Juvenile onset systemic lupus erythematosus: a possible role for vitamin D in disease status and bone health

Purpose: In juvenile onset systemic lupus erythematosus (JoSLE), evidence for the association between vitamin D status, lupus activity, and bone health is very limited and not conclusive. The aim of this study was, therefore, to assess in JoSLE patients the possible relevance of vitamin D deficiency in disease and bone parameters. Methods: Fifty-seven JoSLE patients were initially compared to 37 age, race and body mass index (BMI) -matched healthy controls. The serum concentration of 25 hydroxyvitamin D (25OHD) was determined by radioimmunoassay. Patients with 25OHD deficiency (acurrency sign20 ng/mL) were compared to those with levels > 20 ng/mL. Disease activity was evaluated by SLE Disease Activity Index (SLEDAI). Bone mineral density (BMD) and body composition (BC) were measured using dual-energy X-ray absorptiometry (DXA). Results: 25OHD levels were similar in patients and controls (21.44 +/- 7.91 vs 22.54 +/- 8.25 ng/mL, p = 0.519), regardless of supplementation (65% of patients and none in controls). Thirty-one patients with 25OHD deficiency (acurrency sign20 ng/mL) were further compared to the 26 JoSLE patients with levels > 20 ng/mL. These two groups were well-balanced regarding vitamin D confounding variables: age (p = 0.100), ethnicity (p = 1.000), BMI (p = 0.911), season (p = 0.502), frequency of vitamin D supplementation (p = 0.587), creatinine (p = 0.751), renal involvement (p = 0.597), fat mass (p = 0.764), lean mass (p = 0.549), previous/current use of glucocorticoids(GC) (p = 1.0), immunosuppressors (p = 0.765), and mean current daily dose of GC (p = 0.345). Patients with vitamin D deficiency had higher SLEDAI (3.35 +/- 4.35 vs 1.00 +/- 2.48, p = 0.018), lower C4 levels (12.79 +/- 6.78 vs 18.38 +/- 12.24 mg/dL, p = 0.038), lower spine BMD (0.798 +/- 0.148 vs 0.880 +/- 0.127 g/cm2, p = 0.037) and whole body BMD (0.962 +/- 0.109 vs 1.027 +/- 0.098 g/cm2, p = 0.024). Conclusion: JoSLE vitamin D deficiency, in spite of conventional vitamin D supplementation, affects bone and disease activity status independent of therapy and fat mass reinforcing the recommendation to achieve adequate levels. Lupus (2012) 21, 1335-1342.

The filler content of the dental composite resins and their influence on different properties

The purpose of this study was to compare the inorganic content and morphology of one nanofilled and one nanohybrid composite with one universal microhybrid composite. The Vickers hardness, degree of conversion and scanning electron microscope of the materials light-cured using LED unit were also investigated. One nanofilled (Filtek (TM) Supreme XT), one nanohybrid (TPH (R) 3) and one universal microhybrid (Filtek (TM) Z-250) composite resins at color A2 were used in this study. The samples were made in a metallic mould (4 mm in diameter and 2 mm in thickness). Their filler weight content was measured by thermogravimetric analysis (TG). The morphology of the filler particles was determined using scanning electron microscope equipped with a field emission gun (SEM-FEG). Vickers hardness and degree of conversion using FT-IR spectroscopy were measured. Filtek (TM) Z-250 (microhybrid) composite resin shows higher degree of conversion and hardness than those of Filtek (TM) Supreme XT (nanofilled) and TPH (R) 3 (nanohybrid) composites, respectively. The TPH3 (R) (nanohybrid) composite exhibits by far the lowest mechanical property. Nanofilled composite resins show mechanical properties at least as good as those of universal hybrids and could thus be used for the same clinical indications as well as for anterior restorations due to their high aesthetic properties. Microsc. Res. Tech. 75:758765, 2012. (C) 2011 Wiley Periodicals, Inc

Reducing the parameter space for unparticle-inspired models using white dwarf masses

Based on astrophysical constraints derived from Chandrasekhar's mass limit for white dwarfs, we study the effects of the model on the parameters of unparticle-inspired gravity, on scales Lambda(U) > 1 TeV and d(U) approximate to 1.

