A Clinical Profile of Reactive Arthritis in a Peruvian Series: A Pilot Study
Bibliographic record
Abstract
Enteric pathogens are an endemic cause of acute diarrheal diseases among Peruvians. The frequency of HLA-B27 in the general population (0%-3%) is lower than that among Caucasians in the United States, Canada, and Europe (6%-14%). It was believed that both of these factors were likely to interact to modulate the clinical expression of reactive arthritis (ReA) or Reiter's Syndrome (RS). The objective of our study was to define the clinical characteristics of ReA in a group of patients treated in a general hospital in Lima, Peru. Between December 1, 1976, and June 30, 1993, using a standardized protocol, we studied all patients who presented with peripheral arthritis that occurred within 1 month after urethritis and/or diarrhea. Additional inclusion and exclusion criteria were defined to rule out well-known causes of arthritis. Patients with complete and incomplete RS of undetermined origin were also included. Fifty-five patients (44 males, 11 females) met established criteria; the mean age at onset was 19 +/- 9.8 years (range 7-51). Fever was the most frequent manifestation (63.3%), followed by conjunctivitis/uveitis (61.8%), urethritis/cervicitis (58.2%), diarrhea (45.5%), and balanitis (14.5%). Keratoderma blennorrhagica was absent. Compared with Caucasians, Peruvians were younger at the onset of disease, and their female/male ratio was higher. Additionally, the Peruvians experienced a higher frequency of fever and diarrhea and a lower frequency of balanitis and genitourinary manifestations. Different lines of evidence, including poor public health facilities, the patients' histories, demographics, and the extra-articular constellation of symptoms and signs, suggest that enteropathogenic microorganisms are at least as prevalent as sexually transmitted triggers of ReA in our series. Accordingly, clinicians treating patients with ReA in the Third World should tailor preventive measures and therapy to address the suspected infectious origin. Furthermore, the lower frequency of certain extra-articular manifestations, such as keratoderma blenorrhagica, uveitis, and enthesopathy, as well as a better outcome may be a result of the low frequency of HLA-B27 positivity in this population.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".