Introdução : A obesidade tem sido associada ao aparecimento ou piora de doenças autoimunes. Objetivo : Revisar a presença de autoanticorpos em obesos submetidos à cirurgia bariátrica e verificar a possível alteração deste perfil após o procedimento cirúrgico. Método : Revisão narrativa da literatura efetuada no PubMed e Scielo. A busca utilizou as palavras-chave: “ obesidade, autoimunidade, fator antinuclear, cirurgia bariátrica” . Os critérios de inclusão compreenderam artigos de revisão, estudos experimentais, pesquisas pré-clínicas e clínicas, escritos em português e inglês e disponíveis em texto completo. Resultado : Foram incluídos 63 artigos. Conclusão : Existe alta prevalência de FAN positiva na população obesa e candidata à cirurgia bariátrica que diminui consideravelmente no pós-operatório. O mesmo não pode ser verificado com o fator reumatóide, anticorpos do perfil ENA e anti-ds DNA, anticorpos anticardiolipina IgG e IgM, e anticorpos anti-endomísio. Nenhuma variável clínica ou antropométrica pôde estar ligada à presença de autoanticorpos, salvo níveis de vitamina D que foram significativamente menores nos indivíduos no pré-operatório e FAN positivos.

Introdução : A obesidade tem sido associada ao aparecimento ou agravamento de doenças autoimunes. Objetivo : Rever a presença de autoanticorpos em pacientes obesos submetidos à cirurgia bariátrica e verificar a possível alteração deste perfil após o procedimento cirúrgico. Método : Revisão narrativa da literatura realizada no PubMed e Scielo. A busca utilizou as palavras-chave: “ obesidade, autoimunidade, fator antinuclear, cirurgia bariátrica ”. Os critérios de inclusão compreenderam artigos de revisão, estudos experimentais, pesquisas pré-clínicas e clínicas, escritos em português e inglês e disponíveis em texto completo. Resultado : foram incluídos 63 artigos. Conclusão : Existe alta prevalência de FAN positivo na população obesa e candidata à cirurgia bariátrica, que diminui consideravelmente no pós-operatório. O mesmo não pode ser verificado com fator reumatoide, anticorpos ENA e anti-ds DNA, anticorpos IgG e IgM anticardiolipina e anticorpos antiendomísio. Nenhuma variável clínica ou antropométrica pôde ser associada à presença de autoanticorpos, exceto os níveis de vitamina D, que foram significativamente mais baixos nos indivíduos pré-operatórios e ANA-positivos.

Abstract Objectives: to study the side effects and the risk of disease flare after COVID-19 vaccination in Brazilian patients with Systemic Lupus erythematosus (SLE). Materials and methods: this retrospective study investigated a sample of 101 SLE patients for disease activity through the SLE disease activity index (SLEDAI) prior to and after two vaccine doses against SARS-COv-2. Side effects after vaccination were recorded. Results: in this sample, patients receiving two doses of the same vaccine were 10.3% for CoronaVAc; 42.2% for Pfizer, and 47.3% for Astra-Zeneca. Side effects were detected in 76.2% of them, and most of them were mild and moderate; the most common were local pain (62.3%), headache (36.6%), and fatigue (34.6%). The SLEDAI prior to the first dose and after the second dose did not change significantly (p=0.68). Only 4.1% of individuals had increased in SLEDAI ≥than 3 points. Conclusions: vaccination against COVID-19 was well tolerated and safe in SLE patients.

Resumen Objetivos: estudiar los efectos secundarios y el riesgo de exacerbación de la enfermedad después de la vacunación COVID-19 en una muestra de pacientes con lupus eritematoso sistémico (LES). Materiales y métodos: estudio retrospectivo que investigó 101 pacientes con LES. Se determinó la actividad de la enfermedad mediante el Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) antes y después de dos dosis de la vacuna contra el SARS-COv-2. Se registraron los efectos secundarios después de la vacunación. Resultados: los pacientes que recibieron dos dosis de la misma vacuna fueron el 10,3% para CoronaVAc, el 42,2% para Pfizer y el 47,3% para AstraZeneca. Se detectaron efectos secundarios en el 76,2% y la mayoría fue leve/moderado. Los más frecuentes fueron: dolor local (62,3%), cefalea (36,6%) y fatiga (34,6%). El cambio en la mediana del SLEDAI antes de la primera dosis y después de la segunda no fue estadísticamente significativo (p=0,68). Solo el 4,1% de los individuos aumentó el SLEDAI ≥ de 3 puntos. Conclusiones: la vacunación contra la COVID-19 fue bien tolerada y segura en pacientes con LES.

