Chloroquine diphosphate: a risk factor for herpes zoster in patients with dermatomyositis/polymyositis

OBJECTIVES: Herpes zoster has been widely described in the context of different systemic autoimmune diseases but not dermatomyositis/polymyositis. Therefore, we analyzed the prevalence, risk factors and herpes zoster outcomes in this population. METHOD: A retrospective cohort study of herpes zoster infections in dermatomyositis/polymyositis patients was performed. The patients were followed at a tertiary center from 1991 to 2012. For the control group, each patient with herpes zoster was paired with two patients without herpes zoster. Patients were matched by gender and the type of myositis, age at myositis onset and disease duration. RESULTS: Of 230 patients, 24 (10.4%) had a histories of herpes zoster (19 with dermatomyositis and five with polymyositis, two-thirds female). The mean age of the patients with herpes zoster was 44.6±16.8 years. No difference between the groups was found regarding cumulative clinical manifestations. Disease activity, autoantibody, muscle and leukogram parameters were also comparable between the groups. No differences in immunosuppressive (alone or in association with other immunosuppressive therapies) or glucocorticoid (current use, medium dose and cumulative dose in the last two months) therapies were found between patients with and without herpes zoster. However, a higher proportion of patients in the herpes zoster group received chloroquine diphosphate compared to the control group. All of the patients received acyclovir; 58.3% of patients had postherpetic neuralgia and no cases of recurrence were reported. Furthermore, individuals who were taking high prednisone doses at the time of the herpes zoster diagnosis had reduced levels of postherpetic neuralgia. CONCLUSIONS: These data suggest that chloroquine diphosphate could predispose patients with dermatomyositis/polymyositis to developing herpes zoster, particularly women and dermatomyositis patients

Development and validation of a stability indicating HPLC method to determine diltiazem hydrochloride in tablets and compounded capsules

A stability indicating HPLC method to determine diltiazem hydrochloride (DTZ) in tablets and compounded capsules was developed and validated according to Brazilian and the International Conference on Harmonization (ICH) guidelines. The separation was carried out on a Purospher Star® C18 (150 x 4.6 mm i.d., 5 µm particle size, Merck Millipore) analytical column. The mobile phase consisted of a 0.05% (v/v) trifluoroacetic acid aqueous solution and a 0.05% trifluoroacetic acid methanolic solution (44:56, v/v). The flow rate was 1.0 mL.min-1 with a run time of 14 minutes. The detection of DTZ and degradation products (DP) was performed at 240 nm, using a diode array detector. The method proved to be linear, precise, accurate, selective, and robust, and was adequate for stability studies and routine quality control analyses of DTZ in tablets and compounded capsules

IgA nephropathy and polymyositis: a rare association

AbstractPolymyositis is a systemic and idiopathic inflammatory myopathy that, besides muscle manifestation, may occur with respiratory involvement, gastrointestinal tract and rarely renal involvement. In this latter, there are only two cases of IgA nephropathy, but both in dermatomyositis. On the other hand, we reported, for the first time, a case of IgA nephropathy in polymyositis

Myositis-specific and myositis-associated autoantibody profiles and their clinical associations in a large series of patients with polymyositis and dermatomyositis

