Revista Brasileira De Reumatologia最新文献

{"title":"Evidência molecular de Borrelia burgdorferi sensu lato em pacientes no centro‐oeste brasileiro","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.rbr.2017.04.001","DOIUrl":"10.1016/j.rbr.2017.04.001","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>Borrelia burgdorferi</em> sensu lato in humans in the Midwest region of Brazil. The resulting sequences were similar to GenBank corresponding sequences of <em>Borrelia 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>Borrelia 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":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.2017.04.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42375848","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":"Uso de pamidronato para o tratamento da osteoporose no sistema público de saúde no Brasil","authors":"Leila Bianchet Zanatta ,&nbsp;Cristina Marcatto ,&nbsp;Cassio Slompo Ramos ,&nbsp;Nadila Mañas ,&nbsp;Carolina Moreira ,&nbsp;Victoria Borba","doi":"10.1016/j.rbr.2016.05.005","DOIUrl":"10.1016/j.rbr.2016.05.005","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 (p<!--> <!-->=<!--> <!-->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 (r<!--> <!-->=<!--> <!-->−0.61; p<!--> <!-->=<!--> <!-->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":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.2016.05.005","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43889881","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":"Arterite de Takayasu com acometimento inicial isolado de ramos bilaterais da artéria pulmonar","authors":"Yu‐Hui Zhang ,&nbsp;Wei‐Min Song ,&nbsp;Mei Wu ,&nbsp;Jing Zhu","doi":"10.1016/j.rbr.2015.10.002","DOIUrl":"10.1016/j.rbr.2015.10.002","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.2015.10.002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46552014","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":"Investigação de polimorfismos no gene MEFV (G138G e A165A) em pacientes adultos com febre mediterrânica familiar","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.rbr.2015.09.006","DOIUrl":"10.1016/j.rbr.2015.09.006","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 (p<!--> <!-->&lt;<!--> <!-->0.001). It was found that the MEFV mutation types have no relation with clinical findings and amyloidosis (p<!--> <!-->&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":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.2015.09.006","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45231103","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":"Rastreamento da infecção latente por tuberculose em pacientes com artrite idiopática juvenil previamente à terapia anti‐TNF em um país de alto risco para tuberculose","authors":"Juliana Barbosa Brunelli ,&nbsp;Karina Rossi Bonfiglioli ,&nbsp;Clovis A. Silva ,&nbsp;Katia Tomie Kozu ,&nbsp;Claudia Goldenstein‐Schainberg ,&nbsp;Eloisa Bonfa ,&nbsp;Nadia Emi Aikawa","doi":"10.1016/j.rbr.2016.09.005","DOIUrl":"10.1016/j.rbr.2016.09.005","url":null,"abstract":"<div><h3>Objectives</h3><p>To evaluate, in an endemic country, the long‐term efficacy of latent tuberculosis infection (LTBI) screening and primary prophylaxis in patients with JIA receiving TNF blockers.</p></div><div><h3>Methods</h3><p>This was a retrospective cohort that included JIA patients eligible to anti‐TNF therapy. Patients were screened for LTBI prior to anti‐TNF using tuberculin skin test (TST), chest <span>X</span>‐ray and history of exposure to TB. Subjects were regularly followed at 2‐month intervals.</p></div><div><h3>Results</h3><p>Sixty‐nine JIA patients with current age of 17.4<!--> <!-->±<!--> <!-->5.8 years, mean disease duration of 5.0<!--> <!-->±<!--> <!