Abstract: Introduction: Rheumatoid arthritis (RA) is a chronic inflammatory, autoimmune disease, characterized by chronic, additive, symmetrical polyarthritis, which can present with extra-articular manifestations (ExAM), associated with greater morbidity and mortality. Objective: to describe the most frequent ExAM in RA. Methods: a descriptive, cross-sectional and retrospective study was carried out to review the medical records of patients diagnosed with RA, during the period December 2011-January 2022. Results: 150 patients with RA participated, with an average age of 53.7±12.5 years, the predominant sex was female with 84.6%, the evolution time of RA was 7.2±8.9. years; Regarding serological characteristics, 91.1% had positive Rheumatoid Factor and 76.9% had positive antibodies against cyclic citrullinated peptides. Both upon admission and at the last consultation, patients presented some extra-articular manifestation (ExAM), 61.3% and 70%, respectively, with the most frequent being chronic anemia (at admission 44.6% and at last consultation 50.6%), followed by rheumatoid nodules (at admission with 8% and at the last consultation 9.3%). Conclusions: ExAM occurred in 70% of patients, the most frequent being anemia and rheumatoid nodules. These data show the changes in the frequency of ExAM in the disease over time.

Resumen: Introducción : La artritis reumatoide (AR) es una enfermedad inflamatoria crónica, autoinmune, caracterizada por poliartritis crónica, aditiva, simétrica, que puede cursar con manifestaciones extraarticulares (MExA) asociadas a una mayor morbimortalidad. Objetivo: de describir las MExA más frecuentes en AR. Métodos: se realizó un estudio descriptivo, transversal y retrospectivo de revisión de historias clínicas de pacientes diagnosticados con AR, durante el periodo diciembre 2011-enero 2022. Resultados: Participaron 150 pacientes con AR, con una edad promedio de 53,7±12,5 años, el sexo predominante fue el femenino con 84,6%, el tiempo de evolución de la AR fue de 7,2±8,9 años; en cuanto a las características serológicas, 91,1% tenía Factor reumatoideo positivo y 76,9% tenía anticuerpos contra péptidos cíclicos citrulinados positivo. Tanto al ingreso, como en la última consulta los pacientes presentaron alguna manifestación extraarticular (MExA), 61,3% y 70%, respectivamente, siendo las más frecuentes la anemia de los trastornos crónicos (al ingreso 44,6% y en última consulta 50,6%), seguida de nódulos reumatoideos (al ingreso con 8% y en la última consulta 9,3%). Conclusiones: Las MExA se presentaron en 70% de los pacientes, siendo las más frecuentes la anemia y los nódulos reumatoideos. Estos datos muestras los cambios que han tenido la frecuencia de estas MExA en esta enfermedad a través del tiempo.

Introduction: Rheumatoid arthritis (RA) is treated with conventional and biological disease-modifying drugs (DMARDs). Objectives: To compare the survival of biological drugs used for the treatment of RA patients. Methods: Retrospective study of medical records of patients who used biological medication for the treatment of RA 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. BMI (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, BMI, age and gender) it was not possible to identify a variable that was associated with failure.

Introdução: A artrite reumatoide (AR) é tratada com drogas modificadoras da doença (DMARDs) convencionais e biológicas. Objetivos: Comparar a sobrevida de medicamentos biológicos utilizados para o tratamento de pacientes com AR. Método: Estudo retrospectivo de prontuários de pacientes que utilizaram medicamento biológico para tratamento de AR 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. IMC (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, IMC, idade e sexo) não foi possível identificar variável que se associasse com falha.