ABSTRACT Background: Microscopic colitis (MC) is a chronic inflammatory bowel disease causing non-bloody diarrhea, and several cases are undiagnosed as a hidden cause of chronic diarrhea. Objective: We aimed to report the symptoms, delay diagnosis and the treatment of MC in a case series. Methods: All patients were treated at a Gastroenterology reference office from May 2022 to June 2023. Personal history including preexisting disorders, use of medications and smoking habits were collected. The delay between the onset of symptoms and the correct diagnosis was informed. All patients consented to use budesonide MMX (Corament®) off label. Results: During the study period, six Caucasoid patients were diagnosed with MC, five females and one male, between the ages of 65 and 74. All patients had comorbities and were taking multiple prescription drugs. Laboratory findings showed negative serology for celiac disease for all patients, normal levels of albumin and vitamin B12. The delay between the symptoms and the MC diagnosis varied from 2 months to 6 years. All patients had a previous diagnosis of irritable bowel syndrome. All patients were in complete clinical remission during the treatment and referred no side effects of the drug. Conclusion: Older females using high-risk medications are suggestive of MC. Preventing delay in the diagnosis of MC is crucial to improvement in patients´ quality of life. Budesonide MMX appears to be effective, safe and well-tolerated. Background (MC nonbloody non bloody diarrhea Objective series Methods 202 2023 disorders collected informed Corament® Corament (Corament® label Results period male 74 drugs B12 B years syndrome drug Conclusion highrisk high risk life effective welltolerated. welltolerated well tolerated. tolerated well-tolerated 20 (Corament 7 B1

RESUMO Contexto: A colite microscópica (CM) é uma doença inflamatória intestinal crônica que causa diarreia não sanguinolenta, e vários casos não são diagnosticados como uma causa oculta de diarreia crônica. Objetivo: Esse estudo visou relatar os sintomas, qual o atraso diagnóstico e o tratamento da CM em uma série de casos. Métodos: Todos os pacientes foram atendidos em um consultório de referência em Gastroenterologia no período de maio de 2022 a junho de 2023. Foram coletados antecedentes pessoais, incluindo distúrbios preexistentes, uso de medicamentos e tabagismo. Foi buscado o período entre o início dos sintomas e o diagnóstico correto. Todos os pacientes consentiram em usar budesonida MMX (Corament®) off label. Resultados: Durante o período do estudo, seis pacientes caucasóides foram diagnosticados com CM, cinco mulheres e um homem, com idades entre 65 e 74 anos. Todos os pacientes apresentavam comorbidades e faziam uso de vários medicamentos prescritos. Os achados laboratoriais mostraram sorologia negativa para doença celíaca em todos os pacientes, níveis normais de albumina e vitamina B12. O atraso entre os sintomas e o diagnóstico de CM variou de 2 meses a 6 anos. Todos os pacientes tinham diagnóstico prévio de síndrome do intestino irritável. Todos os pacientes apresentaram remissão clínica completa durante o tratamento e não referiram efeitos colaterais da droga. Conclusão: As mulheres mais velhas que usam medicamentos de alto risco são sugestivas de CM. Evitar o atraso no diagnóstico de CM é fundamental para melhorar a qualidade de vida dos pacientes. A budesonida MMX foi eficaz, segura e bem tolerada. Contexto (CM sanguinolenta Objetivo Métodos 202 2023 pessoais preexistentes tabagismo correto Corament® Corament (Corament® label Resultados homem 7 anos prescritos B12 B irritável droga Conclusão eficaz tolerada 20 (Corament B1

SUMMARY OBJECTIVE: Patients with rheumatic diseases have an increased risk of infections, especially tuberculosis. In this study, we aimed to recognize the positivity rate of tuberculosis skin test in patients with rheumatoid arthritis and spondyloarthritis and the characteristics of the patients with positive results. METHODS: Retrospective study of tuberculosis skin test results in patients followed from 2004 to 2021 in a single rheumatology unit. Data related to clinical and epidemiological features, along with treatment information referring to the period in which the tuberculosis skin test was performed, were collected from patients’ charts. RESULTS: A total of 723 tests were identified (448 tests in 269 rheumatoid arthritis patients and 275 in 174 spondyloarthritis patients). In the rheumatoid arthritis sample, 31/275 (11.5%) individuals had positive tests, and in the spondyloarthritis, 38/174 (21.8%) had positive tests. In the rheumatoid arthritis sample, patients with positive tuberculosis skin tests used a higher dose of methotrexate than those with negative results (median of 25 mg/week versus median of 20 mg/week respectively; p=0.02). In the spondyloarthritis sample, tuberculosis skin test positivity was associated with alcohol ingestion (13.1% versus 2.9% in users and non-users respectively; p=0.02) and sulfasalazine use (15.7% of positivity in users versus 5% in non-users; p=0.01). CONCLUSION: The tuberculosis skin test-positive prevalence in rheumatoid arthritis was lower than in the spondyloarthritis sample. Patients with rheumatoid arthritis using a higher dosage of methotrexate or with spondyloarthritis using sulfasalazine had more frequency of tuberculosis skin test positivity and should be carefully followed by the attending physician in order to avoid the appearance of full-blown tuberculosis. OBJECTIVE infections METHODS 200 202 unit features performed charts RESULTS 72 448 (44 26 27 17 patients. . patients) sample 31275 31 31/27 11.5% 115 11 5 (11.5% 38174 38 38/17 21.8% 218 21 8 (21.8% 2 mgweek mg week respectively p=0.02. p002 p p=0.02 0 02 13.1% 131 13 1 (13.1 29 9 2.9 nonusers non 15.7% 157 15 7 (15.7 p=0.01. p001 p=0.01 01 p=0.01) CONCLUSION testpositive fullblown full blown 44 (4 3127 3 31/2 11.5 (11.5 3817 38/1 21.8 (21.8 p00 p=0.0 13.1 (13. 2. 15.7 (15. 4 ( 312 31/ 11. (11. 381 38/ 21. (21. p0 p=0. 13. (13 15. (15 (11 (21 p=0 (1 (2 p=

