Poster Session : PS 0767 ; Rheumatology ; Arthritis in Older Man: Don`t Forget Paraneoplastic Syndromes

( Helena Martins ),( Tomas Abrantes Da Fonseca ),( Teresa Sequeira ),( Isabel Almeida ),( Antonio Marinho ),( Carlos Vasconcelos ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1

The association of rheumatic manifestations with cancer is now well established. There are various rheumatological diseases that can be manifested as paraneoplastic syndromes, i. e. precede or occur simultaneously with different types of tumors, without local evidence of malignancy and regress after effective treatment of the tumor. In fact, the recognition of rheumatic symptoms as the fi rst translation of malignancy is essential for early treatment of the underlying tumor. The authors present a case of a 66 year-old man with no history of relevant disease nor family history of psoriasisor rheumatic diseases, with initial manifestation of chronic oligoarticular frame of the knees with severe systemic infi ammatory component associated with B symptoms, which evolved into symmetric infiammatory polyarthritis and morning stiffness. Analytically, without anemia or lymphopenia, increased infiammatory parameters, hemosedimentation velocity and C-reactive protein; Negative immunological study, including RF and anti-CCP, interpreted as probable seronegative rheumatoid arthritis. Excluded tuberculosis. Initially treated with NSAIDs, corticosteroids and methotrexate (MTX) without much articular benefi t, subsequently conducted infi ltrations and began salazopyrin (SSZ), with some clinical improvement. Onset of oral ulcers, whose biopsy revealed epidermoid carcinoma. Tumor with lymph node metastasis, requiring dissection, radiotherapy and chemotherapy, with clear improvement of the arthritis afterwards. Assumed paraneoplastic arthritis. Disease currently in remission, sporadically medicated only with NSAIDs. The relationship between malignancy and rheumatic manifestations is not simple. It is often diffi cult to identify the underlying tumor if not thinking about it, since the rheumatic paraneoplastic syndromes mimic well the idiopathic situations. On the other hand, the exhaustive search for a neoplasm in the initial assessment of rheumatic diseases is not recommended unless it is a high risk patient. Additionally, paraneoplastic arthritis may have independent natural history of tumors, thus the diagnosis is always a challenge.

Poster Session : PS 0703 ; Rheumatology ; Remission of Sweet Syndrome Secondary to Rheumatoid Arthritis Treated with Etanercept

( Helena Lobo Martins ),( Tomas Abrantes Da Fonseca ),( Teresa Sequeira ),( Isabel Almeida ),( Antonio Marinho ),( Carlos Vasconcelos ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1

Sweet`s syndrome (SS) is the most common acute neutrophilic dermatosis (ND), often idiopathic although it is associated with a wide range of diseases, especially neoplastic, infi ammatory and infectious. We report the case of SS occurring on a 43-year-old woman with a known seronegative rheumatoid arthritis (RA) since 20 year-old. After diagnosis, was treated by NSAIDs, methotrexate (MTX) and gold salts with complete remission. Medication was suspended. In 2002, develops disabling symmetric polyarthritis, unresponsive to corticosteroids, NSAIDs and sulfasalazine. MTX was avoided due to chronic cholestasis (autoantibodies to primary biliary cirrhosis were negative, IRM excluded primary sclerosing cholangitis and liver biopsy without cirrhosis or interface hepatitis). Initiated Anti-TNF alpha monotherapy (Adalimumab) in 2004 with complete remission. Suspended due to pregnancy in 2007 and stayed in remission without drugs until 2014. In 2012, she presented widespread painful mucocutaneous lesions involving the neck, trunk and upper limbs, with fever, arthralgia and deterioration of general condition, compatible with SS. Biopsy confi rmed diagnosis. Systematically excluded tuberculosis, lympho/myeloproliferative and other autoimmune diseases. Executed corticotherapy unsuccessfully, having developed iatrogenic diabetes. Improvement of lesions with dapsone, maintaining tolerable oral lesions. In 2014, worsening cutaneous lesions and initiates cyclosporine without any benefit. Under cyclosporine, progression to disabling oral lesions, and severe polyarthritis with DAS 28 5. 02 (high activity disease). The authors assumed SS secondary to RA and started anti-TNF alpha etanercept. Skin lesions improved within few days, with complete regression of all clinical and laboratory abnormalities. The authors argue the importance to consider SS in differential diagnosis of new mucocutaneus lesions in patients with known autoimmune diseases, including RA. The diagnosis should be based on clinical,laboratory and histological fi ndings of an acute febril neutrophilic dermatosis without vasculitis. In these cases, the treatment with anti-TNF alpha is an option.

