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Papillon-Lefèvre syndrome is a rare, autosomal recessive genodermatosis with an estimated prevalence of one to four cases per million people, without sexual or racial predominance.1 It is clinically characterized by diffuse palmaoplantar keratoderma, associated with a severe periodontopathology, with premature loss of deciduous and permanent teeth. The cutaneous changes commonly begin during the first four years of life, and the severe destruction of periodontal regions results in loss of t...
Objectives: The objective of this paper is to perform an ultrasonography (US) analysis of hands and wrists in two groups of patients with systemic lupus erythematosus (SLE), with and without Jaccoud’s arthropathy, matched by age and disease duration and to correlate them with levels of CXCL13 clinical features, laboratory tests and disease activity score. Methods: Sixty-four patients with SLE were enrolled, 32 with and 32 without Jaccoud’s arthropathy. Each patient underwent physical examinat...
O avanço das técnicas de exames de imagem levou o diagnóstico clínico a um novo patamar na Medicina moderna, tornando-as indispensáveis para todos os médicos. A fim de que estejam aptos a avaliar adequadamente as imagens adquiridas, além de serem necessários conhecimentos em radiologia, é fundamental que os acadêmicos de Medicina se habituem com a anatomia normal vista através dos exames de imagem. Assim, é necessário que a matriz curricular contemple adequadamente essa necessidade através de...
Objetivo: Revisar os dados já publicados sobre a associação entre doença celíaca materna e desfechos gestacionais desfavoráveis (nascimento de recém-nascidos com baixo peso, prematuros e pequenos para idade gestacional) e sua relação com a dieta isenta em glúten. Fontes dos dados: Revisão sistemática feita nas bases de dados do PubMed e da Biblioteca Virtual em Saúde. Incluídos estudos de coorte que compararam a incidência de desfechos gestacionais desfavoráveis em mulheres com doença celíac...
Psoriasis is an immune-mediated disease that manifests predominantly in the skin, although systemic involvement may also occur. Although associated comorbidities have long been recognized and despite several studies indicating psoriasis as an independent risk factor for cardiovascular events, little has been done in general medical practice regardind screening. In the United States, less than 50% of clinicians are aware of these recommendations. Objective: To identify the prevalence of these ...
The release of myocardial necrosis biomarkers after off-pump coronary artery bypass grafting (OPCAB) frequently occurs. However, the correlation between biomarker release and the diagnosis of procedure-related myocardial infarction (MI) (type 5) has been controversial. This study aimed to evaluate the amount and pattern of cardiac biomarker release after elective OPCAB in patients without evidence of a new MI on cardiac magnetic resonance (CMR) imaging with late gadolinium enhancement (LGE)....
dial necrosis biomarkers and electrocardiographic abnormalities after revascularization procedures has resulted in a change in the myocardial infarction (MI) definition. Methods. Patients with stable multivessel disease who underwent percutaneous or surgical revascularization were included. Electrocardiograms and concentrations of high-sensitive cardiac troponin I (cTnI) and creatine kinase (CK)-MB were assessed before and after procedures. Cardiac magnetic resonance and late gadolinium enha...
A doença celíaca representa uma enteropatia inflamatória crônica do intestino delgado, imunomediada, que ocorre como resposta a uma intolerância permanente ao glúten em pessoas geneticamente predispostas. Essa doença tem várias manifestações clínicas, pode ser assintomática, e em gestantes celíacas não diagnosticadas tem sido associada a risco aumentado de recém‐nascidos com baixo peso ao nascer. Esta revisão tem como objetivo fornecer uma melhor compreensão dos mecanismos fisiopatológicos en...
Introduction: Due to the subjectivity of the tinnitus diagnosis and its diverse etiologies, establishing an effective treatment is complex. In this context, transcranial direct current stimulation, a noninvasive option, is available for most patients and has shown good results in the treatment of other symptoms such as chronic pain. Objective: To evaluate the therapeutic response of tinnitus to transcranial direct current stimulation. Methods: A systematic review of the literature was perform...
Objectives: This study aimed to determine risk factors related to the occurrence of falls in stroke patients and to propose a new predictive scale for falls. Methods: Demographic and clinical data were collected and the following scales were applied: Barthel Index, Timed Up and Go Test (TUG), and National Institutes of Health Stroke Scale (NIHSS). Subjects were followed prospectively for 2 years for the occurrence of recurrent (≥2) falls. Kaplan–Meier curves were constructed and univariable ...
