Lipid profile in adult patients with idiopathic juvenile arthritis

AbstractThe inflammatory processes in the joints of a child with juvenile idiopathic arthritis (JIA) can persist into adulthood. Inflammation has been linked to distortions of the lipid profile and accelerated atherogenesis. In the present study, we examined the lipid profiles of adults with JIA compared with those of healthy people. A lipid profile of a sample of 54 adults with JIA (57.3% with polyarticular JIA, 37.0% with oligoarticular JIA, 1.9% with enthesitis-related JIA and 3.7% with systemic onset JIA) and 54 healthy subjects were compared. In the adults with JIA, data on gender, age, age at disease onset, the presence of rheumatoid factor (RF) and antinuclear antibodies (ANA), a Health Assessment Questionnaire (HAQ) and the disease duration were collected. We found that hypercholesterolaemia, increased low-density lipoprotein (LDL) and decreased high-density lipoprotein (HDL) were more common in patients with JIA than the controls (P=0.016, P<0.0001 and P=0.0008, respectively). Changes in the levels of total cholesterol (TC) and LDL were more common in the individuals who had a later onset of disease (P=0.0017 for TC and P=0.023 for LDL). In the entire JIA group, no other variable, such as RF, ANA, disease duration or responses to the HAQ, could be linked to dyslipidaemia (P = non-significant). We concluded that the adult patients with JIA have a lipid profile with increased TC and LDL levels and decreased levels of HDL compared to the controls. No clinical feature could be correlated with this change except for the age at disease onset

Isotretinoína, Acne e Depressão: Um Estudo Prospectivo Controlado

Introduction: Acne and isotretinoin, one of its treatment, have been linked to the occurrence of depression. Our aim was to study if isotretinoin is associated with depression in a sample of acne patients followed for 6 months comparing them with acne patients under other treatment modalities and control patients without acne. Methods: One hundred individuals were included: 50 controls and 50 with acne (24 using and 26 not using isotretinoin). Patients and controls answered the Beck Depression Inventory (BDI) and the 12 Item-Short Form Health Survey for quality of life (SF-12). Acne patients repeated this evaluation in 90 and 180 days. Results: No differences were found between controls and acne patients regarding BDI results but controls performed worse in the SF-12 mental domain (p=0.004). No differences were found within the acne group between those treated and not treated with isotretinoin in the comparison of the BDI and SF-12 (mental and physical domains) in days 0. 90 and 180 (all with p&gt;0.05). Conclusion: In this small sample isotretinoin treatment showed to be safe regarding the occurrence of depression.Introdução: Depressão tem sido atribuída à acne e a um dos seus tratamentos, a isotretinoína. O nosso objetivo foi estudar se o uso da isotretinoína está associado com a depressão numa amostra de pacientes com acne acompanhados por 6 meses, comparando-se os com pacientes com acne sem este tratamento e com indivíduos de um gripo controlo, sem acne. Métodos: Cem indivíduos foram incluídos: 50 controles e 50 com acne (24 usando e 26 não usando isotretinoína). Pacientes e controles responderam ao Inventário de Depressão de Beck (IDB) e ao SF-12 (12-Item Short-Form Health Survey ou Forma curta com 12 questões do questionário de Pesquisa de Saúde). Pacientes com acne repetiram estes questionários após 90 e 180 dias. Resultados: Indivíduos controles e pacientes com acne não mostraram diferenças quando os valores do IDB foram comparados, mas os controles tiveram um pior desempenho no SF-12 - domínio mental (p=0,004). Também não foi possível verificar diferenças entre os grupos de acne tratados e não tratados com isotretinoína quanto ao IDB e ao SF-12 nos dias 0, 90 e 180 (todos com p&gt;0,05). Conclusão: Nesta pequena amostra o tratamento com isotretinoína se mostrou seguro no que concerne à ocorrência de depressão

Jaccoud arthropathy in systemic lupus erythematosus: clinical and serological findings

SummaryObjectiveTo study the prevalence of Jaccoud arthropathy (JA) in a sample of local systemic lupus erythematosus (SLE) patients and its clinical and serological associations.Methods308 SLE patients from a single university center for the last two years were interviewed and examined. The presence of JA was searched for according to the JA index. After this, charts were reviewed for clinical and serological profile.ResultsThe studied sample was composed by 94.5% females and 5.5% males with mean age of 38.08±12.04 years and mean disease duration of 29.68±11.63 years. A JA prevalence of 6.1% was found in this sample. There was a positive association of JA presence with arthritis complaints (p=0.001) and a negative association with renal involvement (p=0.028). Patients with JA had higher positivity for anti-dsDNA (p=0.022).ConclusionDespite the positive association of JA with arthritis and anti-dsDNA, there was a negative association with nephritis. This could suggest that JA patients belong with a SLE subset with a better prognosis

