Antecedentes: La rinitis alérgica es la enfermedad alérgica más común en el mundo y es causada por hipersensibilidad a los aeroalérgenos. Hasta donde sabemos, no hay estudios previos de sensibilización aeroalergénica en Aguascalientes, México.Objetivo: Describir la sensibilización a aeroalérgenos en pacientes con rinitis alérgica tratados en una clínica privada en Aguascalientes, México.Métodos: Estudio descriptivo, transversal y retrospectivo; se incluyeron pacientes diagnosticados con rinitis alérgica. Se realizaron pruebas cutáneas con 32 extractos alergénicos y se determinaron las frecuencia de reacción a cada uno.Resultados: En total se analizaron 350 pacientes. Los aeroalérgenos más frecuentes fueron los pólenes de pastos (74.8%), seguidos por los pólenes de árboles (64.8%) y Dermatophagoides pteronyssinus (64%). El grupo de edad predominante fue el menor de 20 años (67.1%), seguido del grupo de 21 a 40 años (22.5%).Conclusión: La investigación proporciona información sobre los patrones regionales de sensibilización, que facilitará las pruebas de diagnóstico en la región y las mejores prácticas de inmunoterapia específica.

BackgroundIt is well known that an early diagnosis and treatment for Rheumatoid Arthritis (RA) prevents its complications, therefore there are many efforts to identify individuals at risk to develop RA. The Squeeze test has been used to detect synovitis in metacarpophalangeal joints, even though it is used in daily practice, there is a great variability in their performance among rheumatologists. [2]ObjectivesThe aim of this study is to determine the diagnostic performance of the automated squeeze test (AST) on the metacarpophalangeal (MCP) joints to detect the presence of synovitis, edema, or erosions by magnetic resonance imaging (MRI) using the rheumatoid arthritis magnetic resonance imaging score (RAMRIS) in first-degree relatives (FDR) of RA patients, of whom clinically suspect arthralgia (CSA) in hands was suspected, as well as in RA patients.MethodsIt is an observational and cross-sectional study for a diagnostic test. A total of 60 patients, older than 18 years, were included and divided in three groups: CSA group: 22 with less than 1 year with arthralgia and required to be FDR of RA patients; early RA group: 22 patients who met ACR/EULAR 2010 Classification Criteria with less than 1 year with the disease; and late RA group: 16 patients who met ACR/EULAR 2010 Classification Criteria, with more than 1 year with the disease. The AST was performed in the 60 participants’ dominant hand. The device was evaluated by MRI, which examined the same hand in the 60 patients.ResultsA total of 240 MCP joints were evaluated. The AUC for the total RAMRIS score >10 was [0.480 (95% CI 0.301-0.617) P=0.597], for synovitis RAMRIS score > 7 was [0.459 (95% CI 0.331-0.669) P=0.791], and for the presence of any synovitis by RAMRIS was [0.575 (95% CI 0.428-0.723) P=0.331]. For the RAMRIS synovitis score, the most sensitive and specific cut-off of the force by AST was 4.645 kg with a 66.7% sensitivity and 50% specificity.Abstract AB1128 Table 1 Baseline characteristics TOTAL CSA n=22 ERA n=22 LRA n=16 Age mean (SD) 44.7 (13.7)37.6 (10.9)49.05 (11.9)47.5 (16.2) Female n (%) 50 (83.3)18 (81.8)18 (81.8)14 (87.5) TJC median (IQR) 4 (12)0.5 (4)5 (13)10 (11) SJC median (IQR) 3 (8)0 (3)5 (12)7.5 (9) DAS28-ESR median (IQR) 4.8 (1.5)5.4 (1.4) HAQ median (IQR) 0.64 (0.75)1.47 (0.94) CDAI median (IQR) 18.07(16.8)23.8 (15.5) Married n (%) 41 (68.3)12 (54.5)15 (71.4)14 (93.3) Smoker n (%) 19 (31.7)2 (22.7)10 (45.5)4 (25) Morning stiffness n (%) 31 (51.7)4 (18.2)16 (72.7)11 (68.8) RF IgM positivity n (%) 46 (76.7)9 (40.9)12 (70.6)4 (25) ACPA positivity n (%) 25 (41.7)19 (86.4)20 (90.9)7 (43.8)Clinically suspect arthralgia, CSA; Early Rheumatoid Arthritis, ERA; Late Rheumatoid Arthritis, LRA; Tender Joint Count, TJC; Swollen Joint Count, SJC; Disease Activity Score – Erythrocyte Sedimentation Rate, DAS28-ESR; Health Activity Questionnaire, HAQ; Clinical Disease Activity Index, CDAI; Rheumatoid Factor, RF; Anti-citrullinated peptides antibodies, ACPA.ConclusionThe application of AST with a force of 4.645 kg, to exert pain in the dominant hand...

