Revista Brasileira de Reumatologia (English Edition)最新文献

{"title":"Investigation of MEFV gene polymorphisms (G138G and A165A) in adult patients with familial Mediterranean fever","authors":"Mustafa Ferhat Öksuz ,&nbsp;Mutlu Karkucak ,&nbsp;Orhan Görukmez ,&nbsp;Gökhan Ocakoğlu ,&nbsp;Abdulmecit Yıldız ,&nbsp;Mehmet Ture ,&nbsp;Tahsin Yakut ,&nbsp;Kamil Dilek","doi":"10.1016/j.rbre.2016.02.004","DOIUrl":"10.1016/j.rbre.2016.02.004","url":null,"abstract":"<div><h3>Aim</h3><p>Various mutations have been identified in the Mediterranean fever (MEFV) gene which is reported to be responsible from Familial Mediterranean fever (FMF). In our study, we aimed to determine the frequency of the MEFV mutations in our region and to investigate the impact of G138G (rs224224, c.414A&gt;G) and A165A (rs224223, c.495C&gt;A) gene polymorphisms on the clinical findings of the disease.</p></div><div><h3>Methods</h3><p>One hundred and sixteen patients diagnosed with FMF and 95 control subjects were included in this study. We used the DNA sequence analysis method to identify the most prevailing 10 mutations located in exon 2 and 10 of MEFV gene.</p></div><div><h3>Results</h3><p>As a result of the MEFV mutation analysis, the most common mutation was the M694<span>V</span> mutation allele with a frequency rate of 41.8%. When the patients group and control group were compared in terms of frequency of both polymorphic alleles (G polymorphic allele, observed in G138G and the A polymorphic allele, observed in A165A), the variation was observed to be statistically significant (<em>p</em> <!-->&lt;<!--> <!-->0.001). It was found that the MEFV mutation types have no relation with clinical findings and amyloidosis (<em>p</em> <!-->&gt;<!--> <!-->0.05).</p></div><div><h3>Conclusions</h3><p>To our knowledge, our study is the first study in the Southern Marmara region that reports the frequency of MEFV mutations. Our findings imply that the polymorphisms of G138G and A165A may have an impact on progress of the disease. We think that more studies, having higher number of cases and investigating the polymorphisms of MEFV gene, are needed.</p></div>","PeriodicalId":101096,"journal":{"name":"Revista Brasileira de Reumatologia (English Edition)","volume":"57 6","pages":"Pages 501-506"},"PeriodicalIF":0.0,"publicationDate":"2017-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rbre.2016.02.004","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35282687","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development of rheumatology training in Brazil: the option for a medical residency program","authors":"Cleandro Pires Albuquerque,&nbsp;Leopoldo Luiz dos Santos-Neto","doi":"10.1016/j.rbre.2016.04.001","DOIUrl":"10.1016/j.rbre.2016.04.001","url":null,"abstract":"<div><h3>Objective</h3><p>To describe the characteristics and progression of the supply of new rheumatologists in Brazil, from 2000 to 2015.</p></div><div><h3>Methods</h3><p>Consultations to databases and official documents of institutions related to training and certification of rheumatologists in Brazil took place. The data were compared, summarized and presented descriptively.</p></div><div><h3>Results</h3><p>From 2000 to 2015, Brazil qualified 1091 physicians as rheumatologists, of which 76.9% (<em>n</em> <!-->=<!--> <!-->839) completed a medical residency program in rheumatology (MRPR); the others (<em>n</em> <!-->=<!--> <!-->252) achieved this title without MRPR training. There was an expansion of MRPR positions. At the same time, there was a change in the profile of the newly qualified doctors. Early in the series, the fraction of new rheumatologists without MRPR, entering the market annually, was approaching 50%, dropping to about 15% in recent years. In 2015, Brazil offered 49 MRPR accredited programs, with 120 positions per year for access. There was an imbalance in the distribution of MRPR positions across the country, with a strong concentration in the southeast region, which in 2015 held 59.2% of the positions. Public institutions accounted for 94% (<em>n</em> <!-->=<!--> <!-->789) of graduates in MRPR during the study period, while still maintaining 93.3% (<em>n</em> <!-->=<!--> <!-->112) of seats for admission in 2015.</p></div><div><h3>Conclusions</h3><p>In the last sixteen years, in parallel with the expansion of places of access, MRPR has established itself as the preferred route for rheumatology training in Brazil, mainly supported by public funds. Regional inequalities in the provision of MRPR positions still persist, as challenges that must be faced.</p></div>","PeriodicalId":101096,"journal":{"name":"Revista Brasileira de Reumatologia (English Edition)","volume":"57 6","pages":"Pages 507-513"},"PeriodicalIF":0.0,"publicationDate":"2017-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rbre.2016.04.