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OBJETIVO: Verificar a utilização de monofilamento de 10 g no diagnóstico de neuropatia diabética (NPD) em idosos comparando-o a escores de rastreio de dois instrumentos validados. MÉTODOS: Estudo transversal descritivo, com amostra de conveniência, no qual foram avaliados 50 pacientes com NPD diagnosticada por meio dos instrumentos escore de sintomas neuropáticos (ESN) e escore de comprometimentos neuropáticos (ECN) e sensação protetora plantar através do monofilamento de Semmes-Weinstein de 10 g (laranja). RESULTADOS: 50 idosos foram diagnosticados com NPD pelos instrumentos ESN e ECN e, quando comparados quanto à presença ou ausência do monofilamento de 10 g, não se observou correlação estatística significativa através do teste de Kruskal-Wallis, inclusive, em muitos pacientes o monofilamento estava preservado. CONCLUSÃO: O monofilamento de 10 g isolado não foi capaz de indicar o diagnóstico de neuropatia diabética. Idosos com neuropatia diabética podem apresentar sensação plantar preservada.

The previously underestimated biodiversity of the Caatinga underwent a transformation with the emergence of new studies, intensifying interest in the biota of this complex dry forest. Studies on snakes from the Caatinga have increased recently, resulting in 112 recorded species. Contributing to this, we present a detailed list of 23 species rescued from the Itaparica reservoir implementation in the 1980s. Collected specimens are deposited in the Herpetological and Paleoherpetological Collection at the Universidade Federal Rural de Pernambuco. The recorded snake assemblage is typical of the dry Caatingas of the Sertaneja Depression. We discuss the impacts of flooding and specimen relocation without adequate planning or monitoring on snake diversity. Finally, we conclude by questioning the sustainability aspects of development and interventions in nature.

Técnicas de inteligência artificial vêm sendo utilizadas no auxílio ao diagnóstico de patologias. Com elas, torna-se possível analisar automaticamente uma grande quantidade de dados complexos. Dessa forma, patologias podem ser detectadas em estágios menos avançados. Neste artigo, apresenta-se uma plataforma computacional de código aberto que analisa sinais obtidos por meio de exames de eletrocardiograma. Para isso, foram utilizadas bases de dados públicas que possibilitaram analisar e classificar as informações, considerando diversos métodos de inteligência artificial. Os resultados obtidos demonstram a viabilidade da plataforma para estudos e desenvolvimento de ferramentas computacionais para auxílio no diagnóstico precoce de patologias cardíacas.

Abstract Amyloidosis is a localized or systemic disease caused by deposition of proteins in the extracellular space of various organs and tissues. As part of the disease, proteins that were originally soluble misfold and acquire a fibrillar conformation that renders them insoluble and resistant to proteolysis. Systemic amyloidosis is a rare, often underdiagnosed condition. In recent years, the incidence of newly diagnosed cases of amyloidosis has been increasing in association with the aging of the population and greater access to diagnostic tests. From a clinical perspective, systemic amyloidosis is frequently associated with involvement of the kidneys (causing nephrotic syndrome), heart (cardiac failure and arrhythmia), and peripheral nervous system (sensorimotor polyneuropathy and autonomic dysfunction). This condition is important to the rheumatologist for several reasons, such as its systemic involvement that mimics autoimmune rheumatic diseases, its musculoskeletal manifestations, which when recognized can allow the diagnosis of amyloidosis, and also because reactive or secondary AA amyloidosis is a complication of rheumatic inflammatory diseases. The treatment of amyloidosis depends on the type of amyloid protein involved. Early recognition of this rare disease is fundamental for improved clinical outcomes.

