Abstract The use of carbon nanotubes in cementitious materials improves the mechanical properties of these composites and increases their compressive and flexural strength. The main objective of this study was to evaluate the technical feasibility of reducing the Portland cement content by using functionalized multi-walled carbon nanotubes (MWCNT) in mortar samples, using mechanical properties as parameters (compressive strength, flexural strength and modulus of elasticity). Experimental results allowed us to conclude that the addition of MWCNT in 0.1% by weight of Portland cement, to the mortar samples allowed a reduction of the Portland cement content by up to 10%, while the water/cement ratio remained unchanged without affecting the mechanical behavior.

Resumo A utilização de nanotubos de carbono em materiais cimentícios melhora as propriedades mecânicas destes compósitos, aumentando a sua resistência à compressão e à flexão. O principal objetivo deste estudo foi avaliar a viabilidade técnica da redução do teor de cimento Portland através da utilização de nanotubos de carbono de paredes múltiplas funcionalizados (MWCNT) em amostras de argamassa, utilizando como parâmetros as propriedades mecânicas (resistência à compressão, resistência à flexão e módulo de elasticidade). Os resultados experimentais permitiram concluir que a adição de MWCNT em 0,1% em peso de cimento Portland, às amostras de argamassa, permitiu uma redução do teor de cimento Portland em até 10%, mantendo-se inalterada a relação água/cimento, sem afetar o comportamento mecânico.

ABSTRACT Background: Children presenting enuresis are more likely to be asthmatics. The association between enuresis and sleep-disordered breathing has already been demonstrated and several studies have shown at least partial improvement of two thirds or more of the cases of enuresis adenoidectomy. Studies have already described associations between enuresis and allergies but do not assess the repercussions of allergy treatment in enuretics. Objective: This study aims to evaluated whether asthma treatment alters the course of enuresis and whether there is any predictive factor associated with this improvement. Materials and Methods: Twenty patients (5 - 12 years old) with uncontrolled enuresis and asthma, received treatment for asthma. Children were also assessed for the presence of rhinitis and other allergies. The control of asthma was confirmed by a validated questionnaire and primary enuresis by clinical history and wet night diaries. Patients received only asthma treatment. Results: At least partial improvement of enuresis was observed in 55% of the patients with an increase in 64.4% in the number of dry nights at the end of the study (p=0.01). The “presence of other allergies” and “obstruction seen in nasal endoscopy” positively influenced the improvement of urinary symptoms (OR = 3.350; CI 0.844–13.306) and (OR=1.272; CI 0.480-3.370), respectively. Discussion: Until now, only patients presenting upper airway obstruction were known to benefit from the improvement of urinary symptoms when undergoing treatment for their respiratory problems. In our study, we found at least partial improvement in enuresis in 55% of our patients, with only clinical asthma treatment. Conclusion: Controlling asthma in children with primary enuresis resulted in a significant increase in dry nights.

ABSTRACT Introduction: Contrast-associated acute kidney injury (CA-AKI) is a deterioration of kidney function that occurs after the administration of a iodinated contrast medium (ICM). Most studies that defined this phenomenon used older ICMs that were more prone of causing CA-AKI. In the past decade, several articles questioned the true incidence of CA-AKI. However, there is still a paucity of a data about the safety of newer ICM. Objective: To assess the incidence of CA-AKI in hospitalized patients that were exposed to computed tomography (CT) with and without ICM. Methods: Prospective cohort study with 1003 patients who underwent CT in a tertiary hospital from December 2020 through March 2021. All inpatients aged > 18 years who had a CT scan during this period were screened for the study. CA-AKI was defined as a relative increase of serum creatinine of ≥ 50% from baseline or an absolute increase of ≥ 0.3 mg/dL within 18 to 48 hours after the CT. Chi-squared test, Kruskal-Wallis test, and linear regression model with restricted cubic splines were used for statistical analyses. Results: The incidence of CA-AKI was 10.1% in the ICM-exposed group and 12.4% in the control group when using the absolute increase criterion. The creatinine variation from baseline was not significantly different between groups. After adjusting for baseline factors, contrast use did not correlate with worse renal function. Conclusion: The rate of CA-AKI is very low, if present at all, with newer ICMs, and excessive caution regarding contrast use is probably unwarranted.