HEALTH EDUCATION IN THE CARE TO CLIENTS OF THE BLOOD GLUCOSE SELF-MONITORING PROGRAM

This article reports, in a systemized and analytical way, the experience of an Outreach Program in the period between 2010 and 2011. The study focused on health education interventions as strategies to improve the adherence of individuals with insulin- dependent diabetes mellitus (IDDM), clients of a blood glucose self-Monitoring program. In addition, we intended to contribute to the reorganization of the program's working processes in the unit. Health education strategies were used in both educational groups and home visits, thus permitting the provision of care that was more individualized. Data regarding the clients were organized on a spreadsheet and in files for the Family Health teams, which made it easier to identify the patients, including those who were absent, helping to decentralize the care. By using health education strategies, we intended to contribute to a more comprehensive and emancipatory care of the clients, aimed at a continuous reflection of the workers regarding their practices.

Maize and soybeans production in integrated system under no-tillage with different pasture combinations and animal categories

The adoption of no-till system (NTS) combined with crop-livestock integration (CLI) has been a strategy promoted in Brazil, aiming to maximize areas yield and increase agribusiness profitability. This study aimed to evaluate grains yield and phytotechnical attributes from maize and soybean culture by CLI system under NTS after winter annual pure and diversified pastures with the absence or presence of grazing animals. The experiment was installed in Castro (Parana State, Brazil) on in a dystrophic Humic Rhodic Hapludox with a clay texture, using experimental design of randomized complete blocks in 4 x 2 factorial scheme with three replications. Treatments included four pasture combinations (diversified or pure) and animal categories (light and heavy) subjected or not to grazing animals during the winter. During 2008/09 and 2009/10 summers, the area was cultivated with soybeans and maize, respectively, with yield assessment of grains and phytotechnical attributes. Treatments did not alter the yield and weight of a thousand seeds (WTS) of soybeans. In maize culture, the grazing animal during the winter increased the plant population and grains yield, but gave slight decrease in WTS. Pasture combinations (diversified or pure) and animal categories (light and heavy) did not interfere in soybean culture, but benefited the maize crop.

Hyperbolic-like estimates for higher order equations

The main goal of this paper is to derive long time estimates of the energy for the higher order hyperbolic equations with time-dependent coefficients. in particular, we estimate the energy in the hyperbolic zone of the extended phase space by means of a function f (t) which depends on the principal part and on the coefficients of the terms of order m - 1. Then we look for sufficient conditions that guarantee the same energy estimate from above in all the extended phase space. We call this class of estimates hyperbolic-like since the energy behavior is deeply depending on the hyperbolic structure of the equation. In some cases, these estimates produce a dissipative effect on the energy. (C) 2012 Elsevier Inc. All rights reserved.

Cost-effectiveness of introducing the 10-valent pneumococcal conjugate vaccine into the universal immunisation of infants in Brazil

Background Cost-effectiveness studies have been increasingly part of decision processes for incorporating new vaccines into the Brazilian National Immunisation Program. This study aimed to evaluate the cost-effectiveness of 10-valent pneumococcal conjugate vaccine (PCV10) in the universal childhood immunisation programme in Brazil. Methods A decision-tree analytical model based on the ProVac Initiative pneumococcus model was used, following 25 successive cohorts from birth until 5 years of age. Two strategies were compared: (1) status quo and (2) universal childhood immunisation programme with PCV10. Epidemiological and cost estimates for pneumococcal disease were based on National Health Information Systems and literature. A 'top-down' costing approach was employed. Costs are reported in 2004 Brazilian reals. Costs and benefits were discounted at 3%. Results 25 years after implementing the PCV10 immunisation programme, 10 226 deaths, 360 657 disability-adjusted life years (DALYs), 433 808 hospitalisations and 5 117 109 outpatient visits would be avoided. The cost of the immunisation programme would be R$10 674 478 765, and the expected savings on direct medical costs and family costs would be R$1 036 958 639 and R$209 919 404, respectively. This resulted in an incremental cost-effectiveness ratio of R$778 145/death avoided and R$22 066/DALY avoided from the society perspective. Conclusion The PCV10 universal infant immunisation programme is a cost-effective intervention (1-3 GDP per capita/DALY avoided). Owing to the uncertain burden of disease data, as well as unclear long-term vaccine effects, surveillance systems to monitor the long-term effects of this programme will be essential.

