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Proteases in staphylococcal arthritis /Calander, Ann-Marie, January 2007 (has links)
Diss. (sammanfattning) Göteborg : Göteborgs universitet, 2007. / Härtill 3 uppsatser.
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Interaction of viruses with human joint materialMiki, Nancy Patricia Hana January 1990 (has links)
An in vitro cell and organ culture system for the study of human arthrotropic viruses was established to determine
the permissiveness of joint cells and tissue to five strains of rubella virus (RV), adenovirus type 2 (Ad) and human parvovirus (B19). A semi-continuous line of fetal chondrocytes (FC) and primary synovial membrane/cartilage (SMC) cells were used to investigate virus/joint cell interactions. In addition, the SMC cells were used to determine the ability of a virus to establish a persistent infection in cells of joint origin. Intact
joint tissue containing both synovial membrane and cartilage was also infected to determine the ability of the viruses to replicate in non-dividing cells and also their invasive capability in the presence of an extracellular
matrix.
Results showed that all RV strains and Ad were able to replicate in FC, SMC cells and intact joint tissue. The only exception to this was that replication of RV strain Cendehill was not detected in joint tissue. In contrast, there was no indication, by either DNA-DNA hybridization or immunoperoxidase staining, that B19 was able to replicate in SMC cells. Most importantly, the behaviour of the rubella strains in this model was found to correlate with the clinical data concerning the incidence of complications associated with rubella infection or vaccination. This suggests that arthritogenicity is related to the ability of a particular virus to infect and persist
in joint tissue and establishes the in vitro model as a useful system to evaluate the arthrotropicity of future
rubella vaccines. / Medicine, Faculty of / Pathology and Laboratory Medicine, Department of / Graduate
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Avaliação da terapia fotodinâmica em modelo experimental de artrite por paracoccidioides brasiliensis / Evaluation photodynamic therapy in an experimental model of arthritis induced by paracoccidioides brasiliensisTomadon, Aniele 01 February 2016 (has links)
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Previous issue date: 2016-02-01 / Conselho Nacional de Desenvolvimento Científico e Tecnológico / Paracoccidioidomycosis (PCM), caused by the dimorphic fungus Paracoccidioides brasiliensis, is one of the most prevalent systemic mycosis in Latin America. Infection can occur accidentally through direct inoculation or mainly through inhalation of propagules of P. brasiliensis, which are installed initially in the lungs and can spread to organs and tissues of the host. In the acute form of the disease the major clinical manifestation is the febrile lymphoproliferative syndrome, occurring osteoarticular involvement; the same for the chronic form, in which 60% of cases, bone and joint changes usually treated for extended periods with conventional antifungal agents. Drug therapy is the most widely used to treatment the disease, however, high costs, poor adherence to treatment and adverse side effects, take the need to search for alternative therapies such as photodynamic (PDT), which has low cost and toxicity, local action and does not induce resistance to microorganisms. In vitro studies have shown positive results of PDT against various fungi, but there are no in vivo reports on its action in the control of P. brasiliensis. In this sense, the present study aimed to evaluate the PDT response in an experimental model of arthritis by P. brasiliensis. For this purpose, male Wistar rats (n = 42) were divided into groups submitted to inoculation with P. brasiliensis and PBS (control) in the right knee joint. After the development of arthritis, the mice were treated from the eighth to the eleventh day to the therapy: Groups L40 and L120 laser treated at dosages of 40 and 120 J/cm2, AM group treated with the photosensitizer methylene blue and PDT40 and PDT120 groups treated with PDT at doses of 40 and 120 J/cm2. The laser and AM therapies were used individually as a control for PDT. The groups were evaluated: edema, by measuring the lateral-lateral diameter of the joint; the intensity of