Ingris Peláez-Ballestas
HOSPITAL GENERAL DE MEXICO, Rhematology, Faculty Member
- Universidad Nacional Autónoma de México, Posgrado, Department Memberadd
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Research Interests: Rheumatoid Arthritis, Medicine, Physical Therapy, Osteoarthritis, Mexico, and 15 moreHumans, Internal Medicine, Female, Male, Musculoskeletal pain, Clinical Sciences, Prevalence, Middle Aged, Adult, MEXICO, Rheumatic diseases, Cross Sectional Studies, Pain Measurement, Confidence Interval, and Disability Evaluation
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Research Interests: Humanities and Persona
BackgroundChronic exposure to household air pollution (HAP) from cooking by biomass leads to noncommunicable diseases as chronic obstructive pulmonary disease or lung cancer (1), but it is less well known if it could promote epigenetic or... more
BackgroundChronic exposure to household air pollution (HAP) from cooking by biomass leads to noncommunicable diseases as chronic obstructive pulmonary disease or lung cancer (1), but it is less well known if it could promote epigenetic or proteomic changes leading to autoimmune susceptibility. HAP remains a serious health problem for poor and marginalized indigenous communities. Recent studies have shown a high prevalence of rheumatic disease in Latino American indigenous people (2), but it is unknown if HAP and the PM2.5 particles, could be a risk factor for the pathogenesis of rheumatic diseases.ObjectivesTo evaluate the relationship between the levels of PM2.5 derived from HAP and levels of inflammatory and epigenetic markers in rheumatic patients from an indigenous community in Chiapas, México.MethodsCross-sectional study nested in a cohort of patients with rheumatic disease in a Tzotzil indigenous community in Chiapas (Southern Mexico). Following the COPCORD methodology and emp...
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COVID-19 vaccination is recommended in patients with rheumatic diseases (RDs) to prevent hospitalized COVID-19 and worse outcomes. However, patients' willingness to receive a SARS-CoV-2 vaccine and the associated factors vary across... more
COVID-19 vaccination is recommended in patients with rheumatic diseases (RDs) to prevent hospitalized COVID-19 and worse outcomes. However, patients' willingness to receive a SARS-CoV-2 vaccine and the associated factors vary across populations, vaccines, and time. The objective was to identify factors associated with COVID-19 vaccine acceptance (VA) in Mexican outpatients with RDs. This multicenter study was performed between March 1 and September 30, 2021, and four national centers contributed with patients. Participants filled out a questionnaire, which included 32 items related to patients' perception of the patient-doctor relationship, the COVID-19 vaccine component, the pandemic severity, the RD-related disability, comorbid conditions control, immunosuppressive treatment impact on the immune system, and moral/civil position of COVID-19 vaccine. Sociodemographic, disease-related, and treatment-related variables and previous influenza record vaccination were also obtained. Multiple logistic regression analyses identified factors associated with VA, which was defined based on a questionnaire validated in our population. There were 1439 patients whose data were analyzed, and the most frequent diagnoses were Rheumatoid Arthritis in 577 patients (40.1%) and Systemic Lupus Erythematosus in 427 (29.7%). Patients were primarily middle-aged women (1235 [85.8%]), with (mean±SD) 12.1 (±4.4) years of formal education. Years of education, corticosteroid use, patient perceptions about the vaccine and the pandemic severity, patient civil/moral position regarding COVID-19 vaccine, and previous influenza vaccination were associated with VA. In Mexican patients with RDs, COVID-19 VA is associated with individual social-demographic and disease-related factors, patient´s perceptions, and previous record vaccination. This information is crucial for tailoring effective vaccine messaging in Mexican patients with RDs.
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Background:Syndemics comprises the interaction of two or more biological diseases in different socio-cultural situations and in the context of varying healthcare standards that exacerbates their deleterious effects on the health of... more
Background:Syndemics comprises the interaction of two or more biological diseases in different socio-cultural situations and in the context of varying healthcare standards that exacerbates their deleterious effects on the health of individuals, communities, and societies (1). There is increasing interest in using syndemics in the study of RMDs.Objectives:To identify quantitative and qualitative RMDs studies focused on syndemics through a systematic review and synthesize the available evidence.Methods:Inclusion criteria were using a syndemic framework in methods in RMDs studies. A systematic search of studies published from 2003 up to January 2021 was conducted in two electronic databases (SCOPUS and Web of Science). The systematic search was implemented (Figure 1): 1) the word syndemic(s) was searched using the advanced query string search, in the title, abstract, keywords, and text, to identify the relevant studies; 2) the publications were screened by three peer review groups; 3) ...