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35282688","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lyme disease and juvenile idiopathic arthritis – A pediatric case report","authors":"Mário Correia de Sá ,&nbsp;Catarina Moreira ,&nbsp;Cláudia Melo ,&nbsp;Álvaro Sousa ,&nbsp;Sónia Carvalho","doi":"10.1016/j.rbre.2015.09.006","DOIUrl":"10.1016/j.rbre.2015.09.006","url":null,"abstract":"","PeriodicalId":101096,"journal":{"name":"Revista Brasileira de Reumatologia (English Edition)","volume":"57 6","pages":"Pages 620-622"},"PeriodicalIF":0.0,"publicationDate":"2017-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rbre.2015.09.006","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35637852","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of pamidronate for osteoporosis treatment in public health care in Brazil","authors":"Leila Bianchet Zanatta ,&nbsp;Cristina Marcatto ,&nbsp;Cassio Slompo Ramos ,&nbsp;Nadila Mañas ,&nbsp;Carolina Moreira ,&nbsp;Victoria Borba","doi":"10.1016/j.rbre.2016.07.005","DOIUrl":"10.1016/j.rbre.2016.07.005","url":null,"abstract":"<div><h3>Purpose</h3><p>The use of bisphosphonates for osteoporosis is effective in reducing the risk of fractures. However, oral formulations are sometimes not well tolerated or are contraindicated. Due to its availability in Brazilian public health system, pamidronate is frequently prescribed for osteoporosis, despite the lack of studies demonstrating its anti-fracture efficacy and the absence of FDA or EMEA approval for this purpose. The aim of this study was to evaluate the bone mineral density (BMD) response to pamidronate in a group of women with osteoporosis in a tertiary care hospital.</p></div><div><h3>Patients and methods</h3><p>The medical records of women with osteoporosis who received pamidronate for up to two years of treatment were reviewed. Patients were stratified at high or intermediate risk of fracture.</p></div><div><h3>Results</h3><p>A total of 70 women were in treatment with pamidronate. Among them, 74% were at high risk of fracture. A significant gain in spine BMD after 24 months of treatment was observed (<em>p</em> <!-->=<!--> <!-->0.012). There was no difference between the groups of high and not high risk of fracture. At the femur, no significant increase in BMD was present, though, a strong negative correlation with high PTH levels (<em>r</em> <!-->=<!--> <!-->−0.61; <em>p</em> <!-->=<!--> <!-->0.003) was seen. In the multivariate analysis BMI at 12 months had impact in the response to the treatment.</p></div><div><h3>Conclusion</h3><p>The intravenous pamidronate in a group of postmenopausal women with predominant high risk of fracture promoted an isolated gain in the spine BMD, even though, clinical randomized trials are needed to confirm its anti-fracture efficacy.</p></div>","PeriodicalId":101096,"journal":{"name":"Revista Brasileira de Reumatologia (English Edition)","volume":"57 6","pages":"Pages 514-520"},"PeriodicalIF":0.0,"publicationDate":"2017-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rbre.2016.07.005","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35282689","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reduced activation and CD3 lymphocyte recruitment after TNF-inhibitor use: evaluation of clinical and 99mTc-OKT3 scintigraphic response in a patient with juvenile idiopathic arthritis","authors":"Flavia Paiva Proença Lobo Lopes ,&nbsp;Sergio Augusto Lopes de Souza ,&nbsp;Blanca Elena Rios Gomes Bica ,&nbsp;Lea Mirian Barbosa da Fonseca ,&nbsp;Mario Newton Leitão de Azevedo ,&nbsp;Bianca Gutfilen","doi":"10.1016/j.rbre.2015.08.011","DOIUrl":"10.1016/j.rbre.2015.08.011","url":null,"abstract":"","PeriodicalId":101096,"journal":{"name":"Revista Brasileira de Reumatologia (English Edition)","volume":"57 6","pages":"Pages 616-619"},"PeriodicalIF":0.0,"publicationDate":"2017-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rbre.2015.08.011","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35637371","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Socioeconomic and therapy factor influence on self-reported fatigue, anxiety and depression in rheumatoid arthritis patients","authors":"Mirjana Lapčević ,&nbsp;Mira Vuković ,&nbsp;Branislav S. Gvozdenović ,&nbsp;Vesna Mioljević ,&nbsp;Snežana Marjanović","doi":"10.1016/j.rbre.2017.02.004","DOIUrl":"10.1016/j.rbre.2017.02.004","url":null,"abstract":"<div><h3>Introduction</h3><p>Fatigue, anxiety and depression are very frequent symptoms in patients with rheumatoid arthritis (RA).</p></div><div><h3>Goals</h3><p>In this study we evaluated the influence of socioeconomic characteristics, therapy and comorbidities on the self-reported high fatigue, anxiety and depression in patients with RA.