Julian Barahona Correa

All Publications

• Nervous system involvement in ANCA-associated vasculitis: Single center experience from Latin America SEMINARS IN ARTHRITIS AND RHEUMATISM Quintero-Giraldo, L., Barahona-Correa, J., Corredor-Orlandelli, D., Garcia-Alfonso, C., Herrera-Leano, N., Fernandez-Avila, D. G. 2025; 73: 152751

  Abstract

  Anti-neutrophil cytoplasmic antibodies (ANCA)-associated vasculitides (AAV) present heterogeneous neurological symptoms that are often misdiagnosed, contributing to delays in identification and prompt treatment. Few studies in Latin America have described the frequency of neurological involvement in AVV; none have explicitly described the characteristics of nervous system involvement.This case-control study examined patient records for AVV treated at a university hospital in Colombia between 2005 and 2023. Patients with and without neurological manifestations were compared and a survival analysis was performed.Forty-eight cases and seventy-nine controls were included. The median age was 58 years, 57.5 % were female. The diagnosis was made in 67.7 % of cases during the hospital stay, and in-hospital mortality was 14 %. Nervous system involvement was more frequent in undifferentiated AAV (100 %), followed by eosinophilic granulomatosis with polyangiitis (75 %), microscopic polyangiitis (33.3 %), and granulomatosis with polyangiitis (25.9 %). The most common neurological manifestations were peripheral neuropathy (50 %), patient-reported symptoms of sensory dysfunction (43.7 %), and cranial neuropathy (39.6 %); headache was frequent among patients with neurological involvement. Patients with neurological manifestations presented a lower median creatinine at admission and a lower proportion of patients with a five-factor score > 2. No differences in one-year all-cause mortality were observed.This study presents an exhaustive clinical characterization of the neurological profile of patients with AAV from a single center in Latin America. Patients with nervous system involvement showed less severe renal involvement and a lower proportion of 5-year risk of mortality scores; one-year all-cause mortality was similar between groups.

  View details for DOI 10.1016/j.semarthrit.2025.152751

  View details for Web of Science ID 001499677100001

  View details for PubMedID 40409118

• Evaluation of video content quality on PCSK9 inhibitors in social media. Clinica e investigacion en arteriosclerosis : publicacion oficial de la Sociedad Espanola de Arteriosclerosis David-Pardo, D. G., Barahona-Correa, J. E., Herrera-Leaño, N. M., Calvo Betancourt, L. S., Muñoz Velandia, Ó. M., Fernández-Ávila, D. G., García Peña, Á. A. 2025: 500829

  Abstract

  The internet is a major source of health information, with platforms like YouTube® and Facebook® widely used by patients to learn about diseases and treatments. However, the reliability of content on PCSK9 inhibitors (PCSK9i), a therapy for dyslipidemia, remains unknown. This study aims to evaluate the general characteristics, user engagement metrics, reliability, comprehensiveness, and quality of English- and Spanish-language PCSK9i videos on YouTube® and Facebook®.Analytical observational study. Paired evaluations were conducted using validated tools: the modified DISCERN (mDISCERN) for reliability, a modified content score for comprehensiveness, and the Global Quality Score (GQS) for quality. Comparisons were made based on platform, source, and language.A total of 203 videos were analyzed. YouTube® videos had significantly higher median views, longer duration, and greater engagement than Facebook® videos, while Facebook® contained a higher proportion of non-valuable content (19.6% vs. 3.2%, p<0.001). Most videos targeted patients and healthcare professionals, with professional organizations and independent users as the primary contributors. YouTube® videos were more frequently rated as "good or better" based on mDISCERN, content score, and GQS. Notably, for-profit organizations achieved the highest content scores and GQS values. Inter-rater reliability was excellent across all scoring tools, with kappa coefficients exceeding 0.89.YouTube® videos on PCSK9i had higher engagement and reliability than those on Facebook®. For-profit organizations produced the most reliable and exhaustive videos. However, overall quality remains suboptimal, underscoring the need for greater oversight and effective strategies to ensure the dissemination of accurate, high-quality information.

  View details for DOI 10.1016/j.arteri.2025.500829

  View details for PubMedID 40592703

• Mortality time frame variability in septic shock clinical trials: A systematic review. Medicina intensiva Laserna, A., Cuenca, J. A., Martin, P., Fowler, C., Barahona-Correa, J., Manjappachar, N., Fowler, C., Lopez-Olivo, M. A., Borges, M., Sprung, C. L., Nates, J. L. 2025: 502172