ABSTRACT Background: Omalizumab (OMA) is approved for antihistamine resistant chronic spontaneous urticaria (CSU). The possibility of self-administration (SA), is particularly convenient in current pandemic scenario, avoiding commutements to the hospital. Objectives: CSU control, SA safety, satisfaction, and cost reduction for patients under OMA SA therapy, during a period ≥ 12 weeks and after 2 training sessions in Outpatient Hospital Care (OHC) were evaluated between January and June 2021. Methods: A questionnaire (30 questions) was applied for the characterization of clinical/demographic data, therapy, adverse reactions (AR) and advantages/concerns related to OMA SA. Clinical evaluation of CSU was performed in T0 (last administration in OHC) and T1 (at12 weeks on SA), by urticaria activity score in the last 7 days (UAS7), urticaria control test (UCT) and dermatology life quality index (DLQI). Results: Twenty-five patients with a mean CSU duration of 7.4 ±3.9 years and under OMA for 3.2 ±1.9 years were included. At the time of the questionnaire, 52% had already 3 SA of OMA 300mg, with variable periodicity between 4/4 week (44%) and 8/8 week (12%); 40% without antihistamine H1 (anti-H1) therapy associated. In 88% OMA was SA by patient himself. 64% perceived equal pain intensity with SA than in OHC administration. No serious AR were reported. Regarding the control of CSU, there were no statistically significant differences between scores in T0 and T1. SA was considered advantageous by all patients, being valued the reduction of time/costs. About 48% reported some concerns with SA, especially in OMA manipulation. The majority (76%) considered a simple and practical procedure, valuing initial training sessions in OHC. For 52% there was no need for further improvement, while the simplification of the OMA delivery process was proposed by 28% of patients. Conclusions: OMA SA had a positive impact on satisfaction in patients with CSU, keeping up the good control and therapeutic safety.

RESUMO Fundamentos: O omalizumab (OMA) está aprovado para a urticária crónica espontânea (UCE) refratária aos anti-histamínicos. A possibilidade de autoadministração (AA) de OMA evita deslocações ao hospital, particularmente relevante em tempo de pandemia. Objetivos: Avaliaram-se o controlo da UCE, segurança da AA de OMA, grau de satisfação e redução dos custos para os doentes sob OMA em AA por período igual ou superior a 12 semanas e após duas sessões de ensino em Hospital de Dia (HD), entre janeiro e junho de 2021. Métodos: Aplicou-se um questionário(30 perguntas) visando a caracterização clínica/demográfica, terapêutica, reações adversas (RA), vantagens/preocupações percecionadas e avaliação de UCE em T0 (última administração em HD) e T1 (12 semanas em AA), por score de atividade da urticária nos últimos sete dias (UAS7), teste de controlo da urticária (UCT) e índice de qualidade de vida em dermatologia (DLQI). Resultados: Incluíram-se 25 doentes com tempo médio de UCE de 7,4 ±3,9 anos e duração do tratamento com OMA de 3,2 ±1,9 anos. À data do questionário, 52% tinham 3 AA de OMA 300mg, com periodicidade variável entre 4/4 semanas (44%) e 8/8 semanas (12%); 40% sem anti-histamínico associado. Em 88% administrado pelo próprio; 64% relatou igual intensidade de dor na AA face à administração em HD. Não se registaram RA graves. No controlo da UCE não se verificaram diferenças estatisticamente significativas nos scores entre T0 e T1. Todos consideraram a AA vantajosa, valorizando sobretudo a diminuição do tempo/custos despendidos. 48% referiu algum receio na AA, sobretudo na manipulação do OMA. A maioria (76%) considerou o processo simples e prático, valorizando os ensinos prévios em HD; 52% considerou não haver aspetos a melhorar; das sugestões apontadas, 28% referiam-se à simplificação do processo de entrega do OMA. Conclusões: O OMA em AA apresentou impacto positivo na satisfação dos doentes com UCE, mantendo-se o controlo da UCE e segurança terapêutica.

