Quando anti-TNF não obtém sucesso, anti-IL-12-23 é opção alternativa na psoríase e na artrite psoriásica

Pacientes com psoríase e artrite psoriásica respondem à terapia anti-TNF, mas nem todos os pacientes mantêm uma resposta efetiva e alguns não respondem. Nesse artigo, demonstramos o papel de uma nova via patogenética que, até certo ponto, independe de TNF nesses pacientes. Anti-IL-12-23 é um modo terapêutico novo e alternativo para pacientes com resposta recalcitrante à medicação com anti-TNF

Total hip and knee joint replacement: perioperative clinical aspects

Objective: To understand the profile of patients undergoing hip and knee replacement during two years, and to compare the data obtained with the literature. Methods: A total of 323 medical records were reviewed to analyze the perioperative data of patients submitted to hip and knee replacement. Results: Osteoarthritis was the main indication for both procedures and male patients were heavier than females (p < 0.05). Hypertension was the prevalent disease among patients. Blood loss was more frequent in knee surgery than in the hip. Conclusions: The profile of patients undergoing total arthroplasty improved substantially over the past decade due to shorter hospital stay, lower risk of thromboembolic events and no infection as compared to previous reports

Are we ready to replace anti TNF with anti IL12-23 in Psoriasis and Psoriatic Arthritis

Fil: Pereira Almeida De Piano, Luciana. Hospital Abreu Sodré; BrasilFil: Prado Golmia, Ricardo. Hospital Abreu Sodré; BrasilFil: Scheinberg, Morton A. Hospital Abreu Sodré; BrasilThe privotal role that tumor necrosis factor alpha (TNF alpha) a pro inflammatory cytokine plays in inflammation of the skin and synovium made it a logical target for the treatment of Psoriasis (Ps) and Psoriatic Arthritis (Psa). This cytokine has been shown to play a fundamental role in the pathogenesis of both Ps and Psa through several pathogenetic mechanisms, including the expression of adhesion molecules on the surface of endothelial cells, keratinocytes, and dendritic cells promoting leukocyte migration

Diagnosis of growing pains in a Brazilian pediatric population: a prospective investigation

Objective: To establish the clinical aspects of growing pains and to determine, through differential diagnosis, how many patients who referred themselves to a specialized clinic were found to have growing pains. Methods: This study prospectively examined the presence of growing pains in a self-reported population of children and adolescents with signs and symptoms (lower limb pains) of unexplained etiology. Results: A total of 345 children and adolescents were evaluated; 174 (50.4%) were males and 171 (49.6%) were females. Three hundred cases were classified as growing pains (87%). Conclusion: A high frequency of growing pains was found in our study population and it shows that in a prospective evaluation of patients with signs and symptoms of unknown etiology we can find a frequency higher than that reported in literature

Amiloidose AL em um adulto jovem: remissão clínica e laboratorial com transplante autólogo de células tronco

Transplante autólogo de células tronco é uma das formas de tratamento da amiloidose primária ou AL. Os autores relatam um paciente de 46 anos com hematomas periorbitais bilaterais, macroglossia, em quem, na investigação, se constatou a presença de paraproteínas IgG Kappa no soro. O diagnóstico de amiloidose primária ou AL foi confirmado, e o tratamento proposto com condicionamento com doses altas de Melfalan, seguido de transplante autólogo de células tronco, determinou a remissão completa da doença com desaparecimento de sinais clínicos e ausência do componente monoclonal