</p></div><div><h3>Method</h3><p>Multicenter cross-sectional study was performed in 22 health institutions in Serbia during the period from April–August 2014 in population of older RA patients. Self-reported patients health status was measured by: Fatigue Assessment Scale, Patient Health Questionnaire-9 and Generalized Anxiety Disorder-7. Treatment modalities were defined as: (1) non-steroidal anti-inflammatory drugs (NSAIDs) and/or analgesics and/or corticosteroids; (2) synthetic disease-modifying antirheumatic drugs (DMARDs) alone or in combination with corticosteroids and/or NSAIDs and (3) any RA treatment which includes biologic DMARDs.</p></div><div><h3>Results</h3><p>There were significant predictors of high depression: synthetic DMARDs therapy in combination with corticosteroids and/or NSAIDs, physiotherapist self-payment, frequent taxi use, alternative treatment and employment status. The need for another person's assistance, supplemental calcium therapy and professional qualifications were the predictors of a high fatigue, whereas the age above 65 years had the protective effect on it. Anxiety was an independent high fatigue predictor. The predictors of a high anxiety were: gastroprotection with proton-pump inhibitors and patient occupation.</p></div><div><h3>Conclusion</h3><p>Socioeconomic predictors of self-reported high depression, anxiety or fatigue are different for each of the mentioned outcomes, while accompanied with the basic RA treatment they exclusively explain a high depression. The anxiety, jointed with the socioeconomic variables and supplemental therapy, is a significant fatigue predictor in RA patients.</p></div>","PeriodicalId":101096,"journal":{"name":"Revista Brasileira de Reumatologia (English Edition)","volume":"57 6","pages":"Pages 545-556"},"PeriodicalIF":0.0,"publicationDate":"2017-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rbre.2017.02.004","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35637367","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nephrotic syndrome as the first manifestation of juvenile systemic scleroderma","authors":"Saulo B. Couto ,&nbsp;Adriana M. Sallum ,&nbsp;Luciana S. Henriques ,&nbsp;Denise M. Malheiros ,&nbsp;Clovis A. Silva ,&nbsp;Maria H. Vaisbich","doi":"10.1016/j.rbre.2014.08.004","DOIUrl":"10.1016/j.rbre.2014.08.004","url":null,"abstract":"","PeriodicalId":101096,"journal":{"name":"Revista Brasileira de Reumatologia (English Edition)","volume":"57 6","pages":"Pages 613-615"},"PeriodicalIF":0.0,"publicationDate":"2017-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rbre.2014.08.004","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35637370","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cyclophosphamide administration routine in autoimmune rheumatic diseases: a review","authors":"Kaian Amorim Teles ,&nbsp;Patricia Medeiros-Souza ,&nbsp;Francisco Aires Correa Lima ,&nbsp;Bruno Gedeon de Araújo ,&nbsp;Rodrigo Aires Correa Lima","doi":"10.1016/j.rbre.2016.09.008","DOIUrl":"10.1016/j.rbre.2016.09.008","url":null,"abstract":"<div><p>Cyclophosphamide is an alkylating agent widely used for the treatment of malignant neoplasia and which can be used in the treatment of multiple rheumatic diseases. Medication administration errors may lead to its reduced efficacy or increased drug toxicity. Many errors occur in the administration of injectable drugs. The present study aimed at structuring a routine for cyclophosphamide use, as well as creating a document with pharmacotherapeutic guidelines for the patient. The routine is schematized in three phases: pre-chemotherapy, administration of cyclophosphamide, and post-chemotherapy, taking into account the drugs to be administered before and after cyclophosphamide in order to prevent adverse effects, including nausea and hemorrhagic cystitis. Adverse reactions can alter laboratory tests; thus, this routine included clinical management for changes in white blood cells, platelets, neutrophils, and sodium, including cyclophosphamide dose adjustment in the case of kidney disease. Cyclophosphamide is responsible for other rare – but serious – side effects, for instance, hepatotoxicity, severe hyponatremia and heart failure. Other adverse reactions include hair loss, amenorrhea and menopause. In this routine, we also entered guidelines to post-chemotherapy patients. The compatibility of injectable drugs with the vehicle used has been described, as well as stability and infusion times. The routine aimed at the rational use of cyclophosphamide, with prevention of adverse events and relapse episodes, factors that may burden the health care system.