Bioactive compounds with effects on inflammation markers in humans

Obesity and other chronic diseases are accompanied by adipose tissue, liver, pancreas, muscle and brain low-grade chronic inflammation. Indeed, the obese condition and metabolic syndrome are characterized by an increased expression of inflammatory cytokines and infiltration of immune cells in adipocytes. The inflammatory response promotes the activation of transcriptional factors and pro-inflammatory cytokines, which can lead to an unresolved inflammatory response associated with an inhibition of insulin signalling and high risk for cardiovascular events. Epidemiological and intervention studies have been carried out to find out dietary patterns, foods and bioactive compounds with protective anti-inflammatory actions. The most studied compounds are polyphenols, especially isoflavone and anthocyanin, but quercertin, catechin and resveratrol have also been investigated. Furthermore, some studies have reported the effects of milk peptides, plant sterol and stanol, L-carnitine and alpha-lipoic acid on inflammatory processes. This review aimed to collect and discuss those relevant studies reported in the scientific literature following a systematic scientific search about the effect of such bioactive compounds on inflammation in humans.

W Z plus missing-E-T signal from gaugino pair production at LHC7

LHC searches for supersymmetry currently focus on strongly produced sparticles, which are copiously produced if gluinos and squarks have masses of a few hundred GeV. However, in supersymmetric models with heavy scalars, as favored by the decoupling solution to the SUSY flavor and CP problems, and m((g) over tilde) greater than or similar to 500 GeV as indicated by recent LHC results, chargino-neutralino ((W) over tilde (+/-)(1)(Z) over tilde (2)) production is the dominant cross section for m((W) over tilde1) similar to m((Z) over tilde2) < m(<(g)over tilde>)/3 at LHC with root s = 7 TeV (LHC7). Furthermore, if m((Z) over tilde1) + (m (Z) over tilde) less than or similar to m((Z) over tilde2) less than or similar to m((Z) over tilde1) + m(h), then (Z) over tilde (2) dominantly decays via (Z) over tilde (2) -> (Z) over tilde (1)Z, while (W) over tilde (1) decays via (W) over tilde (1) -> (Z) over tilde W-1. We investigate the LHC7 reach in the W Z + (sic)T channel (for both leptonic and hadronic decays of the W boson) in models with and without the assumption of gaugino mass universality. In the case of the mSUGRA/CMSSM model with heavy squark masses, the LHC7 discovery reach in the W Z+ (sic)T channel becomes competetive with the reach in the canonical (sic)T + jets channel for integrated luminosities similar to 30 fb(-1). We also present the LHC7 reach for a simplified model with arbitrary m((Z) over tilde1) and m((W) over tilde1) similar to m((Z) over tilde2). Here, we find a reach of up to m((W) over tilde1) similar to 200 (250) GeV for 10 (30) fb(-1).

Treatment of Pythiosis in Equine Limbs Using Intravenous Regional Perfusion of Amphotericin B

Objective To evaluate the effects of intravenous regional limb perfusion (IRLP) administration of amphotericin B in horses to treat pythiosis after surgical excision and thermocautery. Study Design Case series. Animals Horses (n = 12) with Pythium insidiosum infection of the distal aspect of the thoracic or pelvic limbs. Methods After surgical excision of granulation tissue and thermocautery, 50 mg amphotericin B was administered by IRLP through a catheter placed in a superficial vein of the affected limb next to the lesion after placing a tourniquet above the injection site. The lesions and locomotor system were evaluated before treatment and at 7, 14, 21, 28, 35, and 60 days. Results Ninety-two percent of horses treated with amphotericin B had complete lesion resolution 35 or 60 days after 1 or 2 IRLP treatments, respectively. IRLP induced limb edema and pain during regional palpation in 42%, and inflammation of the injection site in 33% of horses; however these signs resolved after 14 days. Conclusions IRLP administration of amphotericin B was effective for treating pythiosis in equine limbs, resolving infection with manageable side effects.

