Análise comparativa das afecções podais em fêmeas bovinas adultas das raças Holandesa, Parda Alpina e Girolanda, no Agreste setentrional de Pernambuco

No presente trabalho objetivou-se fazer uma análise comparativa da laminite nas principais raças bovinas leiteiras no Estado de Pernambuco. Para tal foi feito o acompanhamento de 870 vacas de 18 rebanhos bovinos de aptidão leiteira, em regime intensivo e semi-intensivo, sendo 290 de seis rebanhos da raça Holandesa, 290 de seis rebanhos da raça Parda Alpina e 290 de seis rebanhos da raça Girolanda, nos municípios do Agreste Setentrional de Pernambuco, rebanhos esses catalogados em fichas próprias com dados clínicos de todos os casos de afecções das unhas, dados de manejo (instalações, alimentação, aguadas, higiene) e comparados entre si. No total as vacas Holandesas apresentaram 489 lesões (14,05 %), as vacas Parda Alpina apresentaram 128 lesões (3,68 %) e as vacas Girolanda apresentaram 108 lesões (3,10 %). Observou-se que existe uma tendência de aumento da ocorrência de lesões das unhas nos bovinos mais especializados para a produção de leite, nos plantéis mais confinados, nos quais se busca um incremento da produção mediante o avanço genético, nutricional e de manejo, maior concentração de animais em pisos firmes, ásperos e duros, fatores estes que elevam o aparecimento das afecções das unhas nos bovinos, principalmente os produtores de leite.In the present work the objective was to made a comparative analyses of the lameness in the principal milk breed in the Pernambuco State. To this a attendance was performed of 870 cows of 18 bovine herd of milky aptness, in intensive and semi-intensive regime, with 290 belonging dem six race Holland, 290 dem six race Brow Alpine and 290 of six race Girolanda, in the rural northerly pernambucano. This herd was cataloged im owns cards with clinics data of alls the cases of claw affections, handling (installations, feeding, waterings places, hygiene) and between itself confronted in the total the Holland cows presented 489 lesions (14,05 %), the Brown Alpine cows presented 128 lesions (3,68 %) and the Girolando cows presented 108 (3,10 %). Was observeted that exist a tendency of occurrence increase of claw lesions in the bovines plus specializated to the milk production, in the herd plus bordered, in the whiches itself search a increment of the production, by means the genetic advancement, nutrition, handling, greater concentration of animals in firm ground, rough, hard, factores this that have increase the appearing of the claw afections in the bovines, principaly the milk producer

Evaluation of the male effect on the reproductive performance of anglo-nubian goats raised in the semi-arid region of the State of Pernambuco