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Medication compliance is critical to achieve therapeutic efficacy in patients with rheumatoid arthritis; however, among other factors, low patient-health literacy plays a negative role. Therefore, the development and validation of... more
Medication compliance is critical to achieve therapeutic efficacy in patients with rheumatoid arthritis; however, among other factors, low patient-health literacy plays a negative role. Therefore, the development and validation of audiovisual educational material with the participation of health specialists and patients could lead to an improved level of compliance with treatment, while favoring its acceptance. To design and validate audiovisual educational material generated by a multidisciplinary and participative group of patients and health specialists. This study was carried out using a sequential methodology, including qualitative and quantitative techniques: (1) a non-participative observational study with patients and a non-systematic literature search were performed to identify conceptual topics. (2) Pilot videos were qualitatively assessed by patients and health specialists (focus groups and expert committees). (3) Improved versions of seven videos were quantitatively evaluated by patients and specialists following qualitative criteria of attraction, understanding, involvement, acceptance and induction of action. 74 patients with RA, 10 rheumatologists, 4 pharmacists and 2 medical anthropologists participated in the different phases of validation. A total of seven videos lasting 3 min each were generated, incorporating the most relevant suggestions by patients and healthcare professionals. The final version of the videos led to a mean compliance of 96.04 ± 5.2%, according to a representative group of patients and a mean 89.6 ± 9.4%, according to health professionals. With the participation of both patients and health specialists, seven audiovisual educational video recordings were developed and validated, reaching high levels of compliance in accordance with international criteria.
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El trabajo de campo etnográfico, que implica el encuentro con la otredad, es utilizado por la antropología médica para acercarse a la comprensión de problemáticas sociales relacionadas con la salud, la enfermedad, la atención y la... more
El trabajo de campo etnográfico, que implica el encuentro con la otredad, es utilizado por la antropología médica para acercarse a la comprensión de problemáticas sociales relacionadas con la salud, la enfermedad, la atención y la muerte. El objetivo del trabajo fue realizar una reflexión ética de diversas situaciones conflictivas experimentadas por tres antropólogas durante sus investigaciones en México, a través del análisis de sus diarios de campo. Con este fin, se realizó un análisis grupal e interdisciplinario desde una perspectiva ética. Los conflictos encontrados se clasificaron en: 1. Dilemas éticos (como la sinceridad vs. ocultamiento de información); 2. Disonancias éticas (como la justicia en el acceso de los informantes a los servicios médicos, el acceso y la identidad del antropólogo en campo, los límites de la intervención, la reciprocidad y las emociones del investigador); y 3. Otros (conflictos éticos tales como la observación del paternalismo ...
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La artritis reumatoide (AR) es una patología crónica que genera limitación funcional, impactando en la calidad de vida de los pacientes y de su entorno familiar. El objetivo de este estudio fue estimar la prevalencia de AR en las... more
La artritis reumatoide (AR) es una patología crónica que genera limitación funcional, impactando en la calidad de vida de los pacientes y de su entorno familiar. El objetivo de este estudio fue estimar la prevalencia de AR en las comunidades de pueblos originarios qom y wichi de la ciudad de Rosario y Misión Chaqueña (Salta); además de comparar las características entre ambas. Se realizó un estudio transversal, epidemiológico, de base comunitaria, utilizando la metodología Community Oriented Program for the Control of Rheumatic Diseases (COPCORD). Los individuos con dolor músculo—esquelético (casos positivos) fueron evaluados en forma consecutiva por médicos generales y referenciados dentro de la semana al reumatólogo para diagnóstico y eventual tratamiento. La prevalencia de AR fue de 3% (qom) y 3.2% (wichi). Las características de la AR fueron similares en ambas comunidades en relación a la actividad medida por Disease Activity Score—28 (DAS 28) (p 0,341) pero no en la limitación ...
