Sharps Accidents: Occurrence and Knowledge Level among Brazilian Dental Students

ABSTRACT Objective: To evaluate the prevalence of sharps accidents among dental students in southwest Goiás state, Brazil, and further survey their knowledge of biosafety and post-injury management. Material and Methods: A cross-sectional analytical observational study was carried out in 2018 following the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines. The study population included dental students in the 4th and 10th course semester. A pre-formulated self-administered questionnaire containing 14 objective questions was used for data collection. Mean and standard deviation values were calculated. Results: A total of 308 responses were obtained. Overall, 15.9% of the respondents reported having previously experienced accidents with sharps. Most dental students who claimed to know the biological risks to which they are exposed were in the 5th and 8th course semesters, and 67.2% of them reported knowing how to proceed in the event of a sharp accident. Conclusion: A low prevalence of sharps accidents has been reported, and dental students are considered to have a good knowledge of biosafety.

Microbial communities of titanium versus zirconia abutments on implant-supported restorations: Biodiversity composition and its impact on clinical parameters over a 3-year longitudinal prospective study.

BACKGROUND: Shifts in microbial communities are common over time, but they may disturb the host-microbiome homeostasis and result in inflammation of the peri-implant issues if a dysbiotic biofilm is established. PURPOSE: Considering that different oral substrate surfaces may have a relevant impact on the microbial adhesion and colonization, the aim of this study was to investigate the microbial communities of the biofilm formed on single-implant restorations using titanium or zirconia abutments and how they correlate with clinical parameters after 3-years of implant loading. MATERIALS AND METHODS: MiSeq sequencing of 16S rRNA amplicons was used to characterize the oral biofilms of individuals (n = 20) who were sampled longitudinally during 3 years of masticatory loading. Bioinformatics analysis and multivariate statistical analysis were used to evaluate the microbial diversity and clinical outcomes. RESULTS: Microbiomes of both abutment materials presented high alpha-diversity indices during all the experimental period, irrespective of the time of sampling. Microbial communities of titanium and zirconia were quite different over time, differing about 30% after 3 years of functional loading. Similarity of microbiomes between tested abutments and contralateral teeth was also low, ranging between 45% and 50% after 3 years of investigation. Periodontal pathogens commonly associated with peri-implantitis were found in both groups. Furthermore, both abutment materials presented strong correlations of diversity indices and microbial taxa with clinical outcomes. CONCLUSIONS: The type of abutment substrate significantly influenced diversity and clustering of communities during 3 years of functional loading. The time of sampling had no effect on the variables. Large correlations were found between microbial findings and clinical outcomes.

A 3-year longitudinal prospective study assessing microbial profile and clinical outcomes of single-unit cement-retained implant restorations: Zirconia versus titanium abutments.

PURPOSE: The aim of this study was to assess the microbiological and clinical outcomes of implant-supported restorations on zirconia or titanium abutments after 3 years in function. MATERIALS AND METHODS: Twenty two-part dental implants were placed in 20 healthy individuals in need of single-tooth replacement. Ceramic-based reconstructions were cemented in either zirconia or titanium abutments. Clinical, radiographic, and microbiological outcomes were examined at implant loading and then yearly up to 3 years post-loading. RESULTS: Cumulative survival/success implant rates were 95% after 3 years. Mean total marginal bone loss was 0.76 ± 0.21 mm for zirconia and 0.99 ± 0.41 mm for titanium, with no significant differences (P > .05). Overall, titanium and zirconia abutments presented similar values of probing depth, gingival recession, and bleeding on probing over time (P < .05). Microbial profile of implants restored with titanium or zirconia is quite similar to that found in the remaining teeth. CONCLUSIONS: Zirconia and titanium presented different microbial profile and genome counts. Clinical findings for both zirconia and titanium abutments were similar and consistent with a healthy condition, reflecting a high survival rate and low bone loss. Microbiota did not impact the clinical outcomes after 3 years of function.

