Ultrasonographic and power doppler parameters of nails fail to differentiate between onychodystrophy in patients with psoriasis vulgaris or psoriatic arthritis.

BACKGROUND: Nail involvement is frequent in patients with psoriasis (Pso) and psoriatic arthritis (PsA) and there is a relationship between nail involvement and inflammation of the enthesis. The main objective of the present study is to describe the ultrasound findings and clinical characteristics of nails from patients with psoriasis and psoriatic arthritis with and without nail dystrophy. METHODS: A cross-sectional study including consecutive patients with PsO and PsA was carried out. The study patients were divided into 4 groups, totaling 120 participants. Group 1: patients with psoriasis vulgaris and clinically normal nails; Group 2: patients with psoriasis vulgaris and onychodystrophy; Group 3: patients with psoriatic arthritis and clinically normal nails; Group 4: patients with psoriatic arthritis and onychodystrophy; All patients were submitted to dermatological and rheumatological clinical analysis. Ultrasound examinations was performed by a single examiner, blinded to all clinical data, with ultrasound high resolution, in B-mode or gray-scale (GS), Power Doppler (PD) and Spectral Doppler. RESULTS: A significant difference was found between the groups regarding the variable Psoriasis Area and Severity Index (PASI) (p = 0.008) and body surface area (BSA) (p = 0.005), with patients with psoriatic arthritis having lower PASI and BSA compared to patients with only cutaneous psoriasis. A positive relationship was found with the average ultrasound thickness of the nail bed and the Nail Psoriasis Severity Index (NAPSI) in correlation analysis (rho = 0.344). When we grouped patients with psoriasis and psoriatic arthritis, there was no significant difference between the cutaneous psoriasis groups and the psoriatic arthritis groups in terms of nail plate GS (p = 0.442), nail bed PD (p = 0.124). CONCLUSION: Greater nail bed thickness indicates early psoriatic nail disease, as confirmed in our study correlating NAPSI with nail bed thickness. Ultrasonography is a low-cost exam, promising in the evaluation, showing that the ultrasound grayscale is consistent with those who have dystrophic nails, but it can't distinguish psoriasis from psoriatic arthritis, even in those with nail dystrophy.

ANCA in patients with systemic lupus erythematosus. A cross sectional study in Brazilian patients and review of literature.

BACKGROUND: Antineutrophil cytoplasmatic antibodies (ANCA) have been detected in patients with systemic lupus erythematosus (SLE). In this study, we investigated the presence of ANCA in a sample of Brazilian SLE patients and its possible associations with clinical and serological outcomes. Additionally, we reviewed the literature of on ANCA in SLE. RESULTS: The presence of ANCA was detected in 130 patients using indirect immunofluorescence (IIF). The test was positive in 29.9% of the cases (17.6% pANCA and 11.5% cANCA). Male sex and peripheral vasculitis were more prevalent in the ANCA-positive sample. cANCA was associated with lupus anticoagulant and pANCA had a positive association with peripheral vasculitis and a negative association with anti- SSB/La antibodies. In the 22 studies included in the literature review, a wide range of ANCA positivity was found (13% to 81.1% by IIF and 0 to 22.2% by ELISA). ANCA was associated with renal damage in the Asian population. Although other associations have been found in isolated studies, they were not consistently reported. CONCLUSIONS: The ANCA prevalence found in this Brazilian sample was within the range reported in the literature and these autoantibodies were more frequent in males and in patients with vasculitis. The literature showed controversial results on the association between ANCA and SLE disease activity or clinical characteristics.

EVALUATION OF THE IMMUNOLOCALIZATION OF THE PHOSPHATIDYL INOSITOL-3 RECEPTOR (IP3R) IN BASAL CELL AND SQUAMOUS CELL SKIN CARCINOMAS / AVALIAÇÃO DA IMUNOLOCALIZAÇÃO DO RECEPTOR DO FOSFATIDIL INOSITOL-3 (IP3R) EM CARCINOMAS BASOCELULAR E DE CÉLULAS ESCAMOSAS DE PELE

Introduction: Non-melanoma skin neoplasms (basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) form the most common group of all types of neoplasms. Although cancer is not yet being classified as a channelopathy, it has been suggested that pumps and ionic channels contribute to its progression by affecting autophagy, which could become an important therapeutic target in this context. Objective: To evaluate the immunohistochemical expression of IP3R in both skin tumors. Method: Immunohistochemistry was performed on 60 slides of non-melanoma cancer using primary anti-IP3R antibodies, verifying their presence and quantifying Results: For the first time, IP3R immunolocalization was identified in non-melanoma skin neoplasms, being evident above 90% of neoplastic cells was observed in all slides studied, regardless of the histological pattern, invasion and other tumor characteristics. Unlike what was seen in the internal control of normal skin, in which there was immunolocalization of IP3R in basal cell, in tumors, immunohistochemical expression occurred throughout the entire body of the neoplasm. Conclusion: There was immunolocalization of IP3R in tumor cells in both BCC and SCC. It was not possible to establish a correlation between tumor characteristics and IP3R expression, as immunostaining was similar in all analyzed samples. Despite this, IP3R to be associated with the pathophysiology of non-melanoma skin cancer, but its expression does not seem to be associated with tumor aggressiveness.