  Abstract

  We sought to delineate the mortality outcome time frames reported in septic shock randomized control trials (RCTs).Systematic review of PubMed, EMBASE, and the Cochrane Database of Systematic Reviews.Intensive care units.Studies that included adult patients with septic shock.Any type of intervention.Information about the study, specific patient population, type of study intervention, specific intervention, and number of patients. Mortality time frames were analyzed for geographical differences and changes over time.The search yielded 2660 unique citations. After screening, 132 eligible studies were identified. A total of 234 mortality time frames were collected from the included studies, of which 15 timeframes were unique. The most frequently reported time frame was 28-day mortality (n = 98, 74% of trials), followed by hospital mortality (n = 35, 27%), ICU mortality (n = 30, 23%), and 90-day mortality (n = 29, 22%). The most reported mortality time frame was 28 days in studies from every continent except Africa. The studies published between 2008 and 2013 (25%) more frequently reported hospital and ICU mortality combination than studies published between 2014 and 2019 (11.4%) (P = 0.043).There was considerable variability in the mortality time frames reported in ICU-based septic shock trials. This variability may lead to under or overestimation of the problem, overlooking the effectiveness of the interventions studied, and further limiting the application of trials and their pooling in meta-analyses. A consensus regarding time frame reporting in septic shock trials is long overdue.

  View details for DOI 10.1016/j.medine.2025.502172

  View details for PubMedID 40090798

• Frequency of use and annual costs of biological therapy for psoriasis in Colombia in 2019 INTERNATIONAL JOURNAL OF DERMATOLOGY Fernandez-Avila, D. G., Prada-Vanegas, J. D., De la Espriella, M. C., Barahona-Correa, J. E., Charry, L. P., Cuellar, I. 2024; 63 (11): e296-e301

  Abstract

  Evidence describing the types and annual costs of biological treatments for psoriasis in Latin America is scarce. This study aimed to estimate the frequency of use and costs of biologic therapy for psoriasis in Colombia in 2019.This secondary data analysis uses the International Classification of Diseases terms associated with psoriasis, excluding those related to psoriatic arthritis, based on data from the registry of the Colombian Ministry of Health. We estimated the prevalence of psoriasis per 100,000 inhabitants; then, we retrieved the frequency of use of biologic therapy in patients with psoriasis and estimated the cost per year of each and overall therapies in 2019 in US dollars (USD).There were 100,823 patients with psoriasis in Colombia in 2019, which amounts to a prevalence of 0.2% in the general population. Of those patients, 4.9% received biologic therapy, most frequently males (60%). The most commonly used biological therapies for psoriasis in Colombia in 2019 were ustekinumab (35.2%), with an annual cost per patient of $12,880 USD; adalimumab (26%), with a yearly cost per patient of $7130 USD; and secukinumab (19.8%), with an annual cost per patient of $6825 USD.This is the first study to describe the use and cost of biological therapy for psoriasis in Colombia. It provides valuable cost-awareness information for the Colombian health system.

  View details for DOI 10.1111/ijd.17377

  View details for Web of Science ID 001272216200001

  View details for PubMedID 39031993

• Prevalence of axial spondyloarthritis in Colombia: data from the National Health Registry 2017-2021 CLINICAL RHEUMATOLOGY Barahona-Correa, J. E., Herrera-Leano, N. M., Bernal-Macias, S., Fernandez-Avila, D. G. 2024; 43 (1): 49-57

  Abstract

  Registries allow ascertaining the epidemiology of chronic diseases such as axial spondyloarthritis (axSpA). The Colombian Ministry of Health has implemented a National Health Registry (SISPRO) that collects data from each medical contact in the system, which provides close to universal coverage (around 98%).To establish the 5-year prevalence of axSpA in Colombia, and to describe its demographics, using data from January 1st, 2017, to December 31st, 2021.We performed an observational, cross-sectional study using the International Statistical Classification of Diseases and Related Health Problems as search terms related to ax-SpA, based on SISPRO data. We estimated the prevalence using three approaches: (1) ankylosing spondylitis (AS) diagnoses; (2) diagnoses compatible with axSpA; and (3) diagnoses compatible with axSpA, including sacroiliitis. We calculated prevalence per 100,000 inhabitants.Based on our three approaches, patients with a primary diagnosis compatible with ax-SpA ranged between 12,684 and 117,648, with an estimated 5-year adjusted prevalence between 26.3 and 244 cases per 100,000 inhabitants (0.03-0.2%). The male-to-female ratio ranged between 1.2:1 and 0.4:1, which was markedly skewed towards a higher prevalence in women when we included the code for sacroiliitis. We found the highest frequency of cases in the 50-54 years group. A differential prevalence was observed between different regions in our country, particularly in regions known to have European ancestors.This is the first study that describes demographic characteristics of ax-SpA in Colombia and offers valuable information for stakeholders. Key Points • Using the official country-level health database, the prevalence of axSpA in Colombia ranges between 26.3 and 244 cases per 100,000 inhabitants (0.03% - 0.2%) • The prevalence of axSpA peaked among the 50-54 years patient group, suggesting an increased survival • Nations with a substantial admixture, such as Colombia, may present a differential prevalence of axSpA among regions within the country • Including the ICD-10 code for sacroiliitis (M46.1) in epidemiological studies probably overestimates the frequency of axSpA.

