Predictive models of infection in patients with systemic lupus erythematosus: A systematic literature review / Paula Andrea Granda Carvajal  

Público ISBD Título : Predictive models of infection in patients with systemic lupus erythematosus: A systematic literature review Tipo de documento : documento electrónico Autores : Paula Andrea Granda Carvajal, Fecha de publicación : 2021 Títulos uniformes : Lupus Idioma : Inglés (eng) Palabras clave : Systemic lupus erythematosus  clinical prediction models  infection  prognosis  systematic literature review Resumen : Introduction: Having reliable predictive models of prognosis/the risk of infection in systemic lupus erythematosus (SLE) patients would allow this problem to be addressed on an individual basis to study and implement possible preventive or therapeutic interventions. Objective: To identify and analyze all predictive models of prognosis/the risk of infection in patients with SLE that exist in medical literature. Methods: A structured search in PubMed, Embase, and LILACS databases was carried out until May 9, 2020. In addition, a search for abstracts in the American Congress of Rheumatology (ACR) and European League Against Rheumatism (EULAR) annual meetings' archives published over the past eight years was also conducted. Studies on developing, validating or updating predictive prognostic models carried out in patients with SLE, in which the outcome to be predicted is some type of infection, that were generated in any clinical context and with any time horizon were included. There were no restrictions on language, date, or status of the publication. To carry out the systematic review, the CHARMS (Critical Appraisal and Data Extraction for Systematic Reviews of Prediction Modelling Studies) guideline recommendations were followed. The PROBAST tool (A Tool to Assess the Risk of Bias and Applicability of Prediction Model Studies) was used to assess the risk of bias and the applicability of each model. Results: We identified four models of infection prognosis in patients with SLE. Mostly, there were very few events per candidate predictor. In addition, to construct the models, an initial selection was made based on univariate analyses with no contraction of the estimated coefficients being carried out. This suggests that the proposed models have a high probability of overfitting and being optimistic. Conclusions: To date, very few prognostic models have been published on the infection of SLE patients. These models are very heterogeneous and are rated as having a high risk of bias and methodological weaknesses. Despite the widespread recognition of the frequency and severity of infections in SLE patients, there is no reliable predictive prognostic model that facilitates the study and implementation of personalized preventive or therapeutic measures.Protocol registration number: PROSPERO CRD42020171638. Mención de responsabilidad : Mauricio Restrepo-Escobar, Paula A Granda-Carvajal, Daniel C Aguirre, Johanna Hernández-Zapata, Gloria M Vásquez, Fabián Jaimes Referencia : Lupus. 2021 Mar;30(3):421-430. DOI (Digital Object Identifier) : 10.1177/0961203320983462 PMID : 33407048 En línea : https://journals.sagepub.com/doi/10.1177/0961203320983462 Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=5763 Predictive models of infection in patients with systemic lupus erythematosus: A systematic literature review [documento electrónico] / Paula Andrea Granda Carvajal,  . - 2021. Obra : Lupus Idioma : Inglés (eng) Palabras clave : Systemic lupus erythematosus  clinical prediction models  infection  prognosis  systematic literature review Resumen : Introduction: Having reliable predictive models of prognosis/the risk of infection in systemic lupus erythematosus (SLE) patients would allow this problem to be addressed on an individual basis to study and implement possible preventive or therapeutic interventions. Objective: To identify and analyze all predictive models of prognosis/the risk of infection in patients with SLE that exist in medical literature. Methods: A structured search in PubMed, Embase, and LILACS databases was carried out until May 9, 2020. In addition, a search for abstracts in the American Congress of Rheumatology (ACR) and European League Against Rheumatism (EULAR) annual meetings' archives published over the past eight years was also conducted. Studies on developing, validating or updating predictive prognostic models carried out in patients with SLE, in which the outcome to be predicted is some type of infection, that were generated in any clinical context and with any time horizon were included. There were no restrictions on language, date, or status of the publication. To carry out the systematic review, the CHARMS (Critical Appraisal and Data Extraction for Systematic Reviews of Prediction Modelling Studies) guideline recommendations were followed. The PROBAST tool (A Tool to Assess the Risk of Bias and Applicability of Prediction Model Studies) was used to assess the risk of bias and the applicability of each model. Results: We identified four models of infection prognosis in patients with SLE. Mostly, there were very few events per candidate predictor. In addition, to construct the models, an initial selection was made based on univariate analyses with no contraction of the estimated coefficients being carried out. This suggests that the proposed models have a high probability of overfitting and being optimistic. Conclusions: To date, very few prognostic models have been published on the infection of SLE patients. These models are very heterogeneous and are rated as having a high risk of bias and methodological weaknesses. Despite the widespread recognition of the frequency and severity of infections in SLE patients, there is no reliable predictive prognostic model that facilitates the study and implementation of personalized preventive or therapeutic measures.Protocol registration number: PROSPERO CRD42020171638. Mención de responsabilidad : Mauricio Restrepo-Escobar, Paula A Granda-Carvajal, Daniel C Aguirre, Johanna Hernández-Zapata, Gloria M Vásquez, Fabián Jaimes Referencia : Lupus. 2021 Mar;30(3):421-430. DOI (Digital Object Identifier) : 10.1177/0961203320983462 PMID : 33407048 En línea : https://journals.sagepub.com/doi/10.1177/0961203320983462 Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=5763