OBJECTIVE: To analyze the prevalence of myositis-specific and myositis-associated autoantibodies and their clinical correlations in a large series of patients with dermatomyositis/polymyositis. METHOD: This cross-sectional study enrolled 127 dermatomyositis cases and 95 polymyositis cases. The disease-related autoantibody profiles were determined using a commercially available blood testing kit. RESULTS: The prevalence of myositis-specific autoantibodies in all 222 patients was 34.4%, whereas myositis-associated autoantibodies were found in 41.4% of the patients. The most frequently found autoantibody was anti-Ro-52 (36.9%), followed by anti-Jo-1 (18.9%), anti-Mi-2 (8.1%), anti-Ku (4.1%), anti-SRP (3.2%), anti-PL-7 (3.2%), anti-PL-12 (2.7%), anti-PM/Scl75 (2.7%), and anti-PM/Scl100 (2.7%). The distributions of these autoantibodies were comparable between polymyositis and dermatomyositis, except for a higher prevalence of anti-Jo-1 in polymyositis. Anti-Mi-2 was more prevalent in dermatomyositis. Notably, in the multivariate analysis, anti-Mi-2 and anti-Ro-52 were associated with photosensitivity and pulmonary disorders, respectively, in dermatomyositis. Anti-Jo-1 was significantly correlated with pulmonary disorders in polymyositis. Moreover, anti-Ro-52 was associated with anti-Jo-1 in both diseases. No significant correlation was observed between the remaining autoantibodies and the clinical and/or laboratory findings. CONCLUSIONS: Our data are consistent with those from other published studies involving other populations, although certain findings warrant consideration. Anti-Ro-52 and anti-Jo-1 were strongly associated with one another. Anti-Ro-52 was correlated with pulmonary disorders in dermatomyositis, whereas anti-Jo-1 was correlated with pulmonary alterations in polymyositis

TargetEqualizer: Uma Abordagem para Lidar com o Desequilíbrio de Classes na Previsão de Distúrbios Cardiovasculares através da Classificação de Batimentos Cardíacos com Aprendizado de Máquina

Este artigo introduz o TargetEqualizer, uma solução para lidar com o desequilíbrio de classes em conjuntos de dados de doenças cardiovasculares, mantendo a especificidade das previsões. Utilizou-se o método em modelos de aprendizado de máquina para prever doenças cardíacas com dados de sons cardíacos capturados por estetoscópios, seguindo o framework Cross-Industry Standard Process for Data Mining em 585 arquivos de áudio distribuídos em cinco classes. Inicialmente, os sons cardíacos foram convertidos em espectrogramas. O TargetEqualizer, uma combinação de oversampling e undersampling, equilibrou a distribuição dos dados, aprimorando a acurácia dos modelos. Foram treinados os modelos de Random Forest, Logistic Regression e Support Vector Machine com o conjunto de dados balanceado, avaliando-os com acurácia, precisão, recall e F1-Score, demonstrando a eficácia da abordagem. Os resultados indicam alta acurácia, com Random Forest alcançando 90,47% e Logistic Regression e Support Vector Machine atingindo 87,30%.  Isso compete efetivamente com estudos semelhantes e mantém a especificidade das previsões, ao contrário da prática comum de agrupar doenças cardíacas em duas classes, garantindo diagnósticos mais precisos. Palavras-chave: Classificação de Batimentos Cardíacos, Distúrbios Cardiovasculares, Espectrograma, Modelos de Aprendizado de Máquina, Balanceamento de Classes. DOI: 10.7176/RHSS/13-19-02 Publication date: December 31st 202

Adalimumab induced-inflammatory myopathy in rheumatoid arthritis

The application of immunobiologics for the rheumatoid arthritis treatment may present as a rare complication the development of inflammatory myopathy. Until this moment, there have been described in literature only seven cases of inhibitors of tumor necrosis factor induced-myositis. In this paper, we report the case of the patient with 39 years-old with eight years of arthritis rheumatoid and that due to refractory to various immunosuppressive drugs, the adalimumab was introduced, and evolved to dermatomyositis status

Trauma abdominal fechado com lesão de intestino delgado: lesão isolada tem mais risco de complicações do que a associada?