ABSTRACT OBJECTIVE This work aims to analyze the quantity and expenses related to biological drugs used for the treatment of rheumatoid arthritis (RA) in outpatient public care within the Brazilian Unified Health System (SUS). METHODS It is a cross-sectional descriptive study based on secondary data from a historical series, referring to the purchase, volume, and the number of patients treated with different biological drugs (infliximabe, etanercept, adalimumab, rituximab, abatacept, tocilizumab, golimumab, and certolizumab pegol) for RA treatment in outpatient care from 2012 to 2017. The data were extracted from the SUS Outpatient Information System database-SIA/SUS and included ten drugs used for RA treatment. The study assessed the quantity and expenditure of these drugs, the number of RA patients treated, and the expenditure by RA subtypes. The National Broad Consumer Price Index was used to adjust the expenditures for December 2017. RESULTS The Ministry of Health allocated approximately $500 million to provide about 2 million units of biological drugs for RA patients from 2012 to 2017. The supply of adalimumab 40 mg and etanercept 50 mg accounted for 68.3% of the total expenditure. The subtypes “other rheumatoid arthritis with rheumatoid factor” (ICD-10 M05.8), “rheumatoid arthritis without rheumatoid factor” (ICD-10 M06.0), and “Felty’s syndrome” (M05. 0) represented 84.5% of the total expenditures. The proportion of patients treated with biological drugs increased by 33.0%. There was a significant 83.0% increase in the number of patients using biological drugs compared to the overall number of RA patients treated during the study period. CONCLUSIONS The results obtained allow us to draw a more recent profile of expenditure on RA treatment and indicate trends in the use of biological drugs for this condition, generating data that can support management decisions in public health policies.

ABSTRACT Introduction: Left internal thoracic artery to left anterior descending artery (LITA-LADA) grafting has become a fundamental part of coronary artery bypass grafting (CABG). This grafting has led to an increased use of other arterial conduits, of which the radial artery (RA) is the most popular. Whether RA can have the same long-term patency as LITA is controversial. The objective of this study is to access the long-term clinical follow-up and, when available, the patency rate of RA grafts. Methods: Twenty-six patients from a previous study with critical stenosis in all target vessels underwent complete arterial CABG with LITA and RA grafts from 1996 to 2003. They all underwent midterm multidetector computed tomography after surgery with the association of at least one patent LITA and one patent RA graft. Results: Twelve patients (46%) are alive with no angina symptoms. Six patients underwent a second image exam 12 to 16 years (average of 14 years) after surgery, with a total of six LITA-LADA and 14 RA grafts with 100% patency rate. Clinical follow-up five to 23 years after surgery (average of 14 years) showed only one death 12 years after surgery related to coronary artery disease (CAD) (3,8%). Another 12 patients died of non-CAD. Conclusion: Patients with midterm associated LITA and RA patent grafts show similar optimal long-term patency rates of both types of grafts with excellent clinical outcome.

ABSTRACT Introduction: Left internal thoracic artery to left anterior descending artery (LITA-LADA) grafting has become a fundamental part of coronary artery bypass grafting (CABG). This grafting has led to an increased use of other arterial conduits, of which the radial artery (RA) is the most popular. Whether RA can have the same long-term patency as LITA is controversial. The objective of this study is to access the long-term clinical follow-up and, when available, the patency rate of RA grafts. Methods: Twenty-six patients from a previous study with critical stenosis in all target vessels underwent complete arterial CABG with LITA and RA grafts from 1996 to 2003. They all underwent midterm multidetector computed tomography after surgery with the association of at least one patent LITA and one patent RA graft. Results: Twelve patients (46%) are alive with no angina symptoms. Six patients underwent a second image exam 12 to 16 years (average of 14 years) after surgery, with a total of six LITA-LADA and 14 RA grafts with 100% patency rate. Clinical follow-up five to 23 years after surgery (average of 14 years) showed only one death 12 years after surgery related to coronary artery disease (CAD) (3,8%). Another 12 patients died of non-CAD. Conclusion: Patients with midterm associated LITA and RA patent grafts show similar optimal long-term patency rates of both types of grafts with excellent clinical outcome.

