Update on the 2012 Brazilian Society of Rheumatology Guidelines for the treatment of rheumatoid arthritis: position on the use of tofacitinib.

In 2014, tofacitinib, a target-specific, synthetic disease modifying anti rheumatic drug (DMARD) and a selective inhibitor of Janus kinase (JAK) was approved for use in Brazil. This position paper aims to update the recommendations of the Brazilian Society of Rheumatology (SBR) on the treatment of rheumatoid arthritis (RA) in Brazil, specifically regarding the use of target-specific synthetic DMARDs. The method of this recommendation consisted of a literature review of scientific papers held on the Medline database.

[Perinatal and pediatric follow up of children with increased nuchal translucency and normal karyotype].

Purpose: To analyze the perinatal and pediatric outcome of fetuses that showed nuchal translucency (NT) above the 95th percentile (P95) and a normal karyotype in order to obtain data allowing better maternal prenatal counseling.

Methods: fetuses from a tertiary obstetric service with an NT above P95 and a normal karyotype were analyzed between 2005 and 2011. We analyzed gestational ultrasound follow-up, fetal and postnatal echocardiography (ECHO), weight, length and Apgar score at birth, and neuropsychomotor development by the Ages and Stages Questionnaire (ASQ) up to July 2012.

Lag time between onset of symptoms and diagnosis of endometriosis.

Objective: To assess lag time between onset of symptoms and diagnosis of endometriosis in patients followed up at the Outpatients Clinic of Endometriosis and Chronic Pelvic Pain, at the Hospital do Servidor Público Estadual de São Paulo "Francisco Morato de Oliveira", from January 2003 to November 2009.

Methods: In a retrospective analytical study, a total of 310 women with endometriosis confirmed by surgery and pathological examination were evaluated in the period from January 6, 2003 to November 29, 2009. Data were gathered through revision of the follow-up visit forms at the specialized outpatients clinic and medical records.

The value of diagnostic hysteroscopy with biopsy in the preoperative of endometrial ablation.

Objective: To assess the value of diagnostic hysteroscopy with biopsy in the preoperative preparation for endometrial ablation.

Methods: It was a prospective non-randomized study conducted at the division of Gynecologic Endoscopy of Hospital do Servidor Público Estadual "Francisco Morato de Oliveira" from March 2007 to May 2009. A total of 45 patients with abnormal uterine bleeding, and referred to endometrial ablation were included.

Assessment of glutathione S-transferaseM1 (GSTM1) and its polymorphisms GSTM1 null in the response to treatment with chemotherapy in advanced ovarian carcinoma.

Objective: To assess if the genotype of the glutathione S-transferase M1 (GSTM1) enzyme and its GSTM1 null polymorphism can influence the response to chemotherapeutic treatment of advanced ovarian cancer.

Methods: Case-control study of 112 patients with advanced ovarian cancer submitted to chemotherapy during the period from January 1995 to December 2005. The tissue to study the GSTM1 genotype and its deletion came from surgical staging to treat ovarian cancer.

Morbidity in neonates according to the mode of delivery: a comparative study.

Objective: The objective of this study was to compare the effects of the modes of delivery on the health of newborns in a private maternity hospital in the city of São Paulo.

Methods: Between January 1995 and December 1998, all patients consecutively admitted for deliveries were included in this cross-sectional retrospective study. A total of 8,457 medical records were analyzed, being excluded of the sample 460 multiple pregnancies and 517 pregnant women with obstetric and/or clinical disorders.

The need to include obstetric nurses in prenatal care visits in the public health system.

Objective: To investigate, with a qualitative approach, the role of Obstetric Nurses at the primary level of care given to women's health as a vital component of the multidisciplinary team, which today is fundamental for providing care, prevention as well as health education and promotion, especially in programs whose activities are geared towards primary care of pregnant, parturient, and puerpera women.

Methods: Brazilian laws and the determinations of Nursing Councils in reference to the activities of the obstetric nurse were researched, including the nurse's responsibilities and limits. The bibliographic search was conducted in health-related journals, lay publications, and the Internet.

Endometrial hysteroscopic and histological evaluation in menopausal women in continuous use of raloxifene.

Objective: To study the effect of raloxifene on endometrial histopathology of menopausal women.

Methods: Thirty-one patients under raloxifene treatment (60 mg/day) for a six-month period and submitted to diagnostic videohysteroscopy at the Climateric Outpatients Clinic, Department of Gynecology and Obstetrics, Hospital do Servidor Público Estadual Francisco Morato de Oliveira, in the city of São Paulo, and at Hospital Guilherme Álvaro, in the city of Santos, from September 10th, 2003 to June 22nd, 2004, were analyzed. Guided endometrial biopsy was performed on all patients on the anterior wall, using a 3-mm or 5-mm biopsy forceps.

Evaluation of pain in outpatient diagnostic hysteroscopy with gas.

Objective: To evaluate the intensity of pain reported by patients undergoing outpatient diagnostic hysteroscopy.

Methods: Exam performed with a 5-mm lens hysteroscope, vaginal speculum, tenaculum and uterine distention with carbon dioxide gas. Before and after the examination, patients were interviewed to define, in a verbal scale from 0 to 10, pain values that they expected to feel and that they experienced after the end, and also if they would repeat it if indicated.

[Helicobacter pylori infection and its correlation with gastrointestinal symptoms and outcome of pregnancy].

Objective: The present study intended to investigate whether there was a relationship between pregnant women with dyspeptic complaints and with and without Helicobacter pylori infection in the first and second trimester of pregnancy.

Methods: H.pylori seropositivity was determined in 146 (aged 20 to 40 years) antenatal patients at 10 to 23 weeks gestation.

[Clinical and macroscopic variables that influence the prognosis of colorectal carcinoma].

Background And Aims: The paradoxical evolution of approximately one third of patients with neoplasms cataloged in Dukes stages B and C demonstrates the desirability of utilizing other prognostic criteria that are capable of broadening the information provided by these two important variables. Only a small number of investigators have dedicated themselves to the study of the prognostic value of clinical and macroscopic parameters of colorectal neoplasms, and the results obtained have been shown to be controversial. The principal aim of this work was to evaluate the prognostic importance of these parameters.

[Acute pancreatitis due to intramural hematoma of the duodenum by the use of anticoagulants].

Background: Spontaneous intramural hemorrhage of the duodenum due to anticoagulant therapy is rare and the treatment is controversial.

Objective: To present the acquired knowledge with the treatment of these disease.

Case Report: A 71-year-old women receiving for a 3 month period an anticoagulant therapy presented cervical bleeding of soft tissues and symptoms of acute pancreatitis and high small bowel obstruction.