Psoriatic arthritis mutilans: a descriptive study from a Brazilian tertiary center

Abstract In this paper, we sought to determine the prevalence of arthritis mutilans in a single cohort of Brazilian psoriatic arthritis patients followed at a tertiary university reference center. Our study demonstrated a high prevalence of arthritis mutilans associated to comorbidities and biologic therapy. In addition, our data suggest that axial involvement may be an intriguing aspect of psoriatic arthritis mutilans and that rheumatologists should be aware of axial disease, even if the phenotype is marked by peripheral joint severity.

Systemic autoimmune diseases and work outcomes in Brazil: a scoping review

ABSTRACT OBJECTIVE To review articles that assessed work-related outcomes such as workability, work productivity, presenteeism, absenteeism, sick leave, return to work, and employment status of Brazilian patients with rheumatoid arthritis, systemic lupus erythematosus, systemic sclerosis, Sjögren's syndrome, and systemic autoimmune myopathies. METHODS This study was conducted in Medline databases (PubMed), SciELO, and Lilacs through a combination of descriptors of interest. Studies published until December 2020 were considered in the search strategy. RESULTS Eight out of 90 articles met the eligibility criteria and were included in this review. The studies are highly heterogeneous. Most of them are cross-sectional, and all of them address rheumatoid arthritis or systemic lupus erythematosus. A common denominator among these studies is the high proportion of patients outside the labor market. CONCLUSIONS In general, the studies show unfavorable labor outcomes and impaired participation in the Brazilian workforce among the samples of patients assessed. There is a need to better understand several topics about Brazilian patients with systemic autoimmune diseases and their work context, as well as to conduct studies focusing on rarer diseases and on the themes of return and reintegration to work.

Trigeminal Ophthalmic Branch Schwannoma: Case Report and Literature Review

Schwannomas are the fourth most common primary neoplasms affecting the brain and cranial nerves. Central lesions commonly arise from sensory nerve roots, and a common intracranial site is the vestibular branch of the 8th nerve (>85%). We present the case report of a patient who has a schwannoma extending from the pterygopalatine fossa to the orbit, complaining about facial pain in the trajectory of the trigeminal ophthalmic branch. Schwannomas represent 1 to 2% of all neoplasms of the orbit, and trigeminal schwannomas are extremely rare, accounting for less than 0.5% of all intracranial tumors.

Raynaud's phenomenon in the occupational context

SUMMARY OBJECTIVE To review articles that evaluated the prevalence of Raynaud's phenomenon of occupational origin. METHODS The search for articles was carried out in the Medline (via PubMed), Embase, Web of Science, Scientific Electronic Library Online (SciELO), and Latin America and Caribbean Health Sciences Literature (Lilacs) databases. RESULTS 64 articles were obtained from the electronic search; 18 articles met the eligibility criteria. All studies discussed the exposure to vibrations in the upper limbs. In 6 of them, the thermal issue was directly or indirectly addressed. No studies have addressed exposure to vinyl chloride. CONCLUSIO In general, a higher prevalence of Raynaud's phenomenon was found among vibratory tool operators compared to non-exposed workers, with an increase in the number of cases the higher the level of vibration and the time of exposure. Cold is a triggering and aggravating factor of the Raynaud phenomenon and seems to play an important role in the emergence of vascular manifestations of the hand-arm vibration syndrome.

RESUMO OBJETIVO Realizar um estudo de revisão dos artigos que avaliaram a prevalência do fenômeno de Raynaud de origem ocupacional. MÉTODOS A busca pelos artigos foi realizada nas bases de dados Medline (via PubMed), Embase, Web of Science, Scientific Eletronic Library Online (SciELO) e Literatura Latino-Americana e do Caribe em Ciências da Saúde (Lilacs). RESULTADOS Sessenta e quatro artigos foram obtidos a partir da busca eletrônica, dos quais 18 cumpriram os critérios de elegibilidade. Todos os estudos discutiram sobre a exposição a vibrações localizadas em membros superiores. Em seis deles, a questão térmica foi direta ou indiretamente abordada. Nenhum estudo abordou a exposição ao cloreto de vinila. CONCLUSÃO De maneira geral, constatou-se maior prevalência do fenômeno de Raynaud entre operadores de ferramentas vibratórias em comparação aos não expostos, com aumento do número de casos quanto maior o nível de vibração e tempo de exposição. O frio é fator desencadeante e agravante do fenômeno de Raynaud e parece exercer papel importante para o surgimento das manifestações vasculares da síndrome de vibração de mãos e braços.