RESUMO Introdução: Lesão renal aguda associada ao contraste (LRA-AC) é uma deterioração da função renal que ocorre após a administração de meio de contraste iodado (MCI). A maioria dos estudos que definiram esse fenômeno utilizaram MCI mais antigos, mais propensos a causar LRA-AC. Na última década, diversos artigos questionaram a verdadeira incidência de LRA-AC. Entretanto, ainda há escassez de dados sobre a segurança dos MCI mais novos. Objetivo: Avaliar a incidência de LRA-AC em pacientes hospitalizados expostos à tomografia computadorizada (TC) com e sem MCI. Métodos: Estudo de coorte prospectivo com 1.003 pacientes submetidos a TC em hospital terciário, de dezembro/2020 a março/2021. Todos os pacientes internados com idade ≥ 18 anos que realizaram TC nesse período foram selecionados. A LRA-AC foi definida como aumento relativo de creatinina sérica de ≥ 50% em relação ao valor basal ou aumento absoluto de ≥ 0,3 mg/dL dentro de 18 a 48 horas após a TC. Utilizamos o teste qui-quadrado, teste de Kruskal-Wallis e modelo de regressão linear com splines cúbicos restritos para análises estatísticas. Resultados: A incidência de LRA-AC foi 10,1% no grupo exposto ao MCI e 12,4% no grupo controle ao usar o critério de aumento absoluto. A variação da creatinina em relação ao valor basal não foi significativamente diferente entre os grupos. Após ajuste para fatores basais, o uso de contraste não se correlacionou com pior função renal. Conclusão: A taxa de LRA-AC é muito baixa, caso exista, com MCIs mais novos, e a cautela excessiva quanto ao uso de contraste provavelmente não se justifica.

abstract: The effects of chemical and physical methods on multiwalled carbon nanotube (MWCNT) dispersion in Portland cement pastes were investigated. Consistency, rheology, compressive strength, dynamic elastic modulus, flexural strength, water absorption, and void content tests were performed to evaluate these effects. Changes in the rheology of the cement pastes and surfactants resulted in a significant reduction in apparent viscosity and yield strength. Additionally, cement pastes containing carboxyl- functionalized MWCNTs (MWCNT-COOH) and surfactant showed higher compressive strengths at 28 d. However, the ultrasonic dispersion method did not significantly influence the properties of hardened Portland cement compared with Portland cement produced using the non-sonicated aqueous solution.

resumo: Foram investigados os efeitos dos métodos químicos e físicos na dispersão de nanotubos de carbono de paredes múltiplas (MWCNT) em pastas de cimento Portland. Para avaliar estes efeitos, foram realizados testes de consistência, reologia, resistência à compressão, módulo elástico dinâmico, resistência à flexão, absorção de água, e teor de vazio. As alterações na reologia das pastas de cimento e surfactantes resultaram numa redução significativa da viscosidade aparente e da resistência ao escoamento. Além disso, pastas de cimento contendo MWCNT funcionalizados com grupo carboxílicos (MWCNT-COOH) e surfactante mostraram maiores resistências à compressão a 28 d. No entanto, o método de dispersão ultrassônica não influenciou significativamente as propriedades do cimento Portland endurecido em comparação com o cimento Portland produzido utilizando a solução aquosa não sonicada.

ABSTRACT Introduction: Upper airway obstruction (UAO) is a common condition in all pediatric population, with a 27% prevalence. Primary monosymptomatic nocturnal enuresis (PMNE) is a condition related to UAO in 8% to 47% of these children. The specific pathophysiological mechanism of this bond is not well understood. Some authors suggest a connection between brain natrituretic peptide (BNP) and anti-diuretic hormone (ADH) during sleep. The aim of this study was to evaluate hormone profile (ADH and BNP) and improvement in dry nights in a sample of children before and after surgical treatment of the UAO. Methods: This is a longitudinal prospective interventionist study in children, 5 to 14 years of age, with UAO and PMNE recruited in a specialty outpatient clinic. Children presenting UAO and PMNE were evaluated with a 30-day dry night diary and blood samples were collected to evaluate ADH and BNP before and after upper airway surgery. Data were analyzed prior to surgery and 90-120 days after surgery. Results: Twenty-one children with a mean age of 9.7 years were included. Mean BNP before surgery was 116.5 ± 126.5 pg/mL and 156.2 ± 112.3 pg/mL after surgery (p<0.01). Mean ADH was 5.8 ± 3.2 pg/mL and 14.6 ± 35.4 before and after surgery, respectively (p=0.26). The percentage of dry nights went from 32.3 ± 24.7 before surgery to 75.4 ± 33.4 after surgery (p<0.01). Conclusion: Surgery for airway obstruction contributed to an increase in BNP without increasing ADH. A total of 85.8% of the children presented partial or complete improvement of their enuresis.