Effects of radiant exposure and wavelength spectrum of light-curing units on chemical and physical properties of resin cements

Adriano Fonseca Lima,Stephanie Ellen Ferreira Formaggio,Ligia Franca Aires Zambelli,Alan Rodrigo Muniz Palialol,Giselle Maria Marchi,Cintia Helena Coury Saraceni,Marcelo Tavares de Oliveira 대한치과보존학회 2016 Restorative Dentistry & Endodontics Vol.41 No.4

Objectives: In this study, we evaluated the influence of different radiant exposures provided by single-peak and polywave light-curing units (LCUs) on the degree of conversion (DC) and the mechanical properties of resin cements. Materials and Methods: Six experimental groups were established for each cement (RelyX ARC, 3M ESPE; LuxaCore Dual, Ivoclar Vivadent; Variolink, DMG), according to the different radiant exposures (5, 10, and 20 J/cm2) and two LCUs (single-peak and polywave). The specimens were made (7 mm in length × 2 mm in width × 1 mm in height) using silicone molds. After 24 hours of preparation, DC measurement was performed using Fourier transform infrared spectrometry. The same specimens were used for the evaluation of mechanical properties (flexural strength, FS; elastic modulus, E) by a three-point bending test. Data were assessed for normality, after which twoway analysis of variance (ANOVA) and post hoc Tukey’s test were performed. Results: No properties of the Variolink cement were influenced by any of the considered experimental conditions. In the case of the RelyX ARC cement, DC was higher when polywave LCU was used; FS and E were not influenced by the conditions evaluated. The LuxaCore cement showed greater sensitivity to the different protocols. Conclusions: On the basis of these results, both the spectrum of light emitted and the radiant exposure used could affect the properties of resin cements. However, the influence was materialdependent.

Effects of radiant exposure and wavelength spectrum of light-curing units on chemical and physical properties of resin cements

Lima, Adriano Fonseca,Formaggio, Stephanie Ellen Ferreira,Zambelli, Ligia Franca Aires,Palialol, Alan Rodrigo Muniz,Marchi, Giselle Maria,Saraceni, Cintia Helena Coury,de Oliveira, Marcelo Tavares The Korean Academy of Conservative Dentistry 2016 Restorative Dentistry & Endodontics Vol.41 No.4

Objectives: In this study, we evaluated the influence of different radiant exposures provided by single-peak and polywave light-curing units (LCUs) on the degree of conversion (DC) and the mechanical properties of resin cements. Materials and Methods: Six experimental groups were established for each cement (RelyX ARC, 3M ESPE; LuxaCore Dual, Ivoclar Vivadent; Variolink, DMG), according to the different radiant exposures (5, 10, and $20J/cm^2$) and two LCUs (single-peak and polywave). The specimens were made (7 mm in length ${\times}$ 2 mm in width ${\times}$ 1 mm in height) using silicone molds. After 24 hours of preparation, DC measurement was performed using Fourier transform infrared spectrometry. The same specimens were used for the evaluation of mechanical properties (flexural strength, FS; elastic modulus, E) by a three-point bending test. Data were assessed for normality, after which two-way analysis of variance (ANOVA) and post hoc Tukey's test were performed. Results: No properties of the Variolink cement were influenced by any of the considered experimental conditions. In the case of the RelyX ARC cement, DC was higher when polywave LCU was used; FS and E were not influenced by the conditions evaluated. The LuxaCore cement showed greater sensitivity to the different protocols. Conclusions: On the basis of these results, both the spectrum of light emitted and the radiant exposure used could affect the properties of resin cements. However, the influence was material-dependent.

Metabolically healthy overweight adolescents: definition and components

António Videira-Silva,Silvia Freira,Helena Fonseca 대한소아내분비학회 2020 Annals of Pediatirc Endocrinology & Metabolism Vol.25 No.4

Purpose: In adolescents, the definition and clinical implications of metabolically healthy overweight (MHO) status have not been established. This study aimed to investigate the prevalence of MHO according to its most widespread definition, which is based on metabolic syndrome (MS), and to explore further metabolic indicators such as Homeostatic Model Assessment of Insulin Resistance, total cholesterol, low-density lipoprotein cholesterol, alanine aminotransferase, and C-reactive protein levels, together with metabolic health predictors in a sample of adolescents attending a pediatric obesity clinic. Methods: Data from 487 adolescents categorized as overweight (52.6% females, 88.1% white), with a mean body mass index (BMI) z-score of 2.74 (±1.07 standard deviation [SD]), and a mean age of 14.4 years (±2.2 SD) were cross-sectionally analyzed. From this original sample, a subsample of 176 adolescents underwent a second assessment at 12 (±6 SD) months for longitudinal analysis. Results: From the 487 adolescents originally analyzed, 200 (41.1%) were categorized as MHO, but only 93 (19.1%) had none of the metabolic indicators considered in this study. According to longitudinal analysis, 30 of the 68 adolescents (44%) categorized as MHO at baseline became non-MHO over time. BMI z-score was the best predictor of metabolic health both in cross-sectional and longitudinal analyses. Increased BMI z-score reduced the odds of being categorized as MHO (odds ratio [OR], 0.6; 95% confidence interval [CI], 0.4–0.9; P=.008) and increased the odds of having hypertension (OR 2.1, 95% CI: 1.4–3.3, P=0.001), insulin resistance (OR, 2.4; 95% CI, 1.4–4.1, P=0.001), or a proinflammatory state (OR, 1.2; 95% CI, 1.1–1.3, P=0.002). Conclusion: Diagnosis of MHO should not be exclusively based on MS parameters, and other metabolic indicators should be considered. Adolescents categorized as overweight should participate in weight-management lifestyle interventions regardless of their metabolic health phenotype.