</p></div>","PeriodicalId":101096,"journal":{"name":"Revista Brasileira de Reumatologia (English Edition)","volume":"57 6","pages":"Pages 596-604"},"PeriodicalIF":0.0,"publicationDate":"2017-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rbre.2016.09.008","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35637366","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Molecular evidence of Borrelia burgdorferi sensu lato in patients in Brazilian central-western region","authors":"Fernando Aguilar Lopes ,&nbsp;Jania de Rezende ,&nbsp;Danielly Beraldo dos Santos Silva ,&nbsp;Fernanda de Cássia Gonçalves Alves ,&nbsp;Carina Elisei de Oliveira ,&nbsp;Izaías Pereira da Costa","doi":"10.1016/j.rbre.2017.05.001","DOIUrl":"10.1016/j.rbre.2017.05.001","url":null,"abstract":"<div><p>We aimed to detect DNA of <em>Borrelia burgdorferi</em> in whole blood and serum samples of patients with clinical symptoms and epidemiology compatible with Brazilian Lyme-like disease. Four patients with positive epidemiological histories were recruited for the study. Blood samples were collected, screened by serologic testing by ELISA and Western blotting and molecular identification of <em>B. burgdorferi</em> by amplifying a fragment of the conserved gene that synthesizes the hook flagellar <em>flgE</em>. The results showed positive serology and for the first time, the presence of <em>B. burgdorferi sensu lato</em> in humans in the Midwest region of Brazil. The resulting sequences were similar to GenBank corresponding sequences of <em>B. burgdorferi flgE</em> gene. By neighbor-joining the phylogenetic analysis, the <em>flgE</em> sequence of the Brazilian strain clustered in a monophyletic group with the sequence of <em>B. burgdorferi sensu lato</em> under 100% bootstrap support. This study opens up promising perspectives and reinforces the need for additional studies to determine the epidemiological characteristics of the disease, as well as the impact of the prevalence of Brazilian borreliosis in Mato Grosso do Sul State, Brazil.</p></div>","PeriodicalId":101096,"journal":{"name":"Revista Brasileira de Reumatologia (English Edition)","volume":"57 6","pages":"Pages 641-645"},"PeriodicalIF":0.0,"publicationDate":"2017-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rbre.2017.05.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35058446","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Determinants of quality of life in Paget's disease of bone","authors":"Gláucio Ricardo Werner de Castro ,&nbsp;Silvania Ana Fernandes de Castro ,&nbsp;Ivanio Alves Pereira ,&nbsp;Adriana Fontes Zimmermann ,&nbsp;Maria Amazile Toscano ,&nbsp;Fabricio Souza Neves ,&nbsp;Maria Aparecida Scottini ,&nbsp;Juliane Paupitz ,&nbsp;Julia Salvan da Rosa ,&nbsp;Ziliani Buss ,&nbsp;Tânia Silvia Fröde","doi":"10.1016/j.rbre.2017.06.002","DOIUrl":"10.1016/j.rbre.2017.06.002","url":null,"abstract":"<div><h3>Objective</h3><p>To evaluate the parameters associated with quality of life in patients with Paget's disease of bone.</p></div><div><h3>Methods</h3><p>Patients with Paget's disease of bone were evaluated with SF-36 and WHOQOL-bref questionnaires. Patients with other diseases that could cause significant impairment of their quality of life were excluded. We searched for correlations between the results and: age, time from diagnosis, type of involvement, pain related to Paget's disease of bone, limitation to daily activities, deformities, bone specific alkaline phosphatase, the extent of involvement and treatment.</p></div><div><h3>Results</h3><p>Fifty patients were included. Results of the SF-36 total score and its domains, physical and mental health, were significantly correlated with bone pain and deformities. Marital status was significantly correlated with the SF-36 total score and Mental Health Domain. BAP levels and disease extension were significantly correlated to SF-36 Physical Health Domain. After multivariate analysis, the only parameters that remained significantly associated with the SF-36 total score and to its Mental Health and Physical Health Domains were pain and marital status.</p><p>The WHOQOL-bref total score was significantly associated with pain, physical impairment and deformities. WHOQOL-bref Domain 1 (physical) score was significantly associated with marital status, pain and deformities, while Domain 2 (psychological) score was associated with marital status, physical impairment and kind of involvement. After multivariate analysis, the presence of pain, deformities, and marital status were significantly associated with results of the WHOQOL-bref total score and its Domain 1. WHOQOL-bref domain 2 results were significantly predicted by pain and marital status.</p></div><div><h3>Conclusion</h3><p>The main disease-related factor associated with SF-36 results in Paget's disease of bone patients was bone pain, while bone pain and deformities were associated with WHOQOL-bref.</p></div>","PeriodicalId":101096,"journal":{"name":"Revista Brasileira de Reumatologia (English Edition)","volume":"57 6","pages":"Pages 566-573"},"PeriodicalIF":0.0,"publicationDate":"2017-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rbre.2017.06.002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35406035","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}