Objetivou-se avaliar o efeito macho sobre o desempenho reprodutivo de cabras pluríparas (n = 300) da raça Anglo-Nubiana, com idade de 24 a 60 meses, criadas em regime semiextensivo no semi-árido do Estado de Pernambuco. No primeiro experimento objetivou-se ampliar o conhecimento sobre o efeito macho, avaliando a influência da distância do afastamento entre macho e fêmea sobre a atividade reprodutiva durante a estação de monta de 45 dias de cabras (n = 120) da raça Anglo-Nubiana com idade de 24 a 60 meses. As cabras, criadas em regime semi-extensivo no semi-árido do Estado de Pernambuco, foram afastadas a 2 m (T1), 300 m (T2) e 2.000 m (T3) de distância dos reprodutores (n = 6) 60 dias antes do início dos experimentos, e mantidas em piquetes formados por vegetação nativa do tipo arbustiva durante o período seco (PS) e chuvoso (PC). Antes dos experimentos, os reprodutores foram avaliados pelo exame clínico andrológico e as fêmeas foram selecionadas pelo escore de condição corporal, por meio de exame vaginoscópico e ultrassonográfico, além da dosagem de progesterona para constatação da condição de ciclicidade. Tanto no período seco (PS) quanto no chuvoso (PC), as cabras foram equitativamente distribuídas em três grupos. No T1, as cabras foram afastadas dos reprodutores por 2 m, no T2 por 300 m e no T3 por 2.000 m. O primeiro estro no PS ocorreu entre o 2o e o 22o dia da estação de monta e no PC entre o 1o e o 23o dia. No PS, o valor médio da primeira manifestação de estro foi de 7,13 ± 4,49 (T1), 8,84 ± 5,64 (T2) e de 6,37 ± 4,21 (T3) dias e no PC foi de 7,33 ± 5,74 (T1), 6,60 ± 4,88 (T2) e de 8,100 ± 4,87 (T3) dias, não havendo diferença (P > 0,05) entre os tratamentos dentro do mesmo e entre os diferentes períodos climáticos. A indução do estro no PS foi de 100% (T1), 100% (T2) e de 95,5% (T3) e no PC foi de 100% (T1), 100% (T2) e de 100% (T3), não havendo diferença (P > 0,05) entre os tratamentos no PS e no PC. A sincronização do estro no PS ocorreu em 36,6% das fêmeas, sendo de 30% (T1), 35% (T2) e de 45% (T3) e no PC em 56,6% das fêmeas, sendo de 50% (T1), 60% (T2) e de 60% (T3), não havendo diferença (P > 0,05) entre os tratamentos no PS e no PC. A porcentagem de prenhez no PS foi de 80% (T1), 70% (T2) e de 75% (T3) e no PC foi de 90% (T1), 90% (T2) e de 95% (T3), não havendo diferença (P > 0,05) entre os tratamentos no PS e no PC. A prolificidade no PS foi de 1,34 (T1), 1,33 (T2) e de 1,35 (T3) e no PC 1,35 (T1), 1,50 (T2) e de 1,38 (T3), não havendo diferença (P > 0,05) entre os tratamentos no PS e no PC. No segundo experimento objetivouse também ampliar o conhecimento sobre o efeito macho, avaliando a influência da proporção macho/fêmea sobre a atividade reprodutiva de cabras (n = 180) da raça Anglo-Nubiana com idade de 24 a 60 meses. As cabras, criadas em regime semi-extensivo no semi-árido do Estado de Pernambuco, foram afastadas por 300 m de distância dos reprodutores (n = 3) 60 dias antes do início dos experimentos, sendo mantidas em piquetes formados por vegetação nativa do tipo arbustiva durante o período seco (PS) e chuvoso (PC). Antes dos experimentos, os reprodutores foram avaliados pelo exame clínico-andrológico e as fêmeas foram selecionadas pelo escore de condição corporal, por meio de exame vaginoscópico e ultrassonográfico, além da aferição da concentração de progesterona para constatação da condição de ciclicidade. Tanto no período seco (PS) quanto no chuvoso (PC), as cabras foram aleatoriamente e equitativamente distribuídas em três grupos, sendo que no T1:20, os acasalamentos ocorreram na relação macho/fêmea de 1:20, no T1:30 foram acasaladas na relação de 1:30 e no T1:40 na proporção de 1:40. No PS, o valor médio da primeira manifestação de estro foi de 6,83 ± 4,57 (T1:20), 6,72 ± 4,56 (T1:30) e de 7,05 ± 5,23 (T1:30) dias e no PC foi de 6,60 ± 4,74 (T1:20), 6,70 ± 4,43 (T1:30) e de 7,46 ± 4,54 (T1:40) dias, não havendo diferença (P > 0,05) entre os tratamentos dentro do mesmo período climático. A indução do estro no PS foi de 95,00% (T1:20), 80,00% (T1:30) e de 75,50% (T1:40) e no PC foi de 100% (T1:20), 100% (T1:30) e de 97,5% (T1:40), não havendo diferença (P > 0,05) entre os tratamentos no PS e no PC. A sincronização do estro no PS ocorreu em 34,72% das fêmeas, sendo de 35,00% (T1:20), 36,66% (T1:30) e de 32,50% (T1:40) e no PC em 65,75% das fêmeas, sendo de 65,00% (T1:20), 70,00% (T1:30) e de 62,25% no (T1:40), não havendo diferença (P > 0,05) entre os tratamentos no PS e no PC. A porcentagem de prenhez no PS foi de 65,00% (T1:20), 70% (T1:30) e de 62,50% (T1:30) e no PC foi de 90,00% (T1:20), 86,60% (T1:30) e de 95%(T1:40), não havendo diferença (P > 0,05) entre os tratamentos no PS e no PC. A prolificidade no PS foi de 1,30 (T1:20), 1,30 (T1:30) e de 1,35 (T1:40) e no PC 1,29 (T1:20), 1,25 (T1:30) e de 1,30 (T1:40), não havendo diferença (P > 0,05) entre os tratamentos no PS e no PC. Os resultados permitem concluir que o efeito macho pode ser obtido evitando-se apenas o contato táctil entre reprodutor e fêmea, que a estação de monta de 45 dias pode ser realizada tanto no PS quanto no PC, que o efeito macho pode ser obtido com qualquer das relações macho/fêmea aqui testadas, e que qualquer delas pode ser utilizada na estação de monta de 45 dias, tanto no PS quanto no PC, sendo necessário observar a quantidade e a qualidade da pastagem ofertada nos piquetes, principalmente no PS, além de observar o estado de condição corporal, o peso corporal, o período pós-parto e a relação macho/fêmea.The goal of this study was to evaluate the male effect on the reproductive