Research Interests: Humanities and Medicine
Rheumatologic and musculoskeletal diseases (RMDs) are important causes of morbidity and mortality worldwide. The World Health Organization (WHO) considers musculoskeletal conditions to be the leading cause of disability worldwide, and the... more
Rheumatologic and musculoskeletal diseases (RMDs) are important causes of morbidity and mortality worldwide. The World Health Organization (WHO) considers musculoskeletal conditions to be the leading cause of disability worldwide, and the greatest independent contributors to chronic pain. Population-based surveys from low- and middle-income countries (LMICs) have demonstrated similar rates of RMDs compared with high-income countries.
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During 2014 and 2015 the chikungunya virus reached Colombia unleashing an epidemic that spread throughout the whole territory. Concurrently, the Colombian Rheumatology Association was conducting a Community Oriented Program for Control of... more
During 2014 and 2015 the chikungunya virus reached Colombia unleashing an epidemic that spread throughout the whole territory. Concurrently, the Colombian Rheumatology Association was conducting a Community Oriented Program for Control of Rheumatic Diseases (COPCORD) to establish rheumatic disease prevalence in the country. Chikungunya infected patients were identified within the COPCORD population. The aim of this study was to describe the demographics, clinical characteristics and disability of patients with clinical suspicion of chikungunya infection. To confirm chikungunya infection, ELISA IgM and IgG serology was performed. From the 6528-surveyed people of the COPCORD study, 548 where included in the study because of clinical suspicion of chikungunya virus infection. Of those, 295 were positive for IgG or IgM chikungunya serology with 151 patients fulfilling WHO clinical criteria for chikungunya infection (true positives). Most patients were > 45 years (57.7%), and females (...
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Objectives: To assess the physical function of people living with osteoarthritis in a Maya-Yucateco rural community from 3 perspectives and explore factors associated with the presence of disability. Design: Physical function and social,... more
Objectives: To assess the physical function of people living with osteoarthritis in a Maya-Yucateco rural community from 3 perspectives and explore factors associated with the presence of disability. Design: Physical function and social, physical, psychological, and behavioral factors were evaluated in all adults detected with hand, hip, and/or knee osteoarthritis (n = 144) through a Community-Oriented Program for the Control of Rheumatic Diseases–based census in the Mayan community of Chankom, Yucatán. All cases fulfilled the American College of Rheumatology criteria. Physical function was assessed from 3 perspectives: hypothetical or “what people think they can do” (Health Assessment Questionnaire-Disability Index [HAQ-DI]), experimental or “what people could do in standardized conditions” (6-minute walk test [6MWT] + the Functional Dexterity Test) and enacted or “what people actually do” (personal care, work, and leisure activities’ self-report). Results: About 80% of participant...
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Syndemics are a framework that documents health inequities and vulnerabilities in populations with rheumatic diseases. Compared with other approaches, syndemics are able to conjunctly consider epidemiological, biological, sociodemographic... more
Syndemics are a framework that documents health inequities and vulnerabilities in populations with rheumatic diseases. Compared with other approaches, syndemics are able to conjunctly consider epidemiological, biological, sociodemographic and economic factors, and their interactions.ObjectiveTo estimate health inequity and vulnerability among Indigenous and non-Indigenous populations with rheumatic and musculoskeletal diseases (RMD) in Latin America using the syndemic approach.DesignThis is a secondary analysis of a previously published large-scale study on the prevalence of RMD.SettingStudies carried out in five Latin American countries (Argentina, Colombia, Ecuador, Mexico and Venezuela). Health inequity and vulnerability in RMD were identified through a syndemic approach using network and cluster analysis.ParticipantsA total of 44 560 individuals were studied: 29.78% self-identified as Indigenous, 60.92% were female, the mean age was 43.25 years. Twenty clusters were identified i...
