Nailfold capillaroscopy (NFC) is a reproducible, simple, low-cost, and safe imaging technique used for morphological analysis of nail bed capillaries. It is considered to be extremely useful for the investigation of Raynaud's phenomenon and for the early diagnosis of systemic sclerosis (SSc). The capillaroscopic pattern typically associated with SSc, scleroderma ("SD") pattern, is characterized by dilated capillaries, microhemorrhages, avascular areas and/or capillary loss, and distortion of the capillary architecture. The aim of these recommendations is to provide orientation regarding the relevance of NFC, and to establish a consensus on the indications, nomenclature, the interpretation of NFC findings and the technical equipments that should be used. These recommendations were formulated based on a systematic literature review of studies included in the database MEDLINE (PubMed) without any time restriction.

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Bisphosphonates are considered first-line agents in the treatment of postmenopausal osteoporosis based on extensive experience of use, safety, and proven efficacy in reducing vertebral, non-vertebral and femur fractures. However, post-marketing reports based on the treatment of millions of patients/year over lengthy periods of time have revealed the occurrence of initially unexpected adverse effects, such as osteonecrosis of the jaw and atypical femoral fracture, leading to the restriction of treatment duration with bisphosphonates by global regulatory agencies. However, despite the association between these effects and bisphosphonates, this risk should be analyzed in the context of osteoporosis treatment, alongside the benefit of preventing osteoporotic fractures and their clinical consequences. Therefore, we consider it plausible to discuss the restriction to the use of bisphosphonates, possible indications for prolonged treatment and alternative therapies following the suspension of this drug class for patients with persistent high risk of fracture after initial treatment, especially considering the problems of public health funding in Brazil and the shortage of drugs provided by the government. Thus, to standardize the treatment of osteoporosis in the public health care system, we aim to develop a proposal for a scientifically-based pharmacological treatment for postmenopausal osteoporosis, establishing criteria for indication and allowing the rational use of each pharmacological agent. We discuss the duration of the initial bisphosphonate treatment, the therapeutic options for refractory patients and potential indications of other classes of drugs as first-choice treatment in the sphere of public health, in which assessing risk and cost effectiveness is a priority.

ResumoIntrodução: O Lúpus Eritematoso Sistêmico (LES) caracteriza-se pela formação e deposição de autoanticorpos contra os mais diversos órgãos;Objetivo:Descrever a morbidade, o dano e o prognóstico de pacientes com LES internados pela primeira vez. comprometimento em órgãos nobres, como rins e sistema nervoso central. Palavras-chave:Lúpus eritematoso sistêmico. Hospitalização. Prognóstico. AbstractIntroduction: Systemic lupus erythematosus (SLE) is an autoimmune disease characterized by autoantibodies that attack the patient's body.Early diagnosis of this disease is an important factor in improving patient survival. Objective: The aim of this study is to describe the morbidity, the damage and the prognosis of the SLE patients prime hospitalization. Methodology: of SLE patients randomized in the outpatient unit Dr. César Cals General Hospital. These patients had agreed on signing a paper giving their consent for submission to the treatment of this disease. Results: All 30 SLE patients were female and the average age was about 29.8 years.were admitted for establishing diagnosis and only 19 reported taking corticosteroids with or without chloroquine. 66.7% were in frank disease activity, with renal involvement being the most prevalent; renal damage also stood out as the most common, followed by the central nervous 36.7% were readmitted, six due to active nephritis and 3 developed terminal chronic renal failure. Conclusions: These SLE patients series prime of the disease and getting the diagnosis, already presented commitment in vital organs, such as kidneys and central nervous system.