Kinanthropometry in Brazilian Physical Education (1970s): a new knowledge perspective for this field / A Cineantropometria na Educação Física brasileira (década de 1970): uma nova perspectiva de conhecimento para o campo

Abstract The aim of the present study is to understand the constitution of kinanthropometry as scientific disciplinary field in the 1970s in Brazil. Therefore, a bibliographic review was carried out in nine databases and in a specific journal focused on publications from the Kinanthopometry perspective, since this is an element to legitimize a scientific discipline. Only two studies dealing with this topic were selected. Given such a gap in the literature, three interviews with professors who organized the Physical Education (PE) course laboratories, as well as a newspaper report from the period, were used in the study. Different names have been associated with the scientific field of human composition assessment throughout history, as well as formulating different body perceptions, such as Biometrics, Anthropometry and kinanthropometry. Each of these factors determine relationships with the involved socio-cultural context. Such a complexity to understand a conjecture within a historical time expands the space available for analyses. In the 1960s, the term kinanthropometry emerged in foreign countries as a new way of interpreting human body composition assessments linked to knowledge in the PE field based on movement and anatomy. This term was imported by Brazilian researchers after their contact with scientists in USA and Canada, since it offered the possibility of acquiring new representations for research in the PE field back in the 1970s.

Resumo O presente estudo visa compreender a constituição da Cineantropometria como campo disciplinar científico na década de 1970 no Brasil. Para tanto, foi realizada uma revisão bibliográfica em nove bases de dados e no exclusivo periódico com foco específico em publicações na perspectiva da Cineantropometria, por este ser um elemento para a legitimação de uma disciplina científica. Foram identificados apenas dois estudos que tratam sobre a história da Cineantropometria como campo disciplinar. Diante desta lacuna, foram utilizadas três entrevistas com professores que organizaram os laboratórios dos cursos de Educação Física (EF), bem como uma reportagem de jornal do período. Diferentes denominações estiveram ligadas ao longo da história do campo científico da avaliação da composição corporal humana, formulando distintas percepções de corpo, como a Biometria, a Antropometria e a Cineantropometria, cada qual estabelecendo relações com o contexto sociocultural que as envolvia. Nessa complexidade para compreender uma conjectura dentro de um tempo histórico, amplia-se espaço e tempo de análise. Em países do exterior, na década de 1960, o termo Cineantropometria surge como nova forma de interpretação da avaliação da composição corporal humana, vinculado aos conhecimentos do campo da EF, pautada em movimento e anatomia. Com o contato dos pesquisadores brasileiros com cientistas dos Estados Unidos e do Canadá, este termo é importado e oferece uma possibilidade de aquisição de novas representações para a pesquisa em EF na década de 1970.

Being a mother of preterm multiples in the context of socioeconomic disadvantage: perceived stress and psychological symptoms / Ser mãe de múltiplos prematuros no contexto de desvantagem socioeconômica: estresse percebido e sintomas psicológicos

Abstract Objective: This study aimed to examine the differences between mothers of preterm multiples and mothers of preterm singletons regarding perceived stress and maternal psychological symptoms, and to explore the putative adverse amplified effect of socioeconomic disadvantage. Method: Ninety-five mothers of 1-year-olds born preterm participated in this cross-sectional study. Data collection was carried out in two public hospitals from Northern Portugal. To assess maternal perceived daily stress and psychological symptoms, mothers completed two questionnaires. Mothers reported on socioeconomic factors, including family poverty, parent unemployment, and low education, and two groups of family socioeconomic disadvantage were created. A child medical risk index was calculated. Results: Results indicated that mothers of preterm multiples reported higher levels of stress than mothers of preterm singletons. Moreover, and specifically regarding psychological functioning, mothers of preterm multiples reported more symptoms than mothers of preterm singletons, but only when living in a context of socioeconomic adversity. Conclusions: The results of the present study have important implications for practice. Mothers of preterm multiples are at higher risk to present mental health difficulties, in comparison to mothers of singletons, especially when exposed to socioeconomic adversities. The development of psychosocial intervention programs and public policies are of decisive importance in helping mothers of multiples adjust to parenthood.