-->4.9 years were included. Forty‐seven patients received a single anti‐TNF, while 22 patients switched to another anti‐TNF once or twice: 57 were treated with etanercepte, 33 patients with adalimumab and 3 infliximab. LTBI screening was positive in three patients: one had TST‐positive and history of TB exposure and two had solely TST‐positive. No active TB was diagnosed during the study period (median of follow‐up was 3.8 years).</p></div><div><h3>Conclusion</h3><p>Long‐term evaluation revealed that LTBI screening and primary prophylaxis before anti‐TNF treatment was effective in a high‐risk country and TST was the most sensitive parameter to identify these patients.</p></div>","PeriodicalId":48991,"journal":{"name":"Revista Brasileira De Reumatologia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rbr.2016.09.005","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45720003","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":"Errata em “Efeitos do uso do hormônio de crescimento em crianças e adolescentes com artrite idiopática juvenil: revisão sistemática” [Rev Bras Reumatol. 2017;57(2):100‐106]","authors":"Renan Bazuco Frittoli ,&nbsp;Barbara Sugui Longhi ,&nbsp;Amanda Meireles Silva ,&nbsp;Antônio de Azevedo Barros Filho ,&nbsp;Maria Ângela Reis de Góes Monteiro ,&nbsp;Simone Appenzeller","doi":"10.1016/j.rbr.2017.09.001","DOIUrl":"10.1016/j.rbr.2017.09.001","url":null,"abstract":"","PeriodicalId":48991,"journal":{"name":"Revista Brasileira De Reumatologia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rbr.2017.09.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"98062735","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":"Histoplamose disseminada em um adolescente mimetizando uma granulomatose com poliangiíte","authors":"Marlon van Weelden ,&nbsp;Gabriela R. Viola ,&nbsp;Katia T. Kozu ,&nbsp;Nadia E. Aikawa ,&nbsp;Claudia M. Ivo ,&nbsp;Clovis A. Silva","doi":"10.1016/j.rbr.2015.01.003","DOIUrl":"10.1016/j.rbr.2015.01.003","url":null,"abstract":"","PeriodicalId":48991,"journal":{"name":"Revista Brasileira De Reumatologia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rbr.2015.01.003","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33156754","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":"Dor nas costas e hábitos comportamentais de estudantes do ensino médio: estudo comparativo entre duas regiões do Brasil","authors":"Matias Noll ,&nbsp;Priscilla Rayanne e Silva Noll ,&nbsp;João Luiz Ribeiro Neto ,&nbsp;Vanessa Nunes Leal ,&nbsp;Bruna Nichele da Rosa ,&nbsp;Cláudia Tarragô Candotti","doi":"10.1016/j.rbr.2016.06.003","DOIUrl":"10.1016/j.rbr.2016.06.003","url":null,"abstract":"","PeriodicalId":48991,"journal":{"name":"Revista Brasileira De Reumatologia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rbr.2016.06.003","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46903643","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":"Avaliação topográfica das articulações sacroilíacas por ressonância magnética em pacientes com espondiloartrite axial","authors":"Laís Uyeda Aivazoglou ,&nbsp;Orlando Rondan Zotti ,&nbsp;Marcelo de Medeiros Pinheiro ,&nbsp;Moacir Ribeiro de Castro Junior ,&nbsp;Andrea Puchnick ,&nbsp;Artur da Rocha Corrêa Fernandes ,&nbsp;Eloy de Ávila Fernandes","doi":"10.1016/j.rbr.2016.05.007","DOIUrl":"10.1016/j.rbr.2016.05.007","url":null,"abstract":"<div><h3>Objective</h3><p>To evaluate the imaging features of spondyloarthritis in magnetic resonance imaging (MRI) of the sacroiliac (SI) joint, topography (in thirds) and affected margin, considering that this issue is rarely addressed in the literature.</p></div><div><h3>Methods</h3><p>Cross‐sectional study evaluating MRI (1.5<!--> <!-->T) of SI joints in 16 patients with axial spondyloarthritis for the presence of acute changes (subchondral bone edema, enthesitis, synovitis and capsulitis) and chronic changes (erosions, subchondral bone sclerosis, bony bridges, and fatty infiltration), performed by two radiologists blind for clinical data. MRI findings were correlated with clinical data, including age, duration of disease, medications, HLA‐B27, BASDAI, ASDAS‐ESR and ASDAS‐CRP, BASMI, BASFI, and mSASSS.