Our objective was to analyze the effects of cigarette smoking on disease activity, functional capacity, radiographic damage, serology and presence of extraarticular manifestations in patients with rheumatoid arthritis and undifferentiated arthritis. This is a cross-sectional study of 1,305 patients (729 with rheumatoid arthritis and 576 with undifferentiated arthritis) from CONAART, the Argentine Consortium for Early Arthritis that includes patients older than 16 years with <2 years of disease. Sociodemographic data, clinical characteristics of the disease and smoking history were collected. In patients with rheumatoid arthritis the disease activity score of 28 joints was 5.4 ± 1.3 in current smokers, 5.2 ± 1.4 in former smokers and 5.1 ± 1.4 in never smokers (p = 0.011). The simple erosion narrowing score was higher in current smokers and former smokers than in never smokers (M 14.0, R Q 6.0-21.0; M 15.0, R Q 7.0-24.0; M 10.0, R Q 5.0-17.0; p = 0.006). Current smokers had higher rheumatoid factor titer (M 160.0, R Q 80.0-341.0) than former smokers (M 146.8, R Q 6.03-255.5) and never smokers (M 15.0, R Q 9.0-80.0) (p = 0.004). The variable independently associated with tobacco exposure was simple erosion narrowing score (OR = 1.03, 95 % CI 1.00-1.05; p = 0.012). In patients with undifferentiated arthritis, an association between smoking status and parameters of activity or radiographic damage was not observed. Neither was tobacco exposure related to the presence of extraarticular manifestations or to the degree of disability in any of the two groups of patients. No relation was found between disease activity and severity, and number of packs smoked per year. Tobacco.

1. Work disability is higher in patients with inflammatory arthritis as compared to the general population. 2. Prevalence of work disability is comparable among patients with undifferentiated and rheumatoid arthritis. 3. Disease activity is the main disease variable associated with work disability.

<p><span lang="ES">El síndrome de Sjögren primario es una enfermedad autoinmune sistémica de evolución crónica. </span><span lang="ES-AR">Puede presentar compromiso renal hasta en un 30% de los pacientes.</span><span lang="ES">La incidencia de tubulopatías varía de 2.6 a 33%. Se manifiestan por defectos en la concentración de la orina y alteraciones hidroelectrolíticas, principalmente acidosis tubular distal y de manera excepcional acidosis tubular proximal. Estos trastornos pueden asociarse a Nefrocalcinosis y litiasis renal. </span></p><p><span lang="ES">Reportamos el caso de una paciente con Sjögren primario que presentó acidosis tubular renal proximal asociada a cólicos renales recurrentes por litiasis renal y nefrocalcinosis. </span></p><p><span lang="ES">Destacamos la importancia de diagnosticar acidosis tubular renal en pacientes con síndrome de Sjögren que presenten alteraciones en el sedimento urinario y desórdenes electrolíticos para evitar la nefrocalcinosis medular y las nefrolitiasis asociadas. La terapia para la corrección de la acidosis tiene como objetivo evitar la progresión del trastorno y preservar la función renal.</span></p><p> </p>

Background Rheumatoid arthritis (RA) is known to have a variable course resulting in a wide range of outcomes, varying from a mild disease causing hardly any impairment to severe disease leading to extensive disability and radiological damage1,2. Objectives The aim of the present study was to identify predictive factors for unfavorable outcomes in early rheumatoid arthritis patients. Methods The 1-year outcome of RA patients from a prospective inception cohort (CONAART-Argentine Consortium for Early Arthritis) was assessed. We defined the following 3 criteria for unfavorable outcomes: a clinical course with persistent moderate-high disease activity during the last 6 months (DAS28 average ≥ 3.2, or an increase > 1.2 compared to baseline, or at least one DAS28 >5.1), a disability worsening and a radiological damage increasing (HAQ deterioration within 1 year of ≥ 0.5 points and Simple Erosion Narrowing Score (SENS)- deterioration within 1 year of ≥ 1 points, respectively). Two groups of patients (unfavorable outcome or not unfavorable outcome), were identified for each of the 3 outcome dimensions. Significance of the difference between groups was tested using a Student’s t-test, a Mann–Whitney U test, or a chi-square test where appropriate. All baseline parameters (demographic and socioeconomic parameters; comorbidities; disease characteristics; laboratory measures and radiographic measures) for both patient groups were analyzed. To calculate which baseline parameters predict outcome several logistic regression models were constructed. Results A total of 237 patients were included; 200 (84.4%) were women; 73% rheumatoid factor positive and 71% APCA positive. The mean age was 49 years (SD 12) and the median symptoms duration was 7 months (RIQ 3-12). After one year of follow-up, 141 (59.5%) patients had persistent moderate-high disease activity, 19 (8%) HAQ deterioration and 57 (24.1%) SENS worsening. The prognostic factors for persistent moderate-high disease activity were: medical history of anxiety or depression (OR 3.7; p 0.016), female gender (OR 3.1; p 0.003), and DAS28 (OR 1.3 p 0.005). Among all the factors we found that patients with monoarthritis at baseline had more probability of HAQ deterioration (OR 8.2; p 0.03) and greater values of DAS28 reduced it (OR 0.6 p 0.007). There were not baseline variables associated with radiographic progression. Conclusions Our study showed that in short-term follow up of early RA patients, different outcomes could be predicted using widely available baseline parameters. References Arthritis Rheum. 2002;47:383-90. Arthritis Res Ther. 2008;10:R106. Disclosure of Interest L. Casalla Grant/research support from: Pfizer Argentina, R. Chaparro del Moral : None Declared, O. Rillo : None Declared, M. Benegas: None Declared, F. Dal Pra: None Declared, H. Maldonado Ficco: None Declared, G. Citera: None Declared, A. Catalan Pellet: None Declared, A. Berman: None Declared, M. Haye Salina: None Declared, A. Alvarez: None Declared, F. Caeiro: None Declared, J. Marcos: None Decl...

Introducción: Se denomina hiperCKemia a la elevación de niveles de creatinfosfoquinasa (CK) mayor a 1,5 veces el límite superior(CK>285 U/L), siendo producida por múltiples causas, que varían según las poblaciones de estudio. El objetivo principal del estudio fue conocer la frecuencia de hiperCKemia en dos hospitales de la Ciudad de Córdoba y sus principales causas. Metodología: Estudio analítico retrospectivo en dos hospitales de la ciudad de Córdoba en Argentina, donde se identificaron todos los pacientes mayores de 18 años que presentaron valores de CK mayores a 285 U/L en al menos 2 oportunidades en un período entre 1 y 4 semanas, entre los años 2015 y 2017. Resultados: Se identificaron 254 pacientes con hiperCKemia, la mayoría eran de sexo masculino (n=181, 71.3%) y su mediana de edad fue 65 años (rango intercuartil 25-75%=50-73 años). Las principales causas de hiperCKemia fueron la miopatía isquémica en 99 (39%) pacientes y las miopatías inducidas por drogas en 45 (17.7%), siendo las estatinas las drogas más frecuentemente involucradas en 31 casos. En sólo el 3.1% de los casos no se arribó al diagnóstico final. Las hiperCKemias inducidas por drogas al compararse con las otras causas, se presentaron más frecuentemente en pacientes con antecedente de enfermedad renal crónica (9/45[20%] vs 18/209[8.6%], p=0.025) y en no tabaquistas(41/45[91.1%] vs 157/209[75.1%], p=0.019) . Conclusión: Se observaron 254 casos de hiperCKemia, siendo sus principales causas de origen isquémico y secundario a consumo de fármacos, especialmente por estatinas.