  View details for DOI 10.1007/s10067-023-06799-y

  View details for Web of Science ID 001100508100001

  View details for PubMedID 37953369

  View details for PubMedCentralID PMC10774146

• YouTube® as a source of information for Spanish-speaking patients with rheumatoid arthritis REUMATOLOGIA CLINICA Barahona-Correa, J. E., Rueda-Ortiz, C., Munoz, O., Garcia, A., Fernandez-Avila, D. G. 2023; 19 (10): 571-578

  Abstract

  Social media (SoMe) has reshaped access to health information, which may benefit patients with rheumatoid arthritis (RA), although an evaluation of the characteristics of contents for Spanish-speaking patients is lacking. We aimed to assess patient engagement, reliability, comprehensiveness, and quality of data uploaded to YouTube® for Spanish-speaking patients.We evaluated the videos uploaded to YouTube® in Spanish about RA. Information about video length, engagement (i.e., views, likes, popularity index), time online, and the source was retrieved; we appraised reliability (DISCERN), comprehensiveness (content score), and quality (Global Quality Score) using standardized scores.We included 200 videos in the study and classified 67% of the videos as useful. These videos had a higher number of views (19,491 [10,132-61,162] vs. 11,208 [8183-20,538]), a longer time online (1156 [719-2254] vs. 832 [487-1708] days), and a shorter duration (6.3 [3.4-15.8] vs. 11.8 [7.4-20.3] min). Engagement parameters were similar between useful and misleading videos. Useful videos had higher reliability, comprehensiveness, and quality scores. Useful videos were mainly uploaded by independent users and government/news agencies; academic organizations offered only 15% of useful videos.Most of the information in YouTube® for Spanish-speaking patients with RA is useful; however, patient engagement is similar between useful and misleading content. More substantial involvement of academia in developing high-quality educational multimedia is warranted.

  View details for DOI 10.1016/j.reuma.2023.05.002

  View details for Web of Science ID 001111769000001

  View details for PubMedID 38056982

• Evaluation of diuretic efficiency of intravenous furosemide in patients with advanced heart failure in a heart failure clinic THERAPEUTIC ADVANCES IN CARDIOVASCULAR DISEASE Herrera-Leano, N., Barahona-Correa, J. E., Munoz-Velandia, O., Fernandez-Avila, D. G., Marino-Correa, A., Garcia, A. 2023; 17: 17539447231184984

  Abstract

  Diuretic efficiency (DE) is an independent predictor of all-cause mortality in acute heart failure (HF) at long-term follow-up. The performance of DE in advanced HF and the outpatient scenario is unclear.Survival function analysis on a retrospective cohort of patients with advanced HF followed at the outpatient clinic of Hospital Universitario San Ignacio (Bogotá, Colombia) between 2017 and 2021. DE was calculated as the average of total diuresis in milliliters divided by the dose of IV furosemide in milligrams for each 6-h session, considering all the sessions in which the patient received levosimendan and IV furosemide. We stratified DE in high or low using the median value of the cohort as the cutoff value. The primary outcome was a composite of all-cause mortality and HF hospitalizations during a 12-month follow-up. Kaplan-Meier curves and log-rank test were used to compare patients with high and low DE.In all, 41 patients (66.5 ± 13.2 years old, 75.6% men) were included in the study, with a median DE of 24.5 mL/mg. In total, 20 patients were categorized as low and 21 as high DE. The composite outcome occurred more often in the high DE group (13 versus 5, log-rank test p = 0.0385); the all-cause mortality rate was 29.2% and was more frequent in the high DE group (11 versus 1, log-rank test p = 0.0026).In patients with advanced HF on intermittent inotropic therapy, a high DE efficiency is associated with a higher risk of mortality or HF hospitalization in a 12-month follow-up period.

  View details for DOI 10.1177/17539447231184984

  View details for Web of Science ID 001021166200001

  View details for PubMedID 37417658

  View details for PubMedCentralID PMC10331187

• Sleep Quality, Insomnia, and Perceived Stress among Colombian Healthcare Workers during the COVID-19 Pandemic SLEEP SCIENCE Waich, A., Barahona-Correa, J., Figueredo, M., Rondon-Sepulveda, M., Ruiz, A. J., Castellanos, J., Hidalgo-Martinez, P. 2023; 16 (01): 44-50

  Abstract

  Objective  The COVID-19 pandemic has imposed a great burden on healthcare workers worldwide. The aim of the present study was to assess sleep quality, insomnia, and perceived stress in healthcare workers of a high complexity hospital located in Bogota, Colombia. Methods  Cross-sectional study in which 1,155 healthcare workers at the Hospital Universitario San Ignacio in Bogotá, Colombia were included, between September and October 2020. Using an online-based survey, self-reported variables were assessed including demographics, Pittsburgh Sleep Quality Index (PSQI), Insomnia Severity Index (ISI), and 10 item Perceived Stress Scale (PSS-10). Associations between these variables were evaluated. Results  Fifty percent of the respondents were between 31 and 45 years old, and 76 percent were women. Most of the surveyed were the nursing staff. Poor sleep quality, insomnia, and high perceived stress was found in 74.9, 12.4, and 13.2%, respectively. Poor sleep quality was predominantly found in females, in the 31 to 45 years old group and in married personnel. Also, poor sleep quality was found in relation to a moderate to high perceived risk of COVID-19 infection by the family of the workers surveyed. Discussion  Poor sleep quality, moderate rates of insomnia, and perceived stress were found among healthcare workers committed to COVID-19 infected patients in Colombia. The identification of workers at greater risk and the implementation of targeted interventions are called upon as the results.