arthritis, for histopathology and titration of anti-gp43 antibody by ELISA. The results showed that the edema formation was lower in the groups treated with PDT 40 and 120 J/cm2 (p = 0.8359 and p = 0.7167, respectively). The analysis of the intensity of arthritis as assessed by histopathology showed that the group treated with PDT 120 J/cm2 had the lowest morphological changes in the joint. Titration of anti-gp43 antibodies, showed the highest production of specific antibodies in the yeast group, but the differences were not significant when comparing the groups. Thus, the morphological evidence of normal tissue recovery aspects, the joint subjected to PDT 120 J/cm2, revealed the potential use of this therapy in reducing arthritis caused by P. brasiliensis / A Paracoccidioidomicose (PCM), causada pelo fungo dimórfico Paracoccidioides brasiliensis, é uma das micoses sistêmicas de maior prevalência na América Latina. A infecção pode ocorrer acidentalmente por inoculação direta ou, principalmente, através da inalação de propágulos de P. brasiliensis, que se instalam inicialmente nos pulmões e podem se disseminar para órgãos e tecidos do hospedeiro. Na forma aguda da doença a principal manifestação clínica é a síndrome linfoproliferativa febril, podendo ocorrer acometimento osteoarticular; o mesmo para a forma crônica, onde em 60% dos casos há alterações ósseas e articulares, geralmente tratadas por longos períodos com antifúngicos convencionais. A terapia medicamentosa é a mais utilizada para o controle da doença, entretanto, custos elevados, baixa adesão ao tratamento e efeitos colaterais adversos, levam a necessidade de se pesquisar terapias alternativas, como a fotodinâmica (TFD), que apresenta baixo custo e toxicidade, ação local e não induz resistência aos microorganismos. Estudos in vitro têm demonstrado resultados positivos da TFD contra diversos fungos, mas não existem relatos in vivo sobre sua ação no controle de P. brasiliensis. Nesse sentido, o presente estudo objetivou avaliar a resposta da TFD em modelo experimental de artrite por P. brasiliensis. Para tanto, ratos Wistar machos (n=42), foram distribuídos em grupos submetidos à inoculação de P. brasiliensis e PBS (controle) na articulação do joelho direito. Após o desenvolvimento da artrite, os grupos foram tratados, do oitavo ao décimo primeiro dia com as terapias: grupos L40 e L120 tratados com laser nas dosagens de 40 e 120 J/cm2, grupo AM tradado com o fotossensibilizador azul de metileno e grupos TFD40 e TFD120 tratados com TFD nas dosagens de 40 e 120 J/cm2. Os tratamentos com laser e AM foram utilizados de forma individual como controle para a TFD. Nos grupos foram avaliados: o edema, através da medida do diâmetro látero-lateral da articulação; a intensidade da artrite, por exame histopatológico e a titulação do anticorpo anti-gp43, por ELISA. Os resultados mostraram que, a formação do edema foi menor nos grupos tratados com TFD 40 e 120 J/cm2 (p=0,8359 e p=0,7167, respectivamente). A análise da intensidade da artrite, revelou que o grupo tratado com TFD 120 J/cm2 apresentou as menores alterações morfológicas na articulação. A titulação de anticorpos anti-Gp43, demonstrou a maior produção de anticorpos específicos no grupo levedura, porém as diferenças não foram significativas na comparação entre os demais grupos. Assim, as evidências morfológicas de recuperação de aspectos teciduais normais, na articulação submetida a TFD 120 J/cm2, revelaram o potencial uso desta terapia na redução da artrite causada por P. brasiliensis.
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Lipid mediators in the development and resolution of experimental lyme arthritisBlaho, Victoria Alison. January 2007 (has links)
Thesis (Ph. D.)--University of Missouri-Columbia, 2007. / The entire dissertation/thesis text is included in the research.pdf file; the official abstract appears in the short.pdf file (which also appears in the research.pdf); a non-technical general description, or public abstract, appears in the public.pdf file. "May 2007" Includes bibliographical references.
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Identification and characterization of virulence factors of mycoplasmasLuo, Wenyi. January 2009 (has links) (PDF)
Thesis (Ph.D.)--University of Alabama at Birmingham, 2009. / Title from PDF title page (viewed on July 1, 2010). Includes bibliographical references.