Resumo Objetivo: Examinar as diferenças entre mães de múltiplos prematuros e mães de filhos únicos prematuros a respeito de estresse percebido e sintomas psicológicos maternos e explorar o efeito adverso amplificado putativo da desvantagem socioeconômica. Método: Participaram deste estudo transversal 95 mães de crianças de um ano nascidas prematuras. A coleta de dados foi feita em dois hospitais públicos do norte de Portugal. Para avaliar o estresse diário percebido e os sintomas psicológicos maternos, as mães responderam dois questionários. As mães relataram fatores socioeconômicos, incluindo pobreza familiar, desemprego dos pais e baixo nível de escolaridade, e foram criados dois grupos de desvantagem socioeconômica familiar. Foi calculado um índice de risco médico infantil. Resultados: Os resultados indicaram que as mães de múltiplos prematuros relataram maiores níveis de estresse do que as mães de filhos únicos prematuros. Além disso e especificamente com relação ao funcionamento psicológico, as mães de múltiplos prematuros relataram mais sintomas do que as mães de filhos únicos prematuros, porém apenas quando moravam em um contexto de adversidade socioeconômica. Conclusões: Os resultados deste estudo possuem importantes implicações para a prática. As mães de múltiplos prematuros apresentam maior risco de dificuldades de saúde mental, em comparação a mães de filhos únicos, principalmente quando expostas a adversidades socioeconômicas. O desenvolvimento de programas de intervenção psicossocial e políticas públicas é de importância decisiva ao ajudar as mães de filhos múltiplos a se ajustarem à maternidade.

Oral Biofilm Formation on Different Materials for Dental Implants.

Dental implants and their prosthetic components are prone to bacterial colonization and biofilm formation. The use of materials that provides low microbial adhesion may reduce the prevalence and progression of peri-implant diseases. In view of the oral environment complexity and oral biofilm heterogeneity, microscopy techniques are needed that can enable a biofilm analysis of the surfaces of teeth and dental materials. This article describes a series of protocols implemented for comparing oral biofilm formation on titanium and ceramic materials for prosthetic abutments, as well as the methods involved in oral biofilms analyses at the morphological and cellular levels. The in situ model to evaluate oral biofilm formation on titanium and zirconia materials for dental prosthesis abutments as described in this study provides a satisfactory preservation of the 48 h biofilm, thereby demonstrating methodological adequacy. Multiphoton microscopy allows the analysis of an area representative of the biofilm formed on the test materials. In addition, the use of fluorophores and the processing of the images using multiphoton microscopy allows the analysis of the bacterial viability in a very heterogeneous population of microorganisms. The preparation of biological specimens for electron microscopy promotes the structural preservation of biofilm, images with good resolution, and no artifacts.

Tocoyena sellowiana extract decreases bone loss in an experimental model of periodontitis in rats: Putative role for cyclooxygenase-2 and IL-1? inhibition.

Tocoyena sellowiana (Cham. & Schltdl.) K.Schum is one of the most important families of Brazilian medicinal plants. This study aimed to evaluate the effect of Tocoyena sellowiana (Cham. & Schltdl.) K.Schum ethanolic extract in a pre-clinical trial of periodontitis and to investigate possible mechanisms underlying such effects. Periodontitis was induced in Wistar rats by placing a nylon thread ligature around second upper left molars for 11 days. Rats received (per os) Tocoyena sellowiana (0.1, 1 or 10?mg?kg) or vehicle 1?h before ligature and daily until day 11. Macroscopic, histopathological, and COX-2 immunohistochemical analyses were performed to evaluate the periodontium. The gingival tissue was used to quantify the myeloperoxidase (MPO) activity and interleukin (IL)-1? levels by ELISA. Blood samples were collected to evaluate bone-specific alkaline phosphatase (BALP), the dosage of creatinine, aspartate and alanine transaminases. The liver, kidneys, spleen, and body mass variations were also evaluated. Tocoyena sellowiana decreased bone loss, reduced MPO, IL-1? levels as well as COX-2 immunostaining, and increased BALP activity. Moreover, Tocoyena sellowiana did not alter organs nor body weight. Tocoyena sellowiana reduced bone loss in rats and its efficacy was at least partially dependent upon both IL-1? and cyclooxygenase-2 inhibition.