Bilateral Transverse Sinus Angioplasty for the Treatment of Idiopathic Intracranial Hypertension ­ Case Report and Literature Review

Idiopathic intracranial hypertension (IIH) is a disease characterized by an increase in intracranial pressure, without presence of parenchymal lesions or hydrocephalus that justify it. Over 90% of cases there is association with stenosis of the dural venous sinuses. It is characterized by headache, tinidus, nausea, vomiting and visual disturbances. Initial treatment is clinical and when it fails there is indication of invasive procedures, among them shunts and fenestration of the optic nerve sheath. Angioplasty of dural venous sinuses, when indicated, has shown an alternative with better results and less complications. We report a case of a female patient, with 27 years old, diagnosed with IIH and bilateral transverse sinus stenosis, which was treated by bilateral stenting and total resolution of symptoms. Besides describing the case we review the literature about the subject.

Peliosis hepatis and systemic lupus erythematosus: A rare condition identified by magnetic resonance imaging / Peliose hepática e lúpus eritematoso sistêmico: uma rara condição identificada pela ressonância nuclear magnética

Summary Peliosis hepatis is a rare benign disorder characterized by the presence of multiple cavities filled with blood with no preferential localization in the liver parenchyma. It may be related to several etiologic conditions, especially infections and toxicity of immunosuppressive drugs. To our knowledge, there are only three articles reporting the association between peliosis hepatis and systemic lupus erythematosus. In this report, we describe a case of this rare condition, highlighting the importance of magnetic resonance imaging. A short review of this subject is also presented.

Resumo Peliose hepática é uma patologia benigna rara caracterizada pela presença de múltiplas cavidades preenchidas por sangue sem localização preferencial no parênquima do fígado. Pode estar relacionada a uma série de condições etiológicas, dentre elas doenças infecciosas e toxicidade por drogas imunossupressoras. Para nosso conhecimento, existem apenas três artigos que abordam a associação entre peliose hepática e lúpus eritematoso sistêmico. Neste relato, descrevemos um caso desta rara condição, destacando a importância da ressonância magnética. Uma breve revisão sobre o tema é apresentada.

A morphometric study of the intestinal mucosa of rats submitted to omentoenteropexy / Estudo morfométrico da mucosa intestinal de ratos submetidos a omentoenteropexia

CONTEXT: The omentoenteropexy technique was developed as an alternative method for intestinal neovascularization, due to the angiogenic properties of factors from the omentum. OBJECTIVES: This study investigated changes in intestinal villi heights and crypts depths due to surgical techniques: seromiotomy with and without omentoenteropexy. METHOD: Thirty rats were operated on, after being divided into three groups, namely GI, GII and GIII with 10 rats each. In the GI rats were submitted to omentoenteropexy; rats in GII were submitted only to a seromiotomy, and in the GIII only laparotomy. Sixty days after the first surgery, the animals were sacrificed and a segment of intestine was removed for histology using Masson's trichrome technique and morphometric study of intestinal mucosa. RESULTS: The histological findings showed that seromiotomy with or without omentoenteropexy increased the length of intestinal villi when compared with GIII (only laparotomy) (analysis of variance: P = 0.0068; GI 38.88 ± 4.17; GII 39.41± 6.33; GIII 31.85 ± 5.56; GI = GII P>0.05; GII>GIII P<0.05; GI>GIII P<0.001). CONCLUSION: No differences were demonstrated in relation to crypt depths between the groups (P = 0.60). Ongoing studies are being set forth by our group to add more data on the role of omentopexy as a tool to promote neovascularization and intestinal mucosal growth.

CONTEXTO: a omentoenteropexia foi desenvolvida como técnica alternativa para a neovascularização intestinal, devido às propriedades angiogênicas de fatores provenientes do omento. OBJETIVO: Investigar as alterações nas alturas vilositárias e profundidades de cripta na mucosa intestinal de ratos submetidos a seromiotomia com e sem omentopexia. MÉTODOS: Trinta ratos foram operados após serem divididos em três grupos com 10 animais cada um. No grupo I (GI) os ratos foram submetidos seromiotomia seguida por omentoenteropexia; no grupo II (GII) foi realizada apenas a seromiotomia, e no grupo III (GIII) apenas a laparotomia. após 60 dias, os animais foram sacrificados e seus intestinos examinados histologicamente, corados pelo tricrômio de Masson, sendo realizado também estudo morfométrico da mucosa intestinal. RESULTADOS: O estudo mostrou que a altura vilositária é maior nos grupos submetidos a seromiotomia, com ou sem omentopexia, do que no grupo em que se realizou laparotomia apenas, porém entre os dois primeiros grupos não houve diferença significante (análise de variância: P = 0,0068; GI 38,88 ± 4,17; GII 39,41 ± 6,33; GIII 31,85 ± 5,56; GI = GII P>0,05; GII>GIII P<0,05; GI>GIII P<0,001). CONCLUSÕES: Não foram demonstradas diferenças quanto às profundidades de criptas entre os grupos (P = 0,60). Novos estudos estão sendo realizados por este grupo para acrescentar mais dados sobre o papel da omentopexia como forma de promover neovascularização e crescimento da mucosa intestinal.

