Clinical presentation and salivary gland histopathology of paediatric primary Sjogren's syndrome

ObjectiveExplore the presentation, diagnostic criteria and exocrine gland histopathology of paediatric primary Sjogren's syndrome (PPSjS).MethodsA case series of 8 children is reported and American-European Consensus Group (AECG-2002) criteria were examined, as well as minor labial salivary and lachrymal gland biopsies, which were scored by a pathologist blinded to outcome. For all cases, connective tissue diseases and parotid-related infectious disease were excluded.ResultsAge at onset varied from 5-13 years old; 6 were females, all followed from diagnosis up to the last visit (1-10 years). The main features at presentation were recurrent tender parotid swelling and sialectasis imaging, with decreased salivary function assessed by Tc-99 scintigraphy. Mild sicca symptoms were observed in 4/8 cases. Systemic features, including fatigue, myalgia, arthritis, tenosynovitis, joint contractures, transient Raynaud's and high ESR, were recorded at onset. Autoantibody profile was unremarkable for diagnosis, while lymphocytic infiltration of labial salivary glands and sialectasis were observed in all biopsies (8/8). In lachrymal glands, massive lymphocytic infiltration and lymphocytic gastritis were observed during complementary assessment. Flares were treated with low dose steroids and long-term use of hydroxychloroquine (5/8), although only 318 fulfilled AECG-2002 diagnostic criteria, throughout the disease course.ConclusionPPSjS is rare, slowly progressive and its early presentation is variable. Standardised diagnostic algorithms should include recurrent parotid swelling and early diagnosis should rely mostly on salivary and lachrymal gland histopathology in this age group.

Preliminary Criteria for Global Flares in Childhood-Onset Systemic Lupus Erythematosus

Objective. To develop widely acceptable preliminary criteria of global flare for childhood-onset systemic lupus erythematosus (cSLE).Methods. Pediatric rheumatologists (n = 138) rated a total of 358 unique patient profiles with information about the cSLE flare descriptors from 2 consecutive visits: patient global assessment of well-being, physician global assessment of disease activity (MD-global), health-related quality of life, anti-double-stranded DNA antibodies, disease activity index scores, protein: creatinine (P:C) ratio, complement levels, and erythrocyte sedimentation rate (ESR). Based on 2,996 rater responses about the course of cSLE (baseline versus followup), the accuracy (sensitivity, specificity, and area under the receiver operating characteristic curve) of candidate flare criteria was assessed. An international consensus conference was held to rank these candidate flare criteria as per the American College of Rheumatology recommendations for the development and validation of criteria sets.Results. The highest-ranked candidate criteria considered absolute changes (Delta) of the Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) or British Isles Lupus Assessment Group (BILAG), MD-global, P:C ratio, and ESR; flare scores can be calculated (0.5 x Delta SLEDAI + 0.45 x Delta P:C ratio + 0.5 x Delta MD-global + 0.02 x Delta ESR), where values of >= 1.04 are reflective of a flare. Similarly, BILAG-based flare scores (0.4 x Delta BILAG + Delta 0.65 x Delta P:C ratio + 0.5 + Delta MD-global + 0.02 x Delta ESR) of >= 1.15 were diagnostic of a flare. Flare scores increased with flare severity.Conclusion. Consensus has been reached on preliminary criteria for global flares in cSLE. Further validation studies are needed to confirm the usefulness of the cSLE flare criteria in research and for clinical care.

Consenso em reumatologia pediátrica: parte I - definição dos critérios de doença inativa e remissão em artrite idiopática juvenil/artrite reumatóide juvenil

Não há critérios universalmente aceitos para a remissão clínica em artrite idiopática juvenil/artrite reumatóide juvenil (AIJ/ARJ). OBJETIVO: formar consenso sobre estes critérios. MÉTODOS: foi utilizado um inquérito pelo método Delphi para reunir os critérios vigentes e utilizados por especialistas em reumatologia pediátrica (RP) no mundo todo. A análise dos resultados constituiu a base para uma Consensus Conference utilizando a nominal group technique (NGT) para alcançar o consenso nas questões não resolvidas após a análise dos questionários deste inquérito. Cento e trinta RP de 34 países responderam ao inquérito e 20 RP de nove países elegeram os critérios durante dois dias, em processo de discussão estruturada, para formar consenso pela NGT. RESULTADOS: os critérios de doença inativa deveriam incluir: 1) nenhuma articulação com artrite em atividade; 2) ausência de febre, rash, serosite, esplenomegalia ou linfadenopatia generalizada atribuída à AIJ/ARJ; 3) ausência de uveíte em atividade; 4) VHS ou PCR negativas (se ambos forem testados, ambos devem ser normais); 5) a avaliação global pelo médico deve indicar o melhor escore possível, indicando doença inativa. CONCLUSÕES: de acordo com o voto de consenso, seis meses contínuos de doença inativa são necessários para se considerar um paciente em estado de remissão com medicação; 12 meses contínuos de doença inativa e sem medicação são necessários para considerar um paciente em estado de remissão sem medicação. O critério para remissão sem medicação deve prever com acurácia de 95% a probabilidade inferior a 20% de recaída em cinco anos.

