Yellow Fever (YF) vaccination is suggested to induce a large number of adverse events (AE) and suboptimal responses in patients with autoimmune diseases (AID); however, there have been no studies on 17DD-YF primary vaccination performance in patients with AID. This prospective non-interventional study conducted between March and July, 2017 assessed the safety and immunogenicity of planned 17DD-YF primary vaccination in patients with AID. Adult patients with AID (both sexes) were enrolled, along with healthy controls, at a single hospital (Vitória, Brazil). Included patients were referred for planned vaccination by a rheumatologist; in remission, or with low disease activity; and had low level immunosuppression or the attending physician advised interruption of immunosuppression for safety reasons. The occurrence of AE, neutralizing antibody kinetics, seropositivity rates, and 17DD-YF viremia were evaluated at various time points (day 0 (D0), D3, D4, D5, D6, D14, and D28). Individuals evaluated (n = 278), including Valim et al. Yellow Fever Vaccination-Autoimmune Diseases patients with rheumatoid arthritis (RA; 79), spondyloarthritis (SpA; 59), systemic sclerosis (8), systemic lupus erythematosus (SLE; 27), primary Sjögren's syndrome (SS; 54), and healthy controls (HC; 51). Only mild AE were reported. The frequency of local and systemic AE in patients with AID and HC did not differ significantly (8 vs. 10% and 21 vs. 32%; p = 1.00 and 0.18, respectively). Patients with AID presented late seroconversion profiles according to kinetic timelines of the plaque reduction neutralization test (PRNT). PRNT-determined virus titers (copies/mL) [181 (95% confidence interval (CI), 144-228) vs. 440 (95% CI, 291-665), p = 0.004] and seropositivity rate (78 vs. 96%, p = 0.01) were lower in patients with AID after 28 days, particularly those with SpA (73%) and SLE (73%), relative to HC. The YF viremia peak (RNAnemia) was 5-6 days after vaccination in all groups. In conclusion, consistent seroconversion rates were observed in patients with AID and our findings support that planned 17DD-YF primary vaccination is safe and immunogenic in patients with AID.

A disfunção temporomandibular (DTM) constitui uma patologia orofacial relacionada a aspectos articulares, da musculatura, ou a ambos, da articulação temporomandibular (ATM), sendo a dor um dos seus principais sintomas. Muitos dos pacientes respondem de maneira adequada aos tratamentos odontológicos convencionais, mas em muitos casos de DTM o tratamento odontológico, isoladamente, não é efi caz, sendo necessário acompanhamento psicológico para trabalhar as questões da dor. A dor compreende uma vivência que pode ser infl uenciada por eventos negativos da infância e pelos esquemas iniciais desadaptativos (EIDs), que compreendem estruturas cognitivas mais rígidas e infl exíveis associadas às psicopatologias. Objetivou-se identifi car sintomas de ansiedade, depressão e os EIDs numa amostra de pacientes odontológicos com sintomas de DTM. Participaram 40 pacientes odontológicos, 20 com e 20 sem DTM que responderam ao questionário sociodemográfi co,

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BACKGROUND Jaccoud arthropathy (JA) was first described in the 19th century by S. Jaccoud in a patient who had several attacks of rheumatic fever. This arthropathy has also been described in patients with systemic lupus erythematosus with estimated prevalence of 5%, and less frequently in other clinical conditions, like primary hyperparathyroidism and psoriatic arthritis. The classic manifestation of JA is the presence of "reversible deformities," that is reducible to passive movement with preservation of the joint structure. JA generally affects the hands, but can also be observed in feet, knees and shoulders. The most common joint deformities are ulnar deviation, "swan neck," "boutonniere," thumb in Z and hallux valgus. Curiously, in older deformities, a limitation of the joint motion can be observed, probably because of fibrosis secondary contractures of the soft tissues of the joint. The etiopathogenic mechanisms are not known. CASE REPORT A 45 years old male patient is presented in this report who was diagnosed as psoriatic arthritis in 2010. Since then, he has used some different biological treatment with no improvement (Infliximab plus methotrexate since October/2010, switch to Adalimumab since may/2017, switch to Secukinumab since October/2018). He feels diffuse pain, has clinic synovitis in metacarpophalangeal (MCP) and proximal interphalangeal (IP) joints, wrists and shoulders. Ankylosis of the right wrist, deformities as botonière in the fingers and hammer deformities in the toes. Ultrasonography (US) found seven sites with well defined enthesopathy, five ungueal sites with positive PD and moderate active synovitis in 3th and 4th left MCP joints, 1st and 4th left proximal IP joints. Atrophic and scaly atrophic violaceous cutaneous lesions on the knees and legs bilaterally with difficulty of improvement. CONCLUSION Although JA it is most frequently seen in patients with systemic lupus erythematosus, an association with other diseases, like psoriatic arthritis, has occasionally been described.

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