RESUMO A incorporação de nanomateriais em compósitos cimentícios vem se tornando cada vez mais frequente e tem, como um dos principais objetivos, promover melhorias às propriedades mecânicas e microestruturais. Dentre os diversos nanomateriais existente, os nanotubos de carbono (NTC) se destacam devido à sua elevada resistência, principalmente à tração, e à alta capacidade de deformação elástica. Entretanto, um dos impasses em sua utilização é a dificuldade de realizar uma dispersão eficaz e estável, mas pesquisas apontam que a utilização de aditivos contribui para a desaglomeração do nanomaterial. Sendo assim, este trabalho avaliou a influência de dois tipos de superplastificantes (SPA e SPB), adicionados na proporção de 1:0 a 1:3 (NTCPM:SP), em uma solução sonicada por 5 minutos. Os resultados mostraram que o aditivo SPB foi o que melhor proporcionou uma melhor dispersão com um menor consumo. Pastas de cimento Portland também foram produzidas e comprovou-se que o NTCPM reduziu a consistência das pastas e que a inserção de aditivo ajudou a diminuir esse efeito. Por fim, infere-se que o aditivo, além de melhorar a dispersão do NTCPM, também interage com o cimento Portland, promovendo pastas com maior espalhamento.

ABSTRACT The incorporation of nanomaterials in cementitious composites has become more and more frequent and has, as one of the main objectives, to promote improvements to the mechanical and microstructural properties. Among the various existing nanomaterials, carbon nanotubes (CNT) stand out due to their high resistance, mainly to traction, and the high capacity of elastic deformation. However, one of the impasses in its use is the difficulty of achieving an effective and stable dispersion, but research shows that the use of additives contributes to the de-agglomeration of the nanomaterial. Thus, this work evaluated the influence of two types of superplasticizers (SPA and SPB), added in the proportion of 1: 0 to 1: 3 (MWCNT: SP), in a sonicated solution for 5 minutes. The results showed that the SPB additive was the one that best provided a better dispersion with less consumption. Portland cement pastes were also produced and it was found that the MWCNT reduced the consistency of the pastes and that the insertion of additives helped to reduce this effect. Finally, it appears that the additive, in addition to improving the dispersion of the MWCNT, also interacts with Portland cement, promoting pastes with greater spread.

RESUMO Introdução: o tratamento cirúrgico da obesidade acarreta importantes alterações na mecânica respiratória. Objetivo: analisar comparativamente a força muscular respiratória em pacientes submetidos à cirurgia bariátrica do tipo bypass gástrico por laparotomia e por videolaparoscopia durante o internamento cirúrgico. Métodos: estudo observacional com delineamento longitudinal não-randomizado, de caráter quantitativo. Foram coletados dados de 60 pacientes com índice de massa corporal igual ou superior a 40Kg/m2, candidatos a cirurgia bariátrica e divididos em grupo 1, para os operados por laparotomia (n=30), e grupo 2, para os operados por videolaparoscopia (n=30). Foram excluídos os tabagistas, os pacientes incapazes de executar o exame de forma correta e os portadores de doenças pulmonares prévias. Ambos os grupos foram avaliados no pré-operatório imediato, no primeiro e no segundo dias de pós-operatório através do teste de manovacuometria para a força muscular respiratória e da escala visual analógica de dor. Resultados: a amostra foi homogênea em relação à idade, índice de massa corporal e sexo. Foi observado redução das pressões respiratórias máximas após a cirurgia para os operados por laparotomia, sem retorno aos valores basais no dia da alta hospitalar no segundo dia pósoperatório. Esse grupo também cursou com dor mais intensa e maior tempo cirúrgico. Não houve diferença das medidas de pressão respiratória após a cirurgia no grupo operado por laparoscopia. Conclusões: a cirurgia bariátrica pela via convencional reduz a força muscular respiratória no pós-operatório e cursa com dor mais intensa durante a internação cirúrgica em relação à via laparoscópica.