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Factors associated with infection amongst paediatric patients with systemic lupus erythematosus treated in the intensive care unit / Mauricio Restrepo Escobar ; Ruth María Eraso Garnica  

Público ISBD Título : Factors associated with infection amongst paediatric patients with systemic lupus erythematosus treated in the intensive care unit Tipo de documento : documento electrónico Autores : Mauricio Restrepo Escobar, ; Ruth María Eraso Garnica, Fecha de publicación : 2019 Títulos uniformes : Lupus Idioma : Inglés (eng) Palabras clave : Childhood-onset systemic lupus erythematosus  paediatric intensive care unit  nosocomial infection  C-reactive protein  mortality Resumen : Objective: To identify determinants and outcomes associated with infection in paediatric systemic lupus erythematosus (SLE) patients at admission and during hospitalization in intensive care units (ICUs). Patients and methods: A retrospective cohort study of paediatric SLE patients admitted to two ICUs was conducted. Frequency and risk factors of infection as well as mortality were studied. Results: Seventy-three infection episodes amongst 55 patients were analysed. The median age was 14.4 years (IQR 12.5–16). The median SLEDAI was 16 (IQR 12–20). Twenty-nine episodes were documented at admission; the CRP was higher in these patients (6.58 versus 1.04 mg/dl, p Mención de responsabilidad : M Restrepo-Escobar, N A Ríos, L J Hernández-Zapata, M Velásquez, R Eraso Referencia : Lupus. 2019 Aug;28(9):1141-1147. DOI (Digital Object Identifier) : 10.1177/0961203319860194 PMID : 31256746 En línea : https://journals.sagepub.com/doi/abs/10.1177/0961203319860194 Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=4243 Factors associated with infection amongst paediatric patients with systemic lupus erythematosus treated in the intensive care unit [documento electrónico] / Mauricio Restrepo Escobar, ; Ruth María Eraso Garnica,  . - 2019. Obra : Lupus Idioma : Inglés (eng) Palabras clave : Childhood-onset systemic lupus erythematosus  paediatric intensive care unit  nosocomial infection  C-reactive protein  mortality Resumen : Objective: To identify determinants and outcomes associated with infection in paediatric systemic lupus erythematosus (SLE) patients at admission and during hospitalization in intensive care units (ICUs). Patients and methods: A retrospective cohort study of paediatric SLE patients admitted to two ICUs was conducted. Frequency and risk factors of infection as well as mortality were studied. Results: Seventy-three infection episodes amongst 55 patients were analysed. The median age was 14.4 years (IQR 12.5–16). The median SLEDAI was 16 (IQR 12–20). Twenty-nine episodes were documented at admission; the CRP was higher in these patients (6.58 versus 1.04 mg/dl, p Mención de responsabilidad : M Restrepo-Escobar, N A Ríos, L J Hernández-Zapata, M Velásquez, R Eraso Referencia : Lupus. 2019 Aug;28(9):1141-1147. DOI (Digital Object Identifier) : 10.1177/0961203319860194 PMID : 31256746 En línea : https://journals.sagepub.com/doi/abs/10.1177/0961203319860194 Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=4243