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Značaj intraoperativnog mehaničkog ispiranja u prevenciji kontaminacije kalema kod rekonstrukcije prednje ukrštene veze kolena / Importance of intraoperative mechanical irrigation in prevention of graft contamination in anterior cruciate ligament reconstructionRašović Predrag 26 September 2016 (has links)
<p>Intraoperativna kontaminacija autokalema tokom rekonstrukcije prednjeg ukrštenog ligamenta je i dalje tema koja je predmet stalne debate među ortpedskim hirurzima, a koja se preteţno odnosi na potrebu i način njenog tretmana. Ona nastaje kao posledica naseljavanja uzročnika kontaminacije iz vazduha, sa koţe i sluznica kako pacijenata tako i osoblja, kao i preko nesterilisanih ili nedovoljno sterilisanih instrumenata. Patogeni koji je izazivaju su identični uzročnicima koji izazivaju septični arthritis, pa se smatra jednim od faktora rizika za njegov nastanak. Septični arthritis predstavlja najčešću komplikaciju u artroskopskoj hirurgiji uopšte, a njegove posledice mogu bitno uticati na funkcionalni i mentalni status pacijenata. Zbog toga se smatra da je tretman intraoperativne kontaminacije autokalema tokom rekonstrukcije prednjeg ukrštenog ligamenta kolena mandatoran. Najčešće primenjivani agensi u tretmanu intraoperativne kontaminacije alokalema predstavljaju različite vrste antiseptičnih i antibiotskih solucija. I pored toga što intraoperativna irigacija fiziološkim rastvorom predstavlja jednu od najčešče primenjivanih procedura tokom hirurških operacija, u savremenoj literaturi je objavljen mali broj radova na temu primene ove procedure u tretmanu intraoperativne kontamninacije. Cilj ove studije je bio da pokaţe da se dekontaminacija autoklema tokom rekonstrukcije prednjeg ukrštenog ligamenta kolena moţe uspešno tretirati intraoperativnom mehaničkom irigacijom čistim fiziološkim rastvorom, kao i da odredi koja je količina fiziološkog rastvora dovoljna da izvrši potpunu dekontaminaciju autokalema. Jedan od ciljeva se odnosio na utvrđivanje uticaja faktora okruţenja na pojavu intraoperativne kontaminacije. Studija se sastojala iz dva dela- eksperimentalnog i kliničkog. Eksperimentalni deo studije je bio sproveden na Odeljenju za kliničku bakteriologiju Centra za mikrobiologiju Instituta za javno zdravlje Vojvodine i sastojao se iz pravljenja eksperimentalnog modela koji je imao za cilj da u in vitro uslovima obezbedi iste ili pribliţno iste uslove kao i operacionoj sali. On se sastojao od pedeset ispreparisanih i sterilisanih svinjskih tetiva dubokih pregibača prstiju koje su po svojim dimenzijama pribliţno odgovarale humanom prednjem ukrštenom ligamentu kolena. Tetive su potom bile kontaminirane unapred određenom koncetracijom najčešćeg uzročnika kontaminacije, a to je koagulaza negativan stafilokok ( ATCC 12228 Staphylococcus epidermidis). One su se potom mehanički ispirale sa 500 ml, 1000 ml, i 1500 ml fiziološkog rastvora, a nakon svakog ispiranja uzimao se bris. Brisevi su nakon toga bili zasejavani na krvni agar, a nakon 24h inkubacije su očitavane vrednosti brojanjem kolonija uzročnika. Rezultati eksperimentalnog dela pokazuju da je količina od 1500 ml fiziološkog rastvora dovoljna da izazove potpunu dekontaminaciju tetive. Rezultati eksperimentalnog dela su potom bili primenjivani u kliničkom delu studije koji je obuhvatao 200 ispitanika starosne dobi između 15-50 godina i koje je je bilo sprovedeno na Klinici za ortopedsku hirurgiju i traumatologiju Kliničkog centra Vojvodine. Kontrolnu grupu su činili onih 100 pacijenata kod kojih je mehaničko intraoperativno ispiranje autokalema neposredno pred njegovu implantaciju vršeno pomoću 500 ml fiziološkog rastvora, a ispitivanu grupu su činili drugih sto pacijenata kod kojih je isto to ispiranje izvršeno sa 1500 ml fiziološkog rastvora. Rezultati kliničkog dela studije jasno ukazuju da je količina od 1500 ml fiziološkog rastvora kojim se vrši intraoperativna mehanička irigacija dovoljna da izvrši potpunu dekonaminaciju autokalema kao i da stepen kontaminacije autokalema raste sa povećanjem vremena koje kalem provodi na vazduhu tokom obrade, što je u direktnoj vezi sa vremenskim trajanjem operacije i vrstom kalema koji se koristi za rekonstrukciju. Rezultati pokazuju da je rizik za nastanak kontaminacije autokalema u direktnoj vezi sa faktorima okruţenja, odnosno da se porastom broja ljudi u operacionoj sali, kao i redosledom operativnih procedura u toku jednog operativnog dana u smislu da operacije koje počinju kasnije na operativnom programu, povećava i procenat kontaminacije. Intraoperativna mehanička irigacija kontaminiranog autokalema se pokazala kao metoda koja se uspešno moţe koristiti u intaoperativnoj dekontaminaciji autokalema tokom rekonstrukcije prednje ukrštene veze kolena. Rezultati ove studije se mogu se primeniti i na druge asetne hirurgije i mogu posluţiti i daljim kliničkim istraţivanjima.