ABSTRACT Positron emission tomography (PET) is a non-invasive nuclear imaging technique that uses radiotracers to track cell activity. The radiopharmaceutical 18F-fluoro-2-deoxyglucose ([18F] FDG) is most commonly used in nuclear medicine for the diagnosis of various diseases, including stroke. A stroke is a serious condition with high mortality and morbidity rates. Rosmarinic acid (RA) is a promising therapeutic agent that exerts neuroprotective effects against various neurological diseases. Therefore, this study aimed to evaluate the applicability of [18F]FDG/PET for investigating the neuroprotective effects of RA in case of a global stroke model in mice. The [18F]FDG/PET technique facilitates the observation of ischemia and reperfusion injuries in the brain. Moreover, the recovery of glucose metabolism in three specific brain regions, the striatum, superior colliculus, and inferior colliculus, was observed after preconditioning with RA. It was concluded that the [18F]FDG/PET technique may be useful for stroke diagnosis and the assessment of treatment response. In addition, a long-term longitudinal study using biochemical analysis in conjunction with functional imaging may provide further conclusive results regarding the effect of RA on cerebral ischemia.

ABSTRACT Cenostigma pyramidale [Tul.] has timber, forage and medicinal uses, and due to the exploitation of its natural resources, it may become endangered. This work aimed to induce callus in Cenostigma pyramidale and to identify the embryogenic potential by histomorphological and biochemical analysis. Leaf segments were inoculated in MS culture medium containing different concentrations (0.0; 2.5; 5.0 and 10.0 μM) of 2,4-dichlorophenoxyacetic acid (2,4-D), combined with 6-benzylaminopurine (BAP; 0.0; 2.5 and 5.0 μM) and glutamine (0.0; 0.342 and 0.684 mM). The growth curve was performed at 7-day intervals until day 77, and samples were collected for histomorphological analysis and determination of reducing sugars (RA), sucrose, and total soluble sugars (TSS) content. Callus induction is possible using leaf segments in treatment with 5.0 μM of BAP, 7.0 µM of 2.4-D and 0.684 mM of glutamine. The growth curve shows sigmoidal behavior with five distinct phases: lag, exponential, linear, deceleration and decline. It was verified the presence of cells with meristematic characteristics from the 7th day of induction, suggesting that the calli have embryogenic potential. However, differentiation of somatic embryos was not observed. There was a reduction in RA content and increase in AST and sucrose during the lag phase and beginning of the exponential phase, followed by degradation in the exponential phase until the decline phase, showing the involvement of these carbohydrates with callus growth. These results are unprecedented for the species and suggest future studies related to callus maturation aiming the differentiation of somatic embryos.

RESUMO Cenostigma pyramidale [Tul.] possui utilização madeireira, forrageira e medicinal e, em virtude da exploração de seus recursos naturais, pode acabar em via de extinção. Este trabalho objetivou induzir calos em Cenostigma pyramidale e identificar o potencial embriogênico por análises histomorfológica e bioquímica. Segmentos foliolares foram inoculados em meio de cultura MS contendo diferentes concentrações (0,0; 2,5; 5,0 e 10,0 μM) de ácido 2,4-diclorofenoxiacético (2,4-D), combinadas com 6-benzilaminopurina (BAP; 0,0; 2,5 e 5,0 μM) e glutamina (0,0; 0,342 e 0,684 mM). A curva de crescimento foi realizada em intervalos de 7 dias, até o 77º dia, sendo coletadas amostras para análise histomorfológica e determinação do conteúdo de açúcares redutores (AR), sacarose e açúcares solúveis totais (AST). É possível a indução de calos utilizando segmentos foliolares no tratamento com 5,0 μM de BAP, 7,0 µM de 2,4-D e 0,684 mM de glutamina. A curva de crescimento apresenta comportamento sigmoidal com cinco fases distintas: lag, exponencial, linear, desaceleração e declínio. Verificou-se a presença de células com características meristemáticas a partir do 7º dia de indução, sugerindo que os calos possuem potencial embriogênico. Porém, não se observou a diferenciação de embriões somáticos. Verificaram-se redução no conteúdo de AR e aumento de AST e sacarose durante a fase lag e início da fase exponencial, seguido de degradação na fase exponencial até a fase de declínio, mostrando o envolvimento destes carboidratos com o crescimento dos calos. Esses resultados são inéditos para a espécie e sugerem estudos futuros relacionados à maturação dos calos visando a diferenciação de embriões somáticos.