Introdução: As neoplasias de pele não melanoma (carcinoma basocelular (CBC) e carcinoma espinocelular (CEC) formam o grupo mais comum de todos os tipos de neoplasias. Embora o câncer ainda não esteja sendo pautado como canalopatia, tem sido sugerido que bombas e canais iônicos contribuem para a sua progressão por afetar a autofagia. Proteínas iônicas, em especial as de canais de cálcio, como o receptor da fosfatidil inositol 3 (IP3R) participam de maneira ativa na autofagia por estarem envolvidas na etapa inicial de formação do autofagossomo, podendo se tornar em alvo terapêutico importante neste contexto. Objetivo: Avaliar a expressão imuno histoquímica do IP3R em ambos os tumores de pele. Método: Foi realizada imuno histoquímica em 60 lâminas de câncer não melanoma utilizando anticorpos primários anti-IP3R verificando a sua expressão. Resultados: Pela primeira vez foi identificada a imunolocalização do IP3R em câncer de pele não melanoma, sendo evidente em mais de 90% das células neoplásicas em todas as lâminas estudadas, independentemente do padrão histológico, invasão e demais características tumorais. Diferentemente do visualizado no controle interno de pele normal, no qual houve imunolocalização de IP3R em células basais, nos tumores, a expressão imuno histoquímica ocorreu em todo o corpo da neoplasia. Conclusão: Houve imunolocalização de IP3R em células tumorais tanto em CBC quanto em CEC. Não foi possível estabelecer correlação entre as características tumorais e a expressão de IP3R, pois a imunomarcação apresentou-se de forma similar em todas as amostras analisadas. Apesar disso, IP3R está associado à fisiopatologia do câncer de pele não melanoma, mas a sua expressão não parece estar associada à agressividade tumoral.

Primary antiphospholipid syndrome with and without limb ischemia: A retrospective observational study.

OBJECTIVE: To compare clinical and laboratory data obtained from patients with primary Antiphospholipid Syndrome (PAPS) with and without limb ischemia (LI). METHODS: A transverse study with 66 (83.3% female) PAPS patients was performed. All data were evaluated. Patients were subdivided into one of two groups: PAPS with LI and PAPS without LI and compared. RESULTS: Sixty-six primary APS were selected. PAPS with LI group exhibited a longer disease duration (p = .012) and more arterial events (p = .002). A lower frequency of venous events was observed in PAPS with LI (p = .007), and deep venous thrombosis (p = .016). Furthermore, PAPS with LI patients had more deficiency of protein C of coagulation (p = .015) than the others. CONCLUSION: PAPS and LI have a distinct clinical and laboratory spectra from those without LI and it is characterized by an increased frequency of protein C deficiency, and a lower frequency of venous events, deep venous thrombosis and IgM anticardiolipin.

CHARLSON'S COORDINITY INDEX IN SYSTEMIC LUPUS ERYTHEMATOSUS IN BRAZILIAN PATIENTS / ÍNDICE DE COMORBIDADES DE CHARLSON NO LÚPUS ERITEMATOSO SISTÊMICO EM PACIENTES BRASILEIRAS

Introduction: The Charlson comorbidities index (CCI) assesses a person's chances of survival over the next 10 years. In systemic lupus erythematosus (SLE), multiple comorbidities and complications affect patient survival. Objetive: Analize the variables that influence the CCI of a group of females with SLE. Methods: Retrospective study of medical records of 100 lupus patients for CCI, clinical, epidemiological and serological variables. Results: No epidemiological variable interfered in CCI. Regarding clinical manifestations, patients with glomerulonephritis had a worse CCI than those without (p<0.0001) and those with central nervous system manifestations had a tendency to worse CCI (p=0.09). Patients with anti-Ro antibodies (p=0.02) and rheumatoid factor or RF (p=0.002) were associated with a lower CCI. Conclusions: The presence of glomerulonephritis is associated with lower survival and of the anti-Ro and RF antibodies with longer survival in SLE.

Introdução : O índice de comorbidades de Charlson (ICC) avalia as chances de sobrevivência de uma pessoa nos próximos 10 anos. No lúpus eritematoso sistêmico (LES) múltiplas comorbidades e complicações afetam a sobrevida. Objetivo : Verificar as variáveis ​​que influenciam no ICC de um grupo de mulheres com LES. Métodos : Estudo retrospectivo de 100 pacientes lúpicas para o ICC, variáveis ​​clínicas, epidemiológicas e sorológicas. Resultados : Nenhuma variável epidemiológica interferiu no ICC. Quanto à clínica, pacientes com glomerulonefrite tiveram pior ICC do que os sem (p<0,0001) e os com manifestações de sistema nervoso central tiveram tendência para pior ICC (p=0,09). Portadores de anticorpos anti-Ro (p=0,02) e fator reumatoide (FR; p=0,002) se associaram com ICC menor. Conclusões : A presença de glomerulonefrite se associa com menor sobrevida, e a dos anticorpos anti-Ro e FR com maior sobrevida no LES.