</p> / <p>Intraoperative contamination of autograft during anterior cruciate ligament reconstruction still remains a topic for debate among orthopaedic surgeons mainly concerning the need and the way of its treatment. Graft contamination arises after pathogen settlement from the surrounding air, from skin and mucoses of patient and staff, as well as not enough sterilized instruments. Pathogens found in graft contamination are the same ones who are causes of septic arthritis, which is the most common complication in arthroscopic surgery in general. Consequences of septic arthritis usually leave a huge impact on patient’s mental and physical status. In modern surgery, it is mandatory to prevent potential auto-graft contamination by irrigation (during anterior cruciate ligament reconstruction in knee). Most commonly used agents for intraoperative auto-graft irrigation are variety of antiseptic and antibiotic solutions. Even though intraoperative irrigation with saline solution presents one of the most commonly used procedures during different surgical interventions in general, little is said in literature about its usage in auto-graft contamination. The aim of this study was to show that decontamination of auto-graft during anterior cruciate ligament reconstruction of the knee can be successfully done by mechanical irrigation with saline (0,9%) solution and also to define a precise quantity of saline for complete decontamination. Furthermore, effects of different factors in surroundings were inspected. The study consisted of two parts: experimental and clinical. Experimental part was conducted at the Department for clinical bacteriology, at Microbiology Centre at the Institute for public health of Vojvodina. It consisted in making the experimental model with in vitro conditions similar to or as the same as in the operating theatre. Experimental model was made of 50 preparated and sterilized pig tendons of deep finger flexors, which are similar dimensions as human anterior cruciate ligament of the knee. Then, the tendons were contaminated with previously defined concentration of most common cause of contamination which is coagulase negative staphylococcus (ATCC 12228 Staphylococcus epidermidis). Contaminated tendons were mechanicaly irrigated with 500ml, 1000ml and 1500ml saline solution. After each irrigation a swab was taken and put in blood agar to grow. Following 24h of incubation, bacterial colonies were counted. Results of experimental model show that 1500ml of saline solution is required for decontamination of tendon. Results of experimental model were used in clinical part of the study which was conducted at the Clinic for orthopaedic surgery and traumatology in Clinical Centre of Vojvodina. It comprised of 200 patients, who were 15-50 years old. Patients were divided in two equal groups: tested and control group. In control group mechanical irrigation of auto-graft was done prior to its implementation with 500ml saline solution, while in tested group 1500ml of saline was used for irrigation. Results of clinical part of the study show that intraoperative irrigation with 1500ml of saline solution is enough for complete decontamination of auto-graft. Furthermore, degree of auto-graft contamination rises with prolonged exposure time on surrounding air, with incrised number of people in the operating theatre and also with number and sequence of operations during the day. Intraoperative mechanical irrigation proved to be a sufficient method that can be used in intraoperative autograft decontamination during anterior cruciate ligament reconstruction. The results of this study can be applied to other aspects of the surgery and could be used and further clinical<br />studies.</p>
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Manifestações musculoesqueléticas associadas à hepatite C crônica / Musculoskeletal manifestations associated with chronic hepatitis CNakamura, Andréa Aparecida Siqueira 09 September 2013 (has links)
