Revista Brasileira De Reumatologia最新文献

{"title":"Hanseníase que simula esclerose sistêmica: relato de caso","authors":"Bruna Burko Rocha Chu , Giorgina Falcão Brandão Côrtes Gobbo , Rafaela Copês , Glênio Gutjahr , Erick Cavalcanti Cossa , Eduardo dos Santos Paiva","doi":"10.1016/j.rbr.2016.08.001","DOIUrl":"10.1016/j.rbr.2016.08.001","url":null,"abstract":"","PeriodicalId":48991,"journal":{"name":"Revista Brasileira De Reumatologia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rbr.2016.08.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47102180","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":"Estudo caso‐controle do polimorfismo do gene receptor da vitamina D em pacientes paquistaneses com artrite reumatoide","authors":"Peter John , Attya Bhatti , Noor ul Ain , Tahir Iqbal , Tayyaba Sadaf , Javed Mehmood Malik","doi":"10.1016/j.rbr.2015.01.008","DOIUrl":"10.1016/j.rbr.2015.01.008","url":null,"abstract":"","PeriodicalId":48991,"journal":{"name":"Revista Brasileira De Reumatologia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rbr.2015.01.008","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41758945","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":"Policondrite recidivante e meningite linfocitária com sintomas neurológicos variados","authors":"Renata Dal‐Prá Ducci , Francisco Manoel Branco Germiniani , Letícia Elizabeth Augustin Czecko , Eduardo S. Paiva , Hélio Afonso Ghizoni Teive","doi":"10.1016/j.rbr.2015.09.005","DOIUrl":"10.1016/j.rbr.2015.09.005","url":null,"abstract":"","PeriodicalId":48991,"journal":{"name":"Revista Brasileira De Reumatologia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rbr.2015.09.005","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41773907","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":"Presença de corpos riziformes em paciente com artrite idiopática juvenil: relato de caso e revisão de literatura","authors":"Leonardo Rodrigues Campos , Fernanda Cardoso das Neves Sztajnbok , Stélio Galvão , Marise de Araújo Lessa , Ierecê Lins Aymoré , Flavio Sztajnbok","doi":"10.1016/j.rbr.2014.09.002","DOIUrl":"10.1016/j.rbr.2014.09.002","url":null,"abstract":"","PeriodicalId":48991,"journal":{"name":"Revista Brasileira De Reumatologia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rbr.2014.09.002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32873401","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":"Rotina de administração de ciclofosfamida em doenças autoimunes reumáticas: uma revisão","authors":"Kaian Amorim Teles ,&nbsp;Patrícia Medeiros‐Souza ,&nbsp;Francisco Aires Correa Lima ,&nbsp;Bruno Gedeon de Araújo ,&nbsp;Rodrigo Aires Correa Lima","doi":"10.1016/j.rbr.2016.04.009","DOIUrl":"10.1016/j.rbr.2016.04.009","url":null,"abstract":"<div><p>Cyclophosphamide (CPM) 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 (pre‐ChT), administration of cyclophosphamide, and post‐chemotherapy (post‐ChT), 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":48991,"journal":{"name":"Revista Brasileira De Reumatologia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rbr.2016.04.009","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"55035943","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":"Doença de Lyme e artrite idiopática juvenil – Relato de caso clínico pediátrico","authors":"Mário Correia de Sá ,&nbsp;Catarina Moreira ,&nbsp;Cláudia Melo ,&nbsp;Álvaro Sousa ,&nbsp;Sónia Carvalho","doi":"10.1016/j.rbr.2015.08.003","DOIUrl":"10.1016/j.rbr.2015.08.003","url":null,"abstract":"","PeriodicalId":48991,"journal":{"name":"Revista Brasileira De Reumatologia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rbr.2015.08.003","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34115519","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":"Mortalidade por lúpus eritematoso sistêmico no Brasil: avaliação das causas de acordo com o banco de dados de saúde do governo","authors":"Luisa Ribeiro Costi,&nbsp;Hatsumi Miyashiro Iwamoto,&nbsp;Dilma Costa de Oliveira Neves,&nbsp;Cezar Augusto Muniz Caldas","doi":"10.1016/j.rbr.2017.05.007","DOIUrl":"10.1016/j.rbr.2017.05.007","url":null,"abstract":"<div><h3>Objective</h3><p>To characterize the causes of mortality in patients with systemic erythematosus lupus (SLE) in Brazil between 2002 and 2011.</p></div><div><h3>Methods</h3><p>An exploratory ecological study of a time series using data from the Mortality Information System of DATASUS, the Department of the Unified Health System (Brazil's National Health System).</p></div><div><h3>Results</h3><p>Brazil's SLE mortality rate was 4.76 deaths/10⁵ inhabitants. The mortality rate was higher in the Midwest, North and Southeast regions than in the country as a whole. There were 6.3% fewer and 4.2% more deaths than expected in the Northeast and Southeast regions, respectively. The mean age at death was 40.7<!--> <!-->±<!--> <!-->18 years, and 45.61% of deaths occurred between the ages of 20 and 39. Incidence was highest in women (90.7%) and whites (49.2%). Disorders of the musculoskeletal system and connective tissue were mentioned as an underlying cause of death in 77.5% of cases, and diseases of the circulatory system and infectious and parasitic diseases were also noted in fewer cases. SLE was mentioned as an underlying cause of death in 77% of cases, with no difference between the Brazilian regions (p<!--> <!-->=<!--> <!