Abstract Although the terms “rare diseases” (RD) and “orphan diseases” (OD) are often used interchangeably, specific nuances in definitions should be noted to avoid misconception. RD are characterized by a low prevalence within the population, whereas OD are those inadequately recognized or even neglected by the medical community and drug companies. Despite their rarity, as our ability on discovering novel clinical phenotypes and improving diagnostic tools expand, RD will continue posing a real challenge for rheumatologists. Over the last decade, there has been a growing interest on elucidating mechanisms of rare autoimmune and autoinflammatory rheumatic diseases, allowing a better understanding of the role played by immune dysregulation on granulomatous, histiocytic, and hypereosinophilic disorders, just to name a few. This initiative enabled the rise of innovative targeted therapies for rheumatic RD. In this review, we explore the state-of-the art of rare RD and the critical role played by rheumatologists in healthcare. We also describe the challenges rheumatologists may face in the coming decades.

Abstract Systemic autoinflammatory diseases (SAIDs) arise from dysregulated innate immune system activity, which leads to systemic inflammation. These disorders, encompassing a diverse array of genetic defects classified as inborn errors of immunity, are significant diagnostic challenges due to their genetic heterogeneity and varied clinical presentations. Although recent advances in genetic sequencing have facilitated pathogenic gene discovery, approximately 40% of SAIDs patients lack molecular diagnoses. SAIDs have distinct clinical phenotypes, and targeted therapeutic approaches are needed. This review aims to underscore the complexity and clinical significance of SAIDs, focusing on prototypical disorders grouped according to their pathophysiology as follows: (i) inflammasomopathies, characterized by excessive activation of inflammasomes, which induces notable IL-1β release; (ii) relopathies, which are monogenic disorders characterized by dysregulation within the NF-κB signaling pathway; (iii) IL-18/IL-36 signaling pathway defect-induced SAIDs, autoinflammatory conditions defined by a dysregulated balance of IL-18/IL-36 cytokine signaling, leading to uncontrolled inflammation and tissue damage, mainly in the skin; (iv) type I interferonopathies, a diverse group of disorders characterized by uncontrolled production of type I interferons (IFNs), notably interferon α, β, and ε; (v) anti-inflammatory signaling pathway impairment-induced SAIDs, a spectrum of conditions characterized by IL-10 and TGFβ anti-inflammatory pathway disruption; and (vi) miscellaneous and polygenic SAIDs. The latter group includes VEXAS syndrome, chronic recurrent multifocal osteomyelitis/chronic nonbacterial osteomyelitis, Schnitzler syndrome, and Still’s disease, among others, illustrating the heterogeneity of SAIDs and the difficulty in creating a comprehensive classification. Therapeutic strategies involving targeted agents, such as JAK inhibitors, IL-1 blockers, and TNF inhibitors, are tailored to the specific disease phenotypes.

Abstract Sarcoidosis is a systemic inflammatory disease of unknown origin, which consists of the formation of multiple sterile noncaseating granulomas. Inhaled antigens are believed to initiate disease in prone individuals, considering that almost all patients present pulmonary or mediastinal lymph node disease. Extrapulmonary manifestations are common and diverse: practically any organ system can be affected, and treatment can range from simple watchful waiting to intense immunosuppression. In this article, we review current concepts about sarcoidosis in an overview, focusing on recognition and treatment of its major clinical phenotypes.

ABSTRACT Purpose To evaluate the morphological and stereological parameters of the testicles in mice exposed to bisphenol S and/or high-fat diet-induced obesity. Material and Methods Forty adult male C57BL/6 mice were fed a standard diet (SC) or high-fat diet (HF) for a total of 12 weeks. The sample was randomly divided into 4 experimental groups with 10 mices as follows: a) SC - animals fed a standard diet; b) SC-B - animals fed a standard diet and administration of BPS (25 μg/kg of body mass/day) in drinking water; c) HF: animals fed a high-fat diet; d) HF-B - animals fed a high-fat diet and administration of BPS (25 μg/Kg of body mass/day) in drinking water. BPS administration lasted 12 weeks, following exposure to the SC and HF diets. BPS was diluted in absolute ethanol (0.1%) and added to drinking water (concentration of 25 μg/kg body weight/day). The animals were euthanized, and the testes were processed and stained with hematoxylin and eosin (H&E) for morphometric and stereological parameters, including density of seminiferous tubules per area, length density and total length of seminiferous tubules, height of the tunica albuginea and the diameter of the seminiferous tubules. The images were captured with an Olympus BX51 microscope and Olympus DP70 camera. The stereological analysis was done with the Image Pro and Image J programs. Means were statistically compared using ANOVA and the Holm-Sidak post-test (p