  View details for DOI 10.1055/s-0043-1767756

  View details for Web of Science ID 001001156400006

  View details for PubMedID 37151765

  View details for PubMedCentralID PMC10157824

• Effectiveness of mobile telemonitoring applications in heart failure patients: systematic review of literature and meta-analysis HEART FAILURE REVIEWS Rebolledo Del Toro, M., Herrera Leano, N. M., Barahona-Correa, J. E., Munoz Velandia, O. M., Fernandez avila, D. G., Garcia Pena, a. A. 2023; 28 (2): 431-452

  Abstract

  Close and frequent follow-up of heart failure (HF) patients improves clinical outcomes. Mobile telemonitoring applications are advantageous alternatives due to their wide availability, portability, low cost, computing power, and interconnectivity. This study aims to evaluate the impact of telemonitoring apps on mortality, hospitalization, and quality of life (QoL) in HF patients. We conducted a registered (PROSPERO CRD42022299516) systematic review of randomized clinical trials (RCTs) evaluating mobile-based telemonitoring strategies in patients with HF, published between January 2000 and December 2021 in 4 databases (PubMed, EMBASE, BVSalud/LILACS, Cochrane Reviews). We assessed the risk of bias using the RoB2 tool. The outcome of interest was the effect on mortality, hospitalization risk, and/or QoL. We performed meta-analysis when appropriate; heterogeneity and risk of publication bias were evaluated. Otherwise, descriptive analyses are offered. We screened 900 references and 19 RCTs were included for review. The risk of bias for mortality and hospitalization was mostly low, whereas for QoL was high. We observed a reduced risk of hospitalization due to HF with the use of mobile-based telemonitoring strategies (RR 0.77 [0.67; 0.89]; I2 7%). Non-statistically significant reduction in mortality risk was observed. The impact on QoL was variable between studies, with different scores and reporting measures used, thus limiting data pooling. The use of mobile-based telemonitoring strategies in patients with HF reduces risk of hospitalization due to HF. As smartphones and wirelessly connected devices are increasingly available, further research on this topic is warranted, particularly in the foundational therapy.

  View details for DOI 10.1007/s10741-022-10291-1

  View details for Web of Science ID 000913962300001

  View details for PubMedID 36652096

  View details for PubMedCentralID PMC9845822

• Comparative outcomes of direct-acting antiviral treatment in patients with HIV-Hepatitis C co-infection: insights from a single center experience in Colombia. Le infezioni in medicina Vergara-Samur, H., Martinez-Vernaza, S., De la Hoz, A., Barahona-Correa, J., Ortiz, J. P., Gualtero-Trujillo, S., Rumbo-Romero, J., Salazar, L. M., Suarez Quintero, Y., Valderrama-Beltran, S. 2023; 31 (3): 374-383

  Abstract

  Background: Direct-acting antivirals (DAA) were introduced to Latin America with the aim of eliminating hepatitis C (HCV) in the region. There are scarce data on the outcomes of people living with HIV and HCV treated with these medications in Colombia. This study compares the outcomes of patients with HIV-HCV co-infection and HCV mono-infection treated with DAAs.Methods: Retrospective observational study including patients ≥18 years old with HCV infection treated with DAAs from August 2017 to December 2019 in a comprehensive center in Colombia. The main outcome was sustained virologic response (SVR). Secondary outcomes included reinfection, relapse and adverse events.Results: We included 223 individuals with HCV treated with DAAs; 142 (63.6%) individuals were mono-infected and 81 (36.3%) co-infected. Genotypes 1b (49.7%) and 4 (33.9%) were the most common. Overall SVR after DAA treatment was 96.8%. Relapse rate was 2.24%, reinfection rate was 6.28% and adverse events occurred in 27.8% of cases. SVR was comparable in patients with co- and mono-infection (95% vs 97.8%, p=0.245).Conclusion: DAA were effective in mono-infected (HCV) and co-infected (HCV/HIV) patients and reinfection was high in this last group.