Resistin serum levels and its association with clinical profile and carotid intima-media thickness in psoriasis: a cross-sectional study.

BACKGROUND: Psoriasis is a protean disease associated with several comorbidities that may have increased levels of adiponectin such as resistin. This may affect the patients atherosclerotic risk. OBJECTIVE: To study resistin levels in a sample of Brazilian patients with psoriasis and its association with clinical profile, comorbidities, and carotid Intima-Media Thickness (cIMT). METHODS: This is a cross-sectional study of 119 individuals: 34 healthy controls and 85 patients with psoriasis, 42 of which with skin involvement only and 43 with psoriatic arthritis. Clinical and epidemiological data, measurement of PASI (Psoriasis Area Severity Index) and DAPSA (Disease Activity in Psoriatic Arthritis), lipid profile, cIMT by ultrasound were collected from medical records. Resistin serum levels were measured by ELISA. RESULTS: Patients with psoriasis had higher resistin levels (p=0.009) and worse cIMT (p=0.0002) than controls. In the psoriasis sample, no associations of resistin levels with epidemiological, clinical findings, and activity indexes were found. Resistin serum levels were associated with the presence of diabetes (p=0.008) and metabolic syndrome (p=0.01) and correlated with total cholesterol (r=0.26) and triglycerides (r=0.33) but not with cIMT. STUDY LIMITATIONS: This work is limited by its transversal design and by the limited number of patients included. CONCLUSION: Resistin serum levels are elevated in psoriasis patients. In this sample, clinical, epidemiological, and activity indexes were not linked to resistin serum levels, but atherosclerotic risk factors were.

Fecal calprotectin levels in acute anterior uveitis in patients with spondyloarthritis / Níveis de calprotectina fecal na uveite anterior aguda em pacientes com espondiloartrites

ABSTRACT Purpose: This study measured fecal calprotectin levels in a series of patients with anterior uveitis in order to determine whether anterior uveitis patients with associated spondyloarthritis have higher levels of fecal calprotectin than patients with anterior uveitis of other etiologies. A third group of patients with spondyloarthritis without uveitis was also evaluated to understand the role of acute anterior uveitis in increasing fecal calprotectin. Methods: In this cross-sectional study, 28 patients were divided into three groups: (a) Group 1, spondyloarthritis and uveitis (n=9); (b) Group 2, spondyloarthritis without uveitis (n=10); and (c) Group 3, uveitis without spondyloarthritis (n=9). The levels of fecal calprotectin were determined. Results: Groups 1 and 2 showed higher median fecal calprotectin levels (101.0 and 93.0 µg/g, respectively) compared with Group 3 (9.0 µg/g) (p=0.02). However, no relationship between fecal calprotectin levels and the presence of uveitis with spondyloarthritis could be demonstrated. Conclusion: Patients with spondyloarthritis with or without acute anterior uveitis have significantly elevated levels of fecal calprotectin. This test may be useful for differentiating spondyloarthrit-associated uveitis from uveitis of other etiologies.

RESUMO Objetivo: Este estudo avaliou os níveis de calprotectina fecal em uma série de pacientes com uveíte anterior na tentativa de determinar se pacientes com uveíte associada com espondiloartrites apresentam níveis mais elevados desta proteína do que pacientes com uveíte anterior de outras etiologias. Um terceiro grupo com espondiloartrites sem uveíte também foi incluído na avaliação para entendimento do papel da uveíte anterior no aumento da calprotectina fecal. Métodos: Estudo transversal de 28 pacientes divididos em três grupos: (a) com espondiloartrites e uveíte (n=9); (b) com espondiloartrites sem uveíte (n=10) e (c) com uveíte sem espondiloartrites (n=9). A dosagem de calprotectina fecal foi avaliada. Resultados: Pacientes com uveíte anterior associada a espondiloartrites apresentaram valores medianos maiores de calprotectina fecal (101 µg/g) que os valores dos pacientes com uveíte sem espondiloartrites (9 µg/g), pacientes com espondiloartrites sem uveíte que também demonstraram valores maiores (93.0 µg/g) que os dos pacientes com uveíte sem espondiloartrites (p=0,02). Conclusão: Pacientes com espondiloartrites com e sem uveíte anterior aguda demonstraram níveis significativamente elevados de calprotectina fecal. Este teste pode ser útil na diferenciação entre uveítes associadas com espondiloartrites de uveítes de outras etiologias. Entretanto, não foi possível demonstrar associação entre o aumento dos níveis de calprotectina fecal e a presença da uveíte em espondiloartrites.

Fecal calprotectin levels in acute anterior uveitis in patients with spondyloarthritis.