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Research Interests: Medicine, Comorbidity, Physical Therapy, Mexico, Humans, and 15 moreInternal Medicine, Fibromyalgia, Female, Male, Musculoskeletal pain, Clinical Sciences, Middle Aged, Adult, Odds ratio, MEXICO, Cross Sectional Studies, Pain Measurement, Logistic Models, Confidence Interval, and Disability Evaluation
Backyard animal husbandry is common in rural communities in developing countries and, given the conditions in which it occurs, it can increase the risk of disease transmission, such as arboviruses. To determine the presence of the Zika... more
Backyard animal husbandry is common in rural communities in developing countries and, given the conditions in which it occurs, it can increase the risk of disease transmission, such as arboviruses. To determine the presence of the Zika virus (ZIKV) and abundance of its arthropod vectors we evaluated the socioeconomic implications involved in its transmission in two highly vulnerable Mayan communities in the state of Yucatan that practice backyard farming. An analytical cross-sectional study was carried out throughout 2016 to understand socioeconomic variables and seasonal patterns in mosquito populations. We selected 20 households from each community. Social exclusion indicators were analyzed, human and domestic animals were sampled, and mosquitoes were collected and identified. Four out of eight indicators of social exclusion were higher than the reported national averages. We captured 5,825 mosquitoes from 16 species being Culex quinquefasciatus and Aedes aegypti the most abundant...
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Background The children’s agency and that exercised by parents and health professionals in palliative care, along with structural limitations imposed by the conditions of inequality, will provide a new perspective from medical... more
Background The children’s agency and that exercised by parents and health professionals in palliative care, along with structural limitations imposed by the conditions of inequality, will provide a new perspective from medical anthropology and biomedicine to improve pediatric palliative care in complex therapeutic scenarios. The main purpose of the study was to analyze the ways in which pediatric patients have agency in relation to their parents and palliative care (PC) professionals within the hospital setting, as well as the structural circumstances that constrain said agency. Method A hospital ethnography (by means of non-participant observation and interviews) of the palliative care (PC) unit in a children’s hospital was conducted over the course of six months. A thematic analysis was performed using the ATLAS.ti software . Results Thirteen cases were reconstructed of underage patients of both sexes patients together with their families; five health professionals were interviewe...
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Resumen Introduccion El objetivo fue adaptar y validar, de forma culturalmente sensible, la metodologia del Programa orientado a la comunidad para el control de enfermedades reumaticas (COPCORD) en la comunidad indigena misak de Colombia.... more
Resumen Introduccion El objetivo fue adaptar y validar, de forma culturalmente sensible, la metodologia del Programa orientado a la comunidad para el control de enfermedades reumaticas (COPCORD) en la comunidad indigena misak de Colombia. Material y metodos Se realizo una validacion culturalmente sensible del cuestionario Copcord en espanol, que se tradujo al nam trik wam, lengua usada por el pueblo misak del resguardo de Guambia. El cuestionario se adecuo al contexto de esta poblacion y posteriormente se llevo a cabo una retrotraduccion al espanol. Por ultimo, se valido aplicando la encuesta con el apoyo de traductores bilingues. Los participantes con dolor, rigidez o hinchazon en cualquier articulacion en los siete dias previos, o en cualquier momento de la vida, fueron evaluados por medicos y fisioterapeutas. Al confirmarse el diagnostico de una enfermedad musculoesqueletica los participantes eran examinados por un reumatologo. Resultados De la poblacion estudiada (n = 106) el 58,5% fueron mujeres, con una edad promedio de 45,4 anos. En los ultimos siete dias, 51 sujetos (48,1%) informaron tener dolor musculoesqueletico y siete (44,3%) refirieron dolor en algun momento de su vida. Quienes recibieron tratamiento reportaron el uso de medicamentos tradicionales en un 53,1% de los casos, homeopaticos en el 34,4% y alopaticos en el 25%. El cuestionario COPCORD Misak demostro una adecuada capacidad para detectar los trastornos musculoesqueleticos, con una sensibilidad del 63,3%, una especificidad del 80,3%, una razon de verosimilitud positiva de 3,2 y un area bajo la curva de 0,71. Conclusion La metodologia COPCORD es una herramienta valida de cribado de enfermedades musculoesqueleticas en el pueblo misak.