  View details for DOI 10.53854/liim-3103-11

  View details for PubMedID 37701377

• COVID-19 infection during blinatumomab therapy: Is safety a dilemma? SAGE OPEN MEDICAL CASE REPORTS Barahona-Correa, J. E., Rueda-Ortiz, C., Lopez, M., Gualtero, S., Arevalo-Zambrano, M. 2023; 11: 2050313X221148548

  Abstract

  Patients with acute lymphoblastic leukemia may be particularly vulnerable to SARS-CoV-2 infection and severe illness. The mainstay of current treatment is the use of blinatumomab in patients with refractory or relapsed B-cell precursor acute lymphoblastic leukemia. We discuss the case of a patient with relapsed acute lymphoblastic leukemia who became positive for SARS-CoV-2 during blinatumomab therapy. There are no formal recommendations on the decision to continue, withhold, or delay blinatumomab treatment in these patients. More studies exploring this issue are warranted, as SARS-CoV-2 is expected to be here to stay.

  View details for DOI 10.1177/2050313X221148548

  View details for Web of Science ID 000998831900001

  View details for PubMedID 36643709

  View details for PubMedCentralID PMC9834623

• Prevalence of cardiovascular risk factors in a historical cohort of people living with human immunodeficiency virus during a 10-year period SAGE OPEN MEDICINE Garcia-Pena, A., Aldana, J., Botero, J., Vasquez, J., Leon, M., Rodriguez-Lugo, D., Villamil, L., Barahona-Correa, J. E., Tamara, J. 2023; 11: 20503121231166647

  Abstract

  Data on the frequency of cardiovascular disease in people living with human immunodeficiency virus from low- and middle-income countries is scarce.We performed an observational study based on data from a historical cohort of people living with human immunodeficiency virus in Colombia during a 10-year follow-up to describe the prevalence of cardiovascular risk factors and their behavior according to CD4 count.One thousand patients were initially included, out of which 390 had a 10-year follow-up. The mean age was 34 (standard deviation 10) years, and 90% were male. We observed an increase in the prevalence of dyslipidemia (29%-52%, p < 0.001) and obesity (1.1%-3.5%, p < 0.001). Major cardiovascular events occurred in less than 1% of patients. Patients with a CD4 count <200 cells/mm3 had a higher frequency of acute myocardial infarction and obesity.Over time, people living with human immunodeficiency virus present with an increasing prevalence of cardiovascular risk factors, particularly those with a lower CD4 count.

  View details for DOI 10.1177/20503121231166647

  View details for Web of Science ID 000974065900001

  View details for PubMedID 37123385

  View details for PubMedCentralID PMC10134188

• High-Flow Oxygen Therapy for Severe Hypoxemia: Moving toward a More Inclusive Definition of Acute Respiratory Distress Syndrome AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE Barahona-Correa, J. E., Laserna, A., Fowler, C., Esquinas, A. 2022; 206 (4): 514-515

  View details for DOI 10.1164/rccm.202201-0185LE

  View details for Web of Science ID 000842005600022

  View details for PubMedID 35549638

• High-Flow Nasal Cannula in COVID-19 Pneumonia: Practical Issues CRITICAL CARE MEDICINE Laserna, A., Barahona-Correa, J. E., Papadakos, P., Esquinas, A. 2022; 50 (6): E591-E592

  View details for DOI 10.1097/CCM.0000000000005483

  View details for Web of Science ID 000799938700011

  View details for PubMedID 35120045

  View details for PubMedCentralID PMC9112501

• Impact of COVID-19 pandemic on patients with rheumatic diseases in Latin America RHEUMATOLOGY INTERNATIONAL Fernandez-Avila, D. G., Barahona-Correa, J., Romero-Alvernia, D., Kowalski, S., Sapag, A., Cachafeiro-Vilar, A., Melendez, B., Pastelin, C., Palleiro, D., Arrieta, D., Reyes, G., Pons-Estel, G. J., Then-Baez, J., Ugarte-Gil, M. F., Cardiel, M. H., Colman, N., Chavez, N., Burgos, P., Montufar, R., Sandino, S., Fuentes-Silva, Y. J., Soriano, E. R. 2022; 42 (1): 41-49

  Abstract

  The objective of our study was to describe knowledge, attitudes and practices of Latin-American rheumatology patients regarding management and follow-up of their disease during COVID-19 pandemic. A cross-sectional observational study was conducted using a digital anonymous survey. Rheumatic patients ≥ 18 years from non-English-speaking PANLAR countries were included. Our survey included 3502 rheumatic patients living in more than 19 Latin-American countries. Median age of patients was 45.8(36-55) years and the majority (88.9%) was female. Most frequently self-reported disease was rheumatoid arthritis (48.4%). At least one anti-rheumatic treatment was suspended by 23.4% of patients. Fear of contracting SARS-Cov2 (27.7%) and economic issues (25%) were the most common reasons for drug discontinuation. Self-rated disease activity increased from 30 (7-50) to 45 (10-70) points during the pandemic. Communication with their rheumatologist during the pandemic was required by 55.6% of patients, mainly by telephone calls (50.2%) and social network messages (47.8%). An adequate knowledge about COVID-19 was observed in 43% of patients. Patients with rheumatic diseases in Latin America were negatively affected by the COVID-19 pandemic. An increase in self-rated disease activity, a reduction in medication adherence, and hurdles for medical follow-up were reported. Teleconsultation was perceived as a valid alternative to in-person visits during the pandemic.