PURPOSE: This study measured fecal calprotectin levels in a series of patients with anterior uveitis in order to determine whether anterior uveitis patients with associated spondyloarthritis have higher levels of fecal calprotectin than patients with anterior uveitis of other etiologies. A third group of patients with spondyloarthritis without uveitis was also evaluated to understand the role of acute anterior uveitis in increasing fecal calprotectin. METHODS: In this cross-sectional study, 28 patients were divided into three groups: (a) Group 1, spondyloarthritis and uveitis (n=9); (b) Group 2, spondyloarthritis without uveitis (n=10); and (c) Group 3, uveitis without spondyloarthritis (n=9). The levels of fecal calprotectin were determined. RESULTS: Groups 1 and 2 showed higher median fecal calprotectin levels (101.0 and 93.0 µg/g, respectively) compared with Group 3 (9.0 µg/g) (p=0.02). However, no relationship between fecal calprotectin levels and the presence of uveitis with spondyloarthritis could be demonstrated. CONCLUSION: Patients with spondyloarthritis with or without acute anterior uveitis have significantly elevated levels of fecal calprotectin. This test may be useful for differentiating spondyloarthrit-associated uveitis from uveitis of other etiologies.

Alexithymia in systemic lupus erythematosus: A cross sectional study in a Brazilian sample.

BACKGROUND: Alexithymia is considered as a reduced capacity to be aware of, to clearly recognize, and to define one's feelings with a limited fantasy and a concrete, externally oriented cognitive style. Some studies have stated that alexithymia is more common in systemic lupus erythematosus patients (SLE) than in general population but there is a paucity of studies in such context. AIM: To study the prevalence of alexithymia in a sample of SLE patients looking for associated epidemiological and clinical findings and its relationship to quality of life. METHODS: Cross-sectional study in 93 SLE patients collecting clinical, epidemiological, and serological data, data on quality of life by 12 item short health survey (SF-12), and alexithymia by Toronto scale (TAS-26). Disease's cumulative damage was measured by Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage index. RESULTS: In this sample (90.3% females and median age of 46 years), 55.9% had alexithymia; 22/92 (23.9%) did not and 19/93 (20.4%) had inconclusive results. Alexithymia presence had a positive association with age (p = 0.01) and a negative association with presence of glomerulonephritis (25% vs 59%; p = 0.005) and glucocorticoid use (19.2% vs 59.0%; p = 0.0007). A negative correlation of TAS-26 was observed with mental domain of (r = -0.46; p < 0.0001) and physical domain (r = -0.32; p = 0.004) of SF-12, but not with cumulative damage index. CONCLUSION: We found a high prevalence of alexithymia in this sample of SLE patients that negatively associated with quality of life, but not with cumulative damage index.

Resistin serum levels and its association with clinical profile and carotid intima-media thickness in psoriasis: a cross-sectional study

Abstract Background Psoriasis is a protean disease associated with several comorbidities that may have increased levels of adiponectin such as resistin. This may affect the patients atherosclerotic risk. Objective To study resistin levels in a sample of Brazilian patients with psoriasis and its association with clinical profile, comorbidities, and carotid Intima-Media Thickness (cIMT). Methods This is a cross-sectional study of 119 individuals: 34 healthy controls and 85 patients with psoriasis, 42 of which with skin involvement only and 43 with psoriatic arthritis. Clinical and epidemiological data, measurement of PASI (Psoriasis Area Severity Index) and DAPSA (Disease Activity in Psoriatic Arthritis), lipid profile, cIMT by ultrasound were collected from medical records. Resistin serum levels were measured by ELISA. Results Patients with psoriasis had higher resistin levels (p = 0.009) and worse cIMT (p = 0.0002) than controls. In the psoriasis sample, no associations of resistin levels with epidemiological, clinical findings, and activity indexes were found. Resistin serum levels were associated with the presence of diabetes (p = 0.008) and metabolic syndrome (p = 0.01) and correlated with total cholesterol (r = 0.26) and triglycerides (r = 0.33) but not with cIMT. Study limitations This work is limited by its transversal design and by the limited number of patients included. Conclusion Resistin serum levels are elevated in psoriasis patients. In this sample, clinical, epidemiological, and activity indexes were not linked to resistin serum levels, but atherosclerotic risk factors were.

Periodontitis in rheumatoid arthritis: a case-control study in a brazilian sample

To investigate the presence of periodontitis in RA patients comparing it with controls in a Brazilian sample. Methods: This is a case control study conducted in a public health rheumatologic center. One hundred and sixteen RA patients and 68 paired controls were compared for epidemiological data and presence of periodontal disease evaluated by number of remaining teeth, presence of bacterial plaque, bleeding on probing, probing depth and clinical level of gingival insertion. In addition, data on comorbidities was collected. Results: RA patients and controls have the same amount of teeth loss (P = 0.84). RA patients had more calculus (P = 0.02); dental plaques (P = 0.04); gingival recession (P = 0.02) and bleeding (P = 0.01). Although the number of individuals with periodontitis was higher in RA patients, the severity of periodontitis was similar in both groups (P = ns). Presence of diabetes and hypothyroidism also associated with periodontitis (P = 0.01 and 0.02 respectively). In a model of logistic regression built to assess the independence of association of RA and its comorbidities with periodontitis, only diabetes and RA remained independent. Conclusion: This case control study shows higher frequency of periodontitis in RA patients than controls