Developing new cultivars, particularly in perennial species like Coffea arabica, can be a time-consuming process. Employing molecular markers in genome-wide selection (GWS) for predicting genetic values offers an alternative to accelerate this process. However, implementing GWS typically involves genotyping many markers for both training and candidate individuals, which can increase the total genotyping cost for the breeding program. Therefore, this study aimed to assess the feasibility of using low-density marker panels to predict the genetic merit of C. arabica for a range of desirable agronomic traits. For this purpose, GWS analyses were performed using the G-BLUP method with panels of varying marker densities, selected based on marker effect magnitude. The results indicate that employing lower-density panels might be advantageous for this species' improvement. Models based on these panels yielded accurate predictions for various traits and demonstrated high agreement in terms of selected individuals compared to more complex models.

O objetivo desta pesquisa é analisar o que revelam os projetos pedagógicos de cursos (PPCs) presenciais de licenciatura em matemática das instituições de ensino superior (IES) de Rondônia, sobre como são ofertados e quais conhecimentos docentes estão previstos no estágio supervisionado. Metodologicamente, o estudo se caracteriza como abordagem qualitativa do tipo documental. Em Rondônia, há apenas quatro cursos presenciais de licenciatura em matemática, ofertados em duas IES, a saber: Universidade Federal de Rondônia (UNIR), nos campi Porto Velho e Ji-Paraná, e o Instituto Federal de Rondônia (IFRO), nos campi Vilhena e Cacoal. Os resultados mostram conhecimentos previstos como: conhecimento do conteúdo específico em matemática, do planejamento, do ensino e da aprendizagem. Espera-se que os resultados propiciem reflexões sobre a importância desse componente curricular no processo formativo do(a) futuro(a) professor(a) de matemática.

Objetivo: explorar a relactação e translactação em mães adotivas, analisando suas definições, benefícios, desafios e estratégias associadas. Métodos: consiste em uma pesquisa de revisão integrativa. As bases de dados utilizadas foram BVS, PubMed, Scopus, CINAHL, Web Of Science, Cochrane e Embase, com os seguintes descritores: “Aleitamento materno”, “Mulheres”, “Lactação” e “Adoção”. Resultados: apesar da escassez de estudos quantitativos, evidenciou-se a eficácia da relactação na promoção da amamentação, proporcionando vínculo afetivo entre a mãe e o filho e que precisa da capacitação dos profissionais. Conclusão: a indução da lactação ainda apresenta desafios na sua estimulação e os profissionais precisam estar preparados para oferecer uma assistência adequada para as mães adotivas.

ABSTRACT Purpose: To histologically quantify the different tissues that make up the porcine ureter, (epithelial, connective, and muscular tissue) in the three segments labelled: cranial, middle and caudal, in order to identify the segment most compatible for use as a vascular graft. Methods: Fifteen porcine ureters were collected, divided into the three segments, and the samples were stained with hematoxylin and eosin, picrosirius red and Weigert’s resorcin-fuchsin. The immunohistochemistry technique was applied for alpha-smooth muscle actin. Collagen fibers, muscle, epithelium, and elastic fibers tissue were quantified, in the entire ureter, and divided into hemispheres, comparing the different segments. Results: When comparing hemisphere segments, significant differences were observed (p < 0.01) for collagen and muscle tissue, with the cranial segment presenting the greatest amount of these components when compared to the middle and caudal. No significant difference was observed between the segments when comparing the entire ureters. Conclusions: After comparing the segments by hemisphere, the cranial segment presented a slight advantage for use as a vascular graft due to presenting greater collagen fiber content.