  View details for DOI 10.1007/s00296-021-05014-y

  View details for Web of Science ID 000714833400001

  View details for PubMedID 34739574

  View details for PubMedCentralID PMC8570063

• Impact of COVID-19 Pandemic on Rheumatology Practice in Latin America JOURNAL OF RHEUMATOLOGY Fernandez-Avila, D. G., Barahona-Correa, J., Romero-Alvernia, D., Kowalski, S., Sapag, A., Cachafeiro-Vilar, A., Melendez, B., Santiago-Pastelin, C., Palleiro, D., Arrieta, D., Reyes, G., Pons-Estel, G. J., Then-Baez, J., Ugarte-Gil, M. F., Cardiel, M. H., Colman, N., Chavez, N., Burgos, P., Montufar, R., Sandino, S., Fuentes-Silva, Y. J., Soriano, E. R. 2021; 48 (10): 1616-1622

  Abstract

  To describe the effect of the coronavirus disease 2019 (COVID-19) pandemic on Latin American rheumatologists from a professional, economic, and occupational point of view.We conducted an observational cross-sectional study using an online survey sent to rheumatologists of each non-English-speaking country member of the Pan American League of Rheumatology Associations (PANLAR). A specific questionnaire was developed.Our survey included 1097 rheumatologists from 19 Latin American countries. Median (IQR) age of respondents was 48 (40-59) years and 618 (56.3%) were female. Duration of practice since graduation as a rheumatologist was 17 years, and 585 (53.3%) were aged < 50 years. Most rheumatologists worked in private practice (81.8%) and almost half worked in institutional outpatient centers (55%) and inpatient care (49.9%). The median number of weekly hours (IQR) of face-to-face practice before the pandemic was 27 (15-40) hours, but was reduced to 10 (5-20) hours during the pandemic. Telehealth was used by 866 (78.9%) respondents during the pandemic. Most common methods of communication were video calls (555; 50.6%), telephone calls (499; 45.5%), and WhatsApp voice calls (423; 38.6%). A reduction in monthly wages was reported by 946 (86.2%) respondents. Consultation fees also were reduced and 88 (8%) rheumatologists stated they had lost their jobs. A reduction in patient adherence to medication was reported by nearly 50% of respondents. Eighty-one (7.4%) rheumatologists received a COVID-19 diagnosis and 7 (8.6%) of them were hospitalized.The COVID-19 pandemic has reshaped rheumatology practice in Latin America and has had a profound effect on rheumatologists' behaviors and clinical practice.

  View details for DOI 10.3899/jrheum.201623

  View details for Web of Science ID 000709706700021

  View details for PubMedID 34329183

• Renal Amyloidosis and Crohn Disease OCHSNER JOURNAL Barahona-Correa, J. E., Morales, S., Andrade-Perez, R., Hani, A. 2021; 21 (3): 291-295

  Abstract

  Background: Secondary amyloidosis, a rare complication of Crohn disease (CD), is triggered by persistent systemic inflammation. Kidney involvement is the most frequent manifestation and is often characterized by nephrotic syndrome and kidney failure. This complication usually appears in patients with long-standing disease and is associated with increased morbidity and mortality risk. Diagnosis is by microscopic amyloid observation of tissue biopsy, and when the diagnosis is confirmed, the therapeutic objective is disease activity control. Response assessment is challenging because of a lack of reliable biomarkers. Case Report: A 56-year-old male with a long-standing history of CD treated with a tumor necrosis factor-α inhibitor presented with an acute elevation of creatinine in association with clinical and laboratory markers of nephrotic syndrome. Kidney biopsy revealed renal amyloidosis. After treatment adjustment, although a stable creatinine was achieved, the patient had persistent impaired glomerular filtration rate. Conclusion: As a systemic chronic inflammatory disorder, CD may present multisystemic morbidity, for which increased awareness among gastroenterologists is warranted. Renal amyloidosis is an infrequent extraintestinal complication of CD that may lead to chronic kidney impairment. Although evidence-based treatment is lacking, disease activity control is pivotal for management.