Estudo comparativo da qualidade de vida de doentes com lúpus, artrite reumatoide e fibromialgia / Comparative study of quality of life in rheumatoid arthritis, systemic lupus erythematosus and fibromyalgia

Introdução: Doenças reumatológicas são enfermidades que acometem o sistema locomotor e afetam a qualidade de vida dos portadores. Objetivos: Comparar a qualidade de vida naqueles com lúpus, artrite reumatoide e fibromialgia. Métodos: Estudo observacional no qual foi aplicado o Questionário de Qualidade de Vida SF-36 em 136 pacientes diagnosticados com lúpus, artrite reumatóide e fibromialgia. Resultados: Os com lúpus apresentaram menor limitação funcional e os artrite reumatóide apresentaram mais dor. A avaliação do estado geral de saúde (p=0,26), da vitalidade (p=0,09), da aspectos sociais (p=0,44), saúde emocional (p=0,82) não demonstraram relevância estatística. Conclusão: As 3 doenças reumáticas apresentam diminuição da QoL, mas os com mais dor foram os com artrite reumatóide, e os com menor limitação funcional os de lúpus.

Background: Rheumatologic illnesses are diseases that affect the locomotor system and decrease patient's quality of life. Objective: To compare quality of life in patients diagnosed with lupus, rheumatoid arthritis and fibromyalgia. Methods: Cross-sectional study with application of the SF-36 Quality of Life Questionnaire to 136 patients diagnosed with lupus, rheumatoid arthritis and fibromyalgia. Results: Patients with lupus had lower functional limitation and those with rheumatoid arthritis presented more pain. The assessment of general health status (p=0.26), vitality (p=0.09), social aspects (p=0.44), emotional health (p=0.82) did not show statistical relevance. Conclusion: The 3 rheumatic diseases showed a decrease in quality of life, but the one with the most pain was rheumatoid arthritis, and the lowest functional limitation was found in lupus.

Análise preliminar do uso de biológicos no tratamento da artrite reumatoide / Preliminary analysis for the use of biologicals in the treatment of rheumatoid arthritis

Introdução: A artrite reumatoide é tratada com drogas modificadoras da doença convencionais e biológicas. Objetivos: Comparar a sobrevida de medicamentos biológicos utilizados para o tratamento de pacientes com artrite reumatoide. Método: Estudo retrospectivo de prontuários de pacientes que utilizaram medicamento biológico para tratamento de artrite reumatoide de janeiro de 2020 a janeiro de 2022 e este foi suspenso. Dados acerca das causas de retirada, tempo de uso, dados epidemiológicos, clínicos e de comorbidades foram coletados. Resultados: O principal motivo da descontinuidade foi a falha seguida por efeitos colaterais. Infliximabe e adalimumabe foram os que apresentaram maior sobrevida. Índice de massa corporal e o tabagismo, sexo e idade não mostraram interferência nesta sobrevida Conclusão: Falha é a causa mais comum de descontinuidade dos biológicos. Dentre os fatores estudados (fumo, indice de massa corporal, idade e sexo) não foi possível identificar variável que se associasse com falha.

Introduction: Rheumatoid arthritis is treated with conventional and biological disease-modifying drugs. Objectives: To compare the survival of biological drugs used for the treatment of rheumatoid arthritis patients. Methods: Retrospective study of medical records of patients who used biological medication for the treatment of rheumatoid arthritis from January 2020 to January 2022 and this was suspended. Data on the causes of withdrawal, duration of use, epidemiological, clinical and comorbid data were collected. Results: The main reason for discontinuity was failure followed by side effects. Infliximab and adalimumab had the highest survival. Body mass index and smoking, sex and age did not interfere in this survival. Conclusion: Failure is the most common cause of biological discontinuity. Among the factors studied (smoking, body mass index, age and gender) it was not possible to identify a variable that was associated with failure.

Índice de comorbidades de Charlson no lúpus eritematoso sistêmico em pacientes brasileiras / Charlson's coordinity index in systemic lupus erythematosus in brazilian patients

Introdução: O índice de comorbidades de Charlson (ICC) avalia as chances de sobrevida de uma pessoa nos próximos 10 anos. No lúpus eritematoso sistêmico (LES) múltiplas comorbidades e complicações afetam a sobrevida. Objetivo: Verificar as variáveis que influem no ICC de um grupo de mulheres com LES. Métodos: Estudo retrospectivo de 100 pacientes lúpicas para o ICC, variáveis clínicas, epidemiológicas e sorológicas. Resultados: Nenhuma variável epidemiológica interferiu no ICC. Quanto à clínica, pacientes com glomerulonefrite tiveram pior ICC do que os sem (p<0,0001) e os com manifestações de sistema nervoso central tiveram tendência para pior ICC (p=0,09). Portadores de anticorpos anti-Ro (p=0,02) e fator reumatoide (FR; p=0,002) se associaram com ICC menor. Conclusões: A presença de glomerulonefrite se associa com menor sobrevida, e a dos anticorpos anti-Ro e FR com maior sobrevida no LES.

