Inactive Disease and Remission in Childhood-Onset Systemic Lupus Erythematosus

Objective. To define inactive disease (ID) and clinical remission (CR) and to delineate variables that can be used to measure ID/CR in childhood-onset systemic lupus erythematosus (cSLE). Methods. Delphi questionnaires were sent to an international group of pediatric rheumatologists. Respondents provided information about variables to be used in future algorithms to measure ID/CR. The usefulness of these variables was assessed in 35 children with ID and 31 children with minimally active lupus (MAL). Results. While ID reflects cSLE status at a specific point in time, CR requires the presence of ID for >6 months and considers treatment. There was consensus that patients in ID/CR can have <2 mild nonlimiting symptoms (i.e., fatigue, arthralgia, headaches, or myalgia) but not Raynaud's phenomenon, chest pain, or objective physical signs of cSLE; antinuclear antibody positivity and erythrocyte sedimentation rate elevation can be present. Complete blood count, renal function testing, and complement C3 all must be within the normal range. Based on consensus, only damage-related laboratory or clinical findings of cSLE are permissible with ID. The above parameters were suitable to differentiate children with ID/CR from those with MAL (area under the receiver operating characteristic curve >0.85). Disease activity scores with or without the physician global assessment of disease activity and patient symptoms were well suited to differentiate children with ID from those with MAL. Conclusion. Consensus has been reached on common definitions of ID/CR with cSLE and relevant patient characteristics with ID/CR. Further studies must assess the usefulness of the data-driven candidate criteria for ID in cSLE.

An initial proposal for PDP of smes developing hospital furniture

A large percentage of the industrial SMEs has an organizational structure for product development too far from the adequate practices and models, elaborated by renowned authors with expertise in the theme of product development. On the other hand, the authors state that SMEs obtain considerable advantages by adopting a model of product development process (PDP) management. Healt is one of the most innovative sectors in the world, and countries like Brazil and Colombia are transitioning from a system that cares for contagious infecttions diseases where the drug product is the main form of treatment - to a system that cares for chronic degenerative conditions - where the equipment, including hospital furniture, has more relevance to the treatment. This change is offering better opportunities of specialized markets to hospital furniture SMEs that adopt an adquate PDF model. The present study proposes a first outline of a model of PDP management for industrial metal-mechanical SMEs that develop and manufacture hospital furniture, from a review of models proposed for great mechanical area.