribut... more El presente trabajo de graduación presenta el desarrollo práctico de una serie de análisis tributarios y estadísticos que permitan evidenciar el manejo de gastos deducibles en una empresa dedicada a la construcción y remodelación de espacios o locales comerciales en el Ecuador. Cuenta en primera instancia con una sólida base teórica que permite entender claramente el objetivo de la información a preparar para el cumplimiento de la legislación tributaria vigente para el periodo 2008. Luego se presenta una breve reseña que permita al lector entender el manejo del negocio y su diferenciación de los métodos constructivos clásicos, datos que son muy importantes para la comprensión de ciertos tratamientos contables y tributarios. Todos estos datos fueron analizados muy detalladamente dada las oportunidades de nuestro trabajo en la empresa y del conocimiento del negocio que nos brinda el tiempo de labores.
Uploads
Papers by maria intriago