Prospective surveillance study of acute respiratory infections, influenza-like illness and seasonal influenza vaccine in a cohort of juvenile idiopathic arthritis patients

Background Acute respiratory infections (ARI) are frequent in children and complications can occur in patients with chronic diseases. We evaluated the frequency and impact of ARI and influenza-like illness (ILI) episodes on disease activity, and the immunogenicity and safety of influenza vaccine in a cohort of juvenile idiopathic arthritis (JIA) patients. Methods Surveillance of respiratory viruses was conducted in JIA patients during ARI season (March to August) in two consecutive years: 2007 (61 patients) and 2008 (63 patients). Patients with ARI or ILI had respiratory samples collected for virus detection by real time PCR. In 2008, 44 patients were immunized with influenza vaccine. JIA activity index (ACRPed30) was assessed during both surveillance periods. Influenza hemagglutination inhibition antibody titers were measured before and 30-40 days after vaccination. Results During the study period 105 ARI episodes were reported and 26.6% of them were ILI. Of 33 samples collected, 60% were positive for at least one virus. Influenza and rhinovirus were the most frequently detected, in 30% of the samples. Of the 50 JIA flares observed, 20% were temporally associated to ARI. Influenza seroprotection rates were higher than 70% (91-100%) for all strains, and seroconversion rates exceeded 40% (74-93%). In general, response to influenza vaccine was not influenced by therapy or disease activity, but patients using anti-TNF alpha drugs presented lower seroconversion to H1N1 strain. No significant differences were found in ACRPed30 after vaccination and no patient reported ILI for 6 months after vaccination. Conclusion ARI episodes are relatively frequent in JIA patients and may have a role triggering JIA flares. Trivalent split influenza vaccine seems to be immunogenic and safe in JIA patients.

O canteiro do poeta-arquiteto: a conduta criativa de João Cabral de Melo Neto à luz de seus manuscritos

Neste artigo repensamos a metáfora do "poeta-engenheiro", ou "poeta-arquiteto", que geralmente caracteriza o processo criativo de João Cabral de Melo Neto, à luz de uma leitura genética de manuscritos de A educação pela pedra. Veremos que o "arquiteto" da metáfora provém da teoria de Le Corbusier, na qual o desenho (a concepção) determina o canteiro (a execução). No entanto, a análise de transformações de estruturas por meio de reformulações textuais nos manuscritos do poeta mostra que, por vezes, o projeto, ou intenção, se transforma nos trabalhos da página-canteiro.

Prevalence of celiac disease among blood donors in São Paulo: the most populated city in Brazil

OBJECTIVE: Celiac disease is a permanent enteropathy caused by the ingestion of gluten, which leads to an immunemediated inflammation of the small intestine mucosa. The prevalence of celiac disease varies among different nations and ethnic backgrounds, and its diversity is determined by genetic and environmental factors. São Paulo city is one of the largest cities in the world, with a vast population and an important history of internal migratory flow from other Brazilian regions, as well as immigration from other, primarily European, countries, resulting in significant miscegenation. The aim of the present study was to estimate the prevalence of adults with undiagnosed celiac disease among blood donors of São Paulo by collecting information on the ancestry of the population studied. METHODS: The prevalence of celiac disease was assessed by screening for positive IgA transglutaminase and IgA endomysium antibodies in 4,000 donors (volunteers) in the Fundação Pró-Sangue Blood Center of São Paulo, São Paulo, Brazil. The antibody-positive subjects were asked to undergo a small bowel biopsy. RESULTS: Of the 4,000 subjects, twenty-four had positive tests, although both antibody tests were not always concordant. For example, ten subjects were positive for IgA tissue transglutaminase only. In twenty-one positive patients, duodenal biopsies were performed, and the diagnosis of celiac disease was confirmed in fourteen patients (Marsh criteria modified by Oberhuber). In this group, 67% claimed to have European ancestry, mainly from Italy, Portugal and Spain. CONCLUSION: The prevalence of celiac disease is at least 1:286 among supposedly healthy blood bank volunteers in São Paulo, Brazil.

Structural stability of flexible lines in catenary configuration under torsion

Catenary risers can present during installation a very low tension close to seabed, which combined with torsion moment can lead to a structural instability, resulting in a loop. This is undesirable once it is possible that the loop turns into a kink, creating damage. This work presents a numerical methodology to analyze the conditions of loop formation in catenary risers. Stability criteria were applied to finite element models, including geometric nonlinearities and contact constraint due to riser-seabed interaction. The classical Greenhill's formula was used to predict the phenomenon and parametric analysis shows a “universal plot” able to predict instability in catenaries using a simple equation that can be applied for typical risers installation conditions and, generically, for catenary lines under torsion.

Upper crustal earthquake swarms in São Caetano: reactivation of the Pernambuco shear zone and trending branches in intraplate Brazil

Seismogenic fault reactivation of continental-scale structures has been observed in a few intraplate areas, but its cause is still amatter of debate. The objective of the present study is to analyze two seismic swarms that occurred along the EW-trending Pernambuco ductile shear zone and in a NE-trending branch, in 2007 and 2010 in São Caetano County, Northeastern Brazil.We studied both epicentral areas using a nine- and a seven-station network during 180 and 54 days, respectively. The results indicate that the 2007 swarm correspond to a right-lateral, strike–slip fault with a normal component of slip (strike 74°, dip 60°, and rake−145°) and the 2010 swarmcorresponds to a normal fault (strike 265°, dip 79°, and rake −91°). The former reactivated a NE-trending branch, whereas the latter reactivated the main E-W-trending mylonitic belt of the Pernambuco shear zone. These results are consistent with seismogenic reactivation of this major structure, generated by the present-day EW-trending compression and NS-trending extension, as observed by previous studies. This shear zone was reactivated as rift faults in the Cretaceous during the South America–Africa breakup. However, our study confirms that the basement fabric such as continental-scale ductile shear zones, show evidence of crustal weakness outside areas of previous rifting, and it reveals the potential for large earthquakes along dormant rift segments associated with major basement shear belts.