SUMMARY OBJECTIVE: The aim of the study was to compare the epidemiology and clinical profiles of hospital admissions in a single Brazilian Hepatology Unit from the period 2014–2017 to 2019–2022. METHODS: A retrospective analysis of hospital database from the abovementioned periods was done. The study included patients over the age of 18 years who were hospitalized due to complications of diseases such as viral hepatitis, alcoholic disease, nonalcoholic fatty liver disease, and autoimmune liver and drug-induced hepatitis. RESULTS: In both study periods, middle-aged males were predominant and were younger than females. In the first period (2014–2017), hepatitis C (33.5%) was the most prevalent cause of admission, followed by alcoholic liver disease (31.7%). In the second period (2019–2022), nonalcoholic fatty liver disease (38%) and alcoholic liver disease (27.6%) were the most frequent causes of admission. No changes were observed in the proportion of alcoholic liver disease or drug-induced hepatitis in both study periods. The prevalence of viral hepatitis decreased in both genders, with hepatitis C decreasing from 32.4 to 9.7% for males and 35.4 to 10.8% for females, and OR=0.2; 95%CI 0.1–0.3 for both males and females. Similarly, the prevalence of hepatitis B decreased from 19.1 to 8.1% and OR=0.3; 95%CI 0.2–0.5 for males and 8.2 to 3.7% and OR=0.4; 95%CI 0.1–0.9 for females. The prevalence of autoimmune liver diseases increased only in males, from 2.1 to 5.9% and OR=2.9; 95%CI 1.2–6.6. CONCLUSION: Over the past 4 years, there has been a shift in hospital admission profile at a Brazilian Hepatology Unit, with a decrease in viral hepatitis and an increase in autoimmune diseases and nonalcoholic fatty liver disease. Males were more affected at younger ages than females. Furthermore, ascites was the most prevalent cause of complications in both periods analyzed. OBJECTIVE 20142017 2014 2017 2014–201 20192022 2019 2022 2019–2022 METHODS done 1 druginduced drug induced RESULTS middleaged middle aged females 2014–2017, , (2014–2017) 33.5% 335 33 5 (33.5% 31.7%. 317 31.7% . 31 7 (31.7%) 2019–2022, (2019–2022) 38% 38 (38% 27.6% 276 27 6 (27.6% genders 324 32 32. 97 9 9.7 354 35 35. 108 10 8 10.8 OR=0.2 OR02 OR 0 2 95CI CI 95 0103 3 0.1–0. Similarly 191 19 19. 81 8.1 OR=0.3 OR03 0205 0.2–0. 82 8. 37 3.7 OR=0.4 OR04 0109 21 2. 59 5.9 OR=2.9 OR29 1266 1.2–6.6 CONCLUSION Furthermore analyzed 2014201 201 2014–20 2019202 202 2019–202 (2014–2017 33.5 (33.5 31.7 (31.7% (2019–2022 (38 27.6 (27.6 9. 10. OR=0. OR0 010 0.1–0 020 0.2–0 3. 5. OR=2. OR2 126 1.2–6. 201420 20 2014–2 201920 2019–20 (2014–201 33. (33. 31. (31.7 (2019–202 (3 27. (27. OR=0 01 0.1– 02 0.2– OR=2 12 1.2–6 20142 2014– 20192 2019–2 (2014–20 (33 (31. (2019–20 ( (27 OR= 0.1 0.2 1.2– 2019– (2014–2 (31 (2019–2 (2 0. 1.2 (2014– (2019– 1. (2014 (2019 (201 (20