Research Interests: Humanities and Medicine
BACKGROUND: The COPCORD instrument allows the identification of musculoskeletal pain and rheumatic diseases such as osteoarthritis, rheumatoid arthritis, low back pain. The aim of this research is to validate and cross-culturally adapt... more
BACKGROUND: The COPCORD instrument allows the identification of musculoskeletal pain and rheumatic diseases such as osteoarthritis, rheumatoid arthritis, low back pain. The aim of this research is to validate and cross-culturally adapt the COPCORD instrument in the indigenous population as a screening test for the detection of these diseases. METHODS: It is a descriptive study, the universe of 210 indigenous people over 18 years residing in Saraguro - Loja, Ecuador. During the period from December 1, 2016 to January 30, 2017. The COPCORD was adjusted to the Spanish language, a transcultural adaptation and validation was made to the context of the indigenous group. The information was entered into the statistical program of Stata Version 11, analyzed: Cronbach's alpha, correlation matrixes with the Spearman test. The variables were correlated with the diagnosis established by the rheumatologist. RESULTS: The average age was 46.1 years, 64.7 % of the female gender, the screening t...
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In this issue of The Journal of Rheumatology, Carluzzo et al1 explored different factors that contribute to the empowerment of individuals with arthritis. The study used data obtained from 12,560 US participants in the Live Yes! INSIGHTS... more
In this issue of The Journal of Rheumatology, Carluzzo et al1 explored different factors that contribute to the empowerment of individuals with arthritis. The study used data obtained from 12,560 US participants in the Live Yes! INSIGHTS program, based on sociodemographic information and patient-reported outcome measures (PROMs) about physical and mental health, emotional support, and empowerment.
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Background Epidemiological data from Mexico have documented an increase in heroin use in the last decade. However, there is no comprehensive care strategy for heroin users, especially those who have been accused of a crime. The objective... more
Background Epidemiological data from Mexico have documented an increase in heroin use in the last decade. However, there is no comprehensive care strategy for heroin users, especially those who have been accused of a crime. The objective of this study was to describe the heroin and methadone use of intravenous heroin users of both sexes who have been in jail, to offer evidence for the formulation of health policy. Methods This study used an ethnographic approach, with open-ended interviews carried out from 2014 to the present. Heroin users of both sexes attending a private methadone clinic in Mexico City were invited to participate. The sample was non-probabilistic. All interviews were audiotaped and transcribed, and narratives were analyzed using thematic analysis. Results Participants in this study were 33 users of heroin, two of them women, who had been in prison. They ranged in age from 33 to 62 years, had used heroin for a period of 13–30 years, and were from three states: Mich...
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OBJECTIVE Systemic lupus erythematosus (SLE) disproportionately affects Latin Americans and Latinos (La&L), with worse outcomes compared to non-minority populations. Understanding patients' views is critical to provide culturally... more
OBJECTIVE Systemic lupus erythematosus (SLE) disproportionately affects Latin Americans and Latinos (La&L), with worse outcomes compared to non-minority populations. Understanding patients' views is critical to provide culturally competent care. The objective of this research is to analyze lived experiences with SLE from comments made by La&L patients, and their relatives and friends, on the public Facebook group Hablemos de Lupus ("Let's Talk about Lupus"). METHODS De-identified narratives posted as a reaction to the most popular resources shared by the page were extracted with the Facepager application. We conducted a thematic analysis under an interpretative medical anthropology framework. RESULTS Five core themes emerged from social media comments: lived experiences with lupus, religious/spiritual thoughts, metaphors, heredity, and experiences of family and friends. Being diagnosed with lupus is perceived as a life-changing event. The fluctuating course of the disease causes uncertainty and the perception of invisibility within the patient's social circle generates feelings of being misunderstood. Faith and spiritual thoughts are coping strategies. Patients use metaphors about the disease's meaning and their lived experiences (the purple butterfly, not belonging, bellicose discourse) to communicate with others. Relatives and friends are impacted by their loved one's suffering. CONCLUSION Patients perceive lupus as an unpredictable illness and use metaphors to foster empathy and communicate their experiences to others. Religion is as important as medical treatment to cope with the disease. Suffering extends to family and friends. Findings can be used to improve physician-patient communication and lupus education campaigns for the La&L population.
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Additional file 4. CAREGIVERS questionnaire: Impact of Pediatric Rheumatic Diseases on Caregivers Multi-Assessment Questionnaire.