Abstract Net erosion recorded in lithological columns of hundreds of wells from the proximal domain of the Sergipe–Alagoas Basin was quantified through palaeoburial indicators: transit time sonic logs (DT) and vitrinite reflectance profiles (VRe). The preferred determinations with DT logs of pelitic rocks compound a large database and are less subject to variations in sampling and laboratory procedures. The sonic log profiles of 485 wells have been used for the calculation of the net erosion grid, while just 60 VRe profiles have been used for this purpose. Net erosion varies typically from 100 to 700 m in the Sergipe Sub-basin to the south, probably as a result of isostatic compensation to the sedimentary loads of the post-rift stratigraphic sequences. The Alagoas Sub-basin to the north stands as the most eroded. The average net erosion in the Alagoas SB is around 750 m but reaches more than 1,200 m in the north. The main cause of the erosion of the syn-rift strata in the Alagoas SB is probably the long-time sub-aerial exposure of uplifted rift flanks. Late Albian tectonic inversion, focused on northern Alagoas SB, enhanced erosion as evidenced in seismic sections, especially those parallel to the coast.

Abstract The settlement is a critical factor in foundation selection. To ensure the safety and stability of a structure, engineers must accurately predict settlement and design the foundation accordingly. However, in cases where the soil stratigraphy is complex, a more detailed analysis is necessary to determine safe and cost-effective solutions for a building's foundation. This paper presents a case study in which settlement monitoring was performed on a 23-story building with spread footings laid on a stiff rock layer of limited thickness overlying more compressible layers of clay and sand. The building was monitored through four construction stages, during which data on vertical displacements and stress distribution on the soil were obtained. To improve the accuracy of the results, a methodology for calibrating the thicknesses of the soil strata was applied, based on the measured settlements, soil-structure interaction, and estimates from semi-empirical methods. Furthermore, a numerical analysis was performed using the finite element method, where more conservative displacements were observed. Finally, the safety of the building was evaluated by verifying angular distortions.

IntroductionEarly intervention and parental education for preemies are limited in some low-income countries. Thus, this study aimed to assess whether daily tummy time (TT) associated with usual care (UC) enhances motor and cognitive development in preemies from low-income countries. The main and secondary aim was to assess prone head elevation (PHE) and motor and cognitive functions, respectively.MethodsThirty-one preemies with a mean gestational age at birth of 33.3 ± 1.6 weeks and weighing

ABSTRACT Objective: to describe Nursing Process implementation in a faith-based senior living community. Method: strategic action research with 19 nursing professionals and three managers of a faith-based senior living community. Implementation took place in four phases: diagnosis, planning, implementation and assessment. The data collected through semi-structured interviews and focus groups were subjected to discursive textual analysis. Results: the central categories were constructed: Nursing Process in faith-based senior living community: diagnosis of knowledge and application; Nursing Process in faith-based senior living community: implementation; Nursing process in faith-based senior living community: assessment after its implementation. Conclusion: Nursing Process implementation made it possible to structure work management/organization, contributing to knowledge, organization and continuity of care for safety and professional support.