Introduction: The Charlson comorbidities index (CCI) assesses a person's chances of survival over the next 10 years. In systemic lupus erythematosus (SLE), multiple comorbidities and complications affect patient survival. Objetive: Analize the variables that influence the CCI of a group of females with SLE. Methods: Retrospective study of medical records of 100 lupus patients for CCI, clinical, epidemiological and serological variables. Results: No epidemiological variable interfered in CCI. Regarding clinical manifestations, patients with glomerulonephritis had a worse CCI than those without (p<0.0001) and those with central nervous system manifestations had a tendency to worse CCI (p=0.09). Patients with anti-Ro antibodies (p=0.02) and rheumatoid factor or RF (p=0.002) were associated with a lower CCI. Conclusions: The presence of glomerulonephritis is associated with lower survival and of the anti-Ro and RF antibodies with longer survival in SLE.

Câncer de pele não melanoma: revisão integrativa / Non-melanoma skin cancer: an integrative review

Introdução: O câncer de pele não melanoma compeende grupo de neoplasias com alta incidência na população mundial. É dividido em carcinoma basocelular e de células escamosas. Por ser de grande prevalência, entender o processo de oncogênese e a relação com íons, proteínas e receptores celulares no câncer de pele não melanoma pode contribuir para que novas terapêuticas sejam avaliadas. Objetivo: Entender o processo da oncogênese dos tumores de pele não melanomas e sua relação com a imunolocalização do IP3R. Métodos: Revisão integrativa da literatura com síntese de evidências. A base de dados foi o PubMed; a estratégia de busca: "carcinoma espinocelular, AND/ OR carcinoma basocelular, AND/OR IP3R, AND/OR imunoistoquímica". Foram considerados para revisão os trabalhos publicados entre 2018 e 2023. Foram incluídos 40 trabalhos, integralmente lidos e resumidos. Resultados: Câncer de pele não melanoma são os tumores malignos mais comuns em todo o mundo, sendo 75-80% o carcinoma basocelular, e até 25% o de células escamosas. As interações moleculares de forma geral, envolvem grande participação de moléculas supressoras tumorais, assim como de procto-oncogenes. Além disso, canais iônicos voltagem dependente controlam o fluxo citosólico de íons, dentre eles o cálcio. O IP3R (receptor do fosfatidil inositol-3) permite a saída de cálcio do retículo endoplasmático para que seja utilizado pela célula para atividades fisiológias como proliferação, angiogênese, motilidade e capacidade de invasão. Conclusão: O IP3R, pelas características de expressão imunoistoquímica, parece estar relacionado também, à fisiopatologia do câncer de pele não melanoma.

Introduction: Non-melanoma skin cancer comprises a group of neoplasms with a high incidence in the world population. It is divided into basal cell carcinoma and squamous cell carcinoma. As it is highly prevalent, understanding the process of oncogenesis and the relationship with ions, proteins and cellular receptors in nonmelanoma skin cancer can contribute to the evaluation of new therapies. Objective: To understand the oncogenesis process of non-melanoma skin tumors and its relationship with the immunolocalization of IP3R. Methods: Integrative literature review with evidence synthesis. The database was PubMed; the search strategy: "squamous cell carcinoma, AND/OR basal cell carcinoma, AND/OR IP3R, AND/OR immunohistochemistry". Works published between 2018 and 2023 were considered for review; 40 works were included, fully read and summarized. Results: Non-melanoma skin cancer is the most common malignant tumor worldwide, with 75-80% being basal cell carcinoma, and up to 25% being cell carcinoma. Molecular interactions in general involve a large participation of tumor suppressor molecules, as well as procto-oncogenes. Furthermore, voltage-dependent ion channels control the cytosolic flow of ions, including calcium. The IP3R (phosphatidyl inositol-3 receptor) allows the exit of calcium from the endoplasmic reticulum so that it can be used by the cell for physiological activities such as proliferation, angiogenesis, motility and invasion capacity. Conclusion: The IP3R, due to its immunohistochemical expression characteristics, appears may also be related to the pathophysiology of nonmelanoma skin cancer.

EFFICACY OF METHOTREXATE MICROINFUSION IN SCALP LESIONS OF PATIENTS WITH FIBROSING FRONTAL ALOPECIA: A PROSPECTIVE CONTROLLED TRIAL / EFICÁCIA DA MICROINFUSÃO DE METOTREXATO EM LESÕES DO COURO DE PACIENTES COM ALOPECIA FIBROSANTE: ENSAIO CLÍNICO PROSPECTIVO CONTROLADO

