Musculoskeletal syndromes associated with malignancies.

Literature on the association of malignancies with various rheumatic disorders published over the past year is summarized in this review. The possible roles of methotrexate treatment in predisposing to the development of lung cancer and Felty's syndrome in predisposing to non-Hodgkin's lymphoma in rheumatoid arthritis patients are discussed. The increased occurrence of monoclonal gammopathies and non-Hodgkin's lymphoma in patients with Sjögren's syndrome is reported. The possible increased frequency of malignancies among patients with systemic lupus erythematosus (SLE), scleroderma, and polymositis-dermatomyositis is revisited; of interest, the overlapping clinical features of non-Hodgkin's lymphoma and SLE are presented, as well as the increased occurrence of ovarian cancer in patients (especially older women) with dermatomyositis. The proceedings of the first International Workshop on Hypertrophic Osteoarthropathy, as well as the association of this syndrome with nasopharyngeal carcinoma in the childhood years, are presented. Finally, postchemotherapy and post-bacille Calmette-Guérin rheumatism are described.

Use of the "CDC backpack aspirator" for surveillance of Aedes aegypti in San Juan, Puerto Rico.

We constructed a battery-powered backpack aspirator to collect adult Aedes aegypti mosquitoes. This simple, easily constructed aspirator facilitates the indoor collection of this important vector species. The collections made with the aspirator provide useful information about the biology and behavior of Ae. aegypti that can be used in education and vector control programs and in the evaluation of ultra-low volume insecticide spray programs directed against this species. The cost for construction is ca. $150.

The elderly patient: a special case.

The elderly population represents an increasing part of the population, as life expectancy lengthens. As a consequence, rheumatic diseases, especially osteoarthritis, which is highly correlated with age, is increasingly prevalent. NSAIDs, the basic treatment of rheumatic diseases, are thus more and more widely prescribed to elderly patients. These patients must be regarded as a special population because of physiologic changes in absorption, distribution and excretion of drugs due to concomitant treatments of diseases (frequent in the elderly) which may alter metabolism. Specific studies have to be conducted in elderly patients in order to improve the evaluation of the benefit/risk ratio of drugs widely prescribed for this population. This explains why this symposium is devoted to NSAIDs and elderly.

Síndrome compressiva do túnel do carpo: aspectos clínicos e semiológicos; resultados do tratamento cirúrgico

Os autores apresentam uma análise retrospectiva de 30 casos de síndrome do túnel do carpo tratados cirurgicamente com abertura do ligamento transverso do carpo. Enfatizam que o diagnóstico da enfermidade é clínico e que o tratamento cirúrgico é eficaz e inócuo

Efficacy of auranofin as demonstrated by improvement in clinical parameters and decrease in anti-inflammatory usage: a long-term, multicenter study.

An open, noncomparative study at 8 rheumatology centers in Brazil assessed the efficacy and safety of auranofin (AF) when given for up to 24 months. The study enrolled 80 patients with classic or definite rheumatoid arthritis (RA); disease was severe in 20 (25%), moderate in 55 (69%), and mild in 5 (6%). Patients received auranofin, 3 mg twice daily, and varying doses of anti-inflammatory drugs (aspirin, nonsteroidal anti-inflammatory drugs, and corticosteroids). Sixty patients (75%) completed the full 24 months of therapy. No patients were withdrawn from therapy because of insufficient therapeutic effect. There was statistically significant improvement (p less than 0.001) in 9 clinical parameters of disease activity, evident as early as 3 months after beginning AF therapy, increasing steadily over 12 months, and remaining at improved levels for another 12 months. Improvements in some parameters were particularly striking. By 24 months, assessment of well-being had increased by 150%, intensity of pain had decreased by 66%, and duration of morning stiffness had decreased by 78%. The average daily dose of anti-inflammatory drugs also decreased over time. The safety profile of AF was similar to that found in comparable trials. Ten patients (12.5%) were withdrawn because of adverse events: 6 for diarrhea (7.5%), 2 for proteinuria (2.5%), and 1 each for pruritus and anemia (1.25%). Adverse events occurred in 24 of 80 patients; some reported more than one adverse event. The most common adverse events were loose stools (20 patients) or diarrhea (11 patients).(ABSTRACT TRUNCATED AT 250 WORDS)

Hiperuricemia como causa de dor nas artroses. / Hyperuricemia as a cause of pain in arthrosis

Estudando a uricemia em 1.275 pacientes com diferentes formas de reumatismo, foi observada correlacao estatisticamente significante entre hiperuricemia e artrose, principalmente no sexo feminino. Baseado neste fato, o autor enuncia a hipotese de que nos artrosicos, com niveis elevados de acido urico, a cartilagem degenerada facilita e condiciona a precipitacao de uratos do liquido sinovial, desencadeando, assim, crise dolorosa atraves de mecanismo semelhante ao da gota. Este trabalho foi primeiramente publicado em 1975(29) e agora republicado, com comentarios, em virtude da publicacao do artigo de Simkim e cols.(28), que defende ideias semelhantes

Osteoporose idiopatica juvenil. Apresentacao de dois casos. / Juvenile idiopathic osteoporosis. Report of 2 cases

A osteoporose idiopatica juvenil e uma forma rara de osteoporose que tem inicio, geralmente, entre os 8 e 14 anos de idade, evoluindo ate a puberdade, epoca em que tende para a cura espontanea, deixando como sequelas as complicacoes que tenham ocorrido durante seu desenvolvimento. Nao ha tratamento especifico. E uma entidade que deve merecer a atencao de reumatologistas e pediatras, apesar de sua insignificante frequencia, pois, alem de entrar no diagnostico diferencial de inumeras doencas (sindrome de Cushing, leucoses agudas, anemia falciforme, talassemia, osteogenese imperfeita, raquitismo, etc.), pode ser erroneamente interpretada como doenca do grupo propriamente reumatico, como aconteceu com os nossos dois pacientes aqui descritos, um tendo sido diagnosticado como febre reumatica e outro como artrite reumatoide juvenil