O objetivo deste artigo foi analisar a associação entre os fatores sociodemográficos, as características maternas e neonatais e o tempo de introdução da alimentação complementar em recém-nascidos pré-termo e com baixo peso. Trata-se de um estudo de coorte prospectivo feito com 79 recém-nascidos pré-termo com peso menor ou igual a 1.800g. Os dados foram coletados no momento da alta hospitalar e ao 6º, 9º e 12º mês de idade gestacional corrigida (IGC), com auxílio de um questionário estruturado para analisar o tempo de introdução da alimentação complementar e texturas dos alimentos introduzidos. Além disso, para avaliar o risco de atraso de desenvolvimento, utilizou-se o Survey of Well-being of Young Children (SWYC-BR). Para análise das variáveis, aplicou-se regressão de riscos proporcionais de Cox. A introdução da alimentação complementar foi observada nos recém-nascidos pré-termo, com a mediana de idade de introdução de alimentos líquidos (3,50; IQ: 2,50-5,00), seguido por sólidos (4,70; IQ: 3,20-5,20) e pastosos (5,00; IQ: 4,50-5.50). Ainda, verificou-se associação da idade gestacional (RR = 1.25; IC95%: 1,02-1,52) em todo o processo da introdução alimentar. Para os alimentos sólidos e pastosos, aqueles com o maior tempo de internação (RR = 1,03; IC95%: 1,10- 1,05) e em amamentação mista (RR = 2,97; IC95%: 1,24-7,09) adiaram mais o tempo para introduzir a alimentação complementar. Para alimentos líquidos, recém-nascidos pré-termo menos graves (Score for Neonatal Acute Physiology and Perinatal Extension - SNAPPE II [RR = 0,96; IC95%: 0,94-0,98]) e mães que estavam amamentando na alta hospitalar (RR = 11,49; IC95%: 1,57-84,10) postergaram a introdução alimentar. Diretrizes para melhor orientação de profissionais e pais e/ou responsáveis sobre o momento ideal de introdução alimentar se faz necessário.

Orphan perennial native species are gaining importance as sustainability in agriculture becomes crucial to mitigate climate change. Nevertheless, issues related to the undomesticated status and lack of improved germplasm impede the evolution of formal agricultural initiatives. Acrocomia aculeata - a neotropical palm with potential for oil production - is an example. Breeding efforts can aid the species to reach its full potential and increase market competitiveness. Here, we present genomic information and training set optimization as alternatives to boost orphan perennial native species breeding using Acrocomia aculeata as an example. Furthermore, we compared three SNP calling methods and, for the first time, presented the prediction accuracies of three yield-related traits. We collected data for two years from 201 wild individuals. These trees were genotyped, and three references were used for SNP calling: the oil palm genome, de novo sequencing, and the A. aculeata transcriptome. The traits analyzed were fruit dry mass (FDM), pulp dry mass (PDM), and pulp oil content (OC). We compared the predictive ability of GBLUP and BayesB models in cross- and real validation procedures. Afterwards, we tested several optimization criteria regarding consistency and the ability to provide the optimized training set that yielded less risk in both targeted and untargeted scenarios. Using the oil palm genome as a reference and GBLUP models had better results for the genomic prediction of FDM, OC, and PDM (prediction accuracies of 0.46, 0.45, and 0.39, respectively). Using the criteria PEV, r-score and core collection methodology provides risk-averse decisions. Training set optimization is an alternative to improve decision-making while leveraging genomic information as a cost-saving tool to accelerate plant domestication and breeding. The optimized training set can be used as a reference for the characterization of native species populations, aiding in decisions involving germplasm collection and construction of breeding populations

ABSTRACT: Anatomy teaching has been changing over the years, introducing technological methods especially after the pandemic period. An ongoing debate revolves around whether exclusive reliance on technology for anatomy classes, as opposed to traditional methods and face-to-face instruction, enhances knowledge acquisition. This study analyzed the knowledge perception of students from various semesters throughout the Veterinary Medicine course, comparing students who only had online classes with those who had face-to-face classes in Gross Anatomy of Domestic Animals. For this purpose, a questionnaire was distributed for voluntary and anonymous completion, and the responses were subsequently analyzed statistically. The results indicated that 11.5% of the students who took Anatomy remotely failed to apply the knowledge in other subjects, while no face-to-face learning student reported the same. Most students, both remote and face-to-face groups, remember the subject but review the content frequently. Regarding theoretical knowledge, the online group (80.8%) understood better as the course progressed, compared to 59.6% of the face-to-face group. The connection between Anatomy and other subjects was more highlighted by the face-to-face group (30.8%) compared to the online group (15.4%). Both groups agree that physical contact with anatomical specimens is essential; however, some believe that initial exposure through 3D images or photographs is feasible. We concluded based on this preliminary study that the initial interactions with the Anatomy field should include diversified pedagogical techniques with empathetic communication. The use of modern technological resources are allies in the teaching-learning process. Furthermore, after abstracting the contents, technology alone can effectively maintain and update anatomical knowledge.