ABSTRACT Background: Low bone mass density (BMD) is an extraintestinal finding in celiac disease (CD). This may result in bone fractures leading to loss in quality of life. Objective: To assess BMD in male CD patients at diagnosis according to the patient’s age. Methods: Descriptive retrospective carried out during the period between 2013 and 2023 in a single office that studied dual-energy X-ray absorptiometry (DXA) results in 28 male patients with a recent diagnosis of CD, divided into three groups: group 1 (age up to 18 years); group 2 (from 19 to 49 years of age) and group 3 (over 50 years of age). Were studied demographic and anthropometric parameters, time delay between symptoms onset and CD diagnosis and fracture occurrence. Results: Celiac patients studied had median age 36.0 years (IQR=16.5-50.7). Among them, 39.3% had osteopenia and 14.3% had osteoporosis. Only 36% of the sample had normal DXA values (group 1 with 37.5%; group 2 with 46% and group 3 with 14.2%). No pathological fracture was observed in this sample. CD diagnosis delay observed had median 1.0 year (IQR=1.0-4.7). When the number of individuals with normal and abnormal DXA results were compared, there was no difference in body mass index, time of diagnosis delay or Marsh classification (P=0.18). Conclusion: Male patients at the time of CD diagnosis showed a high prevalence of low BMD, which was particularly evident in individuals over 50 years of age. Background (BMD CD. . (CD) life Objective patient s Methods 201 202 dualenergy dual energy Xray X ray (DXA groups years) from 4 5 parameters occurrence Results 360 36 0 36. IQR=16.550.7. IQR165507 IQR IQR=16.5 50.7 16 7 (IQR=16.5-50.7) them 393 39 39.3 143 14 14.3 osteoporosis 37.5% 375 37 46 14.2%. 142 14.2% 14.2%) 10 1. IQR=1.04.7. IQR1047 IQR=1.0 4.7 (IQR=1.0-4.7) compared index P=0.18. P018 P P=0.18 (P=0.18) Conclusion (CD 20 550 IQR=16.550.7 IQR16550 IQR165 IQR=16. 507 50. (IQR=16.5-50.7 39. 14. 37.5 14.2 04 IQR=1.04.7 IQR104 IQR10 IQR=1. 47 4. (IQR=1.0-4.7 P01 P=0.1 (P=0.18 55 IQR=16.550. IQR1655 IQR16 IQR=16 (IQR=16.5-50. 37. IQR=1.04. IQR1 IQR=1 (IQR=1.0-4. P0 P=0. (P=0.1 IQR=16.550 (IQR=16.5-50 IQR=1.04 IQR= (IQR=1.0-4 P=0 (P=0. IQR=16.55 (IQR=16.5-5 (IQR=1.0- P= (P=0 (IQR=16.5- (IQR=1.0 (P= (IQR=16.5 (IQR=1. (P (IQR=16. (IQR=1 (IQR=16 (IQR= (IQR

RESUMO Contexto: A baixa densidade de massa óssea (DMO) é um achado extraintestinal na doença celíaca (DC). Isso pode resultar em fraturas ósseas levando à perda de qualidade de vida. Objetivo: Avaliar a DMO em pacientes masculinos com DC no momento do diagnóstico de acordo com a idade do paciente. Métodos: Estudo retrospectivo descritivo realizado no período entre 2013 e 2023 em um único consultório que estudou resultados de “dual-energy X-ray absorptiometry” (DEXA) em 28 pacientes do sexo masculino com diagnóstico recente de DC, divididos em três grupos: grupo 1 (idade até 18 anos); grupo 2 (de 19 a 49 anos) e grupo 3 (acima de 50 anos). Foram estudados parâmetros demográficos e antropométricos, tempo decorrido entre o início dos sintomas e o diagnóstico da DC e ocorrência de fraturas. Resultados: Os pacientes celíacos estudados tinham mediana de idade de 36,0 anos (IIQ=16,5-50,7). Dentre eles, 39,3% apresentavam osteopenia e 14,3% apresentavam osteoporose. Apenas 36% da amostra apresentou valores normais de DEXA (grupo 1 com 37,5%; grupo 2 com 46% e grupo 3 com 14,2%). Nenhuma fratura patológica foi observada nesta amostra. O atraso no diagnóstico da DC observado teve mediana de 1,0 ano (IQR=1,0-4,7). Quando comparado o número de indivíduos com resultados de DEXA normais e alterados, não houve diferença no índice de massa corporal, tempo de atraso no diagnóstico ou classificação de Marsh (P=0,18). Conclusão: Pacientes do sexo masculino no momento do diagnóstico da DC apresentaram alta prevalência de baixa DMO, o que foi particularmente evidente em indivíduos com mais de 50 anos de idade. Contexto (DMO DC. . (DC) vida Objetivo paciente Métodos 201 202 dualenergy dual energy Xray X ray absorptiometry (DEXA grupos 4 acima 5 anos. antropométricos Resultados 360 36 0 36, IIQ=16,550,7. IIQ165507 IIQ IIQ=16,5 50,7 16 7 (IIQ=16,5-50,7) eles 393 39 39,3 143 14 14,3 osteoporose 37,5% 375 37 46 14,2%. 142 14,2% 14,2%) 10 1, IQR=1,04,7. IQR1047 IQR IQR=1,0 4,7 (IQR=1,0-4,7) alterados corporal P=0,18. P018 P P=0,18 (P=0,18) Conclusão (DC 20 550 IIQ=16,550,7 IIQ16550 IIQ165 IIQ=16, 507 50, (IIQ=16,5-50,7 39, 14, 37,5 14,2 04 IQR=1,04,7 IQR104 IQR10 IQR=1, 47 4, (IQR=1,0-4,7 P01 P=0,1 (P=0,18 55 IIQ=16,550, IIQ1655 IIQ16 IIQ=16 (IIQ=16,5-50, 37, IQR=1,04, IQR1 IQR=1 (IQR=1,0-4, P0 P=0, (P=0,1 IIQ=16,550 IIQ1 IIQ=1 (IIQ=16,5-50 IQR=1,04 IQR= (IQR=1,0-4 P=0 (P=0, IIQ=16,55 IIQ= (IIQ=16,5-5 (IQR=1,0- P= (P=0 (IIQ=16,5- (IQR=1,0 (P= (IIQ=16,5 (IQR=1, (P (IIQ=16, (IQR=1 (IIQ=16 (IQR= (IIQ=1 (IQR (IIQ= (IIQ