  View details for DOI 10.31486/toj.20.0129

  View details for Web of Science ID 000696993800015

  View details for PubMedID 34566512

  View details for PubMedCentralID PMC8442223

• Does healthcare regime affiliation influence the clinical outcomes of patients with rheumatoid arthritis? CLINICAL RHEUMATOLOGY Barahona-Correa, J. E., Florez-Suarez, J., Coral-Alvarado, P., Mendez-Patarroyo, P., Quintana-Lopez, G. 2021; 40 (3): 877-886

  Abstract

  Adequate control of disease activity in rheumatoid arthritis (RA) depends, to a great extent, on the access to a rheumatologist. This study aimed to compare the disease outcomes of patients with RA, based on their healthcare regime affiliation.A retrospective observational study of Colombian patients with RA in three outpatient services of different regimes: Contributory (CR, workers and their families with a monthly income above a yearly defined threshold, approximately US$ 220, who allocate a percentage of their income to financing the national health fund and to get access to healthcare services), subsidized (SR, a vulnerable population with a monthly income below the threshold, who have access to healthcare through the national health fund; comparable to the USA Medicaid population), and an excellence clinical care center (C3, access to specialized care, regardless of their healthcare affiliation regime). Data were collected from clinical records for 2 years of follow-up and included demographics, lag times between appointments, and time in high disease activity. We used the Mantel-Cox test for the analysis of time to remission/low disease activity.A total of 240 patients were included (80 patients per regime). At the start of follow-up, mean age was 53.7 years; 21.6% of patients were men; 79.6% of patients had established RA; 72.9% of patients had high disease activity. Patients in the CR had longer lag times between scheduled appointments (p < 0.0001). During follow-up, SR had the highest proportion of patients with high disease activity. Survival curve analysis showed no significant difference between SR and CR groups (p = 0.2903), but was significantly different compared with the C3 group (p < 0.0001). Median survival in high disease activity was greater in the SR group (293 days), followed by CR (254 days), and finally by C3 (64 days).Patients that were treated in the excellence clinical care center had better outcomes when compared with other regimes. These data support that healthcare regime may influence disease outcome in patients with RA. Key Points • Prompt access to healthcare in patients with rheumatoid arthritis is pivotal for an adequate control of the disease, for timely adjustment of treatment, and to reduce both the societal burden of the disease and its impact on individual well-being. • As an example of "structural iatrogenesis," healthcare regime affiliation appears to influence disease outcomes in patients with rheumatoid arthritis, in whom differences between regimes are observed. The most vulnerable patients appear to experience the worst outcomes. • Excellence clinical care centers for patients with rheumatoid arthritis should be implemented as an alternative to counteract structural healthcare barriers and as an approach to improve clinical outcomes through a tighter disease control.

  View details for DOI 10.1007/s10067-020-05347-2

  View details for Web of Science ID 000561000100001

  View details for PubMedID 32813188

• Epidemiology of Candidemia at a University Hospital in Colombia, 2008-2014 UNIVERSITAS MEDICA Esteban Barahona-Correa, J., Gabriela Calvo-Valderrama, M., Marcela Romero-Alvernia, D., Angulo-Mora, J., Fernanda Alarcon-Figueroa, L., Nelcy Rodriguez-Malagon, M., Ricardo Garzon-Herazo, J. 2019; 60 (1)

  View details for DOI 10.11144/Javeriana.umed60-1.cand

  View details for Web of Science ID 000465302400001

• Comparison of Plasma Cytokine Levels before and after Treatment with Rituximab in Patients with Rheumatoid Arthritis and Systemic Lupus Erythematosus-Associated Polyautoimmunity UNIVERSITAS MEDICA Barahona Correa, J., Franco Cortes, M., Angel Uribe, J., Rodriguez Camacho, L. 2018; 59 (3)

  View details for DOI 10.11144/Javeriana.umed59-3.cyto

  View details for Web of Science ID 000457095800004

• Treatment of the <i>Helicobacter pylori</i> Infection: A Critical Appraisal of the Literature UNIVERSITAS MEDICA Laserna, A., Barahona-Correa, J. E., Helena Alba, L. 2018; 59 (3)

  View details for DOI 10.11144/Javeriana.umed59-3.pylo

  View details for Web of Science ID 000457095800006

• Mixed Malaria: Regarding the Diagnosis of a Case in a Non-Endemic Zone UNIVERSITAS MEDICA Barahona-Correa, J. E., Jimenez, A., de Castro, M., Carlos Lopez, J. 2018; 59 (2)

  View details for DOI 10.11144/Javeriana.umed59-2.mixt

  View details for Web of Science ID 000457094900011

• Economic impact of dengue fever in Latin America and the Caribbean: a systematic review REVISTA PANAMERICANA DE SALUD PUBLICA-PAN AMERICAN JOURNAL OF PUBLIC HEALTH Laserna, A., Barahona-Correa, J., Baquero, L., Castaneda-Cardona, C., Rosselli, D. 2018; 42: e111

  Abstract

  To assess the economic impact of dengue in Latin America and the Caribbean using a systematic review that includes studies not previously considered by other reviews.Cochrane methodology was used to conduct a systematic review of the cost of dengue in Latin America. PubMed Central, EMBASE, and the Biblioteca Virtual en Salud-which includes scientific, peer-reviewed journals not indexed by other databases-were searched from inception through August 2016. All articles that reported cost of illness data for countries in Latin America were included. Included studies underwent a methodological appraisal using a seven-question instrument designed for cost of illness studies. Extracted data were direct and indirect costs for outpatient and hospitalized cases and total cost of the disease. Values were adjusted to 2015 US dollars using the consumer price index.From a total of 848 initial references, 17 studies were included, mainly from Brazil, Colombia, Cuba, Mexico, and Puerto Rico; costs were available for 39 countries. The methodological appraisal showed that 70% of the studies met more than 70% of the evaluated items. The main economic impact of dengue was due to productivity costs. Average annual cost was more than US$ 3 billion. Direct costs represented over 70% of the total share for hospitalized cases. For outpatients, direct medical costs were low, but social costs were significant since indirect costs may account for up to 80% of the total cost.Dengue fever has a significant economic impact in Latin America. It is essential to develop new public health interventions, such as dengue vaccination, to decrease the propagation of the disease and its total cost.