Cross-taxon congruence of alpha and beta diversity among five leaf litter arthropod groups in Colombia

In this study alpha and beta diversity patterns of five leaf litter arthropod groups (ants, predatory ants, oribatid mites, spiders and other arachnids) were described and compared in 39 sampling patches of a transformed landscape in southwestern Colombia, that represented five vegetation types: secondary forest, riparian forest, giant bamboo forest, pasture and sugarcane crop. It was also assessed whether some taxa could be used as diversity surrogates. A total of 6,765 individuals grouped in 290 morphospecies were collected. Species richness in all groups was lower in highly transformed vegetation types (pasture, sugarcane crop) than in native ones (forests). In contrast, there were no clear tendencies of beta diversity among vegetation types. Considering sampling patches, 0.1-42% of the variation in alpha diversity of one taxonomic group could be explained from the alpha diversity of another, and 0.2-33% of the variation of beta diversity of a given taxon was explained by that in other groups. Contrary to recent findings, we concluded that patterns of alpha diversity are more congruent than patterns of beta diversity. This fact could be attributed to a sampling effect that promotes congruence in alpha diversity and to a lack of a clear regional ecological gradient that could promote congruent patterns of beta diversity. We did not find evidence for an ideal diversity surrogate although diversity patterns of predatory ants had the greatest congruencies. These results support earlier multi-taxon evaluations in that conservation planning should not be based on only one leaf litter arthropod group.

A educação em saúde no cuidado de usuários do Programa Automonitoramento Glicêmico

O trabalho relata, de maneira sistematizada e crítica, a experiência de um Projeto de Extensão no período de 2010 a 2011. Teve como foco ações de educação em saúde como estratégia para melhorar a adesão das pessoas com diabetes mellitus e insulinodependentes, de uma Unidade Básica de Saúde do município de São Paulo, ao Programa Automonitoramento Glicêmico. Além disso, pretendeu-se contribuir na reorganização do processo de trabalho em relação ao Programa na unidade. Foram utilizadas estratégias de educação em saúde em grupos educativos e visitas domiciliares, assim, possibilitando cuidados mais singulares. Dados dos usuários foram organizados em planilha e em pastas para as equipes de Saúde da Família, facilitando na identificação dos usuários, inclusive os faltosos, e auxiliando na descentralização do cuidado. Com as ações de educação em saúde, pretendeu-se contribuir para um cuidado mais integral e emancipatório aos usuários, para um contínuo refletir dos trabalhadores quanto a suas práticas.

Tromboflebite plantar: achados em ressonância magnética

OBJETIVO: Demonstrar os achados em ressonância magnética (RM) da tromboflebite plantar. MÉTODOS: Revisão retrospectiva de 20 pacientes com dor na região plantar nos quais os achados de ressonância magnética indicaram tromboflebite plantar. RESULTADOS: Foram avaliados 14 homens e seis mulheres, com idade média de 46,7 anos. Oito desses pacientes também foram submetidos à ultrassonografia com doppler, que confirmaram a tromboflebite. As imagens de ressonância magnética foram avaliadas em consenso por dois radiologistas com experiência em radiologia do sistema musculoesquelético (mais de 10 anos cada um), demonstrando edema perivascular em todos os 20 pacientes (100%) e edema muscular em 19 dos 20 pacientes (95%). Todos os 20 pacientes apresentavam intensidade de sinal intermediária intraluminal em T2 (100%) e ectasia venosa estava presente em 17 dos 20 casos (85%). Veias colaterais foram visualizadas em um dos 20 pacientes (5%). Todos os 14 casos (100%), nos quais o contraste intravenoso foi administrado, apresentavam realce dos tecidos perivenulares e defeito de enchimento intraluminal. Ectasia venosa, perda da compressibilidade e ausência de fluxo na ultrassonografia com doppler também foram observados em todos os oito casos examinados pelo método. CONCLUSÕES: A RM é um método sensível na avaliação de tromboflebite plantar em pacientes com dor plantar.

Um novo escore para dependência a nicotina e uma nova escala de conforto do paciente durante o tratamento do tabagismo

O tabagismo é considerado a maior causa evitável de morbidade e mortalidade. O manuseio farmacológico da síndrome de abstinência de nicotina possibilita melhores taxas de cessação. Desenvolvemos um sistema de coleta de dados em nosso programa de assistência ao fumante, que inclui dois instrumentos novos: um escore para dependência de nicotina em fumantes de < 10 cigarros/dia e uma escala de conforto do paciente durante o tratamento do tabagismo. Descrevemos aqui os dois instrumentos, que estão em processo de validação.