ABSTRACT BACKGROUND AND OBJECTIVES: The feet may be involved in patients with ankylosing spondylitis (AS), causing pain and walking difficulties. This research aimed to study the involvement of the foot in a sample of Brazilian patients with AS. METHODS: The Brazilian version of the Foot Function Index (FFI-BR) was applied to 103 individuals (57 AS patients and 46 controls). Clinical profiles were obtained in AS patients as well as the measurement of disease activity by the ASDAS (Ankylosing Spondylitis Disease Activity Score)-ESR (erythrocyte sedimentation rate), ASDAS-CRP (C reactive protein) and BASDAI (Bath Ankylosing Spondylitis Disease Activity Index) and function by BASFI (Bath Ankylosing spondylitis functional score). RESULTS: Only 19.2% of AS patients did not have any foot complaints and the FFI-BR score presented worse results than the control group (p = 0.02). The "pain" domain of FFI-BR scored highest in AS patients, followed by "disability". There was no association between the results of the FFI-BR and the clinical profile of patients with AS, but there was an association between the score and the disease activity indexes (r = 0.50, p = 0.003 with ASDAS-ESR; r = 0.44, p = 0.005 with ASDAS-CRP; and r = 0.60, p < 0.0001 with BASDAI). The BASFI also showed a positive correlation (r = 0.72; p < 0.0001). CONCLUSION: Pain and disability are common in AS patients and these symptoms are associated with disease activity. OBJECTIVES , (AS) difficulties METHODS FFIBR FFI BR (FFI-BR 10 57 (5 4 controls. controls . controls) ScoreESR Score ESR erythrocyte rate, rate rate) ASDASCRP CRP C protein Bath score. score) RESULTS 192 19 2 19.2 0.02. 002 0.02 0 02 0.02) "pain disability. "disability" 050 50 0.50 0003 003 0.00 ASDASESR ASDAS-ESR 044 44 0.44 0005 005 060 60 0.60 00001 0001 0.000 BASDAI. BASDAI) 0.72 072 72 0.0001. 0.0001) CONCLUSION (AS 1 5 ( 19. 00 0.0 "disability 05 0.5 000 04 0.4 06 6 0.6 0000 0.7 07 7 0.

RESUMO JUSTIFICATIVA E OBJETIVOS: Os pés podem ser acometidos em pacientes com espondilite anquilosante (EA), causando dor e dificuldade de locomoção. O objetivo deste trabalho foi estudar o envolvimento do pé em uma amostra de pacientes brasileiros com EA. MÉTODOS: A versão brasileira do Foot Function Index (FFI-BR) foi aplicada a 103 indivíduos (57 pacientes com EA e 46 controles). O perfil clínico foi obtido para pacientes com EA, bem como a medição da atividade da doença por meio do ASDAS (Ankylosing Spondylitis Disease Activity Score)-ESR. (velocidade de hemossedimentação), ASDAS-CRP (proteína C reativa) e BASDAI (Bath Ankylosing Spondylitis Disease Activity Index) e função pelo BASFI (Bath Ankylosing Spondylitis Functional Score). RESULTADOS: Apenas 19,2% dos pacientes com EA não apresentaram queixas nos pés e o escore FFI-BR apresentou resultados piores do que os do grupo controle (p = 0,02). O domínio "dor" do FFI-BR apresentou a maior pontuação nos pacientes com EA seguido pelo domínio "disfunção". Não se observou associação dos resultados do FFI-BR com o perfil clínico dos pacientes com EA, mas houve associação do escore com os índices de atividade da doença (r = 0,50, p = 0,003 com ASDAS-ESR; r = 0,44, p = 0,005 com ASDAS-CRP; e r = 0,60, p < 0,0001 com BASDAI). O BASFI também apresentou correlação positiva (r = 0,72; p< 0,0001). CONCLUSÃO: Dor e disfunção são comuns em pacientes com EA e estes sintomas se associam com atividade de doença. OBJETIVOS , (EA) locomoção MÉTODOS FFIBR FFI BR (FFI-BR 10 57 (5 4 controles. controles . controles) ScoreESR. ScoreESR Score ESR. ESR Score)-ESR velocidade hemossedimentação, hemossedimentação hemossedimentação) ASDASCRP CRP proteína reativa Bath Score. Score) RESULTADOS 192 19 2 19,2 0,02. 002 0,02 0 02 0,02) "dor disfunção. "disfunção" 050 50 0,50 0003 003 0,00 ASDASESR ASDAS-ESR 044 44 0,44 0005 005 060 60 0,60 00001 0001 0,000 BASDAI. BASDAI) 0,72 072 72 0,0001. 0,0001) CONCLUSÃO (EA 1 5 ( 19, 00 0,0 "disfunção 05 0,5 000 04 0,4 06 6 0,6 0000 0,7 07 7 0,