ABSTRACT Introduction: surgical treatment of obesity causes important changes in respiratory mechanics. Aim: Comparatively analyze respiratory muscle strength in post bariatric patients underwent to gastric bypass by laparotomy and laparoscopy during hospital stay. Methods: observational study with a non-randomized longitudinal design, of a quantitative character. Data were collected from 60 patients with BMI 40Kg/m2, divided in laparotomy group (n=30) and laparoscopy group (n=30). Smokers, patients with previous lung diseases and those unable to perform the exam correctly were excluded. Both groups were evaluated at immediate postoperative, first and second postoperative days with manovacuometry for respiratory muscle strength and visual analogue pain scale. Results: the sample was homogeneous in age, sex and BMI. Reduction in maximal respiratory pressures was observed after surgery for those operated on by laparotomy, no return to baseline values on discharge day on the second postoperative day. This group had also more severe pain and longer operative time. There was no difference in respiratory pressure measurements after surgery in the laparoscopy group. Conclusion: conventional bariatric surgery reduces muscle strength in the postoperative period and leads to more intense pain during hospitalization when compared to the laparoscopy group.

RESUMO A construção de grandes blocos de fundação para edifícios altos tem se tornado comum no país. As altas resistências à compressão dos concretos, aliado ao fato de muitas vezes se tratar de concretos autoadensáveis, geralmente levam à elevados consumos de ligante, possivelmente originando problemas de origem térmica a estes elementos estruturais. Este estudo teve como objetivo avaliar a influência de diferentes adições minerais na elevação da temperatura de concretos massa com elevada resistência à compressão. Para isso, foi utilizado um calorímetro adiabático, o qual simula a condição de um concreto em um regime de cura autógena. As resistências à compressão dos concretos nos regimes de cura autógena e ambiente foram determinadas aos 28 dias. Complementarmente, as pastas que compõem os concretos foram avaliadas através de análise termogravimétrica aos 28 dias, a fim de verificar a influência da temperatura nas reações dos compostos das misturas. Os resultados mostraram que houve uma tendência de menor liberação de calor para os parâmetros °C/MPa e °C/Kg de ligante para o CP III – RS, em relação aos demais ligantes utilizados. A análise termogravimétrica indicou que o tipo de cura não influenciou significativamente na atividade pozolânica e na hidratação do cimento Portland. Por fim, verificou-se que as maiores resistências à compressão para uma mesma relação água/ligante foram obtidas pela combinação de CP V – ARI + metacaulim, pelo fato desta adição mineral apresentar elevada atividade pozolânica. Já na combinação CP V – ARI + sílica ativa, a adição mineral parece ter contribuído de forma predominante pela formação de pontos de nucleação, apresentando pouco consumo de hidróxido de cálcio.

ABSTRACT The construction of large foundation blocks for tall buildings has become common in the country. The high compressive strength of concretes, coupled with the fact that they are often self-compacting concretes, generally lead to high binder consumption, possibly causing problems of thermal origin to these structural elements. The objective of this study was to evaluate the influence of different mineral admixtures on the temperature rise of mass concrete with high compressive strength. For this, an adiabatic calorimeter was used, which simulates the condition of a concrete in an autogenous cure regime. The compressive strengths of the concretes in autogenous and ambient cure regimes were determined at 28 days. In addition, the pastes that composed the concretes were evaluated by thermogravimetric analysis at 28 days, in order to verify the influence of temperature on the reactions of the compounds of the mixtures. The results showed that there was a trend of lower heat release for the parameters °C/MPa and °C/kg of binder for CP III-RS, compared to the other binders used. Thermogravimetric analysis indicated that the type of curing did not significantly influence the pozzolanic activity and the hydration of the Portland cement. Finally, it was verified that the higher compressive strengths for the same water/binder ratio were obtained by the combination of CP V-ARI + metacaulim, because this mineral addition showed high pozzolanic activity. On the other hand, in the CP V - ARI + active silica combination, the mineral admixtures seems to have contributed predominantly to the formation of nucleation points, presenting low calcium hydroxide consumption.