ABSTRACT In this paper, we aimed to identify possibilities and difficulties related to teleservice in physical exercise for children with Autism Spectrum Disorder (ASD) attended by a specialized service in Maceió, Brazil. The AB design was used, and, at baseline, instruments for characterizing the ASD-related symptom profiles of the participants and sociodemographic aspects of both the participants and their family mediators were applied. The intervention phase, which consisted of a teleservice in physical exercise via WhatsApp and a phone call for those who had smartphones and only via phone call for those who did not, was extended from April 2020 to December 2021 and counted on ten male children (6.8 ± 2.1 years old) and their family mediators. During the intervention, analyses of the audiovisual records of the family mediators were conducted regarding the possibilities and difficulties of the application of the intervention. Although there were technological and social difficulties, it was concluded that teleservice was an important strategy to continue the practice of physical activity in the home environment and was associated with an improvement in the relationship between family mediators and individuals with ASD.

RESUMO Neste artigo, objetivou-se identificar possibilidades e dificuldades relacionadas ao teleatendimento em exercício físico para crianças com Transtorno do Espectro Autista (TEA) atendidas por um serviço especializado de Maceió. Utilizou-se o delineamento AB; e, na linha de base, foram aplicados instrumentos de caracterização dos perfis de sintomas relacionados ao TEA dos participantes e de aspectos sociodemográficos, tanto dos participantes quanto de seus mediadores familiares. A fase de intervenção, que consistiu em um teleatendimento em exercício físico via WhatsApp e chamada telefônica para aqueles que tinham smartphones e somente via chamada telefônica para quem não tinha, estendeu-se de abril de 2020 a dezembro de 2021 e contou com dez crianças (6,8 ± 2,1 anos) do sexo masculino e seus mediadores familiares. Ao longo da intervenção, realizaram-se análises dos registros audiovisuais dos mediadores familiares acerca das possibilidades e das dificuldades relacionadas à aplicação da intervenção. Concluiu-se que, ainda que tenha havido dificuldades tecnológicas e sociais, o teleatendimento foi uma importante estratégia para dar continuidade à prática de atividade física no ambiente doméstico e esteve associado à melhoria na relação dos mediadores familiares com os indivíduos com TEA.

ABSTRACT OBJECTIVE This work aims to analyze the quantity and expenses related to biological drugs used for the treatment of rheumatoid arthritis (RA) in outpatient public care within the Brazilian Unified Health System (SUS). METHODS It is a cross-sectional descriptive study based on secondary data from a historical series, referring to the purchase, volume, and the number of patients treated with different biological drugs (infliximabe, etanercept, adalimumab, rituximab, abatacept, tocilizumab, golimumab, and certolizumab pegol) for RA treatment in outpatient care from 2012 to 2017. The data were extracted from the SUS Outpatient Information System database-SIA/SUS and included ten drugs used for RA treatment. The study assessed the quantity and expenditure of these drugs, the number of RA patients treated, and the expenditure by RA subtypes. The National Broad Consumer Price Index was used to adjust the expenditures for December 2017. RESULTS The Ministry of Health allocated approximately $500 million to provide about 2 million units of biological drugs for RA patients from 2012 to 2017. The supply of adalimumab 40 mg and etanercept 50 mg accounted for 68.3% of the total expenditure. The subtypes “other rheumatoid arthritis with rheumatoid factor” (ICD-10 M05.8), “rheumatoid arthritis without rheumatoid factor” (ICD-10 M06.0), and “Felty’s syndrome” (M05. 0) represented 84.5% of the total expenditures. The proportion of patients treated with biological drugs increased by 33.0%. There was a significant 83.0% increase in the number of patients using biological drugs compared to the overall number of RA patients treated during the study period. CONCLUSIONS The results obtained allow us to draw a more recent profile of expenditure on RA treatment and indicate trends in the use of biological drugs for this condition, generating data that can support management decisions in public health policies.