Genome analysis and clinical implications of the bacterial communities in early biofilm formation on dental implants restored with titanium or zirconia abutments.

This cross-sectional study aimed to identify and quantify up to 42 target species colonizing the early biofilm of dental implants restored with titanium or zirconia abutments. A total of 720 samples from 20 healthy individuals were investigated. Biofilm samples were collected from the peri-implant sulci, inner parts of implants, abutment surfaces and prosthetic crowns over a functioning period of 30 days. Checkerboard DNA-DNA hybridization was used for microbial detection and quantitation. Clinical characteristics (probing depth, bleeding on probing, clinical attachment level and marginal bone loss) were also investigated during the monitoring period. Genome counts were low at the implant loading time point for both the abutment materials, and increased over time. Both the titanium and the zirconia groups presented similar microbial counts and diversity over time, and the microbiota was very similar to that colonizing the remaining teeth. Clinical findings were consistent with a healthy condition with no significant difference regarding marginal bone loss between the two materials.

Oral bacterial colonization on dental implants restored with titanium or zirconia abutments: 6-month follow-up.

OBJECTIVE: This investigation aimed to characterize in a 6-month follow-up the microbial profile of implants restored with either titanium or zirconia abutments at the genus or higher taxonomic levels. METHODS: Twenty healthy individuals indicative for implant-retained single restorations were investigated. Half of participants were restored with titanium and half with zirconia abutments. Biofilm was collected from the implant-related sites after 1, 3, and 6 months of loading. The 16S rDNA genes were amplified and sequenced with Roche/454 platform. RESULTS: A total of 596 species were identified in 360 samples and grouped in 18 phyla and 104 genera. Titanium- or zirconia-related sites as well as teeth showed similar total numbers of operational taxonomic units (OTUs) colonizing surfaces over time. Firmicutes, Proteobacteria, Fusobacteria, Bacteroidetes, and Actinobacteria were the most prevalent phyla with significant differences between different surfaces and time point. Unclassified genera were found in lower levels (1.71% up to 9.57%) on titanium and zirconia samples when compared with teeth, with no significant differences. CONCLUSION: Titanium- and zirconia-related surfaces are promptly colonized by a bacterial community similar to those found in the remaining adjacent teeth. Results suggest a selective adhesion of different bacterial genotypes for either titanium or zirconia surfaces. Data also indicate a significant interaction between the relative effects taxa, time point, and sampling site. CLINICAL RELEVANCE: The present study disclosed a wider spectrum of microorganisms colonizing either titanium- or zirconia-related microbiomes in very early stage of implant colonization, revealing differences and suggesting a probably specific mechanism for selective bacterial adhesion.

Being a mother of preterm multiples in the context of socioeconomic disadvantage: perceived stress and psychological symptoms.