performance of pluriparous goats of the Anglo-Nubian race, aged 24 to 60 months, raised in a semi-extensive regime in the semi-arid region of the State of Pernambuco. The goal of the first experiment was to gain further knowledge of the male effect, evaluating the influence of the distance separating males and females on the reproductive activity during a 45-day mating season of Anglo-Nubian goats (n=120), aged 24 to 60 months. The goats, raised in the semi-extensive regime in the semi-arid region of the State of Pernambuco, were kept 2 m (T1), 300 m (T2) and 2.000 m (T3) away from the male (n=3) 60 days before the start of the experiment, separated by shrubby vegetation fences during the dry season (DS) and the rainy season (WS). Before the experiments, a clinical- andrologic test was performed on the male while the females were selected based on the body condition score by vaginoscopic and ultra-sound testing; they also received a dosage of progesterone in order to determine cyclicity. Both during the dry season (DS) and the rainy season (WS), the goats were equitably distributed into three groups. In T1, the goats were 2 m apart from the breeders, while in T2 they were 300 m apart and 2.000 m apart in T3. The first estrous in the DS occurred between the 2nd and the 22nd day of the breeding season and during the WS, it occurred between the 1st and the 23rd day. During the DS, the average value for the first manifestation of estrous was 7,13 ± 4,49 (T1), 8,84 ± 5,64 (T2) and 6,37 ± 4,21 (T3) days while in the WS it was 7,33 ± 5,74 (T1), 6,60 ± 4,88 (T2) and 8,10 ± 4,87 (T3) days, with no difference (P > 0,05) among treatments or among weather seasons. Estrous induction during the DS 100% (T1), 100% (T2) and 95,5% (T3) while in the WS it was 100% (T1), 100% (T2) and 100% (T3), with no difference (P > 0,05) among treatments in the DS and WS. Estrous synchronization during the DS occurred in 36,6% of the females, at 30% (T1), 35% (T2) and 45% (T3) while during the WS it occurred in 56,6 of the females, at 50% (T1), 60% (T2) and 60% (T3), with no statistical difference (P > 0,05) among treatments during the DS or WS. Percentage of pregnancy during the DS was 80% (T1), 70% (T2) and 75% (T3) while in the WS it was 90% (T1), 90% (T2) and 95% (T3), with no statistical difference (P > 0,05) among treatments in the DS and the WS. Prolificacy rate in the DS was 1,34 (T1), 1,33 (T2) and 1,35 (T3), and during the WS it was 1,35 (T1), 1,50 (T2) and 1,38 (T3), with no statistical difference (P > 0,05) among treatments in the DS or the WS. In the second experiment the goal was to also to further our knowledge of the male effect by evaluating the influence of the male/female ratio on the reproductive activity of the Anglo-Nubian goats (n = 180), aged 24 to 60 months. The goats were raised in a semi-extensive regime in the semi-arid region of the State of Pernambuco; they were kept apart a distance of 300 m from the male (n = 3) 60 days before the start of the experiment, maintained fenced in by a shrubby type vegetation during the dry season (DS) and the rainy season (WS). Before the start of the experiment, the male were tested with a clinical andrologic examination while the females were selected by body condition score through vaginoscopic and ultrasound, besides measurement of concentration of progesterone to determine their cyclicity condition. Both in the dry season (DS) and the rainy season (WS), the goats were randomly and equitably distributed into three groups, whereas in T1:20, mating occurred in the male/female ratio of 1:20, in T1:30 mating occurred in the ratio of 1:30 and in T1:40, the ratio was 1:40. During the DS, the average value for first manifestation of estrous was 6,83 ± 4,57 (T1:20), 6,72 ± 4,56 (T1:30) and 7,05 ± 5,23 (T1:30) days, and during the WS, it was 6,60 ± 4,74 (T1:20), 6,70 ± 4,43 (T1:30) and 7,46 ± 4,54 (T1:40) days, with no statistical difference (P > 0,05) among treatments within the same weather period. Induction of estrous in the DS was 95,00% (T1:20), 80,00% (T1:30) and 75,50% (T1:40), and during the WS was 100% (T1:20), 100% (T1:30) and 97,5% (T1:40), with no statistic difference (P > 0,05) among treatments during the DS and the WS. Estrous synchronization during the DS occurred in 34,72% of the females, being 35,00% (T1:20), 36,66% (T1:30) and 32,50% (T 1:40) and during the WS it occurred in 65,75% of the females, being 65,00% (T1:20), 70,00% (T1:30) and 62,25% at (T1:40), with no statistical difference (P > 0,05) among treatments in the DS and WS. Percentage of pregnancy during the DS was 65,00% (T1:20), 70% (T1:30) and 62,50% (T1:30), while during the WS it was 90,00% (T1:20), 86,60% (T1:30) and 95% (T1:40), with no statistical difference (P > 0,05) among treatments during the DS and WS. Prolificacy rate during the DS was 1,30 (T1:20), 1,30 (T1:30) and 1,35 (T1:40), while in the WS it was PC 1,29 (T1:20), 1,25 (T1:30) and 1,30 (T1:40), with no statistical difference (P > 0,05) between treatments in the DS and WS. Results allow us to conclude that the male effect can be obtained by avoiding tactile contact between the breeder and the female, and that the 45-day breeding season can be performed both in the DS and in the WS, that the male effect can use obtained with any of the male/female ratio tested here and that any ratio can be used in the 45-day breeding season in the DS as well as the WS; it will be necessary to observe grazing quantity and quality, especially during the DS, as well as body condition, body weight, post-partum period and the male/female ratio