ABSTRACT Microscopic colitis is a chronic inflammatory bowel disease characterized by non-bloody diarrhea that can range from mild to severe. It is difficult to attribute up to 10-20% of chronic diarrhea to microscopic colitis. The three determinants factors of the diagnosis are characteristic clinical symptoms, normal endoscopic picture of the colon, and pathognomonic histological picture. This manuscript aimed to update considerations and recommendations for professionals involved (gastroenterologist, endoscopists and pathologist) in the diagnosis of MC. In addition, a short recommendation about treatment. nonbloody non bloody severe 1020% 1020 10 20% 20 10-20 symptoms colon gastroenterologist, gastroenterologist (gastroenterologist pathologist MC addition treatment 102 1 2 10-2 10-

RESUMO A colite microscópica é uma doença intestinal inflamatória crônica caracterizada por diarreia não sanguinolenta que pode variar de leve a grave. Atribui-se que cerca de 10-20% das diarreias crônicas são devidas à colite microscópica. Os três fatores determinantes para o diagnóstico são sintomas clínicos característicos, quadro endoscópico normal do cólon e quadro histológico patognomônico. Este manuscrito tem como objetivo atualizar e trazer recomendações para os profissionais envolvidos (gastroenterologista, endoscopista e patologista) no diagnóstico de colite microscópica. Adicionalmente, uma breve recomendação sobre o tratamento. grave Atribuise Atribui se 1020% 1020 10 20% 20 10-20 característicos patognomônico gastroenterologista, gastroenterologista (gastroenterologista patologista Adicionalmente tratamento 102 1 2 10-2 10-

SUMMARY OBJECTIVE: Inflammatory bowel diseases may have extra intestinal manifestations such as those affecting the skin. This study aimed to study skin manifestations in a cohort of Brazilian patients with inflammatory bowel diseases. METHODS: Epidemiological and clinical data were obtained through a cross-sectional study of 70 inflammatory bowel diseases patients and a control group comprising 50 healthy individuals. All patients were subjected to dermatological examination and photography of skin lesions. RESULTS: Out of the 70 inflammatory bowel diseases patients, 50 had ulcerative colitis and 20 had Crohn’s disease. Skin lesions occurred in 95.7% of the inflammatory bowel diseases patients and in 88% of individuals in the control group (p=0.001). Alopecia (p<0.0001), xerosis (p=0.03), striae (p=0.02), and acne (p=0.04) were more common in inflammatory bowel diseases patients than in the control group. Alopecia was more frequent in females (p=0.01) than in males. Two male patients, one with ulcerative colitis and the other with Crohn’s disease, had pyoderma gangrenosum. Erythema nodosum was not observed in both groups. CONCLUSION: There was a high prevalence of skin lesions in the Brazilian inflammatory bowel diseases patients. Additionally, alopecia, xerosis, striae, and acne were more common in patients with inflammatory bowel diseases than in those in the control group. OBJECTIVE METHODS crosssectional cross sectional 7 5 RESULTS 2 Crohns Crohn s disease 957 95 95.7 88 p=0.001. p0001 p p=0.001 . 0 001 (p=0.001) p<0.0001, p00001 p<0.0001 , 0001 (p<0.0001) p=0.03, p003 p=0.03 03 (p=0.03) p=0.02, p002 p=0.02 02 (p=0.02) p=0.04 p004 04 (p=0.04 p=0.01 p001 01 (p=0.01 males gangrenosum groups CONCLUSION Additionally alopecia 9 95. 8 p000 p=0.00 00 (p=0.001 p0000 p<0.000 000 (p<0.0001 p00 p=0.0 (p=0.03 (p=0.02 (p=0.0 (p=0.00 p<0.00 (p<0.000 p0 p=0. (p=0. p<0.0 (p<0.00 p=0 (p=0 p<0. (p<0.0 p= (p= p<0 (p<0. (p p< (p<0 (p<