ABSTRACT The aim of this study was to verify if a growth reduction of yellow passion fruit seedlings’ growth morphophysiology and quality could be changed by paclobutrazol applied through seedling immersion. The experiment was conducted in a greenhouse, with seedlings grown in polyethylene tubes (290 cm3), with substrate. At 40 days after sowing, the seedlings were immersed in an aqueous solution of paclobutrazol at concentrations of 0, 50, 100, 150, and 200 mg L-1. The experiment was conducted in a randomized block design, with five treatments (paclobutrazol concentrations) and four replicates. At 15 and 30 days after treatment, growth characteristics were evaluated. At the end of the assay, destructive evaluations related to mass determination, total leaf area, and seedling quality index were performed. Paclobutrazol treatment induced restrictions in seedling growth, except for fresh and dry mass of root and total fresh mass. Based on these characteristics, the increase in values induced by paclobutrazol was verified. The seedling quality, defined by the major value of the Dickson quality index and a smaller robustness index, was higher when submitted to paclobutrazol treatment.

OBJECTIVES: The aim of this study was to evaluate the role of amphiregulin protein, an epidermal growth factor receptor ligand, in cartilaginous tumors. METHODS: Amphiregulin expression was examined in 31 enchondromas and 67 chondrosarcomas using immunohistochemistry analysis. RESULTS: Overall, 15 enchondromas (48.40%) and 24 chondrosarcomas (35.82%) were positive for amphiregulin. According to the receiver operating characteristic curve test, no difference in amphiregulin expression was observed between enchondromas and low-grade chondrosarcomas (p=0.0880). Additionally, 39 lesions (16 in short bones, 13 in long bones, and 10 in flat bones) were positive for amphiregulin, exhibiting a higher percentage of positive cells (p=0.0030) and intensity of immunohistochemical expression (p=0.0055) in short bone lesions than in others. Among 25 enchondromas localized in short bones, 15 expressed amphiregulin; however, all 6 cases localized in long bones were negative for this marker (p=0.0177). CONCLUSIONS: Amphiregulin did not help in distinguishing enchondromas from low-grade chondrosarcomas. The present study is the first to document the expression of this immunohistochemical marker in enchondromas. Furthermore, amphiregulin expression in enchondromas was localized in short bones, indicating a phenotypic distinction from that in long bones. This distinction may contribute to an improved understanding of the pathogenesis of these lesions.

ABSTRACT The modulus of elasticity of concrete is often calculated as a function of the compressive strength, and as a deterministic value. However, variations in the aggregates properties may result in module values different than those estimated, which may lead to excessive deformation and eventual instability of the structure. In this work, the influence of the coarse aggregate batch variation on the variability of the modulus of elasticity of the concrete was investigated. Three different aggregate sources (one of granite origin and two of gneiss origin), three water/cement ratios (w/c) and five different batches of each aggregate were investigated. The compressive strength and static modulus of elasticity of the concretes were determined at 28 days. The analysis of variance (ANOVA) showed that the variable "batch" had a significant influence on the modulus of elasticity of the concrete, indicating that this property is a probabilistic variable indeed. The normality of the distribution of its values was attested, and values of characteristic modulus of elasticity were proposed, which were from 6 to 10% lower than the mean values. In addition, the use of gneissic aggregates led to modulus of elasticity values 30% higher than those of the concretes with granitic aggregates and equivalent compressive strengths, while the reduction of the w/c ratio from 0.71 to 0.46 increased the modulus of elasticity in about 5%.