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Systematic review of the literature on reproducibility of the interpretation of renal biopsy in lupus nephritis / Mauricio Restrepo Escobar ; Paula Andrea Granda Carvajal ; Fabián Alberto Jaimes Barragán  

Público ISBD Título : Systematic review of the literature on reproducibility of the interpretation of renal biopsy in lupus nephritis Tipo de documento : documento electrónico Autores : Mauricio Restrepo Escobar, ; Paula Andrea Granda Carvajal, ; Fabián Alberto Jaimes Barragán, Fecha de publicación : 2017 Títulos uniformes : Lupus Idioma : Inglés (eng) Palabras clave : Biopsy  nephritis  reliability  renal lupus  reproducibility of results  systematic review Resumen : Objective: Before using a test, it should be determined whether the results are reliable. The reliability of the interpretation of renal biopsy in patients with lupus nephritis has not been clearly elucidated. Our objective was to estimate inter and intraobserver reliability of the histological classification, as well as activity and chronicity indices in renal biopsy of patients with lupus nephritis. Methods: We conducted a systematic search of the literature, which included articles in any language, using PubMed, Embase, Cochrane and Lilacs databases. Search terms included were: reproducibility, reliability, agreement, systemic lupus erythematosus and lupus nephritis. Comparative studies with any design were included, regardless of the year or the language of publication. Two investigators, independently, screened the literature published in accordance with pre-established inclusion and exclusion criteria. Results: We found 13 relevant studies. Inter-observer reproducibility of most measurements was moderate or low, despite the fact that, in most cases, the readings were made by expert nephropathologists. There was great diversity among designs, participants, including samples and outcomes evaluated in different studies. Although there are too many reports on the clinical use, studies evaluating the reliability of classifications on renal biopsy in lupus nephritis are rare. The quality of the methodological design and reporting was fair. Conclusion: The interpretation of renal biopsy in lupus nephritis is poorly reproducible, causing serious doubts about its validity and its clinical application. As it can lead to serious diagnosis, treatment and prognosis errors, it is necessary to intensify research in this field. Mención de responsabilidad : M Restrepo-Escobar, P A Granda-Carvajal, F Jaimes Referencia : Lupus. 2017 Dec;26(14):1502-1512. DOI (Digital Object Identifier) : 10.1177/0961203317706556 PMID : 28441914 En línea : https://journals.sagepub.com/doi/abs/10.1177/0961203317706556 Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=4048 Systematic review of the literature on reproducibility of the interpretation of renal biopsy in lupus nephritis [documento electrónico] / Mauricio Restrepo Escobar, ; Paula Andrea Granda Carvajal, ; Fabián Alberto Jaimes Barragán,  . - 2017. Obra : Lupus Idioma : Inglés (eng) Palabras clave : Biopsy  nephritis  reliability  renal lupus  reproducibility of results  systematic review Resumen : Objective: Before using a test, it should be determined whether the results are reliable. The reliability of the interpretation of renal biopsy in patients with lupus nephritis has not been clearly elucidated. Our objective was to estimate inter and intraobserver reliability of the histological classification, as well as activity and chronicity indices in renal biopsy of patients with lupus nephritis. Methods: We conducted a systematic search of the literature, which included articles in any language, using PubMed, Embase, Cochrane and Lilacs databases. Search terms included were: reproducibility, reliability, agreement, systemic lupus erythematosus and lupus nephritis. Comparative studies with any design were included, regardless of the year or the language of publication. Two investigators, independently, screened the literature published in accordance with pre-established inclusion and exclusion criteria. Results: We found 13 relevant studies. Inter-observer reproducibility of most measurements was moderate or low, despite the fact that, in most cases, the readings were made by expert nephropathologists. There was great diversity among designs, participants, including samples and outcomes evaluated in different studies. Although there are too many reports on the clinical use, studies evaluating the reliability of classifications on renal biopsy in lupus nephritis are rare. The quality of the methodological design and reporting was fair. Conclusion: The interpretation of renal biopsy in lupus nephritis is poorly reproducible, causing serious doubts about its validity and its clinical application. As it can lead to serious diagnosis, treatment and prognosis errors, it is necessary to intensify research in this field. Mención de responsabilidad : M Restrepo-Escobar, P A Granda-Carvajal, F Jaimes Referencia : Lupus. 2017 Dec;26(14):1502-1512. DOI (Digital Object Identifier) : 10.1177/0961203317706556 PMID : 28441914 En línea : https://journals.sagepub.com/doi/abs/10.1177/0961203317706556 Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=4048