</p></div><div><h3>Results</h3><p>Bone edema and erosions were predominant in the upper third of SI joints (p<!--> <!-->=<!--> <!-->0.050 and p<!--> <!-->=<!--> <!-->0.0014, respectively). There was a correlation between disease duration and structural changes by affected third (p<!--> <!-->=<!--> <!-->0.028‐0.037), as well as between the presence of bony bridges with BASMI (p<!--> <!-->=<!--> <!-->0.028) and mSASSS (p<!--> <!-->=<!--> <!-->0.014). Patients with osteitis in the lower third showed higher values of ASDAS (ESR: p<!--> <!-->=<!--> <!-->0.011 and PCR: p<!--> <!-->=<!--> <!-->0.017).</p></div><div><h3>Conclusion</h3><p>Chronic inflammatory changes and bone edema predominated in the upper third of SI joints, but a simultaneous involvement of middle or lower thirds of the joint was also noted. The location of involvement in the upper third of SI joints is insufficient to differentiate between degeneration and inflammation.</p></div>","PeriodicalId":48991,"journal":{"name":"Revista Brasileira De Reumatologia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rbr.2016.05.007","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48696200","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":"Lombalgia crônica em pacientes com lúpus eritematoso sistêmico: prevalência e preditores da força muscular de extensão de tronco e sua correlação com a incapacidade","authors":"Raíssa Sudré Cezarino ,&nbsp;Jefferson Rosa Cardoso ,&nbsp;Kedma Neves Rodrigues ,&nbsp;Yasmin Santana Magalhães ,&nbsp;Talita Yokoy de Souza ,&nbsp;Lícia Maria Henrique da Mota ,&nbsp;Ana Clara Bonini‐Rocha ,&nbsp;Joseph McVeigh ,&nbsp;Wagner Rodrigues Martins","doi":"10.1016/j.rbr.2017.03.001","DOIUrl":"10.1016/j.rbr.2017.03.001","url":null,"abstract":"<div><h3>Objective</h3><p>To determine the prevalence of Chronic Low Back Pain (CLBP) and predictors of Back Muscle Strength (BMS) in patients with Systemic Lupus Erythematosus (LES).</p></div><div><h3>Methods</h3><p>Cross‐sectional study. Ninety‐six ambulatory patients with LES were selected by non‐probability sampling and interviewed and tested during medical consultation. The outcomes measurements were: Point prevalence of CLBP, Oswestry Disability Index, Tampa Scale of Kinesiophobia, Fatigue Severity Scale and maximal voluntary isometric contractions (MVIC) of handgrip and of the back muscles. Correlation coefficient and multiple linear regression were used in statistical analysis.</p></div><div><h3>Results</h3><p>Of the 96 individuals interviewed, 25 had CLBP, indicating a point prevalence of 26% (92% women). The correlation between the Oswestry Index and maximal voluntary isometric contraction of the back muscles was <em>r</em> <!-->=<!--> <!-->‐0.4, 95% CI [‐0.68;‐0.01] and between the MVIC of handgrip and of the back muscles was <em>r</em> <!-->=<!--> <!-->0.72, 95% CI [0.51;0.88]. The regression model presented the highest value of R² being observed when MVIC of the back muscles was tested with five independent variables (63%). In this model handgrip strength was the only predictive variable (ß<!--> <!-->=<!--> <!-->0.61, <em>P</em> <!-->=<!--> <!-->0.001).</p></div><div><h3>Conclusions</h3><p>The prevalence of CLBP in individuals with LES was 26%. The MVIC of the back muscles was 63% predicted by five variables of interest, however, only the handgrip strength was a statistically significant predictive variable. The MVIC of the back muscles presented a linear relation directly proportional to handgrip and inversely proportional to Oswestry Index i.e. stronger back muscles are associated with lower disability scores.</p></div>","PeriodicalId":48991,"journal":{"name":"Revista Brasileira De Reumatologia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rbr.2017.03.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46308388","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}