INTRODUÇÃO: A infecção pelo vírus C é um grande problema de saúde pública e tem se tornado a principal indicação de transplante de fígado. Com uma distribuição universal, é a segunda doença crônica viral mais frequente no mundo. No entanto, a hepatite C crônica é mais que uma doença hepática. Pacientes com infecção crônica pelo HCV podem desenvolver um grande número de manifestações extra-hepáticas independentemente da gravidade da doença hepática. Há muitas doenças reumatológicas associadas à infecção pelo HCV, incluindo artralgia, mialgia e artrite. MÉTODOS: Um estudo transversal desenvolvido entre os pacientes atendidos no Ambulatório de Hepatites da Divisão de Clínica de Moléstias Infeciosas e Parasitárias do HCFMUSP, na cidade de São Paulo, no período de 2004 a 2008, selecionou 243 pacientes que preencheram os critérios de inclusão e assinaram o termo de consentimento após esclarecimentos sobre a pesquisa. Foi realizada uma entrevista com os pacientes, em que foram coletadas informações demográficas, epidemiológicas e clinico-laboratoriais. Foram realizados exames laboratoriais, bioquímicos, hematológicos, imunológicos, PCR, HCV, RNA quantitativo e genotipagem do HCV. A avaliação das características da infecção pelo HCV (epidemiológica, histológica, virológica), associada às manifestações extra-hepáticas clínicas reumatológicas (aquelas com prevalência > 10%) e laboratoriais (com prevalência > 5%), foi realizada utilizando-se as análises univariada e multivariada (regressão logística). Odds ratios (OR) ajustados e intervalos de confiança de 95% (IC 95%) foram derivados do coeficiente do modelo logístico multivariado final. Todas as análises foram realizadas com o pacote estatístico SPSS. RESULTADOS: Dos 243 pacientes estudados, pudemos determinar a provável forma de infecção em 147 (60,49%). Dos 147 pacientes, 93 (38,27%) sofreram transfusão sanguínea prévia, 10 (4,11%) tinham histórico de uso droga injetável há mais de 1 ano, 15 (6,17%) tinham antecedente de uso do droga inalatória há mais de 1 ano, 11 (4,52%) eram profissionais da saúde com histórico de acidente com material perfuro-cortante, 10 (4,11%) realizaram tatuagem e 8 (3,29%) tinham parceiro portador de hepatite C crônica. Nessa análise, 148 (60,9%) dos pacientes com hepatite C crônica apresentaram queixa de artralgia, 145 (59,7%) apresentaram queixa de mialgia, 144 (59,3%), de cansaço. A artrite esteve presente em 50 (20,57%) dos pacientes avaliados nesse estudo. Dentre estes pacientes, o envolvimento foi predominantemente poliarticular em 36 (72%) deles, acometendo grandes e pequenas articulações, simultaneamente, em 29 (58%). Idade maior que 50 anos, dor nas costas e crepitação em articulações mostraram-se fatores associados à artrite. Observou-se que sexo feminino, tabagismo importante e fibrose hepática avançada (F3 e F4) foram fatores associados à artralgia. Sexo feminino e tabagismo importante foram fatores associados à mialgia. CONCLUSÃO: Foi encontrada elevada prevalência de manifestações musculoesqueléticas entre os pacientes portadores de hepatite C crônica deste serviço. Os fatores de risco mais frequentes para a presença das manifestações extra-hepáticas foram sexo feminino e idade maior que 50 anos. Os autoanticorpos, embora freqüentes, não mostraram significância estatística com relação às principais manifestações musculoesqueléticas analisadas. Infiltrado inflamatório hepático e nível de transaminases também não apresentaram significância estatística / INTRODUCTION: C virus infection is a major public health problem and has become the leading indication for liver transplantation. With a worldwide distribution, is the second most common chronic viral worldwide. However, chronic hepatitis C is more than a liver disease. Patients with chronic HCV infection may develop a large number of extra hepatic manifestations regardless of the severity of liver disease. There are many rheumatic diseases associated with HCV infection including arthralgia, myalgia and arthritis. METHODS: A cross-sectional study carried out among patients treated in outpatient Hepatitis Clinical Division of Infectious and Parasitic Diseases of the HC-USP, in São Paulo, in the period from 2004 to 2008, selected 243 patients who met the inclusion criteria and signed the consent form after clarification of the research. An interview was conducted with patients which were collected demographic, epidemiological and clinical-laboratory. Laboratory tests were carried, biochemical, hematological, immunological, quantitative PCR HCV RNA and HCV genotyping. The evaluation of the characteristics of HCV infection (epidemiological, histological, virological) associated with extrahepatic