Perfil lipídico e uso de anti-TNF-α

AbstractThe use of anti-TNF-α has been associated with several changes in lipid profile, although some study results are conflicting. The knowledge of this fact is of great importance when one observes at the association between rheumatic diseases and accelerated atherogenesis. The aim of this analysis was search for changes in lipid profile in anti TNF-α users in the population of Southern Brazil and its association with duration of use, indications, patient gender and type of anti-TNF. For this purpose, we studied the profiles of total cholesterol (TC), HDL cholesterol (HDLc), LDL cholesterol (LDLc), atherogenic index (ATI) and triglycerides (TGs) of 58 patients (42 with rheumatoid arthritis and 16 with spondyloarthritis) before and after using this drug for a median of 16.0 months. There were no changes in the levels of TC, HDLc, LDLc and ATI (P=NS). However, there was a significant increase in TG levels (P=0.03). The median difference between first and second TG measurements was 16mg/dL and this increase was not associated with gender, time of use, use indication or type of anti TNF-α (P=NS). It was concluded that the use of anti TNF-α is associated with increased values of TG

Ultrassonografia no diagnóstico da síndrome do túnel do carpo

ResumoObjetivoDeterminar a importância da ultrassonografia (US) no diagnóstico da síndrome do túnel do carpo (STC).MétodosDuzentos pacientes (400 mãos) foram submetidos a uma US do punho para medir a área do nervo mediano (ANM). Foram perguntados quanto à presença de parestesia e dor no território do nervo mediano e submetidos aos testes de Tinel e Phalen. Uma ANM>9mm2 foi considerada diagnóstica de STC.ResultadosO valor da ANM medida pela US foi>9mm2 em 27% das mãos. Foram encontrados uma boa associação com a dor (p<0,0001), parestesia (p<0,0001), teste de Tinel (p<0,0001) e teste de Phalen (p<0,0001). De acordo com os critérios clínicos para a classificação da STC da American Academy of Neurology, a ANM medida pela US teve 64,8% de sensibilidade e 77% de especificidade nessa amostra.ConclusãoA mensuração da ANM pela US é adequada e pode ser usada como primeira opção para a investigação de pacientes com STC.AbstractObjectiveWe aimed to determine the value of ultrasonography (US) in the diagnosis of carpal tunnel syndrome (CTS).MethodsTwo hundred patients (400 hands) were submitted to wrist US to measure median nerve area (MNA), questioning on paresthesia and pain in the median nerve territory, Tinel and Phalen maneuvers. An MNA>9mm2 was considered diagnostic of CTS.ResultsMeasurement of MNA by US was>9mm2 in 27% of the hands. A good association with pain (p<0.0001), paresthesia (p<0.0001), Tinel test (p<0.0001) and Phalen test (p<0.0001) was found. According to the clinical criteria for classification of CTS from American Academy of Neurology the MNA by US had 64.8% of sensibility and 77.0% of specificity in this sample.ConclusionMeasurement of MNA by US performs well and can be used as first option for the investigation of patients with CTS

ANÁLISE PRELIMINAR DO USO DE BIOLÓGICOS NO TRATAMENTO DA ARTRITE REUMATOIDE

Introduction: Rheumatoid arthritis (RA) is treated with conventional and biological disease-modifying drugs (DMARDs). Objectives: To compare the survival of biological drugs used for the treatment of RA patients. Methods: Retrospective study of medical records of patients who used biological medication for the treatment of RA from January 2020 to January 2022 and this was suspended. Data on the causes of withdrawal, duration of use, epidemiological, clinical and comorbid data were collected. Results: The main reason for discontinuity was failure followed by side effects. Infliximab and adalimumab had the highest survival. BMI (body mass index) and smoking, sex and age did not interfere in this survival. Conclusion: Failure is the most common cause of biological discontinuity. Among the factors studied (smoking, BMI, age and gender) it was not possible to identify a variable that was associated with failure.Introdução: A artrite reumatoide (AR) é tratada com drogas modificadoras da doença (DMARDs) convencionais e biológicas. Objetivos: Comparar a sobrevida de medicamentos biológicos utilizados para o tratamento de pacientes com AR. Método: Estudo retrospectivo de prontuários de pacientes que utilizaram medicamento biológico para tratamento de AR de janeiro de 2020 a janeiro de 2022 e este foi suspenso. Dados acerca das causas de retirada, tempo de uso, dados epidemiológicos, clínicos e de comorbidades foram coletados. Resultados: O principal motivo da descontinuidade foi a falha seguida por efeitos colaterais. Infliximabe e adalimumabe foram os que apresentaram maior sobrevida. IMC (índice de massa corporal) e o tabagismo, sexo e idade não mostraram interferência nesta sobrevida Conclusão: Falha é a causa mais comum de descontinuidade dos biológicos. Dentre os fatores estudados (fumo, IMC, idade e sexo) não foi possível identificar variável que se associasse com falha