Introduction: Jaccoud arthropathy (JA) is characterized by the presence of joint deformities similar to those seen in rheumatoid arthritis but generally with a “reversible” pattern. The etiopathogenic mechanisms are not known, and its therapeutical approach has been regarded as disappointing. The aim of the present study was to perform a systematic review of the literature on the scientific evidence of the surgical procedures for JA. Methods: TheMEDLINE, LILACS, and Scielo databases wer...
Introduction: Jaccoud arthropathy (JA) is a deforming nonerosive arthropathy, characterized by the presence of “reversible” joint deformity. The study aims at describing themainmusculoskeletal ultrasound (US) findings of a series of systemic lupus erythematosus (SLE) patients with JA. Methods: Consecutive patients diagnosed as having JA and SLE were included in the study. All patients underwent a whole clinical evaluation and US of the hands and wrists. The US scan evaluated the presenc...
Abstract—Diagnosis of synovitis/tenosynovitis by physical examination can be difficult. Ultrasound (US) can be an effective tool for the evaluation of joint involvement in systemic lupus erythematosus (SLE). This study will describe musculoskeletal findings by US in SLE patients and the evaluation of their correlation with physical examination. SLE patients underwent clinical/sonographic evaluation of hand/wrists. In total, 896 joints were evaluated: at least 1 change on physical examination...
A imunoglobulina intravenosa humana (IgIV) faz parte do arsenal terapêutico de algumas doenças autoimunes e é constituída por um pool de anticorpos humanos, obtidos de doadores saudáveis. Relata-se o caso de uma paciente lúpica, portadora da síndrome antifosfolipídica secundária, que apresentou um importante envolvimento hematológico, caracterizado por plaquetopenia e anemia hemolítica, refratário à pulsoterapia com metilprednisolona e para o qual foi indicada a IgIV. Durante o uso dessa med...
Free heme is an inflammatory molecule capable of inducing migration and activation of neutrophils. Here, we examine the heme-driven oxidative stress-associated cell death mechanisms in human neutrophils infected with Leishmania infantum, an etiologic agent of visceral leishmaniasis (VL). We first performed exploratory analyses in a population of well characterized treatment-naïve VL patients as well as uninfected controls, who were part of previously reported studies. We noted a positive cor...
Canine Visceral Leishmaniasis (CVL) is caused by Leishmania infantum, which in the New World is transmitted by Lutzomyia longipalpis. While prospective clinical and immunological assessments of dogs experimentally challenged with L. infantum have been previously reported over a relatively short follow-up period, the long-term characterization of infected animals has not been performed to date. We evaluated dogs in a subclinical state for six years following experimental infection with L. ...
Abstract Background Hematological changes can drive damage of endothelial cells, which potentially lead to an early endothelial dysfunction in patients with sickle cell anemia (SCA). An association may exist between endothelial dysfunction and several clinical manifestations of SCA. The present study aims to evaluate the links between changes in endothelial function and clinical and laboratory parameters in children and adolescents with SCA. Methods This study included 40 children and a...
In human immunodeficiency virus (HIV) infection, persistent inflammation despite effective antiretroviral therapy (ART) is linked to increased risk of non-infectious chronic complications such as cardiovascular and thromboembolic disease. A better understanding of inflammatory and coagulation pathways in HIV infection is needed to optimize clinical care. Markers of monocyte activation and coagulation independently predict morbidity and mortality associated with non-AIDS events. In this study,...
Visceral leishmaniasis (VL) remains a major public health problem worldwide. Cytokine balance is thought to play a critical role in the development of this disease. Here, we perform a prospective exploratory study addressing whether simultaneous assessment of circulating levels of different lipid mediators and cytokines could highlight specific pathways involved with VL pathogenesis. VL patients displayed substantial increases in serum levels of Prostaglandin F2α (PGF2α), Leukotriene B4 ...
Abstract Background Clinical trials that evaluate new anti-tubercular drugs and treatment regimens take years to complete due to the slow clearance of Mycobacterium tuberculosis infection and the lack of early biomarkers that predict treatment outcomes. Host Inflammation markers have been associated with tuberculosis (TB) pathogenesis. In the present study, we tested if circulating levels of C-reactive protein (CRP) and ferritin reflect mycobacterial loads and inflammation in pulmonary...