Skin is the most frequently damaged system in recent-onset systemic lupus erythematosus in a tropical region.

The objective of this study was to evaluate the early damage as measured by the Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index (SLICC/ACR DI) in Brazilian systemic lupus erythematosus (SLE) patients with disease duration of 2 and 3 years and to evaluate the possible association between SLICC/ACR DI score and sociodemographic and clinical data. The SLICC/ACR DI was measured in 54 patients with SLE according to the ACR criteria for SLE and a mean (SD) disease duration of 29 (3.8) months. The patients were provided by outpatient clinics and hospitals of the public health network and private clinics in the city of Natal in Brazil. The SLICC/ACR DI scores for each type of organ damage, prevalence of damage within organ systems, and the association with sociodemographic variables were assessed. Disease duration was considered as the time from diagnosis until the study. Organ damage was present in 18 (33%) of the 54 patients while 36 patients (67%) had no damage. The skin (11%), renal (9%), and pulmonary (7.4%) systems were the most frequently involved, followed by the neuropsychiatric and musculoskeletal systems, premature gonadal failure, and diabetes. The most frequent individual items on the SLICC/ACR DI were scarring chronic alopecia and pleural fibrosis. No association was demonstrated between organ damage (SLICC/ACR scores) and sociodemographic and clinical variables. Early organ damage demonstrated in Brazilian patients with SLE was similar to other populations studied in the world, despite a low socioeconomic status. In contrast to reports in other studies, a cutaneous lesion was the most frequent cause of damage in our patients.

Uso das Tecnologias de Informação e Comunicação no Curso de Medicina da UFRN / Use of Information and Communication Technologies in the UFRN Medicine Course

RESUMO Está claro na literatura que as Tecnologias de Informação e Comunicação (TICs) oferecem um ambiente acadêmico virtual que melhora a interação entre docentes e alunos. Baseado nisto, nosso trabalho descreveu de que modo o estudante de Medicina da Universidade Federal do Rio Grande do Norte utiliza as TICs. Também investigou quais dessas ferramentas são utilizadas e a interferência da língua inglesa emseu uso. Esta pesquisa éum estudo descritivo de delineamento transversal, cujo instrumento de coleta de dados foi um questionário autoaplicável, padronizado e anônimo.Ao final do estudo, obteve-se uma taxa geral de respostas de 82% (n = 489). Verificou-se que as redes sociais são utilizadas por quase a totalidade dos estudantes (97,3%), que há um uso mais frequente de artigos científicos para o aprendizado ao longo dos períodos e que o uso majoritário da língua inglesa nessas ferramentas não constitui uma barreira para a maior parte da amostra (72%).

ABSTRACT It is clear in the literature that Information and Communication Technologies (ICTs) offer a virtual academic environment that enhances interaction between teachers and students. Based on this, our work described how medical studentsat theFederal University of Rio Grande do Norteuse ICTs. The investigation focused on which of these tools are used and the interference of the English language in the use of ICTs.This research is a descriptive, cross-sectional study, which drew on data collected through a self-administered,standardized and anonymous questionnaire.Bythe end of the study we obtained an overall response rate of 82% (n = 489). It was found that social networks are used by almost all the students (97.3 %); it was also observed that there is more frequent use of scientific articles for learning throughout academic terms and that the use of the English language by the majority of ICTs does not constitute a barrier for most of the sample (72%).

Double-blind, randomized, controlled clinical trial of clofazimine compared with chloroquine in patients with systemic lupus erythematosus.

OBJECTIVE: To evaluate the efficacy of clofazimine (CFZ) compared with chloroquine diphosphate (CDP) for the treatment of cutaneous involvement in systemic lupus erythematosus (SLE). METHODS: A prospective, randomized, controlled, double-blind clinical trial was carried out in SLE patients with active cutaneous lesions, of whom 16 were randomized to receive CFZ at 100 mg/day and 17 received CDP at 250 mg/day for 6 months. All drugs had a similar appearance to avoid identification. Both groups received broad-spectrum sunscreens twice a day and the prednisone dose was kept stable during the study. Cutaneous lesions were evaluated by 2 blinded observers at baseline and at months 1, 2, 4, and 6. RESULTS: Thirty-three patients were randomized to a treatment group, of whom 27 completed 6 months of treatment. The groups were homogeneous and comparable in terms of demographic and clinical characteristics. Five CFZ-treated patients and 1 CDP-treated patient (P = 0.15) dropped out due to development of severe lupus flare. At the end of the study, 12 CFZ-treated patients (75%) and 14 CDP-treated patients (82.4%) had complete or near-complete remission of skin lesions; intention-to-treat analysis showed no significant difference in the response rates between groups. Side effects, mainly skin and gastrointestinal events, were frequent in both groups, but no patients had to discontinue their treatment. CONCLUSION: These findings suggest that CFZ is equally as effective as CDP in controlling cutaneous lesions in SLE patients. However, we cannot exclude the possibility that the CFZ itself could be the cause of systemic lupus flare.

Lúpus eritematoso sistêmico (LES): perfil clínico-laboratorial dos pacientes do Hospital Universitário Onofre Lopes (UFRN-Natal/Brasil) e índice de dano nos pacientes com diagnóstico recente / Systemic lupus erythematosus (SLE): clinical and laboratory profile of patients followed at the Onofre Lopes University Hospital (UFRN-Natal/Brazil) and early organ damage in patients with recently diagnosed disease

Objetivo: Determinar a freqüência das manifestações clínicas e laboratoriais de pacientes com lúpus eritematoso sistêmico (LES) e identificar os danos precoces nos pacientes com diagnóstico recente. Métodos: Avaliação retrospectiva de 164 pacientes com LES do ambulatório de Reumatologia do Hospital Universitário Onofre Lopes - UFRN, de abril de 2003 a dezembro de 2004. As manifestações clínicas e laboratoriais avaliadas referem-se aos critérios de classificação do Colégio Americano de Reumatologia. A avaliação do índice de dano, através do SLICC/ACR DI (Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index) foi realizada em 32 pacientes que tinham entre dois e três anos de diagnóstico. Resultados: As manifestações clínicas mais freqüentes foram as cutâneas (90,2 por cento), em especial a fotossensibilidade. As demais manifestações clínicas e laboratoriais foram semelhantes às descritas na literatura. Dano orgânico precoce foi identificado em nove pacientes com doença recente (28,1 por cento) e, novamente, o acometimento cutâneo foi o mais freqüente (12,5 por cento). Conclusão: Tanto as manifestações clínicas quanto os danos orgânicos precoces mais comuns foram relacionados à pele. Portanto, faz-se necessário o incentivo à fotoproteção em nossa região, que tem alta influência dos raios ultravioleta.