OBJECTIVE: This study aimed to examine the differences between mothers of preterm multiples and mothers of preterm singletons regarding perceived stress and maternal psychological symptoms, and to explore the putative adverse amplified effect of socioeconomic disadvantage. METHOD: Ninety-five mothers of 1-year-olds born preterm participated in this cross-sectional study. Data collection was carried out in two public hospitals from Northern Portugal. To assess maternal perceived daily stress and psychological symptoms, mothers completed two questionnaires. Mothers reported on socioeconomic factors, including family poverty, parent unemployment, and low education, and two groups of family socioeconomic disadvantage were created. A child medical risk index was calculated. RESULTS: Results indicated that mothers of preterm multiples reported higher levels of stress than mothers of preterm singletons. Moreover, and specifically regarding psychological functioning, mothers of preterm multiples reported more symptoms than mothers of preterm singletons, but only when living in a context of socioeconomic adversity. CONCLUSIONS: The results of the present study have important implications for practice. Mothers of preterm multiples are at higher risk to present mental health difficulties, in comparison to mothers of singletons, especially when exposed to socioeconomic adversities. The development of psychosocial intervention programs and public policies are of decisive importance in helping mothers of multiples adjust to parenthood.

Avaliação das interações medicamentosas potenciais em prescrições de pacientes em Unidade de Terapia Intensiva / Evaluation of potential drug interactions in prescriptions for patients in Intensive Care Cnits

A identificação e prevenção de interações entre medicamentos estão diretamente relacionadas com a segurança do paciente e são de grande importância no ambiente hospitalar. O objetivo deste trabalho foi identificar e avaliar a existência de interações medicamentosas potenciais na farmacoterapia prescrita. Trata-se de estudo observacional, com 308 prescrições de 195 pacientes internados na Unidade de Terapia Intensiva de um hospital de ensino, realizado de agosto a dezembro de 2015. Para identificação das interações utilizou-se a base de dados Micromedex®. Das 308 prescrições analisadas, 101 apresentaram pelo menos uma interação medicamentosa, totalizando 173 interações, referentes a 71 pacientes. Destes, 43 eram do sexo masculino, com idade média de 61,9 anos. A média de internação na unidade foi de 7 dias. Nas 101 prescrições que apresentaram interações medicamentosas, foi prescrito o total de 1.349 medicamentos com média de 13,3 medicamentos/paciente/dia. Identificar essas interações possibilita evitar situações de insucesso terapêutico e toxicidade medicamentosa.

The identification and the interaction of drugs are directly related to patient´s safety and are highly relevant within the hospital. Current analysis identifies and evaluates potential drugs interactions within prescribed pharmacotherapy. The study, undertaken between August and December 2015, comprises 308 prescriptions of 195 patients hospitalized in the UTI of a university hospital. Micromedex® database identified interactions. Further, 101 out of 308 prescriptions revealed at least one drug interaction, with a total of 173 interactions with 71 patients, of which 43 were males with an average age of 61,9 years. Mean hospitalization period in the ICUs was 7 days. The 101 prescriptions with drug interactions totaled 1,349 drugs, at an average of 13,3 drugs/patient/day. The identification of these interactions avoids therapeutic failure and toxicity.

Formas utilizadas para tentativa de suicídio e características sociodemográficas dos pacientes atendidos no serviço de emergência de um hospital de ensino / Methods used in suicide attempts and sociodemographic characteristics of patients treated at the emergency department of a teaching hospital