Desempenho reprodutivo usando distâncias diferentes para o pré-condicionamento do efeito macho em caprinos durante dois períodos climáticos distintos

The objective of the present study was to determine if separation distance between bucks and does during two distinct climate seasons could affect the reproductive performance of goats subjected to a 45-day mating season (MS). Anglo Nubian does (n = 120) were kept apart from bucks at distances of 2 m (T1), 300 m (T2), and 2000 m (T3) for 60 days prior to the 45-day MS during two distinct climate seasons [dry season (DS, February to March) and rainy season (RS, September to October)] in Sertânia, Pernambuco state, Brazil. There were no effects of distance of separation between bucks and does in any response variable evaluated. However, during the DS, the mean of the first estrous manifestation varied significantly (P&gt;0.05) between groups [7.13±4.49 (T1), 8.84±5.64 (T2), and 6.37±4.21 (T3) days] and during the RS [7.33±5.74 (T1), 6.60±4.88 (T2) and 8.10±4.87 (T3) days]. Similar (P&gt;0.05) estrous induction rates were found during both the DS [100.00% (T1), 100.00% (T2) and 95.50% (T3)] and the RS [100.00% (T1), 100.00% (T2) and 100.00% (T3)]. The estrous synchronization rate was found to be lower during the DS [36.60%; 30.00% (T1), 35.00% (T2) and 45.00% (T3)] than during the RS [56.60%; 50.00% (T1), 60.00% (T2) and 60.00% (T3)]. Pregnancy rates during the DS [P&gt;0.05; 80.00% (T1), 70.00% (T2) and 75.00% (T3)] were lower than during the RS [P&gt;0.05; 90.00% (T1), 90.00% (T2) and 95.00%(T3)]. In summary, the separation distance between bucks and does did not affect the reproductive outcome of Anglo Nubian goats over a 45-day MS under tropical conditions. Greater reproductive outcome was observed during the RS than the DS regardless of the separation distance between bucks and does.</span

