RESUMO
Abstract Introduction/Objectives: To assess people's level of recognition of rheumatic disease symptoms and their awareness that the rheumatologist is the main effector when it comes to these disorders. Materials and methods: Survey performed in 8 towns in the Buenos Aires Province. Every town had at least one rheumatologist. Three clinical cases were presented: (1) inflammatory low back pain, (2) systemic disease, and (3) chronic polyarthritis. The population was asked whether (a) a physician should be immediately consulted, or (b) they could wait. They were asked whether they would advocate any initial treatment. They were also asked which physician should be consulted. Results: Out of 150 surveys, 68% were female, the average age was 51.7 years old. Most people asserted that treatment with anti-inflammatory drugs should come first: 83% in inflammatory low back pain, 70% in systemic disease, and 70% in chronic polyarthritis (p = 0.02). The number of men that suggested waiting was higher (47% vs. 28% of women; p = 0.04). A rheumatologist was recommended by 51% for chronic polyarthritis, 15% for systemic disease, and 8% for inflammatory low back pain (p < 0.0001). Thirty-eight percent of those who never considered consulting a rheumatologist had elementary education vs. 19% of those who considered consulting a rheumatologist for one of the 3 cases (p = 0.01) Conclusions: Chronic polyarthritis was the disease people identified best as within the rheumatologist's field of expertise. Men tended to delay consultation more than women. Consultation is less likely when the level of education is lower.
RESUMEN Introducción/Objetivos: Evaluar el nivel de conocimiento de la población con respecto a los síntomas reumáticos y determinar si se reconoce al reumatólogo como el profesional que debe ser consultado en primer lugar ante su aparición. Materiales y métodos: Encuesta realizada en 8 localidades del interior de la provincia de Buenos Aires. Cada ciudad tenía al menos un reumatólogo. Se presentaron tres casos clínicos: (1) lumbalgia inflamatoria, (2) enfermedad sistémica y (3) poliartritis crónica. Se preguntó si (a) aconsejarían consultar a un médico de inmediato, o (b) aconsejarían esperar. Se preguntó si aconsejarían algún tratamiento y a qué médico aconsejarían consultar en primer lugar. Resultados: Sobre 150 encuestados, el 68% fueron mujeres y la edad promedio fue de 51,7 años. El 83% de los encuestados aconsejó usar antiinflamatorios en lumbalgia inflamatoria vs. 70% en enfermedad sistémica y 70% en poliartritis crónica (p = 0,02). Los hombres sugirieron esperar con mayor frecuencia que las mujeres (47% vs. 28%; p = 0,04). Un 51% de los encuestados recomendó consultar al reumatólogo en primer lugar en poliartritis crónica vs. 15% en enfermedad sistémica y 8% en lumbalgia inflamatoria (p < 0,001). Entre aquellos que nunca consideraron consultar a un reumatólogo, el 38% tenía educación primaria vs. el 19% entre los que sugirieron consultar a un reumatólogo en alguno de los 3 casos (p = 0,01). Conclusiones: La poliartritis crónica fue la enfermedad mejor identificada dentro del campo de la reumatología. Los hombres tienden a retrasar la consulta con el médico. La consulta con el reumatólogo es menos probable cuanto menor es el nivel de educación.
RESUMO
To assess breastfeeding in patients with systemic lupus erythematosus (SLE), a cross-sectional study of patients with SLE compared to a non-SLE sample was performed. Patients who had pregnancies subsequent to their diagnosis of SLE and who were followed up in the hospital were interviewed. The group of non-SLE mothers consisted of patients who had no known rheumatic disease at the time of their pregnancy, and who were approached at the hospital paediatrics service waiting room. Thirty-six pregnancies in 31 patients with SLE and the same number of non-SLE mothers were studied. The number of SLE patients who did not initiate breastfeeding was higher than that of non-SLE mothers (19.4 vs 5.6%, respectively; p 0.07). The average duration of breastfeeding in SLE patients was 6 months (SD 6 months) versus 12 months (SD 8 months) in non-SLE mothers (log rank p: 0.003). Fifty-three percent of the non-SLE mothers indicated no particular reason for weaning, and considered that they had nursed their children a suitable amount of time. Conversely, SLE patients often set weaning in motion on the grounds that they had been placed on medication (41%). However, when the treatment was analysed, in 6 out of 12 cases, it consisted of low doses of either corticosteroids or hydroxychloroquine. Patients with SLE showed reduced rates of initiating breastfeeding. They also showed reduced duration of breastfeeding, and the reason for cessation was frequently cited to be therapies which were actually of low risk. Breastfeeding duration could be optimised by improving the level of information provided to patients.