Paciente con dermatitis y artritis durante sus embarazos / A patient with dermatitis and arthritis during her two pregnancies

Paciente femenina que presentó durante sus dos embarazos eritema nodoso, úlceras nasales y artritis. Debido a la persistencia del eritema nodoso después del segundo parto, se practicó determinación de ANA y anti-DNA ­ IF, resultando este último positivo, por lo que se plantea el diagnóstico de lupus eritematoso y es referida al Centro Nacional de Enfermedades Reumáticas, (CNER) donde se le practicó biopsia de piel que resultó compatible con lepra: borderline o dimorfa (BB-BL) en estado reaccional tipo II (eritema nodoso leproso: ENL). Se discuten algunos de aspectos de la lepra haciendo especial énfasis en síntomas que presentó la paciente y la exacerbación de los mismos durante los embarazos, posiblemente en relación con algunos cambios inmunológicos adaptativos que son generados para mantener la tolerancia materno fetal(AU)

Female young patient with erythema nodosum, nasal ulcers and arthritis during her two pregnancies. Due to the persistence of the erythema nodosum after the second delivery, ANA and anti-DNA - IF determination were done, the latter being positive, and she was diagnosed with lupus erythematosus and was referred to the National Center for Rheumatic Diseases, where skin biopsy showed to be compatible with leprosy: borderline or dimorphic (BB-BL) in type II reactional state (leprous erythema nodosum: LEN). Some aspects of leprosy are discussed with special emphasis on symptoms that the patient presented and their exacerbation during pregnancies, possibly in relation to some adaptive immunological changes that was generated to maintain maternal fetal tolerance(AU)

The Effect of Sleep Duration on the Risk of Unintentional Injury in Korean Adults / 예방의학회지

OBJECTIVES: The decrease or increase in sleep duration has recently been recognized as a risk factor for several diseases, including hypertension and obesity. Many studies have explored the relationship of decreased sleep durations and injuries, but few have examined the relationship between increased sleep duration and injury. The objective of this research is to identify the risk for injury associated with both decreased and increased sleep durations. METHODS: Data from the 2010 Community Health Survey were used in this study. We conducted logistic regression with average sleep duration as the independent variable, injury as a dependent variable, and controlling for age, sex, occupation, education, region (cities and provinces), smoking, alcohol use, body mass index, hypertension, diabetes, arthritis, and depression. Seven categories of sleep duration were established: or =10 hours. RESULTS: Using 7 hours of sleep as the reference, the adjusted injury risk (odds ratio) for those sleeping a total of or =10 hours. The difference in risk was statistically significant for each category except for the 8 and 9 hours. In this study, risk increased as the sleep duration decreased or increased, except for the 8 and 9 hours. CONCLUSIONS: This research found that either a decrease or increase in sleep duration was associated with an increased risk for injury. The concept of proper sleep duration can be evaluated by its associated injury risk.

Conceitos atuais em osteoartrite / Current concepts in osteoarthritis

A osteoartrite (OA), forma mais comum de doença articular, afeta principalmente quadris, joelhos, mãos e pés, levando a grande incapacidade e perda de qualidade de vida, sobretudo na população idosa. A importância desta doença cresce a cada ano, na medida em que observamos uma tendência de envelhecimento da população brasileira, com grande aumento da população idosa em relação aos mais jovens. O progressivo entendimento da fisiopatologia da OA, a percepção de que o processo não é puramente mecânico e/ou de envelhecimento, e o esclarecimento das vias inflamatórias envolvidas levaram, recentemente, à aplicação clínica de vários outros medicamentos e medidas. Esta atualização tem como objetivo expor os mais recentes conceitos sobre a fisiopatologia e tratamento da OA.

Osteoarthritis (OA), the most common form of joint disease, affects mainly the hips, knees, hands and feet, leading to severe disability and loss of quality of life, particularly in the elderly population. Its importance grows every year with the aging of the population, with a large increase in the elderly population compared to younger patients. The progressive understanding of the pathophysiology of OA, the perception that the process is not purely mechanical and/or aging, and clarification of the inflammatory pathways involved led recently to the clinical application of various drugs and other measures. This update aims to expose the current concepts on the pathophysiology and treatment of OA.

Síndrome de Lõfgren / Lõfgren’s Syndrome

A sarcoidose é uma doença crônica granulomatosa, de origem desconhecida, que pode envolver praticamente qualquer órgão, mas na qual a presença de artrite é incomum. Apresentamos um caso no qual a artrite foi o achado inicial, associada ao eritema nodoso, levando à investigação e ao diagnóstico da síndrome de Lõfgren. Nessa forma de apresentação da sarcoidose, além da artrite ou artralgias e do eritema nodoso, também deve estar presente a linfadenopatia hilar bilateral como critério diagnóstico. A síndrome de Lõfgren é chamada algumas vezes de sarcoidose aguda, estando geralmente associada com um bom prognóstico e resolução espontânea.

Sarcoidosis is a chronic granulomatous disease, of unknown origin, that may involve virtually any organ, but in which the presence of arthritis is uncommon. Here we present a case in which arthritis was the first finding, associated with erythema nodosun, leading to the investigation and diagnosis of Lõfgren Syndrome. In this form of sarcoidosis presentation, in addition to arthritis or arthralgia and erythema nodosun there must be bilateral hilar lymphadenopathy as a diagnostic criterion. Lõfgren’s syndrome is sometimes called acute sarcoidosis, usually being associated with good prognosis and spontaneous resolution.

