Ambulatório conjunto de Dermatologia e Reumatologia para tratamento de psoríase e artrite psoriásica: experiência de um hospital terciário no sul do Brasil

Introduction: several guidelines emphasize the advantages of multidisciplinary management of patients with psoriasis (PSO) or psoriatic arthritis (PSA). Early diagnosis of PSA relates to better outcomes in 5 years. However, early diagnosis of PSA remains a challenge. Methods: retrospective cohort of patients with previous or suspect diagnosis of PSO and/or PSA who were cared for in the combined dermatology and rheumatology clinic from January 2013 to January 2017.Results: among the 55 patients previously diagnosed with PSO, 30.9% (n=17) were diagnosed with PSA. Changes in medical therapy were made for 58.5% (n = 48) of patients, mainly due to poor cutaneous or articular disease control. Imunobiologicals were the most commonly initiated class of medicine, corresponding to 35.4% (n = 17) of changes in medical therapy. Methotrexate was the second most initiated medicine (18.7%; n = 9), or with changes in its dosage or route of administration (20.8%; n = 10), totaling 39.5% (n = 19) of changes in medical therapy. There was an increase in the proportions of patients undergoing systemic therapies (79.2%; n = 65).Conclusions: this study reenforces the importance of a multidisciplinary approach in the early diagnosis of PSA and demonstrates that a combined approach between dermatology and rheumatology is feasible in Brazil, with similar outcomes to those reported in international literature

Individual serological follow-up of patients with suspected or confirmed abdominal angiostrongyliasis

Abdominal angiostrongyliasis (AA) is a zoonotic nematode infection caused by Angiostrongylus costaricensis, with widespread occurrence in the Americas. Although the human infection may be highly prevalent, morbidity is low in Southern Brazil. Confirmed diagnosis is based on finding parasitic structures in pathological examination of biopsies or surgical resections. Serology stands as an important diagnostic tool in the less severe courses of the infection. Our objective is to describe the follow up of humoral reactivity every 2-4 weeks up to one year, in six individuals with confirmed (C) and ten suspected (S) AA. Antibody (IgG) detection was performed by ELISA and resulted in gradually declining curves of reactivity in nine subjects (56%) (4C + 5S), that were consistently negative in only three of them (2C + 1S) after 221, 121 and 298 days. Three individuals (2C + 1S) presented with low persistent reacitivity, other two (1C + 1S) were serologically negative from the beginning, but also presenting a declining tendency. The study shows indications that abdominal angiostrongyliasis is usually not a persistent infection: although serological negativation may take many months, IgG reactivity is usually declining along time and serum samples pairing may add valuable information to the diagnostic workout

Epidemiological analysis of patients with psoriatic arthritis in follow-up at the brazilian Unified Health System

Abstract Introduction/Objectives Psoriatic arthritis (PsA) is a chronic multisystem osteoarticular disease that requires specialized care. Most Brazilians depend on the public healthcare provided by the Unified Health System (Sistema Único de Saúde, SUS). This study aimed to describe the epidemiological characteristics of patients with PsA in follow-up in SUS, focusing on the incidence and prevalence of the disease, comorbidities, and hospitalizations. Methods We collected data from the Outpatient Data System of SUS (Sistema de Informações Ambulatoriais do SUS, SIA/SUS) regarding outpatient visits and hospitalizations in the Brazilian public healthcare system from January 2008 to March 2021 using the Techtrials Disease Explorer® platform and the medical code related to PsA were selected. Results We evaluated 40,009 patients and found a prevalence of 24.4 cases of visits due to PsA per 100,000 patients in follow-up in SUS. Female patients were predominant (54.38%). The incidence of visits due to PsA has been increasing in recent years and we observed an incidence of 8,982 new visits in 2020. The main comorbidities of these patients were osteoarthritis, lower back pain, shoulder injuries, oncological diseases, crystal arthropathies, and osteoporosis. Hospitalizations were mainly due to treating clinical or cardiovascular conditions and performing orthopedic procedures. Conclusion The number of visits due to PsA in SUS has increased in recent years, mainly on account of new diagnoses of the disease, although the prevalence found in this study’s population was lower than that observed in the general population

Ambulatório conjunto de Dermatologia e Reumatologia para tratamento de psoríase e artrite psoriásica: experiência de um hospital terciário no sul do Brasil

Introduction: several guidelines emphasize the advantages of multidisciplinary management of patients with psoriasis (PSO) or psoriatic arthritis (PSA). Early diagnosis of PSA relates to better outcomes in 5 years. However, early diagnosis of PSA remains a challenge. Methods: retrospective cohort of patients with previous or suspect diagnosis of PSO and/or PSA who were cared for in the combined dermatology and rheumatology clinic from January 2013 to January 2017.Results: among the 55 patients previously diagnosed with PSO, 30.9% (n=17) were diagnosed with PSA. Changes in medical therapy were made for 58.5% (n = 48) of patients, mainly due to poor cutaneous or articular disease control. Imunobiologicals were the most commonly initiated class of medicine, corresponding to 35.4% (n = 17) of changes in medical therapy. Methotrexate was the second most initiated medicine (18.7%; n = 9), or with changes in its dosage or route of administration (20.8%; n = 10), totaling 39.5% (n = 19) of changes in medical therapy. There was an increase in the proportions of patients undergoing systemic therapies (79.2%; n = 65).Conclusions: this study reenforces the importance of a multidisciplinary approach in the early diagnosis of PSA and demonstrates that a combined approach between dermatology and rheumatology is feasible in Brazil, with similar outcomes to those reported in international literature

Additional file 1 of Epidemiological analysis of patients with psoriatic arthritis in follow-up at the brazilian Unified Health System

Supplementary Material

Hormônio anti-Mülleriano como preditor de reserva ovariana em pacientes lúpicas: uma revisão

RESUMO O hormônio anti-Mülleriano (HAM) é secretado a partir das células da granulosa dos folículos ovarianos em crescimento e parece ser o melhor marcador endócrino capaz de estimar a reserva ovariana. O lúpus eritematoso sistêmico (LES) é uma doença autoimune que acomete predominantemente mulheres em idade reprodutiva e pode afetar negativamente sua fertilidade pela atividade da doença, bem como pelos tratamentos usados. Conhecer o real impacto do LES e de seu tratamento na fertilidade vem sendo o objetivo de estudos recentes, os quais têm usado o HAM para esse fim