Influence of male-to-female ratio and climatic conditions on the reproductive performance of Anglo Nubian goats

The objective of this study was to test the “male effect” on the reproductive performance of Anglo Nubian does (n = 180), aged between 24 and 60 months, under different male-to-female ratios (1:20 – T20, 1:30 – T30, and 1:40 – T40) and climatic conditions (dry season – DS, and rainy season – RS). Does were randomly distributed into three groups (T20, T30, and T40) and were isolated from bucks at a distance of 300 m for 60 days before the start of the experiments. The first manifestation of estrous during the DS occurred 6.83 ± 4.54 (T20), 6.72 ± 4.56 (T30) and 7.05 ± 5.23 (T40) days following the onset of the breeding season (P&gt;0.05). In the RS, onset of estrous was observed 6.60 ± 4.74 (T20), 6.70 ± 4.43 (T30) and 7.46 ± 4.54 (T40) days after the beginning of the breeding season (P&gt;0.05). Estrous induction in females during the DS occurred in 95% (T20), 80% (T30), and 75.5% (T40) of all females. During the RS, estrous detection reached 100% (T20), 100% (T30), and 97.5% (T40) of all females, with no difference between all RS and DS groups. Estrous synchronization during the DS occurred in 35.00% (T20), 36.66% (T30), and 32.50% (T40) of all females, for an average occurrence of 34.72%. During the RS, synchronization occurred in 65% (T20), 70% (T30) and 62.25% (T40) of all females, for an average occurrence of 65.75%; no difference was detected between the RS and the DS. Pregnancy rates in the DS groups were 65.0% (T20), 70.0% (T30), and 62.5% (T40), while pregnancy rates in the RS were 90.0% (T20), 86.6% (T30), and 95.0% (T40). No difference was observed for conception rates between any of the RS and DS groups. Prolificacy during the DS was 1.30 (T20), 1.30 (T30) and 1.35 (T40), while in the RS prolificacy was 1.29 (T20), 1.25 (T30) and 1.30 (T40). Thus, the male effect can be used effectively for goats under 1:20–1:40 male-to-female ratios in a 45-day mating season under varying climatic conditions

Recommendations of the Brazilian Society of Rheumatology for the diagnosis and treatment of chikungunya fever. Part 2 – Treatment