Análise comparativa entre aparelhos de pressão arterial (digital e aneróide) e entre glicosímetros de diferentes marcas na detecção de pacientes hipertensos e diabéticos / Comparative analysis of blood pressure devices (aneroid and digital) and between different brands of glucometers in detecting hypertension and diabetes patients

Objetivo: O objetivo do presente estudo foi comparar e testar a confiabilidade e eficiência de dois aferidores de pressão arterial, aneróide (BD®) e digital (G-Tech®) e dois aparelhos medidores de glicemia capilar (Accu-Chek Active® e Optium Xceed®), em uma situação de pré-cirúrgico odontológico. Métodos: A amostra total de 60 pacientes foi avaliada por um único examinador calibrado. As aferições da pressão arterial foram realizadas com ambos os aparelhos (aneróide e digital) com o paciente em repouso e o braço ao nível do coração, e em seguida, as mensurações de testes de glicemia capilar foram realizadas por meio de dois glicosímetros (Accu-Chek Active® e Optium Xceed®). Todos os aparelhos estavam devidamente calibrados e certificados pelo INMETRO. Foram aplicados o teste t de "Student" e a análise do coeficiente de correlação. Resultados: As médias da pressão arterial sistólica (PAS) e pressão arterial diastólica (PAD) para o método auscultatório foram respectivamente, 124,5 mmHg e 80,67 mmHg; e para o oscilométrico, 132,80 mmHg e 82,20 mmHg. Em relação à glicemia capilar, as médias foram de 115,05 mg/dl para o Optium Xceed® e 107,28 mg/dl para Accu-Check Active®. Diferença estatisticamente significante (p menor que 0,001) foi encontrada entre os métodos avaliados. Quanto à análise do coeficiente de correlação, obteve-se correlação normal entre PAS (r=0,6486) e PAD (r=0,6618), e excelente entre os glicosímetros (r=0,9621). Conclusão: A utilização dos dois métodos, auscultatório e oscilométrico, permitiu verificar uma correlação normal entre as aferições obtidas para PAS e para PAD. Houve excelente correlação entre os valores de glicemia capilar, encontrados por meio dos glicosímetros, Accu-Check Active® (Roche) e Optium Xceed® (Abbott).

Objective: The aim of the present study was to compare and test the reliability and efficiency of two blood pressure measurements devices, aneroid (BD®) and digital (G-Tech®), and two glucose measurements devices (Accu-Chek Active® and Optium Xceed®), in the a preoperative dentistry situation. Methods: A sample with 60 patients was evaluated by one calibrated examiner. Blood pressure measurement was performed with both devices (aneroid and digital) with the patient at rest and the arm at the level of the heart, and then, the measurements of capillary blood glucose were performed by two glucometers (Accu-Chek Active® and Optium Xceed®). All equipment was properly calibrated and certified by INMETRO. We applied Student's t test and analysis of the correlation coefficient. Results: The medias of systolic blood pressure (SBP) and diastolic blood pressure (DBP) to the auscultatory method were respectively, 124,50 mmHg and 80,67 mmHg; and to the oscillometric method were 132,80 mmHg and 82,20 mmHg. In relation to capillary glucose, the media were 115,05 mg/dl to Optium Xceed® and 107,28 mg/dl to the Accu-Check Active®. There was a statistically significant difference (p less than 0,001) between the methods evaluated. As for correlation, we obtained normal correlation between SBP (r=0,6486) and DBP (r=0,6618) and between the two glucometers (r=0,9621). Conclusions: The use of two methods, auscultatory and oscillometric, has show a normal correlation between measurements obtained for SBP and DBP. There was excellent correlation between capillary glucose values, found by the glucometer, Accu-Check Active® (Roche) and Optium Xceed® (Abbott).