  View details for DOI 10.26633/RPSP.2018.111

  View details for Web of Science ID 000463257000014

  View details for PubMedID 31093139

  View details for PubMedCentralID PMC6386068

• Sleep disturbances, academic performance, depressive symptoms and substance use among medical students in Bogota, Colombia SLEEP SCIENCE Esteban Barahona-Correa, J., Diego Aristizabal-Mayor, J., Lasalvia, P., Ruiz, A. J., Hidalgo-Martinez, P. 2018; 11 (4): 260-268

  Abstract

  Poor sleep patterns are common in undergraduates and may turn them prone to mood disorders, substance abuse and impaired academic performance. The aim of this study was to assess sleep disturbances among medical students, and whether associations with academic performance, depressive symptoms or substance use were present.Cross-sectional study in which 544 medical students of the Pontificia Universidad Javeriana in Bogota, Colombia were included. Using a computer-based survey, self-reported variables were assessed, including demographics, Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS), Berlin Questionnaire, Diagnostic and Statistical Manual of Mental Disorders (DSM) - IV depression criteria, Grade Point Average (GPA), and substance use. Associations between these variables were obtained.Fifty-four percent of students were women. Poor sleep quality (PSQI>5) and daytime sleepiness (ESS>10) were found in 65% of the population. A higher GPA was more frequent in students with good sleep quality (OR= 2.6 [1.5-4.5]), lack of daytime sleepiness (OR= 2 [1.3-3.1]) and low risk of Obstructive Sleep Apnea Syndrome (OSAS) (OR= 3.1 [1.6-5.9]). DSM-IV depression criteria were fulfilled by 26% of the students and were associated with poor sleep patterns. Energy drinks use was associated with poor sleep quality.Poor sleep quality, daytime sleepiness and depressive symptoms are frequent among medical students and are associated with lower academic performance. The identification of students at risk and the implementation of targeted interventions are warranted. Fostering adequate sleep habits and training on sleep medicine may partly counteract these issues.

  View details for DOI 10.5935/1984-0063.20180041

  View details for Web of Science ID 000456956400008

  View details for PubMedID 30746044

  View details for PubMedCentralID PMC6361310

• Pen Devices for Insulin Self-Administration Compared With Needle and Vial: Systematic Review of the Literature and Meta-Analysis. Journal of diabetes science and technology Lasalvia, P., Barahona-Correa, J. E., Romero-Alvernia, D. M., Gil-Tamayo, S., Castaneda-Cardona, C., Bayona, J. G., Triana, J. J., Laserna, A. F., Mejia-Torres, M., Restrepo-Jimenez, P., Jimenez-Zapata, J., Rosselli, D. 2016; 10 (4): 959-66

  Abstract

  OBJECTIVES: Pen devices offer advantages compared with vial and syringe (VaS). The purpose of this article was to evaluate efficacy of pen devices compared to VaS.METHODS: A systematic review of literature was performed in 8 different databases. References were independently screened and selected. Primary observational or experimental studies comparing pen devices with VaS for insulin administrations were included. Studies on specific populations were excluded. Risk of bias was evaluated using appropriate tools. Data on glycosylated hemoglobin (HbA1c), hypoglycemia, adherence, persistence, patient preference, and quality of life (QOL) were collected. Meta-analysis was performed when appropriate. Heterogeneity and risk of publication bias were evaluated. Otherwise, descriptive analyses of the available data was done.RESULTS: In all, 10348 articles were screened. A total of 17 studies were finally selected: 7 experimental and 10 analytical. The populations of the included articles were mainly composed of adults with type 2 diabetes mellitus. Important risk of bias was found in all of the articles, particularly experimental studies. Meta-analyses were performed for HbA1c, hypoglycemia, adherence and persistence. Pen device showed better results in mean HbA1c change, patients with hypoglycemia, adherence and persistence compared to VaS. No difference was observed in number of patients achieving <7% HbA1c. Preference studies showed a tendency favoring pen devices, however nonvalidated tools were used. One QoL study showed improvements in some subscales of SF-36.CONCLUSIONS: There is evidence that pen devices offer benefits in clinical and, less clearly, patient-reported outcomes compared to VaS for insulin administration. However, these results should be taken with caution.

  View details for DOI 10.1177/1932296816633721

  View details for PubMedID 26920639