manifestations rheumatology clinics (those with prevalence > 10%) and laboratory (with prevalence > 5%) were performed using univariate and multivariate analysis (regression logistics). Odds ratios (OR) and adjusted confidence intervals of 95% (95% CI) were derived from the ratio of the final multivariate logistic model. All analyzes were performed with the SPSS statistical package. RESULTS: Of the 243 patients studied were able to determine the likely form of infection in 147 (60.49%). Of the 147 patients, 93 (38.27%) had previous blood transfusion, 10 (4.11%) had a history of injection drug use for more than 1 years, 15 (6.17%) had prior use of the drug is inhaled over 1 year, 11 (4.52%) were health professionals with a history of accidents with sharp objects, 10 (4.11%) underwent tattooing and 8 (3.29%) had a partner with hepatitis C chronic. In this analysis, 148 (60.9%) of patients with chronic hepatitis C complained of arthralgia, 145 (59.7%) complained of myalgia, 144 (59.3%) of fatigue. Arthritis was present in 50 (20.57%) of the patients evaluated in this study. Among patients with arthritis of this study, involvement was predominantly polyarticular in 36 (72%) of them, affecting large and small joints simultaneously in 29 (58%). Age greater than 50 years, back pain and crepitus in the joints proved to be factors associated with arthritis. We observed that female smoking important and advanced liver fibrosis (F3 and F4) were associated with arthralgia. Female gender and smoking were important factors associated with myalgia. CONCLUSION: We found a high prevalence of musculoskeletal manifestations among patients with chronic hepatitis C of this service. The most common risk factors for the presence of extra hepatic manifestations were female and older than 50 years. The autoantibodies, although frequently not statistically significant compared with the major musculoskeletal manifestations analyzed. Inflammatory infiltrate and liver transaminase levels did not show statistical significance
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Manifestações musculoesqueléticas associadas à hepatite C crônica / Musculoskeletal manifestations associated with chronic hepatitis CAndréa Aparecida Siqueira Nakamura 09 September 2013 (has links)
INTRODUÇÃO: A infecção pelo vírus C é um grande problema de saúde pública e tem se tornado a principal indicação de transplante de fígado. Com uma distribuição universal, é a segunda doença crônica viral mais frequente no mundo. No entanto, a hepatite C crônica é mais que uma doença hepática. Pacientes com infecção crônica pelo HCV podem desenvolver um grande número de manifestações extra-hepáticas independentemente da gravidade da doença hepática. Há muitas doenças reumatológicas associadas à infecção pelo HCV, incluindo artralgia, mialgia e artrite. MÉTODOS: Um estudo transversal desenvolvido entre os pacientes atendidos no Ambulatório de Hepatites da Divisão de Clínica de Moléstias Infeciosas e Parasitárias do HCFMUSP, na cidade de São Paulo, no período de 2004 a 2008, selecionou 243 pacientes que preencheram os critérios de inclusão e assinaram o termo de consentimento após esclarecimentos sobre a pesquisa. Foi realizada uma entrevista com os pacientes, em que foram coletadas informações demográficas, epidemiológicas e clinico-laboratoriais. Foram realizados exames laboratoriais, bioquímicos, hematológicos, imunológicos, PCR, HCV, RNA quantitativo e genotipagem do HCV. A avaliação das características da infecção pelo HCV (epidemiológica, histológica, virológica), associada às manifestações extra-hepáticas clínicas reumatológicas (aquelas com prevalência > 10%) e laboratoriais (com prevalência > 5%), foi realizada utilizando-se as análises univariada e multivariada (regressão logística). Odds ratios (OR) ajustados e intervalos de confiança de 95% (IC 95%) foram derivados do coeficiente do modelo logístico multivariado final. Todas as análises foram realizadas com o pacote estatístico SPSS. RESULTADOS: Dos 243 pacientes estudados, pudemos determinar a provável forma de infecção em 147 (60,49%). Dos 147 pacientes, 93 (38,27%) sofreram transfusão sanguínea prévia, 10 (4,11%) tinham histórico de uso droga injetável há mais de 1 ano, 15 (6,17%) tinham antecedente de uso do droga inalatória há mais de 1 ano, 11 (4,52%) eram profissionais da saúde com histórico de acidente com material perfuro-cortante, 10 (4,11%) realizaram tatuagem e 8 (3,29%) tinham parceiro portador de hepatite C crônica. Nessa análise, 148 (60,9%) dos