ABSTRACT Introduction: The superiority of the functional results of robot-assisted radical prostatectomyis still controversial. Despite this, it is known that minimally invasive surgery obtains better results when analyzing blood loss, blood transfusion and length of stay, for example. Several studies have analyzed the impact of the resident physician's involvement on the results of urological surgeries. The simple learning curve for robot-assisted radical prostate surgery is estimated to be around 10 to 12 cases. Learning curve data for robotic surgeons is heterogeneous, making it difficult to analyze. Rare studies compare the results of a radical prostatectomy of an inexperienced surgeon starting his training in open surgery, with the results of the same surgeon, a few years later, starting training in robotic surgery. Objective: to analyze the results of open radical prostatectomy surgeries (ORP) performed by urology residents, comparing them to the results of robot-assisted radical prostatectomy (RARP), performed by these same surgeons, after completing their training in urology. Materials and methods: a retrospective analysis of the cases of only 3 surgeons was performed. 50 patients underwent ORP (group A). The surgeons who operated on the ORP patients were in the 3rd and final year of the urology residency program and beginners in ORP surgery, but with at least 4 years of experience in open surgery. The same surgeons, already trained urologists, began their training in robotic surgery and performed 56 RARP surgeries (group B). For the comparative analysis, data were collected on age, number of lymph nodes removed, surgery time, hospitalization time, drain volume, drain permanence time, indwelling bladdercateter (IBC) permanence time, positive surgical margin, biochemical recurrence, risk classification (ISUP), intra and postoperative complications, urinary incontinence (UI) and erectile dysfunction (ED). The console used was the Da Vinci Si, from Intuitive®. For statistical analysis, the Shapiro-Wilk test verified that the data did not follow normality, the Levene test guaranteed homogeneity, and the Mann-Whitney test performed the comparative analysis of the quantitative data. For the analysis of qualitative data, the Chi-square test was used for nominal variables and the Mann-Whitney U test for ordinal variables. Additionally, the Friedman test analyzed whether there was an improvement in the perception of UI or ED over the months, for each group individually (without comparing them), and the post-hoc Durbin-Conover test, for the results with statistically significant difference. We used a p-value < 0.05, and the Jamovi® program (Version 2.0). Results: there was no statistically significant difference between the groups for age, number of lymph nodes removed, positive surgical margin, biochemical recurrence, risk classification and urinary incontinence. Additionally, we observed that the surgical time was longer in group B. On the other hand, the length of stay, drain volume, drain time, IBC time, complication rate and levels of erectile dysfunction in the third and sixth months were higher in group A, when compared to group B. We also observed that there was no evolutionary improvement in ED over the months in both groups, and that there was a perception of improvement in UI from the 1st to the 3rd month in group A, and from the 1st to the 6th month, and from the 3rd to the 12th month, in group B. Conclusion: the learning curve of RARP is equivalent to the curve of ORP. In general, the results for the robotic group were better, however, the functional results were similar between the groups, with a slight tendency of advantage for the robotic arm.