PURPOSE: The objective of this study was to compare patients with isolated blunt small bowel injury (SBI) to patients with multiple intra-abdominal injuries and analyze whether delayed laparotomy affected outcome. METHODS: Medical records of patients that suffered a blunt SBI between 1994 and 2005 were reviewed. The patients were divided into two groups: those with isolated SBI and those with other associated intra-abdominal injuries (non-isolated). The method of diagnosis, time to operation, small bowel Organ Injury Scale (OIS) assessment (grade > 2), injury severity score (ISS), morbidity, and mortality were analyzed. RESULTS: A total of 90 patients met the inclusion criteria, including 62 (68.9%) isolated cases and 28 (31.1%) non-isolated cases. Isolated cases required more supplementary diagnostic methods than the non-isolated cases. Non-isolated cases had a shorter diagnosis to treatment period (p 2), ISS e morbimortalidade dos pacientes. RESULTADOS: Noventa pacientes preencheram os critérios de inclusão, 62 (68,9%) no grupo isolada e 28 (31,1%) no associada. Pacientes do grupo isolada necessitaram mais de métodos diagnósticos complementares. O tempo de diagnóstico até o tratamento foi significantemente menor no grupo associada, e estes pacientes apresentavam ISS mais elevado (média de 22,5 versus 17,2 no grupo isolada). A morbidade e mortalidade nos grupos foram, respectivamente, 51,6% e 16,1% no grupo isolada, e 53,6% e 28,6% no associada, sem diferença estatística. Demora para o diagnóstico foi comum no grupo isolada, porém sem agravar a evolução dos pacientes. Pacientes com lesões associadas, quantificadas pelo ISS, tiveram maior mortalidade. CONCLUSÃO: A presença de lesões abdominais associadas significativamente interferiu no quadro clínico e momento do diagnóstico em pacientes com lesão de delgado, porém não influenciou na morbimortalidade. No grupo isolada a demora para tratamento cirúrgico foi freqüente, porém sem interferir nas complicações. A elevada mortalidade foi reflexo da gravidade de lesões associadas.19219

Perfil e distribuição da síndrome cólica em equinos em três unidades militares do Estado do Rio de Janeiro, Brasil

Este estudo teve como objetivo avaliar o perfil e a distribuição da síndrome cólica em eqüinos de três unidades militares no Estado do Rio de Janeiro, o Regimento Escola de Cavalaria (REsC), a Academia Militar das Agulhas Negras (AMAN) e o Esquadrão Escola de Cavalaria (EEC). No período entre 2003 e 2004, 770 eqüinos foram acompanhados para a ocorrência de casos clínicos de cólica. Realizou-se análise descritiva dos dados, e foram calculadas a taxa de incidência de cólica e a proporção de eqüinos acometidos. O teste do χ2 foi utilizado para avaliar a associação entre síndrome cólica e variáveis relativas às características dos eqüinos e do manejo. A incidência variou entre as unidades militares, 0,12 na AMAN, 0,21 no EEC e 0,95 casos/eqüino-ano no REsC, sendo acometidos 15% dos eqüinos da AMAN, 30% do EEC e 69% do REsC. A maior incidência foi de episódios de origem gástrica, 76,5%. Casos de reincidência foram elevados, sendo 62,5% no REsC, 36,7% na AMAN e 29,0% no EEC. A síndrome cólica estava significativamente associada às variáveis unidade militar, sistema de criação, quantidade de grãos ingerido e suplemento mineral-vitamínico. As altas incidências, reincidências e proporção de animais acometidos observadas ocorreram de forma diferenciada nas três unidades, indicando que, apesar de possuírem como característica comum pertencerem a unidades militares, os eqüinos formam um grupo heterogêneo no que diz respeito à ocorrência de síndrome cólica, provavelmente devido às diferentes condições de manejo.This research aimed to verify the profile and distribution of colic syndrome in horses of three military units in Rio de Janeiro, Brazil, which were Regimento Escola de Cavalaria (REsC), Academia Militar das Agulhas Negras (AMAN), and Esquadrão Escola de Cavalaria (EEC). From 2003 to 2004, 770 horses were followed up for the incidence of colic cases. A descriptive analysis of clinical data, incidence of colic cases and rate of horses affected was established. Chi-squared test was used to evaluate the association among colic syndrome and variables related to horses characteristics and management. Colic syndrome incidence varied among military units as follows: 0.12 cases/horse-year at AMAN, 0.21 at EEC and 0.95 at REsC, affecting 15% of horses in AMAN, 30% in EEC and 69% in REsC. The highest incidence was of gastric episodes (76.5%). Recurrence cases were 62.5% in REsC, 36.7% in AMAN and 29.0% in EEC. Colic syndrome occurred associated with variables: military unit, management, amount of intake grains and supplemented mineral-vitamin. High incidence, recurrence and horses rate with colic were differentiated among the three units. Although the horses of military units had common characteristic , they formed a heterogeneous group in respect to colic syndrome occurrence, probably due to different management conditions