pacientes com hepatite C crônica apresentaram queixa de artralgia, 145 (59,7%) apresentaram queixa de mialgia, 144 (59,3%), de cansaço. A artrite esteve presente em 50 (20,57%) dos pacientes avaliados nesse estudo. Dentre estes pacientes, o envolvimento foi predominantemente poliarticular em 36 (72%) deles, acometendo grandes e pequenas articulações, simultaneamente, em 29 (58%). Idade maior que 50 anos, dor nas costas e crepitação em articulações mostraram-se fatores associados à artrite. Observou-se que sexo feminino, tabagismo importante e fibrose hepática avançada (F3 e F4) foram fatores associados à artralgia. Sexo feminino e tabagismo importante foram fatores associados à mialgia. CONCLUSÃO: Foi encontrada elevada prevalência de manifestações musculoesqueléticas entre os pacientes portadores de hepatite C crônica deste serviço. Os fatores de risco mais frequentes para a presença das manifestações extra-hepáticas foram sexo feminino e idade maior que 50 anos. Os autoanticorpos, embora freqüentes, não mostraram significância estatística com relação às principais manifestações musculoesqueléticas analisadas. Infiltrado inflamatório hepático e nível de transaminases também não apresentaram significância estatística / INTRODUCTION: C virus infection is a major public health problem and has become the leading indication for liver transplantation. With a worldwide distribution, is the second most common chronic viral worldwide. However, chronic hepatitis C is more than a liver disease. Patients with chronic HCV infection may develop a large number of extra hepatic manifestations regardless of the severity of liver disease. There are many rheumatic diseases associated with HCV infection including arthralgia, myalgia and arthritis. METHODS: A cross-sectional study carried out among patients treated in outpatient Hepatitis Clinical Division of Infectious and Parasitic Diseases of the HC-USP, in São Paulo, in the period from 2004 to 2008, selected 243 patients who met the inclusion criteria and signed the consent form after clarification of the research. An interview was conducted with patients which were collected demographic, epidemiological and clinical-laboratory. Laboratory tests were carried, biochemical, hematological, immunological, quantitative PCR HCV RNA and HCV genotyping. The evaluation of the characteristics of HCV infection (epidemiological, histological, virological) associated with extrahepatic manifestations rheumatology clinics (those with prevalence > 10%) and laboratory (with prevalence > 5%) were performed using univariate and multivariate analysis (regression logistics). Odds ratios (OR) and adjusted confidence intervals of 95% (95% CI) were derived from the ratio of the final multivariate logistic model. All analyzes were performed with the SPSS statistical package. RESULTS: Of the 243 patients studied were able to determine the likely form of infection in 147 (60.49%). Of the 147 patients, 93 (38.27%) had previous blood transfusion, 10 (4.11%) had a history of injection drug use for more than 1 years, 15 (6.17%) had prior use of the drug is inhaled over 1 year, 11 (4.52%) were health professionals with a history of accidents with sharp objects, 10 (4.11%) underwent tattooing and 8 (3.29%) had a partner with hepatitis C chronic. In this analysis, 148 (60.9%) of patients with chronic hepatitis C complained of arthralgia, 145 (59.7%) complained of myalgia, 144 (59.3%) of fatigue. Arthritis was present in 50 (20.57%) of the patients evaluated in this study. Among patients with arthritis of this study, involvement was predominantly polyarticular in 36 (72%) of them, affecting large and small joints simultaneously in 29 (58%). Age greater than 50 years, back pain and crepitus in the joints proved to be factors associated with arthritis. We observed that female smoking important and advanced liver fibrosis (F3 and F4) were associated with arthralgia. Female gender and smoking were important factors associated with myalgia. CONCLUSION: We found a high prevalence of musculoskeletal manifestations among patients with chronic hepatitis C of this service. The most common risk factors for the presence of extra hepatic manifestations were female and older than 50 years. The autoantibodies, although frequently not statistically significant compared with the major musculoskeletal manifestations analyzed. Inflammatory infiltrate and liver transaminase levels did not show statistical significance
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