-->0.2058). The main SLE‐related causes of death were, sequentially, diseases of the respiratory and circulatory systems and infectious and parasitic diseases.</p></div><div><h3>Conclusions</h3><p>This study identified a need for greater control of risk factors for cardiovascular diseases and a better understanding of the pathogenesis of atherosclerosis in SLE. Infectious causes are still frequent, and management should be improved, especially in the early stages of the disease.</p></div>","PeriodicalId":48991,"journal":{"name":"Revista Brasileira De Reumatologia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rbr.2017.05.007","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43646954","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":"Desfechos clínicos e sobrevida em pacientes com amiloidose AA","authors":"Yavuz Ayar ,&nbsp;Alparslan Ersoy ,&nbsp;Mustafa Ferhat Oksuz ,&nbsp;Gokhan Ocakoglu ,&nbsp;Berna Aytac Vuruskan ,&nbsp;Abdülmecit Yildiz ,&nbsp;Emel Isiktas ,&nbsp;Aysegül Oruc ,&nbsp;Sedat Celikci ,&nbsp;Ismail Arslan ,&nbsp;Ahmet Bilgehan Sahin ,&nbsp;Mustafa Güllülü","doi":"10.1016/j.rbr.2016.12.002","DOIUrl":"10.1016/j.rbr.2016.12.002","url":null,"abstract":"<div><h3>Aim</h3><p>AA amyloidosis is a rare complication of chronic inflammatory conditions. Most patients with AA amyloidosis present with nephropathy and it leads to renal failure and death. We studied clinical characteristics and survival in patients with AA amyloidosis.</p></div><div><h3>Methods</h3><p>A total of 81 patients (51 males, 30 females) with renal biopsy proven AA amyloidosis were analyzed retrospectively. The patients were divided into good and poor outcomes groups according to survival results.</p></div><div><h3>Results</h3><p>Most of the patients (55.6%) had nephrotic range proteinuria at diagnosis. Most frequent underlying disorders were familial Mediterranean fever (FMF, 21.2%) and rheumatoid arthritis (10.6%) in the good outcome group and malignancy (20%) in the poor outcome group. Only diastolic blood pressure in the good outcome group and phosphorus level in the poor outcome group was higher. Serum creatinine levels increased after treatment in both groups, while proteinuria in the good outcome group decreased. Increase in serum creatinine and decrease in eGFR of the poor outcome group were more significant in the good outcome group. At the time of diagnosis 18.5% and 27.2% of all patients had advanced chronic kidney disease (stage 4 and 5, respectively). Median duration of renal survival was 65<!--> <!-->±<!--> <!-->3.54 months. Among all patients, 27.1% were started dialysis treatment during the follow‐up period and 7.4% of all patients underwent kidney transplantation. Higher levels of systolic blood pressure [hazard ratios (HR) 1.03,95% confidence interval (CI):1‐1.06, p<!--> <!-->=<!--> <!-->0.036], serum creatinine (HR 1.25,95% CI: 1.07‐1.46, p<!--> <!-->=<!--> <!-->0.006) and urinary protein excretion (HR 1.08,95% CI: 1.01‐1.16, p<!--> <!-->=<!--> <!-->0.027) were predictors of end‐stage renal disease. Median survival of patients with organ involvement was 50.3<!--> <!-->±<!--> <!-->16 months.</p></div><div><h3>Conclusion</h3><p>Our study indicated that FMF constituted a large proportion of cases and increased number of patients with idiopathic AA amyloidosis. Additionally, it was observed that patient survival was not affected by different etiological causes in AA amyloidosis.</p></div>","PeriodicalId":48991,"journal":{"name":"Revista Brasileira De Reumatologia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rbr.2016.12.002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46813380","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":"Evolução da formação de reumatologistas no Brasil: a opção pela residência médica","authors":"Cleandro Pires Albuquerque,&nbsp;Leopoldo Luiz Santos‐Neto","doi":"10.1016/j.rbr.2016.03.002","DOIUrl":"10.1016/j.rbr.2016.03.002","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% (n<!--> <!-->=<!--> <!-->839) completed a medical residency program in rheumatology (MRPR); the others (n<!--> <!-->=<!--> <!-->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% (n<!--> <!-->=<!--> <!-->789) of graduates in MRPR during the study period, while still maintaining 93.3% (n<!--> <!-->=<!--> <!-->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":48991,"journal":{"name":"Revista Brasileira De Reumatologia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rbr.2016.03.002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"55035533","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":"Influência de fatores socioeconômicos e de tratamento sobre a fadiga, ansiedade e depressão autorrelatadas em pacientes com artrite reumatoide","authors":"Mirjana Lapčević ,&nbsp;Mira Vuković ,&nbsp;Branislav S. Gvozdenović ,&nbsp;Vesna Mioljević ,&nbsp;Snežana Marjanović","doi":"10.1016/j.rbr.2016.12.004","DOIUrl":"10.1016/j.rbr.2016.12.004","url":null,"abstract":"<div><h3>Introduction</h3><p>Fatigue, anxiety and depression are very frequent symptoms in patients with rheumatoid arthritis (RA).</p><p>Goals: 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":48991,"journal":{"name":"Revista Brasileira De Reumatologia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rbr.2016.12.004","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"55036467","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}