Universidade Federal de Pernambuco. Recife, PE, Brasil; Universidade Federal de Pernambuco. Hospital das Clínicas. Recife, PE, Brasil; Universidade Federal de Pernambuco. Hospital das Clínicas. Serviço de Reumatologia. Recife, PE, Brasil; Instituto de Medicina Integral Professor Fernando Figueira. Recife, PE, Brasil; Hospital Getúlio Vargas. Ambulatório de Chikungunya. Recife, PE, Brasil; Universidade Federal da Paraíba. João Pessoa, PB, Brasil; Universidade Federal da Paraíba. Hospital Universitário Lauro Wanderley. Serviço de Reumatologia. João Pessoa, PB, Brasil; Universidade Estadual de Ciências da Saúde de Alagoas. Maceió, AL, Brasil; Universidade Federal do Rio Grande do Norte. Natal, RN, Brasil; Universidade Federal do Ceará. Faculdade de Medicina. Departamento de Medicina Clínica. Fortaleza, CE, Brasil; Universidade Federal da Bahia. Instituto de Ciências da Saúde. Salvador, BA, Brasil; Universidade Estadual do Piauí. Faculdade de Medicina. Teresina, PI, Brasil; Universidade Federal de Sergipe. Aracaju, SE, Brasil; Universidade do Estado do Rio de Janeiro. Disciplina de Reumatologia. Rio de Janeiro, RJ, Brasil; Fundação Oswaldo Cruz. Escola Nacional de Saúde Pública Sérgio Arouca. Rio de Janeiro, RJ, Brasil; Universidade Federal do Rio de Janeiro. Hospital Universitário Clementino Fraga Filho. Rio de Janeiro, RJ, Brasil; Hospital dos Servidores do Estado do Rio de Janeiro. Rio de Janeiro, RJ, Brasil; Hospital Estadual Eduardo Rabello. Serviço de Reumatologia. Rio de Janeiro, RJ, Brasil; Universidade Federal do Amazonas. Faculdade de Medicina. Manaus, AM, Brasil; Universidade Federal de Mato Grosso do Sul. Campo Grande, MS, Brasil; Universidade Federal de Mato Grosso do Sul. Hospital Universitário Maria Aparecida Pedrossian. Serviço de Reumatologia. Campo Grande, MS, Brasil; Universidade de São Paulo. Faculdade de Medicina de Ribeirão Preto. Serviço de Reumatologia e Imunologia Pediátrica. Ribeirão Preto, SP, Brasil; Universidade Federal de São Paulo. São Paulo, SP, Brasil; Universidade de Santo Amaro. São Paulo, SP, Brasil; Universidade de São Paulo. Hospital das Clínicas. Ambulatório da Divisão de Moléstias Infecciosas de Parasitárias. São Paulo, SP, Brasil; Instituto de Medicina Integral Professor Fernando Figueira. Hospital Miguel Arraes. Paulista, PE, Brasil; Universidade Federal de Pernambuco. Hospital das Clínicas. Divisão de Gestão do Cuidado. Recife, PE, Brasil; CRP Fisioterapia. Rio de Janeiro, RJ, Brasil; Universidade Estadual do Piauí. Teresina, PI, Brasil; Sociedade Brasileira de Reumatologia. São Paulo, SP, Brasil; Santa Casa de Misericórdia de Maceió. Maceió, AL, BrasilSubmitted by Fátima Lopes ([email protected]) on 2017-10-24T13:42:18Z No. of bitstreams: 1 RecomendaçõesSociedadeBrasileiraP2.pdf: 984331 bytes, checksum: 9e4f277be0f65c545e7ac6b277aac848 (MD5)Approved for entry into archive by Fátima Lopes ([email protected]) on 2017-10-24T13:58:50Z (GMT) No. of bitstreams: 1 RecomendaçõesSociedadeBrasileiraP2.pdf: 984331 bytes, checksum: 9e4f277be0f65c545e7ac6b277aac848 (MD5)Made available in DSpace on 2017-10-24T13:58:50Z (GMT). No. of bitstreams: 1 RecomendaçõesSociedadeBrasileiraP2.pdf: 984331 bytes, checksum: 9e4f277be0f65c545e7ac6b277aac848 (MD5) Previous issue date: 2017Multipla - ver em NotasA febre chikungunya tem se tornado um importante problema de saúde pública nos países onde ocorrem as epidemias, visto que metade dos casos evolui com artrite crônica, persistente e incapacitante. Os dados na literatura sobre terapêuticas específicas nas diversas fases da artropatia ocasionada pela infecção pelo vírus chikungunya (CHIKV) são limitados, não existem estudos randomizados de qualidade que avaliem a eficácia das diferentes terapias. Há algumas poucas publicações sobre o tratamento das manifestações musculoesqueléticas da febre chikungunya, porém com importantes limitações metodológicas. Os dados atualmente disponíveis não permitem conclusões favoráveis ou contrárias a terapêuticas específicas, bem como uma adequada avaliação quanto à superioridade entre as diferentes medicações empregadas. O objetivo deste trabalho foi elaborar recomendações para o tratamento da febre chikungunya no Brasil. Foi feita uma revisão da literatura com seleção de artigos baseados em evidência, nas bases de dados Medline, SciELO, PubMed e Embase e de resumos de anais de congressos, além da opinião dos especialistas para dar apoio às decisões tomadas para definir as recomendações. Para a definição do grau de concordância foi feita uma metodologia Delphi, em duas reuniões presenciais e várias rodadas de votação on line. Este artigo refere-se à parte 2 das Recomendações da Sociedade Brasileira de Reumatologia para Diagnóstico e Tratamento da Febre Chikungunya, que trata especificamente do tratamento