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Gender differences in disease activity and clinical features in newly diagnosed systemic lupus erythematosus patients / Carolina Muñoz Grajales  

Público ISBD Título : Gender differences in disease activity and clinical features in newly diagnosed systemic lupus erythematosus patients Tipo de documento : documento electrónico Autores : Carolina Muñoz Grajales, Fecha de publicación : 2016 Títulos uniformes : Lupus Idioma : Inglés (eng) Palabras clave : Systemic lupus erythematosus  gender  male  SLEDAI (Systemic Lupus |Erythematosus Disease Activity Index) Resumen : Objective: The objective of this paper is to compare disease activity and clinical features at diagnosis in male and female patients with systemic lupus erythematosus (SLE). Methods: This was a cross-sectional study in which every male patient (n 1⁄4 40) was matched with three female patients of the same age (5 years) and racial/ethnic group; disease activity as per the Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) and disease manifestations at the time of diagnosis were compared. Results: Alopecia and anti-Ro antibodies were more frequent in female patients. No statistically significant difference in any other disease characteristics was found. However, male gender was associated with a risk of severe disease activity at the time of diagnosis (as determined by SLEDAI 12 score) independent of age, racial/ethnic group, anti-Ro positivity or time to criteria accrual (OR: 3.11 95% CI, 1.09–8.92; p 1⁄4 0.035). Conclusion: In newly diagnosed SLE patients, male gender is associated with higher disease activity despite the fact that male and female patients seem to experience similaroverall disease manifestations. Mención de responsabilidad : C Muñoz-Grajales, L A González, G S Alarcón, J Acosta-Reyes Referencia : Lupus. 2016 Oct;25(11):1217-23. DOI (Digital Object Identifier) : 10.1177/0961203316635286 PMID : 26921269 En línea : https://journals.sagepub.com/doi/abs/10.1177/0961203316635286 Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=3987 Gender differences in disease activity and clinical features in newly diagnosed systemic lupus erythematosus patients [documento electrónico] / Carolina Muñoz Grajales,  . - 2016. Obra : Lupus Idioma : Inglés (eng) Palabras clave : Systemic lupus erythematosus  gender  male  SLEDAI (Systemic Lupus |Erythematosus Disease Activity Index) Resumen : Objective: The objective of this paper is to compare disease activity and clinical features at diagnosis in male and female patients with systemic lupus erythematosus (SLE). Methods: This was a cross-sectional study in which every male patient (n 1⁄4 40) was matched with three female patients of the same age (5 years) and racial/ethnic group; disease activity as per the Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) and disease manifestations at the time of diagnosis were compared. Results: Alopecia and anti-Ro antibodies were more frequent in female patients. No statistically significant difference in any other disease characteristics was found. However, male gender was associated with a risk of severe disease activity at the time of diagnosis (as determined by SLEDAI 12 score) independent of age, racial/ethnic group, anti-Ro positivity or time to criteria accrual (OR: 3.11 95% CI, 1.09–8.92; p 1⁄4 0.035). Conclusion: In newly diagnosed SLE patients, male gender is associated with higher disease activity despite the fact that male and female patients seem to experience similaroverall disease manifestations. Mención de responsabilidad : C Muñoz-Grajales, L A González, G S Alarcón, J Acosta-Reyes Referencia : Lupus. 2016 Oct;25(11):1217-23. DOI (Digital Object Identifier) : 10.1177/0961203316635286 PMID : 26921269 En línea : https://journals.sagepub.com/doi/abs/10.1177/0961203316635286 Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=3987