Acanthosis nigricans as a clinical marker of insulin resistance among overweight adolescents

Antonio Videira­Silva,Carolina Albuquerque,Helena Fonseca 대한소아내분비학회 2019 Annals of Pediatirc Endocrinology & Metabolism Vol.24 No.2

Purpose: Acanthosis nigricans (AN) is a hyperpigmented dermatosis associated with obesity and insulin resistance (IR). There is no consensus whether AN extension scoring offers added value to the clinical estimation of IR. In this study we aimed to assess and score AN using both a short and an extended version of the scale proposed by Burke et al. and analyze the relationships of both versions with hyperinsulinemia and IR. Methods: We analyzed data from 139 overweight adolescents (body mass index ≥85th percentile) aged 12–18 with (n=67) or without (n=72) AN who were followed at a pediatric obesity clinic. Results: Adolescents with AN had higher levels of insulin (d=0.56, P=0.003) and HOMA­IR (d=0.55, P=0.003) compared to those without. Neither the short nor the extended versions of AN scores explained either hyperinsulinemia (β=1.10, P=0.316; β=1.15, P=0.251) or IR (β=1.07, P=0.422; β=1.10, P=0.374). The presence of AN alone predicted hyperinsulinemia and the presence of IR in 7.3% (β=2.68, P=0.008) and 7.1% (β=2.59, P=0.009) of adolescents, respectively. Conclusion: Screening for AN at the neck and axilla is a noninvasive and costeffective way to identify asymptomatic overweight adolescents with or at risk of developing IR.

The influence of nanofillers on the properties of ethanol-solvated and non-solvated dental adhesives

da Cruz, Leonardo Bairrada Tavares,Oliveira, Marcelo Tavares,Saraceni, Cintia Helena Coury,Lima, Adriano Fonseca The Korean Academy of Conservative Dentistry 2019 Restorative Dentistry & Endodontics Vol.44 No.3

Objectives: The aim of this study was to evaluate the influence of different concentrations of nanofillers on the chemical and physical properties of ethanol-solvated and non-solvated dental adhesives. Materials and Methods: Eight experimental adhesives were prepared with different nanofiller concentrations (0, 1, 2, and 4 wt%) and 2 solvent concentrations (0% and 10% ethanol). Several properties of the experimental adhesives were evaluated, such as water sorption and solubility (n = 5, 20 seconds light activation), real-time degree of conversion (DC; n = 3, 20 and 40 seconds light activation), and stability of cohesive strength at 6 months (CS; n = 20, 20 seconds light activation) using the microtensile test. A light-emitting diode (Bluephase 20i, Ivoclar Vivadent) with an average light emittance of $1,200mW/cm^2$ was used. Results: The presence of solvent reduced the DC after 20 seconds of curing, but increased the final DC, water sorption, and solubility of the adhesives. Storage in water reduced the strength of the adhesives. The addition of 1 wt% and 2 wt% nanofillers increased the polymerization rate of the adhesives. Conclusions: The presence of nanofillers and ethanol improved the final DC, although the DC of the solvated adhesives at 20 seconds was lower than that of the non-solvated adhesives. The presence of ethanol reduced the strength of the adhesives and increased their water sorption and solubility. However, nanofillers did not affect the water sorption and strength of the tested adhesives.

Effect of Subchronic Selenium Treatment in the Liver of BALB/C Mice with Transplantable Ehrlich Tumor

Jose´ Francisco Ramos dos Santos,Tania Passeti,Giuliana Petri,Adriana Helena de Almeida,Glaucia Luciano da Veiga,Juliana Veridiano,Bruno Bertassoli,Fernando Luiz Affonso Fonseca,Beatriz da Costa Aguia 한국식품영양과학회 2022 Journal of medicinal food Vol.25 No.11

Selenium has an anti-inflammatory, antioxidant, and possibly antitumoral action. Thus, we hypothesized that this element could be an ally in cancer treatment. We evaluated the effect of chelated selenium treatment of BALB/c mice with Erhlich Tumor on tumor size, histology, and biochemical parameters of the liver. A total of 96 male mice were treated for 7, 15, and 30 days with different doses of chelated selenium. During the 7 days of treatment, livers presented mild hydropic degeneration; after 15 days, the livers presented mild hydropic degeneration, inflammatory infiltrate, and steatosis, which was intensified in the animals treated for 30 days. Biochemical analysis showed an increase of the alanine transaminase enzyme in those animals, indicating hepatotoxicity. At the beginning of treatment, selenium was able to inhibit tumor growth. After 30 days of treatment, however, hepatotoxicity could be seen.