OBJETIVOS: Caracterizar as formas utilizadas para tentativa de suicídio e características sociodemográficas de pacientes atendidos no serviço de emergência de um hospital de ensino. MÉTODOS: Estudo transversal retrospectivo, com busca ativa em prontuários eletrônicos de pacientes atendidos entre janeiro e dezembro de 2015 no serviço de emergência de um hospital de ensino, que integra a rede pública de saúde do interior do estado do Rio Grande do Sul, Brasil. Foram incluídos todos os casos de tentativa de suicídio, independente de sua forma. Não foram investigados os casos que resultaram em óbito por suicídio. Foi utilizada estatística descritiva e foram avaliadas associações por análise univariada, sendo aplicado o teste do quiquadrado de Pearson. RESULTADOS: No período estudado foram encaminhados 233 pacientes atendidos na emergência para realização de avaliação psiquiátrica, sendo 122 casos caracterizados por tentativa de suicídio. Desses, a média de idade dos pacientes foi de 36,8±14,3 anos, com mínima de 14 e máxima de 88 anos e, 74 (60,6%) eram do sexo feminino. As formas mais utilizadas de tentativa de suicídio foram ingesta de medicamentos (72 casos, 59%) e ingesta de agrotóxicos (14 casos, 11,5%). Do total de pacientes, 119 (97,5%) residiam no município de Santa Cruz do Sul, com predominância nos moradores da zona urbana (103 pacientes, 84,4%). Dos 50 (41,0%) encaminhamentos, 32 (64,0%) foram para o Centro de Atendimento Psicossocial, 7 (14%) para Centro de Atendimento Psicossocial da Infância e Adolescência, 6 (12%) para internação em unidade de saúde mental e 5 (10%) para o Centro de Atendimento Psicossocial Álcool e Drogas. Em 66 (54,1%) pacientes não foi encontrado nenhum registro em prontuário eletrônico sobre o desfecho após a alta e 6 (4,9%) pacientes evadiram. CONCLUSÕES: A maioria dos pacientes atendidos por tentativa de suicídio foram adultos jovens do sexo feminino. Como principal forma utilizada para a tentativa de suicídio identificou-se a ingesta de medicamentos e em seguida a de agrotóxicos.

AIMS: To describe the methods used in suicide attempts and sociodemographic characteristics of suicidal patients treated at the emergency department of a teaching hospital. METHODS: Observational and descriptive study, with active search for electronic medical records of patients treated at the emergency department of a public teaching hospital in the countryside of Rio Grande do Sul, Brazil, from January to December 2015. All cases of suicide attempt were included, regardless of the suicide methods used. Successful suicide cases were not investigated. The statistical analyses included descriptive statistics, univariate analysis, and Pearson's chi-square test. RESULTS: A total of 233 patients treated at the emergency department were referred for psychiatric evaluation, and 122 of them had attempted suicide. The mean age of the suicidal patients was 36.8±14.3 years, (minimum of 14 years and maximum of 88 years) and 74 (60.6%) of them were female. The most common suicide attempt methods were ingestion of medications (72 cases, 59%) and of pesticide (14 cases, 11.5%). Of all patients, 119 (97.5%) lived in Santa Cruz do Sul, predominantly in the urban area (103 patients, 84.4%). Of the 50 (41.0%) referrals, 32 (64.0%) were sent to the Center for Psychosocial Care, 7 (14%) to the Center for Children's and Adolescents' Psychosocial Care, 6 (12%) were admitted to a mental health unit, and 5 (10%) were sent to Psychosocial Care Center for Alcohol and Drug Abuse. Sixty-six (54.1%) patients had no electronic medical records of their outcome after discharge and 6 (4.9%) were lost to follow-up. CONCLUSIONS: Most of the treated suicidal patients were young adult females. The most common method of suicide attempt was the ingestion of medications, followed by the ingestion of pesticides.

A lectin from the green seaweed Caulerpa cupressoides reduces mechanical hyper-nociception and inflammation in the rat temporomandibular joint during zymosan-induced arthritis.

Seaweed lectins have been widely investigated as anti-nociceptive and anti-inflammatory agents. This study analyzed the anti-nociceptive and anti-inflammatory responses of a lectin from the green seaweed Caulerpa cupressoides (CcL) on zymosan-induced arthritis of the rat temporomandibular joint (TMJ). Rats received i.v. CcL 30 min prior to injection of zymosan (2mg/art.) or 0.9% saline into the left TMJ. Mechanical hyper-nociception was measured by the electronic von Frey method at baseline and 4h after zymosan injection. Animals were euthanized 6h after zymosan injection and the synovial fluid was collected for leukocyte counting and myeloperoxidase activity assessment. Other animals were treated with ZnPP-IX (3mg/kg; s.c.), a specific heme oxygenase-1 pathway inhibitor, and naloxone (10 µg/art.), a nonselective opioid receptor antagonist. TMJ tissues were excised to perform histopathological and immunohistochemistry analyses. CcL (0.1, 1 or 10mg/kg) significantly reduced zymosan-induced hyper-nociception (81, 83 and 89.5%, respectively) and inhibited the leukocyte influx (77.3, 80.7 and 98.5%, respectively) compared with the zymosan-only group, as confirmed by myeloperoxidase activity; however, treatment with naloxone or ZnPP-IX did not revert the effects of CcL (10mg/kg), suggesting that the naloxone-sensitive opioid and heme oxygenase-1 pathways are not involved. CcL also reduced the leukocyte influx and the expression of IL-1ß and TNF-α in the TMJ, based on histopathological and immunohistochemistry analyses, respectively. Therefore, CcL reduces TMJ hyper-nociception and inflammation with a mechanism that is partially dependent on TNF-α and IL-1ß inhibition. CcL reveals a potentially valuable alternative tool for future studies of TMJ disorders.