Gut dysbiosis and systemic inflammation promote cardiomyocyte abnormalities in an experimental model of steatohepatitis

BACKGROUND Cardiovascular disease is the main cause of death in metabolic-associated fatty liver disease, and gut microbiota dysbiosis is associated with both of them. AIM To assess the relationship between gut dysbiosis and cardiovascular risk (CVR) in an experimental model of steatohepatitis. METHODS Adult male Sprague-Dawley rats were randomized to a control group (n = 10) fed a standard diet and an intervention group (n = 10) fed a high-fat choline-deficient diet for 16 wk. Biochemical, molecular, hepatic, and cardiac histopathology. Gut microbiota variables were evaluated. RESULTS The intervention group had a significantly higher atherogenic coefficient, Castelli’s risk index (CRI)-I and CRI-II, interleukin-1β, tissue inhibitor of metalloproteinase- 1 (all P < 0.001), monocyte chemoattractant protein-1 (P = 0.005), and plasminogen activator inhibitor-1 (P = 0.037) than the control group. Gene expression of miR-33a increased (P = 0.001) and miR-126 (P < 0.001) decreased in the intervention group. Steatohepatitis with fibrosis was seen in the intervention group, and heart computerized histological imaging analysis showed a significant decrease in the percentage of cardiomyocytes with a normal morphometric appearance (P = 0.007), reduction in the mean area of cardiomyocytes (P = 0.037), and an increase of atrophic cardiomyocytes (P = 0.007). There were significant correlations between the cardiomyocyte morphometry markers and those of progression and severity of liver disease and CVR. The intervention group had a lower Shannon diversity index and fewer changes in the structural pattern of gut microbiota (both P < 0.001) than controls. Nine microbial families that are involved in lipid metabolism were differentially abundant in intervention group and were significantly correlated with markers of liver injury and CVR. CONCLUSION The study found a link between gut dysbiosis and significant cardiomyocyte abnormalities in animals with steatohepatitis

Interspecific Genetic Differences and Historical Demography in South American Arowanas (Osteoglossiformes, Osteoglossidae, Osteoglossum)

The South American arowanas (Osteoglossiformes, Osteoglossidae, Osteoglossum) are emblematic species widely distributed in the Amazon and surrounding basins. Arowana species are under strong anthropogenic pressure as they are extensively exploited for ornamental and food purposes. Until now, limited genetic and cytogenetic information has been available, with only a few studies reporting to their genetic diversity and population structure. In the present study, cytogenetic and DArTseq-derived single nucleotide polymorphism (SNP) data were used to investigate the genetic diversity of the two Osteoglossum species, the silver arowana O. bicirrhosum, and the black arowana O. ferreirai. Both species differ in their 2n (with 2n = 54 and 56 for O. ferreirai and O. bicirrhosum, respectively) and in the composition and distribution of their repetitive DNA content, consistent with their taxonomic status as different species. Our genetic dataset was coupled with contemporary and paleogeographic niche modeling, to develop concurrent demographic models that were tested against each other with a deep learning approach in O. bicirrhosum. Our genetic results reveal that O. bicirrhosum colonized the Tocantins-Araguaia basin from the Amazon basin about one million years ago. In addition, we highlighted a higher genetic diversity of O. bicirrhosum in the Amazon populations in comparison to those from the Tocantins-Araguaia basin. © 2019 by the authors. Licensee MDPI, Basel, Switzerland