Despite the frequent assertion that the weather conditions change the intensity of pain in osteoarthritis (OA), this infl uence is controversial and diffi cult to measure. This analysis aims to review articles related to the infl uence of meteorological elements in the OA pain. The literature review was performed with the bibliographical survey databases of the Medical Literature Analysis and Retrieval System Online (MEDLINE) and the Latin American and Caribbean Health Sciences (LILACS), and active search in the list of references of the articles and reviews retrieved. The inclusion criteria for this analysis were prospective studies that evaluated the presence of pain related to some variable of weather in OA patients. The articles were published in Portuguese, English, and Spanish. Of the 247 abstracts analyzed, eight (3.2%) included articles from the electronic database consulted (n = 7), and active case fi nding (n = 1). Atmospheric pressure was the most frequently variable with some infl uence on OA pain in fi ve of the included studies, while precipitation was less related to the symptoms of OA; wind was not analyzed. Despite the methodological diversity and biases of the analyzed studies, there is a trend to confi rm the infl uence of weather in OA pain intensity, mainly in more recent publications. Besides checking the effect of meteorological elements in the OA pain, it is necessary to evaluate the interference in daily activities and impairing of the quality of life.

Objectives: to assess the bibliometric, clinical and therapeutic features of fungal vertebral osteomyelitis case reports, retrieved from electronic databases. Methods: systematic review with secondary data analysis done on proven cases from Medline, Embase and Lilacs databases and active search of referenced published reports, since 1966 until 2004. Results: there was a growing trend from 1966 to 2004 (R 2 = 0.5518) in the 318 retrieved cases of fungal vertebral osteomyelitis: 218/318 (68.5%) of them from 1990 on. Reports with diagnosis from North America prevailed (148/318 [46.5%]). The most common causative agent was Candida spp (131/318 [41.2%]), followed by Aspergillus spp (102/318 [32.1%]). Time elapsed between symptom appearance and diagnosis ranged from one week to 9.6 years, mean 24.4±41.6 weeks. The lumbar-sacral spine was the most affected segment (188/318 [59.1%]), and the cervical spine was involved in only 24/318 descriptions (7.5%). The combination L2+L3 was the most frequent infectious event (35/318 [11%]); L2 and L3 were the most affected vertebrae (84/318 [26.4%]). Surgical treatment was carried out in 194/307 (63.2%) cases. Arthrodesis was the surgical procedure performed in 91/307 (29.6%) with clear notification. There was a growing trend of azole compound utilization, in substitution to amphotericin B, between 1966-1989 (10/37) and 1990-2004 (40/63). Conclusion: fungal vertebral osteomyelitis has been more frequently reported since the 1990s. Great attention to the possibility of this diagnosis is necessary so that the fungal vertebral infection is not missed due to the lack of a routine mycological search in a general microbiology laboratory.

We present an uncommon case of a 3-year-old boy with a finger sucking habit who developed dystrophic calcification in his left thumb. Two years after excision, there was no recurrence, and the thumb retained full range of motion. We also discuss its probable pathogenesis and present a brief review of the literature about orthopedic complications in the hand due to this habit.

BackgroundThe aim of this work was to investigate the association between meteorological variables and pain, stiffness, and function of the hand in patients with osteoarthritis. MethodsThe survey was carried out over 2 months in 2009, covering July and November. The patients filled out a questionnaire, consisting of visual analogue scales covering the three categories of symptoms that primarily determine the situation with rheumatism of the hands: function, joint stiffness, and pain. The questionnaire was completed on Monday, Wednesday, and Friday for every week in July and every week in November. The meteorological variables recorded included atmospheric pressure, air temperature, relative humidity of the air, and precipitation. The climate records were checked against the variables of functional evaluation of the hands from each patient using bivariate analysis and multiple regression analysis. ResultsIn general, air temperature and relative humidity were the variables that displayed statistically significant higher association in all evaluated aspects of the hands, being explained by the influence of temperature in 40-88% (r) and relative humidity in 39-85% (r). In the multivariate analysis, there was a reduction in the number of weather variables that influenced pain. The variation of pain was explained by the average atmospheric pressure of the day of the questionnaire and the temperature the day before and the day after the questionnaire (52-88% [R2]). ConclusionsThe results implied individual variation in perception and quantification of function, stiffness, and pain. The lowest temperature associated with worsening of symptoms of pain and function in osteoarthritis of hands was the variable weather most frequently observed.

objectives: Discuss neuropsychiatric aspects and differential diagnosis of catatonic syndrome secondary to systemic lupus erythematosus (SLE) in a pediatric patient. Methods: Single case report. result: A 13-year-old male, after two months diagnosed with SLE, started to present psychotic symptoms (behavioral changes, hallucinations and delusions) that evolved into intense catatonia. During hospitalization, neuroimaging, biochemical and serological tests for differential diagnosis with metabolic encephalopathy, neurological tumors and neuroinfections, among other tests, were performed. The possibility of neuroleptic malignant syndrome, steroid-induced psychosis and catatonia was also evaluated. A complete reversal of catatonia was achieved after using benzodiazepines in high doses, associated with immunosuppressive therapy for lupus, which speaks in favor of catatonia secondary to autoimmune encephalitis due to lupus. conclusion: Although catatonia rarely is the initial clinical presentation of SLE, the delay in recognizing the syndrome can be risky, having a negative impact on prognosis. Benzodiazepines have an important role in the catatonia resolution, especially when associated with parallel specific organic base cause treatment. The use of neuroleptics should be avoided for the duration of the catatonic syndrome as it may cause clinical deterioration. resUMo objetivos: Discutir aspectos neuropsiquiátricos e o diagnóstico diferencial da síndrome catatônica secundária a lúpus eritematoso sistêmico (LES) em paciente pediátrico. Méto-dos: Relato de caso individual. resultado: Adolescente do sexo masculino com 13 anos de idade iniciou, após dois meses de diagnosticado com LES, quadro psicótico (alterações comportamentais, alucinações e delírios) que evoluiu para franca catatonia. Durante internação hospitalar foram realizados, entre outros, exames de neuroimagem, bioquímicos e sorologias para diagnóstico diferencial com encefalopatia metabólica, tumores neurológicos e neuroinfecções. Foi avaliada também a possibilidade de síndrome neuroléptica maligna, psicose e catatonia induzida por corticoides. Houve reversão completa da catatonia após o uso de benzodiazepínico em altas doses associado à terapia imunossupressora para o lúpus, o que fala a favor de uma catatonia secundária a uma encefalite autoimune de base lúpica.