Value of Chest Radiographic Pattern in RSV Disease of the Newborn: A Multicenter Retrospective Cohort Study.

Respiratory syncytial virus (RSV) lower respiratory tract infection is the most common viral respiratory infection in infants. Several authors have sought to determine which risk factors are the best predictors for severe RSV disease. Our aim was to evaluate if a specific chest radiographic pattern in RSV disease can predict the disease severity. We conducted a multicenter retrospective cohort study in term and preterm neonates with confirmed lower respiratory tract RSV infection, admitted to neonatal intensive care units (NICU) from 2000 to 2010. To determine which factors independently predicted the outcomes, multivariate logistic regression analysis was performed. A total of 259 term and preterm neonates were enrolled. Patients with a consolidation pattern on the chest radiograph at admission (n = 101) had greater need for invasive mechanical ventilation (OR: 2.5; P = .015), respiratory support (OR: 2.3; P = .005), supplemental oxygen (OR: 3.0; P = .008), and prolonged stay in the NICU (>7 days) (OR: 1.8; P = .025). Newborns with a consolidation pattern on admission chest radiograph had a more severe disease course, with greater risk of invasive mechanical ventilation, respiratory support, supplemental oxygen, and prolonged hospitalization.

Lipodermatosclerosis in patients with diffuse connective tissue diseases.

Lipodermatosclerosis (LDS) is a clinical condition characterized by the appearance of hardened, painful, and hyperchromic plaques on the legs. We describe three patients with diffuse connective tissue diseases (DCTD) who developed this clinical condition. The first one was a systemic lupus erythematosus patient with secondary antiphospholipid syndrome; the second patient had a superposition of DCTD (rheumatoid arthritis, Sjögren's syndrome, morphea); and the last one had been diagnosed with CREST 10 years earlier but had more recently developed primary biliary cirrhosis. Although its etiopathogenesis is unknown, LDS has been frequently seen in association with venous insufficiency. Its recognition by professionals who deal with DCTD is very relevant since it is characterized by thickening of the skin, similar to scleroderma. Its identification can avoid the inadvertent use of medications such as penicillamine and immunosuppressants, which have potentially serious side effects.

Ureteral stenosis secondary to granulomatous vasculitis.

Vasculitic syndromes are a group of disorders characterized by inflammation of the blood vessels. They include polyarteritis nodosa (PAN), Churg-Strauss syndrome (CS), and Wegener granulomatosis (WG) that differ on type, size, and location of the involved vessels. We report a rare case of granulomatous vasculitis leading to ureteral stenosis in the absence of other systemic manifestations of the disease. The patient was a 56-year-old woman who began to complain of left lumbar pain, nocturia, and dysuria. Computed tomography scan demonstrated a large abdominal mass with ureteral compression. A tissue specimen obtained by laparotomy revealed the presence of a chronic inflammatory process with fibrosis, granulomatous reaction, extravascular eosinophilia, and prominent vasculitis. She was put on corticosteroids and azathioprine with a decrease of the tumoral mass. This incompletely classified vasculitis was an unexpected cause of the abdominal mass.