Abstract Objective To review current literature to support the use of mesna as a preventive therapy for hemorrhagic cystitis and bladder cancer in patients with systemic autoimmune diseases and systemic vasculitis treated with cyclophosphamide. Materials and methods The search for articles was conducted systematically through MEDLINE, LILACS, Cochrane Library, and Embase databases. Only articles in English were selected. For available records, titles and abstracts were selected independently by two investigators. Results Eighteen studies were selected for analysis. The known adverse effects of cyclophosphamide were hematological toxicity, infections, gonadal toxicity, teratogenicity, increased risk for malignancy and hemorrhagic cystitis. Long-term toxicity was highly dependent on cyclophosphamide cumulative dose. The risk of bladder cancer is especially higher in long-term exposure and with cumulative doses above 36 g. The risk remains high for years after drug discontinuation. Hemorrhagic cystitis is highly correlated with cumulative dose and its incidence ranges between 12 and 41%, but it seems to be lower with new regimens with reduced cyclophosphamide dose. No randomized controlled trials were found to analyze the use of mesna in systemic autoimmune rheumatic diseases and systemic vasculitis. Retrospective studies yielded conflicting results. Uncontrolled prospective studies with positive results were considered at high risk of bias. No evidence was found to support the use of mesna during the treatment with cyclophosphamide for autoimmune diseases or systemic vasculitis to prevent hemorrhagic cystitis and bladder cancer. In the scenarios of high cumulative cyclophosphamide dose (i.e., > 30 g), patients with restricted fluid intake, neurogenic bladder, therapy with oral anticoagulants, and chronic kidney disease, mesna could be considered. Conclusion The current evidence was found to be insufficient to support the routine use of mesna for the prophylaxis of hemorrhagic cystitis and bladder cancer in patients being treated for systemic autoimmune diseases and systemic vasculitis with cyclophosphamide. The use may be considered for selected cases.

Abstract Immunoglobulin G4-related disease is a systemic immune-mediated disease with insidious evolution characterized by fibroinflammatory lesions over virtually any organ system. Despite the remarkable progression of knowledge, its etiology remains undefined. Due to its relapse-remitting pattern, it could accumulate irreversible damage, increasing comorbidities and mortality. This paper emphasizes key concepts for diagnosing and treating patients with this condition.

Abstract Hereditary connective tissue disorders include more than 200 conditions affecting different organs and tissues, compromising the biological role of the extracellular matrix through interference in the synthesis, development, or secretion of collagen and/or its associated proteins. The clinical phenotype includes multiple signs and symptoms, usually nonspecific but of interest to rheumatologists because of musculoskeletal involvement. The patient´s journey to diagnosis is long, and physicians should include these disorders in their differential diagnoses of diseases with systemic involvement. In this review, insights for the diagnosis and treatment of osteogenesis imperfecta, hypermobility spectrum disorder/Ehlers–Danlos syndrome, Marfan, Loeys–Dietz, and Stickler syndromes are presented.

Abstract Relapsing polychondritis is a rare multisystem disease involving cartilaginous and proteoglycan-rich structures. The diagnosis of this disease is mainly suggested by the presence of flares of inflammation of the cartilage, particularly in the ears, nose or respiratory tract, and more rarely, in the presence of other manifestations. The spectrum of clinical presentations may vary from intermittent episodes of painful and often disfiguring auricular and nasal chondritis to an occasional organ or even life-threatening manifestations such as lower airway collapse. There is a lack of awareness about this disease is mainly due to its rarity. In 2020, VEXAS (vacuoles, E1 enzyme, X-linked, autoinflammatory, somatic) syndrome, a novel autoinflammatory syndrome, was described. VEXAS syndrome is attributed to somatic mutations in methionine-41 of UBA1, the major E1 enzyme that initiates ubiquitylation. This new disease entity connects seemingly unrelated conditions: systemic inflammatory syndromes (relapsing chondritis, Sweet’s syndrome, and neutrophilic dermatosis) and hematologic disorders (myelodysplastic syndrome or multiple myeloma). Therefore, this article reviews the current literature on both disease entities.