RESUMO A consolidação da produção de conhecimento em Educação Especial no Brasil é marcada pela trajetória de professores pioneiros que puderam vivenciar formações internacionais e trazer para o país inovações da atuação junto aos estudantes com deficiência, além da expertise em delineamentos de pesquisa para essa produção. Assim sendo, este texto traz uma entrevista com a Professora Maria Amélia Almeida, da Universidade Federal de São Carlos, com a narrativa das oportunidades de formação em pesquisa vivenciadas e o seu interesse na área da Deficiência Intelectual. A Professora Maria Amélia Almeida destaca o processo de tradução e de validação, para o Brasil, da Escala de Intensidade de Suporte sob o qual ela tem se debruçado em seu grupo de pesquisa ao longo dos últimos anos e reconhece o importante papel da Revista Brasileira de Educação Especial para a área no Brasil. deficiência sendo Carlos Intelectual validação

ABSTRACT The consolidation of the production of knowledge in Special Education in Brazil is marked by the trajectory of pioneer teachers who were able to experience international training and bring to the country innovations of the performance with students with disabilities, in addition to the expertise in research projects for this production. Thus, this text brings an interview with Professor Maria Amélia Almeida, from the Federal University of São Carlos, with the narrative of the research training opportunities experienced and her interest in Intellectual Disability. Professor Maria Amélia Almeida highlights the process of translation and validation for Brazil of the Support Intensity Scale under which she has focused on her research group over the last few years and recognizes the important role of the Brazilian Journal of Special Education for the area in Brazil. disabilities Thus Carlos Disability

Resumo: O objetivo do artigo é investigar o uso da Realidade Aumentada quanto à sua executabilidade e viabilidade, de forma integrada ao livro didático, a partir de um jogo educativo digital. Para se alcançar os objetivos propostos, foi realizada uma pesquisa do tipo Estudo de Caso em que a coleta de dados se deu por meio da realização de Grupos Focais. A partir da Análise Textual Discursiva, foram discutidas as categorias exequibilidade e viabilidade do jogo de RA em contexto pedagógico. Identificamos que a proposta é exequível, tanto no desenvolvimento e na implementação prática do jogo, quanto nas possibilidades da RA ao ensino. No que se refere à viabilidade, observamos que a RA é uma tecnologia digital possível de ser inclusa enquanto Objetos Educacionais Digitais (OED) nos livros didáticos. Entretanto, os cenários sociais/econômicos de desigualdades e as políticas educacionais no Brasil à formação docente, põem em xeque essa proposta. Resumo didático propostos Focais Discursiva pedagógico exequível ensino OED (OED didáticos Entretanto sociaiseconômicos sociais econômicos docente

Abstract: The objective in this article is to investigate the use of Augmented Reality as to its feasibility and viability in terms of integration with the textbook, based on a digital educational game. In order to reach the proposed objective, a case study was carried out in which data were collected through focus groups. Based on textual discourse analysis, the categories feasibility and viability of the AR game in a pedagogical context were discussed. We identified that the proposal is feasible, both in the development and practical implementation of the game, and for the affordances of AR in teaching. Regarding feasibility, we observed that AR is a digital technology that can be included as Digital Educational Objects (OED) in textbooks. However, the social/economic scenarios of inequalities, and the educational policies in Brazil regarding teacher training, pose challenges to this proposal. Abstract textbook groups analysis discussed feasible teaching OED (OED textbooks However socialeconomic social economic inequalities training