ABSTRACT Introduction: Preoperative tests (EPO) aim to detect abnormalities and give greater safety to the procedure. However, the request for these tests is still controversial, either because they do not bring about changes in conduct for the procedure or result in some harm to the patient. The objective is to assess the frequency of EPO requests and abnormalities in aesthetic plastic surgery patients, to verify what these abnormalities are, what preoperative management should be done based on the finding, and to associate the data obtained with the patient’s profile and the planned surgery. Method: Retrospective study evaluating medical records of aesthetic plastic surgery patients who underwent routine EPO in a plastic surgery hospital in 2019. Results: 978 patients were studied, and 51% had some abnormality in EPO. 93.7% were women, with a mean age of 46.5 years. 12.3 exams were performed per patient, and abnormality was observed in 6.1% of EPO. The exams that had the most abnormalities were the lipidogram (23.8%) and the cardiac evaluation (14.1%). Hypothyroidism was the most common comorbidity (18.4% of patients); 70% of diabetics had a glycemic level above the recommended level. Only 3.4% of the patients suffered a change in preoperative management due to EPO abnormality, and in 57.9% of these cases, the surgery was postponed. Test alterations were more frequent in male patients (p<0.0001). Conclusion: The performance of routine EPO showed a low frequency of altered exams (3.4%) and implied changes in the preoperative conduct of plastic surgery patients. Introduction (EPO However controversial patient are finding s Method 2019 Results 97 studied 51 937 93 7 93.7 women 465 46 5 46. years 123 12 3 12. 61 6 1 6.1 23.8% 238 23 8 (23.8% 14.1%. 141 14.1% . 14 (14.1%) 18.4% 184 18 4 (18.4 patients) 70 34 3.4 579 57 9 57.9 cases postponed p<0.0001. p00001 p p<0.0001 0 0001 (p<0.0001) Conclusion (3.4% 201 93. 6. 23.8 2 (23.8 14.1 (14.1% 18.4 (18. 3. 57. p0000 p<0.000 000 (p<0.0001 (3.4 20 23. (23. 14. (14.1 18. (18 p000 p<0.00 00 (p<0.000 (3. (23 (14. (1 p00 p<0.0 (p<0.00 (3 (2 (14 ( p0 p<0. (p<0.0 p<0 (p<0. p< (p<0 (p< (p

RESUMO Introdução: Os exames pré-operatórios (EPO) visam detectar anormalidades e dar maior segurança ao procedimento. No entanto, a solicitação desses exames ainda é controversa, seja por não trazerem mudanças de conduta para o procedimento ou resultar em alguns malefícios para o paciente. O objetivo é avaliar a frequência de solicitações e de anormalidades dos EPO em pacientes de cirurgia plástica estética, verificar quais são estas anormalidades, qual conduta pré-operatória mediante o achado e associar os dados obtidos com o perfil do paciente e cirurgia prevista. Método: Estudo retrospectivo avaliando prontuários de pacientes de cirurgia plástica estética que realizaram EPO de rotina em um hospital de cirurgia plástica durante o ano de 2019. Resultados: Foram estudados 978 pacientes e 51% desses apresentaram alguma anormalidade nos EPO. 93,7% eram mulheres, com média de idade 46,5 anos. Foram realizados 12,3 exames por paciente e observada anormalidade em 6,1% dos EPO. Os exames que mais tiveram anormalidades foram o lipidograma (23,8%) e os da avaliação cardíaca (14,1%). Hipotireoidismo foi a comorbidade mais achada (18,4% dos pacientes); 70% dos diabéticos estavam com o nível glicêmico acima do recomendado. Apenas 3,4% dos pacientes sofreram alteração da conduta pré-operatória devido anormalidade dos EPO e em 57,9% desses casos houve adiamento da cirurgia. Alterações de exames foram mais frequentes em pacientes do sexo masculino (p<0,0001). Conclusão: A realização de EPO de rotina mostrou baixa frequência de exames alterados (3,4%) e implicou em mudanças na conduta pré-operatória em pacientes de cirurgia plástica. Introdução préoperatórios pré operatórios (EPO entanto controversa préoperatória operatória prevista Método 2019 Resultados 97 51 937 93 7 93,7 mulheres 465 46 5 46, anos 123 12 3 12, 61 6 1 6,1 23,8% 238 23 8 (23,8% 14,1%. 141 14,1% . 14 (14,1%) 18,4% 184 18 4 (18,4 pacientes) 70 recomendado 34 3,4 579 57 9 57,9 p<0,0001. p00001 p p<0,0001 0 0001 (p<0,0001) Conclusão (3,4% 201 93, 6, 23,8 2 (23,8 14,1 (14,1% 18,4 (18, 3, 57, p0000 p<0,000 000 (p<0,0001 (3,4 20 23, (23, 14, (14,1 18, (18 p000 p<0,00 00 (p<0,000 (3, (23 (14, (1 p00 p<0,0 (p<0,00 (3 (2 (14 ( p0 p<0, (p<0,0 p<0 (p<0, p< (p<0 (p< (p

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. profile IntimaMedia Intima Media . (cIMT) crosssectional cross sectional 11 individuals 3 8 4 arthritis data Index Disease Arthritis, Arthritis , Arthritis) records ELISA p 0.009 0009 0 009 0.0002 00002 0002 findings found 0.008 0008 008 0.01 001 01 r 0.26 026 26 0.33 033 33 included (cIMT 1 0.00 000 00 0.000 0000 0.0 0.2 02 2 0.3 03 0.

Aim 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. sample center 6 plaque insertion addition collected P 0.84. 084 0.84 . 0 84 0.84) 002 02 0.04 004 04 0.04) 0.01. 001 01 0.01) ns. ns ns) 0.0 respectively. respectively respectively) independent 08 0.8 8 00 0.