Background:Pharmacovigilance is the science and activities related to detection, evaluation, understanding and prevention of adverse effects of medications or any other health problem related to them. (1)Within the scope of the pharmacovigilance study, following domains are included: adverse drug reaction, interaction between medications, counterfeit or inferior quality medications, lack of efficacy of medications, misuse or abuse of medications and medication errors (ME). (2)ME is any preventable incident that can cause harm to the patient or lead to improper use of medications when they are under the control of healthcare professionals or the patient. (3)Objectives:To determine the frequency of ME in the prescriptions among rheumatology outpatient’s clinic.Methods:Prospective observational study.Frequency of ME was sought by a randomized review of the prescriptions from rheumatology outpatient’s clinic of the University Hospital “Dr. José Eleuterio González” before and after the implementation of an electronic medical prescription system (REPAIR®) (January 2018-December 2019)REPAIR® displays an automated menu with the stages of the medical prescription: Name, presentation and dosage of the medicine and duration of the treatment. Figure 1. Once the review began, semiannual reports were made to the doctors involved in which frequency of errors and the stage of medical prescription with highest incidence of ME were reported.Figure 1Example image displayed by REPAIR®Descriptive statistics were performed, reporting frequencies and percentages.Results:A total of 1599 medical prescriptions were evaluated. The number of prescriptions with ME was 196 (12.2%). Table 1Table 1General description about errors in medical prescriptionsPrescriptions evaluated1599Prescription with ME n (%)196 (12.2%)Medications evaluated n10 413Medications with ME n (%)907(8.7%)Average medications per prescription6.4Average medications with ME per prescription0.78Prescription Stage Name of the drug n (%)2/10 413 (0.01%) Medication presentation n (%)77/ 10 413 (0.7%) Dose of the drug n (%)0/10 413 (0%) Duration of prescription n (%)725/10 413 (6.9%)The incidence of ME decreased, at beginning of the study incidence was reported 31.6%, and at the end were 1.5%. Graph 1The percentage of medications with ME also decreased from 17.2% to 0.8% at the end of the study. Table 2Table 2Errors in prescriptions per semesterJanuary-June 2018July-December 2018January-June 2019July-December 2019Prescriptions evaluated n321411407460Prescriptions with ME n (%)73 (31.6%)93 (22.6%)23 (5.6%)7 (1.5%)Medications evaluated n2126278426802823Medications with ME n (%)367 (17.2%)469 (16.8%)36 (1.7%)35 (0.8%)Average medications per prescription evaluated6.66.76.26.4Average medications per prescription evaluated1.1461.1430.0820.081Prescription Stage n (%) Name1/367(0.2%)1/469 (0.2%)00 Presentation37/367 (10%)37/469 (7.8%)1/36 (2.7%)2/35 (5.7%) Dose0000 Duration290/367 (89%)367/469 (88.2%)35/36 (97.2%)33/35 (94.2%)Conclusion:Decrease in the incidence of ME in rheumatology consultation is important because outcome of the patients depends significantly on treatment adherence. This study results shows that through the application of an electronic prescription system, it is possible to reduce the incidence of ME in rheumatology consultation.References:[1]Jeetu G, Anusha G. Pharmacovigilance: a worldwide master key for drug safety monitoring. J Young Pharm. 2010;2(3):315-20.[2]Organization WH. WHO pharmacovigilance indicators: a practical manual for the assessment of pharmacovigilance systems. 2015.[3]Elden NM, Ismail A. The Importance of Medication Errors Reporting in Improving the Quality of Clinical Care Services. Glob J Health Sci. 2016;8(8):54510.Graph 1Disclosure of Interests:None declared

Background:Primary care physicians (PCP) are usually the first contact of people with inflammatory rheumatic diseases, and find the early symptoms of Rheumatoid Arthritis (RA) difficult to distinguish from those of other rheumatic diseases. A time-delay in the reference to Rheumatology is a health issue in several countries. The clinical aspects that general practitioner took into account in hand arthralgia patients are important to make the reference. In particular the Squeeze Test (ST) - which is simple to perform and rapidly done, ST is useful for identifying progression to RA in patients with undifferentiated arthritis. The ST has been described as not reliable because is clinician-dependent.Objectives:To identify the required force that needs to be applied in order to obtain a positive Automatized Squeeze Test (AST) in a cohort of patients with hand arthralgia.Methods:Ninety-seven patients were recruited in Family Medicine Consultation and in Rheumatology Consultation of the Hospital Universitario “Dr. José Eleuterio González” in Monterrey, Nuevo León, México. Eligible patients were adults (aged≥18 years) with hand arthralgia (that wasn’t caused by trauma) as their chief complaint. After obtaining informed consent and after a questionnaire application, patients were submitted to AST maneuver, using an automated compressor with different forces already predetermined in the interface of the software used for compression.Results:In this cohort of 98 patients, 79 (80.6%) were women. The mean age was 51.14 years (SD 14.66). Ninety-six (97.9%) patients were right handed. The diagnoses were Osteoarthritis (OA) (16.3%), RA (5.1%), Undifferentiated arthritis (1.2%), Psoriatic arthritis (1.2%) and Fibromyalgia (2%). Force measures according to diagnoses are reported in Table 1.Table 1.Diagnoses and mean forcesDiagnosisn (%)Right hand force mean (kg/s2) (SD)Left hand force mean (kg/s2) (SD)OA16 (16.3)3.53 (2.74)3.18(2.73)RA5 (5.1)3.60 (2.53)3.16(1.36)UA1 (1.2)7.60(0)8.70(0)PsA1 (1.2)7.60(0)7.80(0)FM2 (2.0)4.11(4.40)1.75(1.06)OA, Osteoarthritis;RA, Rheumatoid Arthritis;UA, Undifferentiated Arthritis;PsA, Psoriatic Arthritis;FM, Fibromyalgia;SD, Standard DeviationConclusion:In the cases of RA and OA, the means of force to obtain a positive AST was lower than in the rest of the diagnoses.References:[1]Stack R, Nightingale P, Jinks C, Shaw K, Herron-Marx S, Horne R et al. Delays between the onset of symptoms and first rheumatology consultation in patients with rheumatoid arthritis in the UK: an observational study. BMJ Open. 2019;9(3):e024361.Disclosure of Interests:None declared