Artrite como primeira manifestaçäo de leucemia aguda / Artritis like first manifestation of acute leukemia

Artrite é uma conhecida manifestação da leucemia, observada mais freqüentemente em crianças e em casos agudos, podendo ser o sintoma inicial desta doença, porém ainda com fisiopatologia obscura. As características clínicas podem mimetizar doenças reumatológicas, retardando o diagnóstico, por isso devemos considerar essa possibilidade na investigação de rotina para as artrites. Nosso estudo descreve as manifestações osteoarticulares de pacientes admitidos neste serviço cujo diagnóstico final foi leucemia

Cartilagem articular e osteoartrose / Articular cartilage and osteoarthrosis

O conhecimento da fisiologia da cartilagem e da fisiopatologia da osteoartrose deverá, sem dúvida alguma auxiliar o ortopedista atuar de forma mais consciente na prevençäo e na terapêutica precoce.

Hyperuricaemia in a community of modern affluence Al Kharj, Kingdom of Saudi Arabia

Hyperuricaemia was detected in [17.7%] of hospital patients examined for arthritic complaints in a four year period. A male predominance [20.6%] to females [11.8%] was noted. Hyperuricaemia was found to be associating Diabetes and Hyperlipidaemia. The purpose of the Study was to appraise the effect of modern affluent health services in a rural hospital in the Kingdom of Saudi Arabia

Consideraciones generales sobre las artritis reactivas / General considerations of reactive arthritis

Las artritis reactivas constituyen un proceso inflamatorio aséptico, secundaria a un proceso infeccioso a distancia, generalmente intestinal o urogenital. Cuando se acompañan de manifestaciones extraarticulares, especialmente conjuntivitis y uretritis contituyen el Síndrome de Reiter. En su etiología participan fundamentalmente gérmenes Gram (-) que tendrían un poder "artritogénico", en un terreno genético, esto es una condición especial del huésped que permitiría esta respuesta tan peculiar. Dicho terreno tiene una íntima ligazón con el antígeno HLA B27, al igual como sucede en la espondiloartritis anquilosante, lo que ha permitido suponer una relación entre dichas entidades, estando incluidas ambas en el grupo de las pelviespondilopatías, al que pertenecen también la artritis de las enteropatías: colitis ulcerosa y enteritis regional y la artropatía psoriática

Arthritis in childhood: a report on 65 consecutive cases observed at the University Hospital of the West Indies

In a two-year period (Octuber 1985 - September 1987), 65 children presented to the Child Health department and/or rheumatology clinic at the University Hospital with arthritis. Eighteen children (28%) had Juvenile Chronic Arthritis, ten (15%) rheumatic fever, eight (12%) systemic lupus erythematosus and thirteen (20%) had self-limiting arthritis. Systemic onset of Juvenile Chronic Arthritis occurred only in one child; nine children had polyarticular and eight pauci-articular onset of disease. The self-limiting arthritis was difficult to different from Juvenile Chronic Arthritis; therefore serological testing for bacterial and viral infections should be performed before anti rheumatic therapy is undertaken. Arthritis in chilhood is not uncommon in Jamaica. However, the outcome appears to be generally favourable except in a few cases of Juvenile Chronic Arthritis

Gota / Gout

Se realizó un trabajo retrospectivo estudiando las características clínicas, de laboratorio, evolución y supervivencia de 31 pacientes diagnosticados de Gota entre los años 1969 y 1986 en el Hospital Cayetano Heredia. La edad promedio fue de 52 años, siendo el 97% de sexo masculino. Todos tuvieron historia de artritis'81%tuvieron niveles elevados de ácido úrico y 74% presentaron disminución de la Depuración de Creatinina. El perfil clínico de la enfermedad demostró semejanzas con lo decrito en la literatura. Se demostró una relación una relación entre la presencia de Urolitiasis y los niveles de ácido úrico urinario. Igualmente se observó una supervivencia del 85% a los 6 meses de seguimiento entre los hallazgos más resaltantes

El caso de infecciosas: hepatitis B y artritis bilateral de rodillas / The infectious case: hepatitis B and knee's bilateral arthritis

Se presenta el caso de un Medico Interno con diagnostico de Hepatitis B, quien a la septima semana de ictericia presento franca artritis bilateral de rodillas. Los hallazgos de histopatologia, niveles de complemento aumentados y la presencia de antigeno superficial de Hepatitis B en el liquido sinovial y biopsia sinovial por puncion, sugieren dano directo por el virus y no por complejos inmunes. Se revisan las manifestaciones extrahepaticas de la infeccion por el VHB y su diagnostico

Contribuiçäo ao estudo das artrites especificas em pacientes hansenianos / Specific arthrites in patients with hanseniasis

Foram estudados cinco pacientes hansenianos, visando esclarecer o quadro articular, realizando-se avaliaçäo clínica, laboratorial e estudo anátomo-patológico da membrana sinovial. Os pacientes enquadravam-se nas seguintes formas clínicas: virchowiano näo reacional (3 casos), virchowiano reacional (1 caso) e tuberculóide reacional (1 caso). A biopsia sinovial mostrou presença de BAAR na membrana sinovial nos pacientes que se encontravam em formas näo reacionais. Os achados referidos näo se adaptam plenamente aos modelos fisiopatológicos propostos na literatura, fazendo-nos crer na possível participaçäo direta do Mycobacterium leprae na gênese das lesöes sinoviais.