Resumo Objetivo: Avaliar os níveis séricos de vitamina D e sua sazonalidade em gestantes do sul do Brasil. Métodos: Estudo observacional transversal analítico realizado em contexto ambulatório pré-natal de dois hospitais públicos universitários. Foram incluídas 520 gestantes, 256 no verão e 264 no inverno de 2016, que foram divididas em dois grupos: um grupo de alto risco, de mulheres com preeclampsia, diabetes gestational ou soropositividade para o vírus da imunodeficiência humana, e um grupo de baixo risco, de mulheres sem doenças gravídicas ou associadas à gravidez. Foram recolhidos dados sociodemográficos, epidemiológicos e clínicos, bem como uma amostra de sangue para dosagem dos níveis séricos de vitamina D. Os níveis de 25-hydroxyvitamina D foram quantificados por quimioluminescência. Resultados: A concentração média de vitamina D na população estudada foi de 22.5 ± 8.70 ng/mL no grupo de alto risco e 56.2 ± 21.75 nmol/L no grupo de baixo risco, sendo significativamente mais elevada no verão (26.7 ± 7.80 ng/mL e 66.7 ± 19.50 nmol/L, respetivamente) do que no inverno (18.3 ± 7.50 ng/mL e 45.7 ± 18.75 nmol/L, respetivamente; p <0.001). A prevalência de hipovitaminose D foi de 69.9% no verão e 91.3% no inverno (p <0.001). Ambos os grupos registaram uma prevalência significativamente mais elevada de hipovitaminose D no inverno do que no verão (grupo de alto risco, 92.4% vs. 71.2%, p <0.001; grupo baixo risco, 87.0% vs. 64.7% p <0.011%). Conclusão: Foi identificada uma elevada prevalência de hipovitaminose D na população estudada, particularmente durante o inverno, alertando para a necessidade de recomendar uma nutrição adequada, através de uma dieta saudável e equilibrada, e adequada exposição solar nos cuidados pré-natais.

Abstract Objective: To evaluate serum vitamin D levels and respective seasonality in pregnant women in southern Brazil. Methods: This was an analytical prospective cross-sectional study set at prenatal outpatient clinics of two public teaching hospitals. A total of 520 pregnant women were included, 256 in the Summer and 264 in the Winter of 2016. Women were divided into a high-risk group of patients with preeclampsia, gestational diabetes mellitus, or human immunodeficiency virus seropositivity, and a low-risk group of disease-free patients. Sociodemographic, epidemiologic, and clinical data were collected, and blood was sampled for assessment of vitamin D levels. Serum 25 hydroxyvitamin D levels were measured by chemiluminescence. Results: The mean serum vitamin D levels were 22.5 ± 8.70 ng/mL in the high-risk group and 56.2 ± 21.75 nmol/L in the low-risk group, with significantly higher levels in Summer (26.7 ± 7.80 ng/mL and 66.7 ± 19.50 nmol/L, respectively) compared with Winter (18.3 ± 7.50 ng/mL and 45.7 ± 18.75 nmol/L, respectively; p <0.001). The prevalence of hypovitaminosis D was 69.9% in Summer and 91.3% in Winter (p <0.001). Both groups had a significantly higher prevalence of hypovitaminosis D in Winter compared to Summer (high-risk group, 92.4% vs. 71.2%, p <0.001; low-risk group, 87.0% vs. 64.7 p <0.011%). Conclusion: A high prevalence of hypovitaminosis D was found in this cohort of pregnant women, particularly during Winter, raising awareness of the need to recommend adequate nutrition through a healthy and balanced diet and adequate sun exposure in prenatal care.

Abstract Background Patients with colorectal cancer may seek the emergency department for symptoms related to chemotherapy and radiotherapy side effects as well as those from the disease itself and from surgery complications. Objectives To establish the epidemiological and clinical profile of colorectal cancer patients that look for consultations in the emergency department. Methods Retrospective study of emergency room charts from colorectal cancer patients that consulted in a single oncological hospital for the period of 1 year. Results Four hundred and forty-six consultations were identified (49.5% males and 50.5% females) with a mean age of 63 years and with advanced disease (most with tumor, node, metastases [TNM] stages III and IV). The most common complaint was abdominal pain (27.5%), followed by nausea (4.7%; more commonly seen in females with p =0.03) and bladder symptoms (4.7%; more commonly seen in males, with p =0.003). Infections (10.3%) and acute abdominal pain (9.1%) were the most frequent diagnoses. About 18% of them were admitted to the hospital and 80% were discharged home. Conclusion The profile of patients with colorectal cancer seeking the emergency department comprises patients with advanced disease and a similar proportion of males and females. Symptom-driven complaints were the most frequent reason for consultations. complications year fortysix forty six 49.5% 495 49 5 (49.5 505 50 50.5 6 tumor node TNM [TNM IV. IV . IV) 27.5%, 275 27.5% , 27 (27.5%) 4.7% 47 4 7 (4.7% =0.03 003 0 03 =0.003. 0003 =0.003 =0.003) 10.3% 103 10 3 (10.3% 9.1% 91 9 (9.1% diagnoses 18 80 home Symptomdriven Symptom driven 49.5 (49. 50. 27.5 2 (27.5% 4.7 (4.7 =0.0 00 000 =0.00 10.3 (10.3 9.1 (9.1 8 49. (49 27. (27.5 4. (4. =0. 10. (10. 9. (9. (4 (27. =0 (10 (9 ( (27 = (1 (2