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Massardo L.,University of Santiago de Chile | Pons-Estel B.A.,Hospital Provincial de Rosario | Wojdyla D.,National University of Rosario | Cardiel M.H.,Hospital General Dr. Miguel Silva | And 17 more authors.
Arthritis Care and Research | Year: 2012

Objective To determine the influence of socioeconomic factors on disease activity in a Latin American (LA) early rheumatoid arthritis (RA) multinational inception cohort at baseline. Methods Clinical evaluation, ethnicity, socioeconomic status (SES), 4-variable Disease Activity Score in 28 joints using the erythrocyte sedimentation rate (DAS28-ESR), Health Assessment Questionnaire (HAQ) disability index (DI), and erosions were recorded in 1,093 patients with early RA (<1 year from onset). Multivariate analyses evaluated influences of sex, age, marital status, education, medical coverage, SES, and ethnicity on HAQ DI, DAS28-ESR, and presence of erosions. Results Ethnicities included 43% Mestizo, 31% Caucasian, 19% African LA, 4% Amerindian, and 3% other. Fifty-eight percent were of low/low-middle SES, 42% had <8 years of education, 21% had no medical coverage, median disease duration was 6 months (25th, 75th percentiles 4, 9 months), median HAQ DI score was 1.25 (25th, 75th percentiles 0.63, 2.00), median DAS28-ESR score was 6.2 (25th, 75th percentiles 4.9, 7.2), and 25% had erosions. Women and Mestizos, African LA, and Amerindians had earlier onset than men or Caucasians (P < 0.01). When adjusted by country, the analysis of covariance model showed that low/low-middle SES, female sex, partial coverage, and older age were associated with worse HAQ DI scores; only low/low-middle SES was associated with higher DAS28 scores. Statistically significant differences were found in HAQ DI and DAS28 scores between countries. When excluding country, low/low-middle SES, female sex, and no coverage were associated with worse HAQ DI and DAS28 scores, whereas separated/divorced/ widowed status was associated with worse HAQ DI scores and age was associated with worse DAS28 scores. Logistic regression showed that older age, no coverage, and the Amerindian and other ethnic groups were associated with erosions. Conclusion We compared early RA patients from the main LA ethnic groups. Our findings suggest that low/low-middle SES is important in determining disease activity. A more genetic-related background for erosions is possible. Copyright © 2012 by the American College of Rheumatology. Source


Silva S.,University of Panama | Zuniga-Cisneros J.,Complejo Hospitalario Metropolitano Dr. Arnulfo Arias Madrid | Zuniga-Cisneros J.,University of Panama | Ortega-Loubon C.,University of Panama | And 12 more authors.
Archivos de Medicina | Year: 2013

Introduction: Studies have shown that engaging in scientific research as a medical student is strongly associated with research initiatives after finishing the career. Despite the above, in Panama there are no studies that describe the knowledge and attitudes of medical students towards research. Objective: To describe knowledge and attitudes about research in medical students of the University of Panama. Materials and Methods: Cross-sectional study based on surveys of medical students at University of Panama. The attitude and knowledge were measured by means of a questionnaire with 10 and 24 items respectively, measured by Likert scale. Descriptive statistics were used and simple and multivariate linear regression to predict to predict the behavior of knowledge and attitude variables. Results: Mean score of knowledge was 38.30 ± 17.27 out of 100 points. Mean score of attitude was 2.98 ± 0.59 out of 5 points. The multivariate linear regression shows as predictor variables of attitude career year (p = 0.048, β1= -0.24) and completion of a research paper. (p <0.001, β1= 0.234), while for the knowledge the predictor was the year of study (p = <0.001, β1= 2.86). © iMedPub. Source

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