"Dry oral and ocular manifestations and autoantibodies characteristic of primary Sjögren's syndrome in multiple sclerosis".

INTRODUCTION: The relationship between primary Sjögren syndrome (pSS) and demyelinating diseases is still not well understood. These diseases seem to coexist amidst autoimmunity, raising questions about clinical characteristics, relationship with immunomodulatory treatment, and possible common immunological background underlying their pathogenesis. OBJECTIVE: calculate the frequency of dry oral and ocular manifestations and autoantibodies characteristic of primary Sjögren's Syndrome in Multiple Sclerosis. METHODS: 202 patients with multiple sclerosis answered a questionnaire to identify complaints of xerostomia and xerophthalmia, according to diagnostic criteria for primary Sjögren's syndrome; 43 answered positively to at least one question; 27 had comorbidities or used drugs that cause dry symptoms and were excluded; 16 patients were selected for examinations for oral, ocular and serum anti-Ro/SS-A autoantibody evaluation. RESULTS: Eleven (68.75%) patients complained of xerostomia; 14 (87.5%) of xerophthalmia. Sialometry < 0.1 ml/min was observed in three (18.8%); 13 patients underwent minor salivary gland biopsy and histopathological examination: focal score > 1 in three (23.1%). Schirmer test was < 5 mm/5 min in four (25%). Lyssamine green/fluorescein dye score was > 5 in three (18.8%). Anti-Ro/SS-A > 10 UI/mm in two (12.5%). Three (1,49%) patients met current criteria for primary Sjögren's syndrome. CONCLUSIONS: Patients with MS may report xerostomia and/or xerophthalmia even in the absence of comorbidities and use of medications capable of causing these symptoms, which may fulfill the diagnostic criteria for pSS. In this study, the frequency of pSS according to current criteria was within the range observed in the literature with older criteria. But the question remains whether the association between these diseases is fortuitous or whether there is a pathogenic link.

Estudo comparativo entre duas estratégias de "marketing" na motivação para consulta de retorno em clientela de consultório oftalmológico / Comparative study between two marketing strategies to encourage patients to return for new clinical appointments in an ophthalmologic office

Objetivo: Comparar duas estratégias de “marketing” direto (mala direta e “telemarketing”) na motivação para agendamento de consulta de regresso, identificando um canal gerador de retorno de pacientes em consultório oftamológico. E observar se há diferença do tempo de ausência no tempo de demora na resposta ao estímulo. Métodos: Foram contactados 400 pacientes, extraídos de fichário médico de Clínica particular selecionados a partir de ordem alfabética. O grupo A constante de pacientes com período de ausência de um a três anos e o grupo B, de três a cinco anos. A primeira metade de cada grupo recebeu correspondência (mala direta) e a segunda, contato telefônico (“telemarketing”) , sendo considerada positiva a resposta que realizou agendamento de uma consulta de retorno, no intervalo de tempo de três meses. Resultados: Apresentaram resposta positiva ao “marketing” direto 3,5 por cento dos pacientes, sendo 3,5 para mala direta e 3,5 para o “telemarketing”. Conclusão: Observaram-se, na utilização do “marketing” direto na área de saúde, resultados sem diferença estatística entre as duas vias estudadas (mala direta e “telemarketing”).