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Rituximab induces a rapid and sustained remission in Colombian patients with severe and refractory systemic lupus erythematosus / Luis Fernando Pinto Peñaranda ; Carlos Jaime Velásquez Franco ; Carolina Prieto Saldarriaga ; Javier Darío Márquez Hernández  

Público ISBD Título : Rituximab induces a rapid and sustained remission in Colombian patients with severe and refractory systemic lupus erythematosus Tipo de documento : documento electrónico Autores : Luis Fernando Pinto Peñaranda, ; Carlos Jaime Velásquez Franco, ; Carolina Prieto Saldarriaga, ; Javier Darío Márquez Hernández, Fecha de publicación : 2011 Títulos uniformes : Lupus Idioma : Inglés (eng) Palabras clave : Nephritis  rituximab  systemic lupus erythematosus Resumen : Despite aggressive treatment for systemic lupus erythematosus (SLE) with high-dose glucocorticoids and immunosuppressive agents, a significant proportion of patients persist with activity or relapse. Although the results from randomized studies showed no beneficial effects of rituximab (RTX) in SLE, this treatment has proven promising results in open label trials including patients with severe and refractory disease. We report a prospective cohort of 42Colombian patients with severe and refractory SLE treated with RTX after failure response to glucocorticoids and, at least, another immunosuppressive drug. We observed a reduction in steroid requirement [47.4 mg/day at 24 months (p  Mención de responsabilidad : L F Pinto, C J Velásquez, C Prieto, L Mestra, E Forero, J D Márquez Referencia : Lupus. 2011 Oct;20(11):1219-26. DOI (Digital Object Identifier) : 10.1177/0961203311409273 PMID : 21784778 En línea : https://journals.sagepub.com/doi/10.1177/0961203311409273 Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=3564 Rituximab induces a rapid and sustained remission in Colombian patients with severe and refractory systemic lupus erythematosus [documento electrónico] / Luis Fernando Pinto Peñaranda, ; Carlos Jaime Velásquez Franco, ; Carolina Prieto Saldarriaga, ; Javier Darío Márquez Hernández,  . - 2011. Obra : Lupus Idioma : Inglés (eng) Palabras clave : Nephritis  rituximab  systemic lupus erythematosus Resumen : Despite aggressive treatment for systemic lupus erythematosus (SLE) with high-dose glucocorticoids and immunosuppressive agents, a significant proportion of patients persist with activity or relapse. Although the results from randomized studies showed no beneficial effects of rituximab (RTX) in SLE, this treatment has proven promising results in open label trials including patients with severe and refractory disease. We report a prospective cohort of 42Colombian patients with severe and refractory SLE treated with RTX after failure response to glucocorticoids and, at least, another immunosuppressive drug. We observed a reduction in steroid requirement [47.4 mg/day at 24 months (p  Mención de responsabilidad : L F Pinto, C J Velásquez, C Prieto, L Mestra, E Forero, J D Márquez Referencia : Lupus. 2011 Oct;20(11):1219-26. DOI (Digital Object Identifier) : 10.1177/0961203311409273 PMID : 21784778 En línea : https://journals.sagepub.com/doi/10.1177/0961203311409273 Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=3564

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