Abstract Introduction In chronic arthropathies, there are several mechanisms of joint destruction. In recent years, studies have reported the implication of receptor activator of nuclear factor kappa-B ligand (RANKL) and osteoprotegerin (OPG) in the process of activation and differentiation of osteoclasts, a key cell in the development of bone erosion. The RANKL/OPG ratio is increased in the serum of patients with malignant diseases and lytic bone disease, as well as rheumatoid arthritis (RA). The objective of this study was to measure and compare the concentrations of OPG and RANKL in the synovial fluid (SF) of patients with rheumatoid arthritis, spondyloarthritis (SpA) and osteoarthritis (OA). Methods This was an observational and cross-sectional study with 83 patients, 33 with RA, 32 with SpA and 18 with OA, followed up regularly in the outpatient clinics of the Rheumatology Department of the Clinics Hospital of the Ribeirão Preto Medical School-USP. All patients were assessed for indications for arthrocentesis by the attending physicians at the time of SF collection and were evaluated for demographic variables and medication use. Disease activity was assessed in individuals with RA and SpA. The quantification of SF OPG and RANKL levels was performed by ELISA, and the correlations of the results with clinical, laboratory and radiological parameters were assessed. Results We found no statistically significant difference in the RANKL and OPG levels among the groups. Patients with RA showed a positive correlation between the SF cell count and RANKL level (r = 0.59; p < 0.05) and the RANKL/ OPG ratio (r = 0.55; p < 0.05). Patients with OA showed a strong correlation between C-reactive protein (CRP) and the RANKL/OPG ratio (r = 0.82; p < 0.05). There was no correlation between the OPG and RANKL levels and markers of inflammatory activity or the disease activity index in patients with RA or SpA. Conclusion Within this patient cohort, the RANKL/OPG ratio was correlated with the SF cell count in patients with RA and with serum CRP in patients with OA, which may suggest a relationship with active inflammation and more destructive joint disease.

Abstract Introduction Although Rheumatoid Arthritis (RA) extra-articular manifestations (ExtRA) occurrence has been decreasing over time, they are still a major mortality risk factor for patients. Objective To determine the prevalence of ExtRA in a large cohort, and its association with demographic and clinical variables. Method Cross-sectional and observational study, based on a multi-centric database from a prospective cohort, in which 11 public rheumatology centres enrolled RA patients (1987 ARA or 2010 ACR-EULAR). Data collection began in 08-2015, using a single online electronic medical record. Continuous variables were compared using Mann–Whit-ney U-test, and Fisher's exact test or chi-square test, as appropriate, were used for categorical variables. The level of significance was set at 5% (p < 0.05). Results 1115 patients were included: 89% women, age [mean ± SD] 58.2 ± 11.5 years, disease duration 14.5 ± 12.2 years, positive Rheumatoid Factor (RF, n = 1108) in 77%, positive anti-cyclic citrullinated peptide (ACPA, n = 477) in 78%. Regarding ExtRA, 334 occurrences were registered in 261 patients, resulting in an overall prevalence of 23.4% in the cohort. The comparison among ExtRA and Non-ExtRA groups shows significant higher age (p < 0.001), disease duration (p < 0.001), RF high titers (p = 0.018), Clinical Disease Activity index (CDAI) (p < 0.001), Disease Activity Index 28 (DAS 28) (p < 0.001), and Health Assessment Questionnaire (HAQ) (p < 0.001) in ExtRA group. Treatment with Azathioprine (p = 0.002), Etanercept (p = 0.049) Glucocorticoids (GC) (‘p = 0.002), and non-steroidal anti-inflammatory drugs (NSAIDs) (p < 0.001) were more frequent in ExtRA group. Conclusions ExtRA manifestations still show an expressive occurrence that should not be underestimated. Our findings reinforce that long-term seropositive disease, associated with significant disability and persistent inflammatory activity are the key factors related to ExtRA development.