Recommendations of the Brazilian Society of Rheumatology for diagnosis and treatment of Chikungunya fever. Part 1 - Diagnosis and special situations

Abstract Chikungunya fever has become a relevant public health problem in countries where epidemics occur. Until 2013, only imported cases occurred in the Americas, but in October of that year, the first cases were reported in Saint Marin island in the Caribbean. The first autochthonous cases were confirmed in Brazil in September 2014; until epidemiological week 37 of 2016, 236,287 probable cases of infection with Chikungunya virus had been registered, 116,523 of which had serological confirmation. Environmental changes caused by humans, disorderly urban growth and an ever-increasing number of international travelers were described as the factors responsible for the emergence of large-scale epidemics. Clinically characterized by fever and joint pain in the acute stage, approximately half of patients progress to the chronic stage (beyond 3 months), which is accompanied by persistent and disabling pain. The aim of the present study was to formulate recommendations for the diagnosis and treatment of Chikungunya fever in Brazil. A literature review was performed in the MEDLINE, SciELO and PubMed databases to ground the decisions for recommendations. The degree of concordance among experts was established through the Delphi method, involving 2 in-person meetings and several online voting rounds. In total, 25 recommendations were formulated and divided into 3 thematic groups: (1) clinical, laboratory and imaging diagnosis; (2) special situations; and (3) treatment. The first 2 themes are presented in part 1, and treatment is presented in part 2

Recommendations of the Brazilian Society of Rheumatology for the diagnosis and treatment of chikungunya fever. Part 2 - Treatment

Abstract Chikungunya fever has become an important public health problem in countries where epidemics occur because half of the cases progress to chronic, persistent and debilitating arthritis. Literature data on specific therapies at the various phases of arthropathy caused by chikungunya virus (CHIKV) infection are limited, lacking quality randomized trials assessing the efficacies of different therapies. There are a few studies on the treatment of musculoskeletal manifestations of chikungunya fever, but these studies have important methodological limitations. The data currently available preclude conclusions favorable or contrary to specific therapies, or an adequate comparison between the different drugs used. The objective of this study was to develop recommendations for the treatment of chikungunya fever in Brazil. A literature review was performed via evidence-based selection of articles in the databases Medline, SciELO, PubMed and Embase and conference proceedings abstracts, in addition to expert opinions to support decision-making in defining recommendations. The Delphi method was used to define the degrees of agreement in 2 face-to-face meetings and several online voting rounds. This study is part 2 of the Recommendations of the Brazilian Society of Rheumatology (Sociedade Brasileira de Reumatologia - SBR) for the Diagnosis and Treatment of chikungunya fever and specifically addresses treatment