Introdução: A alopecia frontal fibrosante (AFF) é uma cicatriz linfocítica, com queda de cabelo pela linha de implantação frontal do couro cabeludo e outras áreas do corpo. Drogas tópicas e sistêmicas, como casos o MTX, não controlam a atividade da doença na maioria dos casos, a necessidade de novas terapias. Objetivo: Avaliar a diligência da microinfusão de metotrexato em AFF. Métodos: Ensaio clínico prospectivo, controlador, realizado com 17 voluntários com 1 diagnóstico clínico e histológico de AFF. As aplicações de MTX por MMP® (método de microinfusão de pele) foram feitas a cada 30 dias, num total de 3 aplicações, na direita da área de alopecia; a outra metade serviu como controle.medidas frontais glalares e parciais, dermatoscópicas, índice de avaliação externa dos olhos, a percepção do plano dos sinais do paciente (LPPAI). Hemograma total e testes de função hepática também foram médios. Resultados: Houve uma redução significativa nas medidas fronto-glabela e frontal temporo-parietal no local tratado, enquanto no local nãou a AAF aumentou. A paciente refere melhora do prurido e descamação, mas não da queda de cabelo e eritema local. A das fotos dermatoscópicas e a análise do LPPAI não são relevantes. Cerca de 9 participantes e todos nós não resultaram em 5% dos resultados com nenhum resultado de nenhum dos exames.Conclusão: A aplicação de MTX por MMP® melhorou os sintomas associados à AFF e as medidas fronto-glabela e fronto-parietal.

Introdução: A alopecia frontal fibrosante (AFF) é cicatricial linfocítica, com queda de cabelo pela linha de implantação frontal do couro cabeludo e outras áreas do corpo. Drogas tópicas e sistêmicas, como o metotrexato (MTX), não controlam a atividade da doença na maioria dos casos, mostrando a necessidade de novas terapias. Objetivo: Avaliar a eficácia da microinfusão de metotrexato em AFF. Métodos: Ensaio clínico prospectivo, controlado, realizado com 17 voluntários com diagnóstico clínico e histológico de AFF. As aplicações de MTX por MMP® (método de microinfusão de drogas na pele) foram feitas a cada 30 dias, totalizando 3 aplicações, na metade direita da área da alopecia; a outra metade serviu como controle. Foram avaliadas as medidas frontoglabela e frontal temporoparietal. Fotos de dermatoscopia foram analisadas por avaliadores cegos e externos com percepção de sinais e sintomas do paciente e o Índice de Atividade do Líquen Planopilar (LPPAI). Hemograma total e testes de função hepática também foram medidos. Resultados: Houve redução significativa nas medidas frontoglabela e frontal temporoparietal no local tratado, enquanto no não tratado a AAF aumentou. Houve melhora do prurido e descamação, mas não da queda de cabelo e eritema local. A análise das fotos dermatoscópicas e o cálculo do LPPAI não mostraram alterações relevantes. Cerca de 95% dos participantes ficaram satisfeitos ou muito satisfeitos com os resultados e nenhum deles teve alteração nos resultados dos exames laboratoriais. Conclusão: A aplicação de MTX por MMP® melhorou os sintomas associados à AFF e as medidas frontoglabela e frontoparietal. Esta técnica mostrou-se segura e bem tolerada.

Alexithymia, masculinity and sexual behavior among Brazilian men / Alexitimia, masculinidade e comportamento sexual entre homens Brasileiros

Normative masculinity and alexithymia may negatively affect sexual life and men's well-being. In this study, the endorsement of traditional male norms, alexithymia and sexual behavior were assessed through an online survey directed to Brazilian men. Relationship status and religion were also addressed, and associations and correlations between variables were carried out. The survey presented 66 items, including standardized questionnaires, such as Meanings of Adolescent Masculinity Scale, Toronto Alexithymia Scale and Male Sexual Quotient. The sample consisted in 528 Brazilian men with high socioeconomic and educational levels. Alexithymia was negatively correlated with sexual satisfaction. The endorsement of traditional male norms was positively correlated with pornography use and was also associated with sharing of pornographic material through social media. Married men had the lowest levels of alexithymia, with significant difference when compared with men who are not currently in a relationship. Furthermore, having a religion was associated with greater endorsement of traditional male norms. These findings suggest that alexithymia may have greater influence on behaviors associated with interpersonal relations, including sexual satisfaction and relationship status. Conversely, normative masculinity was linked to personal variables, which did not involve a partner, including pornography consumption and religion.

A masculinidade normativa e alexitimia podem afetar negativamente a vida sexual e o bem-estar dos homens. Neste estudo, a concepção de masculinidade, alexitimia e comportamento sexual foram avaliados por meio de uma pesquisa online dirigida aos homens brasileiros. O status de relacionamento e religião também foram abordados, efetivando-se associações e correlações entre as diferentes variáveis. A pesquisa apresentou 66 itens, incluindo questionários estandardizados, como a Escala de Concepções de Masculinidade, Escala de Alexitimia de Toronto e Quociente Sexual - versão masculina. A amostra consistiu em 528 homens brasileiros com altos níveis socioeconômicos e educacionais. Alexitimia foi negativamente correlacionada com a satisfação sexual. O endosso das normas tradicionais masculinas foi positivamente correlacionado com o uso de pornografia, bem como associado ao compartilhamento de material pornográfico por meio das mídias sociais. Os homens casados obtiveram os níveis mais baixos de alexitimia, com diferença significativa quando comparados com homens que não mantém atualmente um relacionamento. Além disso, ter uma religião foi associado a uma maior percepção de importância das normas tradicionais masculinas. Os achados sugerem que a alexitimia pode possuir maior influência sobre os comportamentos associados às relações interpessoais, incluindo satisfação sexual e status de relacionamento. Por outro lado, a masculinidade normativa foi ligada a variáveis pessoais, que não envolviam um parceiro, incluindo o consumo de pornografia e a religião.