Abstract This study evaluated the efficacy of incorporating different concentrations of bioactive glass-ceramic (Biosilicate) into coconut oil on the remineralizing potential and surface roughness of white spot lesions. Fragments (6 x 6 x 2mm) of bovine teeth were sectioned and initial microhardness (KHN) and surface roughness (Ra) readings were obtained. The samples were submitted to cariogenic challenge to form white spot lesions and were separated into six groups (n=13): 1) Artificial Saliva (AS); 2) Coconut Oil (CO); 3) CO+2% Biosilicate (CO+2%Bio); 4) CO+5% Biosilicate (CO+5%Bio); 5) 2% Biosilicate Suspension (2% Bio) and 6) 5% Biosilicate Suspension (5% Bio). The treatments for 1 cycle/day were: immersion into the treatments for 5 minutes, rinsing in distilled water, and storage in artificial saliva at 37ºC. After 14 days, KHN and Ra readings were taken. The surface roughness alteration ((Ra) was analyzed (Kruskal-Wallis, Dunn’s post-test, p<0.05). CO+2%Bio had higher (p = 0.0013) (Ra followed by CO+5%Bio (p = 0.0244) than AS. The relative KHN and remineralization potential were analyzed (ANOVA, Tukey, p<0.05), and 5% Bio treatment presented a higher relative microhardness than all other groups (p>0.05). The remineralizing potential of all the treatments was similar (p > .05). When Biosilicate was added, the pH of the suspensions increased and the alkaline pH remained during the analysis. Biosilicate suspension is more efficient than the incorporation of particles into coconut oil at white spot lesion treatment. In addition to the benefits that coconut oil and Biosilicate present separately, their association can enhance the remineralizing potential of Biosilicate.

Resumo Este estudo avaliou a eficácia da incorporação de diferentes concentrações de vitrocerâmica bioativa (biosilicato) ao óleo de coco no potencial remineralizante e na rugosidade superficial de lesões de manchas brancas. Fragmentos (6 x 6 x 2mm) de dentes bovinos foram seccionados e as leituras iniciais de microdureza (KHN) e rugosidade superficial (Ra) foram obtidas. As amostras foram submetidas ao desafio cariogênico para formação de lesões de manchas brancas e foram separadas em seis grupos (n=13): 1) Saliva Artificial (AS); 2) Óleo de Coco (CO); 3) CO+2% Biosilicato (CO+2%Bio); 4) CO+5% Biosilicato (CO+5%Bio); 5) Suspensão de Biosilicato 2% (2% Bio) e 6) Suspensão de Biosilicato 5% (5% Bio). Os tratamentos de 1 ciclo/dia foram: imersão nos tratamentos por 5 minutos, enxágue em água destilada e armazenamento em saliva artificial a 37ºC. Após 14 dias, foram feitas as leituras de KHN e Ra. A alteração da rugosidade superficial ((Ra) foi analisada (Kruskal-Wallis, pós-teste de Dunn, p<0,05). CO+2%Bio apresentou maior (p = 0,0013) (Ra seguido de CO+5%Bio (p = 0,0244) do que AS. O KHN relativo e o potencial de remineralização foram analisados (ANOVA, Tukey, p<0,05), e o tratamento 5% Bio apresentou uma microdureza relativa maior do que todos os outros grupos (p>0,05). A suspensão de biosilicato é mais eficiente que a incorporação de partículas ao óleo de coco no tratamento de lesões de mancha branca. Além dos benefícios que o óleo de coco e o Biosilicato apresentam separadamente, sua associação pode amplificar o potencial remineralizante do Biosilicato.