RESUMO Objetivo: Verificar a segurança, a efetividade e a reprodutibilidade da triagem de pacientes potencialmente neurocirúrgicos feita por smartphones. Métodos: Estudo retrospectivo e multicêntrico. Dados de prontuários dos pacientes submetidos à avaliação neurocirúrgica de urgência foram coletados e comparados com a avaliação realizada por neurocirurgiões por meio de smartphones, determinando a capacidade de identificar alterações na tomografia computadorizada de crânio, pacientes potencialmente graves e necessidade de transferência. Resultados: Foram analisados 232 casos. O principal diagnóstico foi traumatismo crânio encefálico, com 119 casos (51,3%). Destes, 105 (45,3%) tiveram alta após a avaliação. Os avaliadores por telemedicina apresentaram acurácia de 95,69% para identificação de alteração na tomografia computadorizada, com concordância de 0,858. Com relação à identificação de gravidade, a acurácia foi de 95,26%, com concordância de 0,858. Com relação à conduta, os avaliadores apresentaram concordância de 0,672, aumentando para 100% nos casos de tratamento cirúrgico. Conclusão: O uso da telemedicina em nosso estudo foi seguro, efetivo e reprodutível para triagem dos pacientes com afecções neurológicas agudas. A implementação do método tem potencial de impacto na melhora do resultado para o paciente devido à redução das transferências desnecessárias e do tempo até o atendimento.

ABSTRACT Objective: To ascertain the safety, effectiveness and reproducibility of screening potential neurosurgical patients by means of smartphones. Methods: This is a retrospective and multicentric study. Data were collected from the medical records of patients subjected to real emergency neurosurgical evaluations and compared with assessments by neurosurgeons using smartphones to determine the feasibility of identifying changes in cranial computed tomography scans, potentially serious conditions of patients, and the need for transfer to reference centers. Results: We analyzed 232 cases. The main diagnosis was traumatic brain injury, with 119 cases (51.3%). Of this, 105 (45.3%) patients were discharged immediately after the assessment. The telemedicine evaluators presented 95.69% accuracy in the identification of changes in computed tomography scans, with 0.858 concordance. Accuracy in the identification of severity was 95.26%, with 0.858 concordance. As for procedure, the concordance among evaluators was 0.672, increasing to 100% in cases that required surgical treatment. Conclusion: Our study indicated that the use of telemedicine for screening patients with acute neurological disorders was safe, effective and reproducible. Implementation of the method shows a promising potential to improve the patient's outcome by reducing unnecessary transfers and decreasing the time elapsed until a specialist can be consulted.

Introdução: O impacto extra-articular do quadril envolve um grupo de lesões reconhecidas apenas recentemente, comumente subdiagnosticadas e pouco compreendidas por muitos especialistas da área ortopédica. Porém, são lesões capazes de levar a dor e declínio funcional importante nos pacientes acometidos. O correto diagnóstico dessas condições é fundamental. Envolve a necessidade de um conhecimento adequado de sua patogênese e avaliação clínica através de manobras do exame físico específicas, assim como correta interpretação dos exames de imagem. Objetivo: Atualizar profissionais médicos, fisioterapeutas, educadores físicos ou quaisquer outros que trabalhem em contato direto com os pacientes acometidos. Material e métodos: Foi realizado uma revisão da literatura nas bases de dados PubMed e Birene/Lilacs a respeito da anatomia, patogênese, achados clínicos, exames de imagem e tratamento das principais causas descritas de impacto extra-articular do quadril. Resultados: As síndromes de impacto extra-articular mais citadas na literatura são os impactos isquiofemoral, subespinhal, pélvico trocantérico e o do iliopsoas. Essas síndromes são condições dinâmicas e o diagnóstico deve ser feito observando a presença de alterações anatômicas, exame clínico positivo e confirmação por exame de imagem ou achado intra-operatório. Por serem lesões com baixa prevalência relatada, existem poucas evidências a respeito dessas condições e mais estudos são necessários. Conclusão: O conhecimento das síndromes de impacto extra-articular do quadril é essencial na avaliação de pacientes com dor no quadril e deve fazer parte do diagnóstico diferencial.