Primary Antiphospholipid Syndrome with Livedo Reticularis is Linked to Female Sex and Stroke and Negatively Associated with Thyroid Disease.

AIMS: To study the clinical and laboratory findings between patients with primary Antiphospholipid Syndrome (pAPS) with and without LR. BACKGROUND: Livedo Reticularis (LR) is a common manifestation of Antiphospholipid Syndrome (APS). Although no previous study evaluated patients with and without LR. METHODS: A transversal study including 66 pAPS patients was performed. Demographical, anthropometric, medication use, antiphospholipid antibodies profile data were evaluated, and LR's clinical and laboratory features. Patients were subdivided into one of two groups: pAPS with LR and pAPS without LR. RESULTS: Both groups were alike concerning demographics and anthropometrics. Interestingly, the frequency of stroke (28.5 vs. 7.5%, p=0.04), as well as of Sneddon's syndrome (100 vs. 30.0%, p<0.0001), were higher in pAPS with LR than the other group. Conversely, patients in the pAPS without LR group had more thyroidopathy than those in the pAPS with LR group (80% vs. 50% %, p=0.03). CONCLUSION: Patients with pAPS and LR have more stroke and seem to be protected from thyroidopathy. Careful follow-up of these patients is therefore advised.

Low-fluence and low-density CO2 laser: histological analysis of collagen fiber changes in skin and its clinical repercussions in photorejuvenation.

This study refers to clinical and histologic analysis of effects on photorejuvenation after one single treatment of fractional CO2 laser with low fluence and low density. To analyze histologically the quantitative variation of collagen fibers type I and III, elastic fibers, and epidermal thickness on D84, besides clinical evaluation of amount, length, thickness, and depth of periocular wrinkles during the same period. This is an open, prospective, interventional study. There were 40 healthy female with age between 35 and 65 years. Twenty-six participants were randomly selected for D0 and D84 biopsy. A single session of fractional CO2 laser was done in the hole face, using a 800-µm tip, 5% density, and 10 mJ fluence with a single pass. On D0, D42, and D84, a clinical comparative analysis of amount, length, depth, and thickness of periocular wrinkles has been done. On histological analysis, a comparative quantitative evaluation of collagen fibers type I and III, elastic fibers, and epidermal thickness has been done on D0 and D84. The results of this study denoted a significant clinical improvement of amount (- 32.17%; p < 0.0001), thickness (- 33%; p < 0.0001), lenght (- 35.84%; p < 0.0001), and depth of periocular wrinkles (- 32.46%; p < 0.0001). A significant increase in the amount of collagen fibers type III was observed on D84 (+ 60.67%; p = 0.0013). Collagen fibers type I and elastic fibers did not have the same result, with a nonsignificant increase (+ 8.31%; p = 0.3820) and a decrease (- 12.4%; p = 0.0585) respectively. Epidermal thickness has a tendency to significant variation (p = 0.05553). The results demonstrate that fractional CO2 laser with low fluence and low density is a safe and efficient option for photorejuvenation of the face.

Seropositivity for syphilis among Brazilian blood donors. A retrospective study 2015-2020.

INTRODUCTION: Syphilis is a transfusion-transmitted infection and the disease re-emerged in many countries, including Brazil, as a public health risk. OBJECTIVE: Evaluate the prevalence of positive serology in blood donations rejected by Hemobanco (Curitiba- PR) from January 2015 to December 2020, with special focus in syphilis. METHODOLOGY: In the studied period, we analyzed the number of blood donations discarded annually for each serological test performed on blood donors' samples, according to gender and donors age. RESULTS: Within the studied period, 134,741 blood donation were analyzed. 54.5 % of sample were male. Otherwise, it was observed a significant increase in the number of donations by females (P < 0.0001). There was an increase of 437 % in the prevalence of syphilis positive serology made by donors with ≥ 60 years. Besides that, it was noticed a significant increase in donations by aged people throughout these six years (P < 0.0001). The percentage of total blood donation deferred had a significant reduction, although it was observed an increase in the rate of discarded blood bags due to positive serology in the first 4 studied years. It was observed an increase of 20 % in positive syphilis serology. CONCLUSION: The greatest cause of discard of blood donations changed during the analyzed 5-years; there was an increase in seropositivity donations from donors with ≥ 60 years old. In 2015, Hepatitis B (0.8 %) was the most prevalent and in 2020, syphilis became more prevalent (0.82 %). The medical community should be aware of the rising number of cases of syphilis infection. There is an urgent need to implement actions against the dissemination of this disease.