Abstract This study evaluates the effects of a green tea (Camellia sinensis) and hyaluronic acid gel on fibroblast activity and alveolar bone repair following third molar extractions. By examining the gene expression related to cell survival, proliferation, and angiogenesis, the study bridges in vitro findings with clinical outcomes in a split-mouth randomized trial. Human fibroblasts were exposed to the treatment gel, analysing gene expression through RT-qPCR. Twenty participants undergoing bilateral third molar extractions received the test gel on one side and a placebo on the other. Assessments included patient-reported outcomes, professional evaluations, and radiographic analyses at multiple postoperative intervals. The test gel significantly enhanced AKT, CDKs, and VEGF gene expressions, indicating a positive effect on angiogenesis and cell proliferation. Clinically, it resulted in reduced exudate, swelling, and secondary interventions, with radiographs showing improved alveolar bone density after 90 days. The green tea and hyaluronic acid gel significantly improves soft tissue and bone healing post-extraction, offering a promising adjunctive therapy for enhancing postoperative recovery. This gel represents a novel adjuvant treatment option for facilitating improved healing outcomes after third molar extractions, highlighting its potential utility in clinical dental practice.

Abstract Despite their rarity, Lyme disease and Whipple’s disease are of significant importance in rheumatology, as both can manifest as chronic arthritis, presenting challenges in the differential diagnosis of inflammatory arthropathies. In Lyme disease, arthritis typically emerges as a late manifestation, usually occurring six months after the onset of erythema migrans. The predominant presentation involves mono- or oligoarthritis of large joints, with a chronic or remitting-recurrent course. Even with appropriate antimicrobial treatment, arthritis may persist due to inadequate immunological control triggered by the disease. In contrast, Whipple’s disease may present with a migratory and intermittent seronegative poly- or oligoarthritis of large joints, preceding classic gastrointestinal symptoms by several years. Both disorders, particularly Whipple’s disease, can be misdiagnosed as more common autoimmune rheumatic conditions such as rheumatoid arthritis and spondyloarthritis. Epidemiology is crucial in suspecting and diagnosing Lyme disease, as the condition is transmitted by ticks prevalent in specific areas of the United States, Europe, and Asia. On the contrary, the causative agent of Whipple’s disease is widespread in the environment, yet invasive disease is rare and likely dependent on host genetic factors. In addition to erythema migrans in Lyme disease and gastrointestinal manifestations in Whipple’s disease, neurological and cardiac involvement can further complicate the course of both. This article offers a comprehensive review of the epidemiological, pathophysiological, clinical, and therapeutic aspects of both diseases.

Este trabalho tem como objetivo apresentar um método para ajustar dados longitudinais de casos confirmados e acumulados de Covid-19, proporcionalmente ao número de habitantes dos estados das regiões Sul e Sudeste do Brasil, considerando o tempo como variável explicativa. Com o modelo proposto, é possível fazer previsões de novos casos da doença como forma de oferecer suporte para gestores públicos e privados na elaboração e planejamento de estratégias para prevenir ou atenuar impactos sociais e econômicos de doenças de propagação viral coma a Covid-19 e outras doenças com propagação similar. Considerou-se modelos de regressão spline com efeitos mistos, úteis para ajuste de dados correlacionados que não possuam relação linear, e modelos autorregressivos e de médias móveis (ARMA) para os resíduos, uma vez que estes apresentaram essa característica, além de serem estacionários. Utilizou-se o modelo de regressão spline cúbica com efeitos mistos para calcular as taxas de crescimento e para predição de observações futuras do número acumulado de infectados pela Covid-19 nos sete estados estudados. Os resultados obtidos demonstraram boa concordância entre os dados ajustados com o modelo e os dados observados para todos os estados analisados. As previsões para os estados de São Paulo, Espírito Santo e Minas Gerais apresentaram os menores valores absolutos dos desvios relativos entre valores preditos e observados.