Introduction: The extra-articular hip impingement involves a group of recently recognized lesions, commonly underdiagnosed and poorly understood by many orthopedic specialists. However, these lesions are capable of leading to pain and important functional decline in the affected patients. The correct diagnosis of these conditions is primal. It involves the need for an adequate knowledge of its pathogenesis and clinical evaluation through specific physical examination maneuvers, as well as correct interpretation of the imaging exams. Objective: To update medical professionals, physiotherapists, physical educators or any others who work in direct contact with the affected patients. Material and methods: A review of the literature was conducted on the PubMed and Birene /Lilacs databases on regard of anatomy, pathogenesis, clinical findings, imaging and treatment of the main causes of extra-articular hip impingement. Results: The most cited extra-articular impingement syndromes in the literature are the ischiofemoral, subspinal, trochanteric and iliopsoas impingements. These syndromes are dynamic conditions and the diagnosis must be done observing the presence of anatomical abnormalities, positive clinical examination and confirmation by imaging exams or intraoperative finding. Because they are lesions with a low prevalence reported, there is little evidence regarding these conditions and more studies are needed. Conclusion: Knowledge of extra-articular hip impingement syndromes is essential in the evaluation of patients with hip pain and should be part of the differential diagnosis.

Resumo Objetivos: Correlacionar a expressão basal das proteínas reguladoras do complemento (PRC) CD55, CD59, CD35 e CD46 nos linfócitos B do sangue periférico de uma coorte de 10 pacientes com artrite reumatoide (AR) iniciando tratamento com rituximabe (RTX) com a depleção e tempo de repopulação dessas células. Métodos: Dez pacientes com AR receberam duas infusões de 1 g de RTX com intervalo de 14 dias. Análises imunofenotípicas para detecção de CD55, CD59, CD35 e CD46 nos linfócitos B foram feitas imediatamente antes da primeira infusão. A população de linfócitos B foi analisada por meio da expressão de CD19 basal e após um, dois e seis meses após a infusão de RTX e então trimestralmente até a recaída clínica. Depleção de linfócitos B no sangue periférico foi definida como expressão de CD19 < 0,005 × 109/l. Resultados: Dez mulheres com mediana de 49 anos e DAS 28 basal de 5,6 foram avaliadas; nove eram soropositivas para o fator reumatoide. Cinco pacientes apresentaram repopulação de linfócitos B após dois meses e as outras cinco aos seis meses. Houve correlação entre a expressão basal de CD46 e o tempo de repopulação (coeficiente de correlação -0,733, p = 0,0016). Tendência semelhante foi observada com CD35, porém sem significância estatística (coeficiente de correção 0,522, p = 0,12). Conclusão: Expressão aumentada de CD46 foi preditora de repopulação mais rápida de linfócitos B em pacientes tratados com RTX. Estudos com um número maior de pacientes serão necessários para confirmar a utilidade da expressão basal das PRC como preditora de resposta clínica.

Abstract Objectives: To correlate the basal expression of complement regulatory proteins (CRPs) CD55, CD59, CD35, and CD46 in B-lymphocytes from the peripheral blood of a cohort of 10 patients with rheumatoid arthritis (RA) initiating treatment with rituximab (RTX) with depletion and time repopulation of such cells. Methods: Ten patients with RA received two infusions of 1 g of RTX with an interval of 14 days. Immunophenotypic analysis for the detection of CD55, CD59, CD35, and CD46 on B-lymphocytes was carried out immediately before the first infusion. The population of B-lymphocytes was analyzed by means of basal CD19 expression and after 1, 2, and 6 months after the infusion of RTX, and then quarterly until clinical relapse. Depletion of B-lymphocytes in peripheral blood was defined as a CD19 expression <0.005 × 109/L. Results: Ten women with a median of 49 years and a baseline DAS28 = 5.6 were evaluated; 9 were seropositive for rheumatoid factor. Five patients showed a repopulation of B-lymphocytes after 2 months, and the other five after 6 months. There was a correlation between the basal expression of CD46 and the time of repopulation (correlation coefficient = −0.733, p = 0.0016). A similar trend was observed with CD35, but without statistical significance (correction coefficient = −0.522, p = 0.12). Conclusion: The increased CD46 expression was predictive of a faster repopulation of B-lymphocytes in patients treated with RTX. Studies involving a larger number of patients will be needed to confirm the utility of basal expression of CRPs as a predictor of clinical response.