OBJECTIVES: To retrospectively evaluate the performance and distinctive pattern of latent tuberculosis (TB) infection (LTBI) screening and treatment in patients with ankylosing spondylitis (AS) and psoriatic arthritis (PsA) under anti-tumor necrosis factor (TNF) therapy and determine the relevance of re-exposure and other risk factors for TB development. METHODS: A total of 135 and 83 patients with AS and PsA, respectively, were evaluated for LTBI treatment before receiving anti-TNF drugs via the tuberculin skin test (TST), chest radiography, and TB exposure history assessment. All subjects were evaluated for TB infection at 3-month intervals. RESULTS: The patients with AS were more often treated for LTBI than were those with PsA (42% versus 30%, p=0.043). The former also presented a higher frequency of TST positivity (93% versus 64%, p=0.002), although they had a lower frequency of exposure history (18% versus 52%, p=0.027) and previous TB (0.7% versus 6%, p=0.03). During follow-up [median, 5.8 years; interquartile range (1QR), 2.2-9.0 years], 11/218 (5%) patients developed active TB (AS, n=7; PsA, n=4). TB re-exposure was the main cause in seven patients (64%) after 12 months of therapy (median, 21.9 months; IQR, 14.2-42.8 months) and five LTBI-negative patients. TB was identified within the first year in four patients (36.3%) (median, 5.3 months; IQR, 1.2-8.8 months), two of whom were LTBI-positive. There was no difference in the TB-free survival according to the anti-TNF drug type/class; neither synthetic drug nor prednisone use was related to TB occurrence (p>0.05). CONCLUSION: Known re-exposure is the most critical factor for incident TB cases in spondyloarthritis. There are also some distinct features in AS and PsA LTBI screening, considering the higher frequency of LTBI and TST positivities in patients with AS. Annual risk reassessment taking into consideration these peculiar features and including the TST should be recommended for patients in endemic countries.

RESUMO A ferrugem asiática da soja (FAS), causada pelo fungo Phakopsora pachyrhizi, é uma das doenças mais severas na cultura. Dentre as estratégias para seu manejo propõe-se a utilização de genótipos com resistência horizontal ou parcial, ainda restritos no mercado, mas promissores pela durabilidade da resistência. O objetivo deste trabalho foi avaliar a resistência de diferentes genótipos de soja à ferrugem asiática para futura utilização em programas de melhoramento. Na safra 2015/2016, foram avaliados 11 genótipos de soja provenientes do LAGER-UFU e a cultivar Desafio 8473 (padrão de suscetibilidade) frente à infecção artificial e natural de P. pachyrhizi no campo. Com os dados de severidade da FAS, calculou-se a área abaixo da curva de progresso da doença (AACPD). O percentual de área foliar afetada e os valores da AACPD dos genótipos avaliados oscilaram de 1,56 a 80,75 e de 380,62 a 975,62, respectivamente. Os genótipos L-210, L-166, L-268, L-203, L-279, L-224, L-216 e L-218 apresentam menores valores de AACPD, indicando resistência parcial, enquanto os genótipos L-144, L-104, L-266 e a cv. Desafio 8473 apresentaram maiores valores de AACPD, portanto, com menor resistência parcial ou suscetíveis. Ainda assim, os genótipos L-144, L-104 e L-266 apresentaram coeficientes de progresso da severidade da doença de 1,8 a 2,0 vezes menores comparativamente à cv. Desafio 8473. Conclui-se que os genótipos do Programa de Melhoramento Genético da UFU (LAGER-UFU), apresentam potencial de utilização no desenvolvimento de cultivares de soja resistentes à P. pachyrhizi.

ABSTRACT Asian soybean rust (ASR), caused by the fungus Phakopsora pachyrhizi, is one of the most severe diseases that affect the crop. Among management strategies is the use of genotypes with horizontal or partial resistance, which are still restricted in the market but promising due to their resistance durability. The objective of this study was to evaluate the resistance of different genotypes to Asian soybean rust for future use in breeding programs. In the 2015/2016 crop season, 11 soybean genotypes from LAGER-UFU and cv. Desafio8473 (susceptibility pattern) were evaluated for artificial and natural infection by P. pachyrhizi in the field. ASR severity data were used to calculate the area under the disease progress curve (AUDPC). The percentage of affected leaf area and the AUDPC values of the evaluated genotypes ranged from 1.56 to 80.75% and from 380.62 to 975.62, respectively. The genotypes L-210, L-166, L-268, L-203, L-279, L-224, L-216 and L-218 have lower AUDPC values, indicating partial resistance, while the genotypes L-144, L-104, L-266 and cv. Desafio 8473 showed higher AUDPC values and therefore lower partial resistance or susceptibility. Even so, the genotypes L-144, L-104 and L-266 showed coefficients of disease severity progress 1.8 to 2.0-fold lower than those of cv. Desafio 8473. In conclusion, the genotypes from UFU Breeding Program (LAGER-UFU) showed potential to be used in the development of soybean cultivars resistant to P. pachyrhizi.

RESUMOAs recomendações propostas pela Comissão de Síndrome de Sjögren da Sociedade Brasileira de Reumatologia para tratamento da síndrome de Sjögren foram baseadas em uma revisão sistemática da literatura nas bases de dados Medline (PubMed) e Cochrane até outubro de 2014 e opinião de especialistas na ausência de artigos sobre o assunto. Foram incluídos 131 artigos classificados de acordo com Oxford & Grade. Essas recomendações foram elaboradas com o objetivo de orientar o manejo adequado e facilitar o acesso aos tratamentos para aqueles pacientes com adequada indicação de recebê-los, considerando o contexto socioeconômico brasileiro e os medicamentos disponíveis no país.

ABSTRACTThe recommendations proposed by the Sjögren's Syndrome Committee of the Brazilian Society of Rheumatology for the treatment of Sjögren's syndrome were based on a systematic review of literature in Medline (PubMed) and the Cochrane databases until October 2014 and on expert opinion in the absence of studies on the subject. 131 articles classified according to Oxford & Grade were included. These recommendations were developed in order to guide the management and facilitate the access to treatment for those patients with an appropriate indication, considering the Brazilian socioeconomic context and pharmacological agents available in this country.