COPD causes a significant impact on the quality of life of caregivers. The two most important predictors of COPD burden are the relationship between caregivers and patients and caregiver MCS scores.

The aim of the present study was to identify the risk factors for ovarian failure in patients with systemic lupus erythematosus. Seventy-one women aged 17 to 45 years with systemic lupus erythematosus were studied. Patients were interviewed and their medical records reviewed. Demographic characteristics, clinical and serologic profiles, and menstrual and obstetric histories were recorded. Disease activity was measured by the systemic lupus erythematosus disease activity index. Serum FSH, LH, estradiol, progesterone, TSH, prolactin, and antimicrosomal and antithyroglobulin antibodies were measured. Patients who developed ovarian failure were compared to those who did not. Ovarian failure occurred in 11 patients (15.5%) and nine had premature menopause (11.3%). Cyclophosphamide administration and older patient age were found to be associated with ovarian failure. The cumulative cyclophosphamide dose was significantly higher in patients with ovarian failure than in those without this condition (18.9 vs 9.1 g; P = 0.04). The relative risk for ovarian failure in patients with cumulative cyclophosphamide dose higher than 10 g was 3.2. TSH levels were high in 100% of patients with ovarian failure who had received pulse cyclophosphamide. Ovarian failure, and premature menopause in particular, is common in patients with systemic lupus erythematosus, with the most important risk factors being cyclophosphamide dose and age. Thyroid problems may be another risk factor for ovarian failure in patients with lupus.

After surgical treatment of colorectal cancer, depression and indexes of anxiety were higher in the group of patients treated with chemotherapy when compared to the control group.

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Objective: To determine the quality of life of COPD patients by using the Medical Outcomes 36-item Short-Form Survey (SF-36) and the Saint George's Respiratory Questionnaire (SGRQ), correlating the scores with respiratory function parameters. Methods: This was a cross-sectional study involving 42 COPD patients. We used the SGRQ (a specific questionnaire) and the SF-36 (a general questionnaire), together with their component summaries, in order to determine the quality of life of these patients. The functional profile was assessed by means of spirometry, arterial blood gas analysis and the six-minute walk test. Results: Of the 42 patients, 30 (71.4%) were male and 12 (28.6%) were female. The mean age of the patients was 65.4 ± 8.0 years. The mean physical component summary and mean mental component summary scores were 37.05 ± 11.19 and 45.61 ± 15.65, respectively. The physical component summary correlated significantly with FEV 1 in L/s (r = 0.38; p = 0.012). There was a correlation between the SGRQ total score and FEV 1 (r = −0.50; p < 0.01). The SGRQ activity domain showed negative correlations with all respiratory function parameters. The multiple regression analysis showed that only FEV 1 correlated significantly with the SGRQ total score, as well as with the activity domain score (r= −0.32; p = 0.04 and r = −0.34; p = 0.03, respectively). Conclusions: In COPD patients, a decline in FEV 1 is associated with poorer quality of life, as evaluated using the SGRQ. The objective of the present study was to determine how respiratory function parameters-as assessed by spirometry, arterial blood gas analysis and the six-minute walk test (6MWT)-correlate with the quality of life of COPD patients by using the SGRQ (a specific questionnaire), as well as the SF-36 (a general questionnaire) and its component summaries (PCS and MCS).

A 20-year-old female was admitted with tophus gout and chronic kidney disease (CKD), progressing to dialysis need and death. The familial investigation evidenced several cases of hyperuricemia, gout and CKD, as well as several cases of early death due to CKD. After analyzing these cases, it was concluded that the diagnosis was familial juvenile hyperuricemic nephropathy. This is an autosomal dominant disorder caused by mutations in the uromodulin gene, characterized by early beginning hyperuricemia and gout, in men and women, associated with progressive CKD.

Artigo originAl originAl Article RESUMO Objetivo: avaliar condutas tomadas pelos reumatologistas de todo Brasil frente a situações clínicas comuns na prática do dia-a-dia. Método: cenários clínicos fictícios sobre várias doenças reumáticas foram montados, com perguntas objetivas acerca do tratamento. Os questionários foram enviados aos 831 sócios com títulos de especialistas pela Sociedade Brasileira de Reumatologia (SBR), com envelope selado para envio das respostas. Resultados: a taxa média de devolução dos questionários foi de apenas 21,4%. A média de idade (DP) dos reumatologistas respondedores foi de 42,7 anos (DP=11,7), com tempo médio de formados de 19,8 anos (DP=10,1). No cenário clínico sobre artrite reumatóide (AR) de início recente em atividade, a maioria dos colegas (84,7%) tratava inicialmente o paciente com prednisona ou prednisolona. As drogas modificadoras da doença mais escolhidas foram metotrexato (84,2%) e cloroquina (63,8%). Quatro médicos (2,8%) escolheram os agentes biológicos (infliximabe e etanercepte) como droga de primeira escolha no tratamento inicial da doença. A profilaxia para osteoporose induzida pelo corticóide com suplementação de cálcio e vitamina D só foi orientada por 61,2% e 46,5% dos reumatologistas, respectivamente. No cenário clínico de um paciente com lúpus eritematoso sistêmico (LES), a grande maioria dos colegas optou pelo tratamento com corticóide oral (93,7%), cloroquina (92,5%)

Background: Lupus Nephritis (LN) progression to Chronic Kidney Disease (CKD) and End-Stage-Renal-Disease (ESRD) represents one of the most dreaded complications of Systemic Lupus Erythematosus (SLE), directly impacting quality of life and overall survival in affected patients. Identifying LN patients at high risk for poor renal outcome could lead to individualized management and treatment strategies regarding this population. We hypothesized that 24-hour urine proteinuria (PTU) after 12 months of treatment could act as a predictor of poor renal outcome in LN patients Methods: two hundred and fourteen patients who were diagnosed with LN and were followed up for more than 10 years in our center were enrolled retrospectively. Receiver operating characteristics curves (ROC) were used to test the best cut-off value of PTU who predict bad long-term renal outcome. Results: the statistical difference was observed from 12 months when the outcome was ESRD, with a tendency from 6 months (p=0.06). Proteinuria > 0.9g/day at 12 months was the best predictor of ESRD, with the highest AUC (0.72). The sensitivity, specificity, positive predictive value and negative predictive value were 0.83, 0.65, 0.40, and 0.93, respectively. In the first year of LN treatment the serum creatinine was statistically different in any time for CKD (chronic kidney disease), but only at baseline for ESRD. Conclusions: In a population with more severe LN followed for a long time (>10 years), the cut-off point of PTU > 0.9/day is the best that predict progression to ESRD. The high negative predictive value emphasizes the need for a 1-year PTU-based LN treat to target treatment as a predictor of long-term renal outcome.