Análise histológica em tecido epitelial sadio de ratos Wistar (in vivo) irradiados com diferentes intensidades do ultrassom

CONTEXTUALIZAÇÃO: O Ultrassom (US) é um dos recursos físicos amplamente utilizado e pesquisado nos tratamentos de fisioterapia. Sabe-se que diante de uma escassa literatura sobre efeitos do US em tecidos sadios, muitos profissionais fisioterapeutas acabam realizando aplicações infundadas de métodos e parâmetros. OBJETIVO: Avaliar possíveis alterações histológicas e morfométricas do tecido sadio in vivo de ratos Wistar irradiados com diferentes intensidades de US. MÉTODOS: Trinta ratos da linhagem Wistar, distribuídos aleatoriamente em cinco grupos de seis animais cada foram tratados na região dorsal do lado direito numa área de 4cm². O lado esquerdo serviu como controle. O tratamento foi feito durante quatro dias com 2 minutos de irradiação. Verificou-se a intensidade de saída com dosímetro de precisão antes das aplicações. Analisou-se a histologia e a morfometria por meio do software Image Tool. RESULTADOS: Observou-se um discreto infiltrado inflamatório e adelgaçamento das fibras da derme, principalmente dos grupos irradiados com 1.5 e 2W/cm². Notou-se também um aumento na espessura da epiderme nas amostras dos animais irradiados. Para avaliar os resultados quantitativos, utilizou-se como análise estatística ANOVA one way e o teste post hoc de Tukey. Na espessura da epiderme, obtiveram-se diferenças significativas entre grupo controle e os grupos irradiados com 1.0, 1.5 e 2.0W/cm². CONCLUSÃO: Sob ação do US nas doses maiores houve alterações na epiderme e derme, respectivamente, o aumento da espessura e proliferação com adelgaçamento das fibras colágenas, o que alerta para possíveis implicações do uso do US em estética.

In vivo determination of incorporated activity of Tc-99(m)-MDP in bone tissue

In vivo determination of the incorporated activity of Tc-99(m)-MDP (methylene diphosphonate) in bone tissue by means of a scintillation camera requires calibration of the device. This can be carried out by using an anthropomorphic physical phantom. In this work, a new human tibia and fibula phantom is presented to estimate incorporated activity to bone tissue. A tibia and a fibula, taken from a real skeleton, were used to develop the phantom. Images were acquired of the legs of 65 volunteers at different times of incorporation (minimum of 120 and maximum of 2500 min after injection) and count rates of such a region were obtained by means of a computer program. The calibration factor obtained was then used to assess the activity in the two bents. The final result is 0.4995 kBq per cpm for technetium. The proposed method can be used both for radiation protection purposes and for metabolism studies.

Thermoluminescence measurements of entrance surface skin dose in exams of dog's chest in veterinary radiology

This study aims to determine the entrance surface skin doses in dogs (with suspected pulmonary metastasis) submitted to chest X-rays using the technique of thermoluminescence (TL) dosimetry. Twenty seven radiologic exams of dogs of different breed and sizes were performed. The radiation doses were assessed using thermoluminescent dosimeters of calcium sulphate doped with dysprosium (CaSO(4):Dy) produced at Instituto de Pesquisas Energeticas e Nucleares (IPEN-CNEN). The entrance surface skin dose range evaluated in this type of procedure was between 0.43 mGy to small size dogs and 4.22 mGy to big size dogs with repeated exams. The obtained results indicate that is extremely important the assessment of radiation doses involved in veterinary diagnostic radiology procedures, to evaluate the delivered doses to the animals, to be used as a parameter in the individual monitoring of pet's owners, who assist the animal positioning, and to protect occupationally exposed workers at the Veterinary Radiology Clinics. (C) 2010 Elsevier Ltd. All rights reserved.

Structural and thermal characterization of dioctadecyldimethylammonium bromide dispersions by spin labels

Dioctadecyldimethylammonium bromide (DODAB) dispersions obtained by simply mixing the amphiphile in water, and by bath-sonication, were investigated by electron spin resonance (ESR) of stearic acids and their methyl ester derivatives, labeled at the 5th and 16th carbons of the acyl chain. The ESR spectra indicate that the non-sonicated dispersions are formed mainly by one population of DODAB vesicles, either in the gel (T < T-m) or in the liquid-crystalline (T > T-m) state. Around T-m there is a co-existence of the two phases, with a thermal hysteresis of about 3.2 degreesC. In sonicated DODAB dispersions, spin labels indicate two different environments even for temperatures far below T-m: one similar to that obtained with non-sonicated samples, a gel phase, and another one in the liquid-crystalline state. The fluid phase domain present below T-m could correspond to either the periphery of bilayer fragments, reported to be present in sonicated DODAB dispersions, or to high curvature vesicles. (C) 2001 Elsevier B.V. Ireland Ltd. All rights reserved.

New layered double hydroxides intercalated with substituted pyrroles. 1. In situ polymerization of 4-(1H-pyrrol-1-yl)benzoate

The two-dimensional hybrid organic-inorganic materials Zn-2-Cr and Zn-2-Al-LDHs (Layered Double Hydroxides) containing 4-(1H-pyrrol-1yl)benzoate anions as the interlayer anions were synthesized by the co-precipitation method at constant pH followed by subsequent hydrothermal treatment for 72 h. The materials were characterized by PXRD, C-13 CP-MAS NMR, ESR, TGA, and TEM. The basal spacing found by the X-ray diffraction technique is coincident with the formation of bilayers of the intercalated anions. Solid-state C-13 NMR and ESR data strongly suggest the partial in situ polymerization of the 4-(1H-pyrrol-1yl)benzoate anions during coprecipitation. (c) 2006 Elsevier Ltd. All rights reserved.

New layered double hydroxides intercalated with substituted pyrroles. 2. 3-(Pyrrol-1-yl)-propanoate and 7-(pyrrol-1-yl)-heptanoate LDHs

We report the synthesis and characterization of organic-inorganic hybrid materials: Zn-2-Al-LDHs (layered double hydroxides) containing 3-(1H-pyrrol-1-yl)-propanoate and 7-(1H-pyrrol-l-yl)-heptanoate as the interlayer anions. The LDHs were synthesized by the co-precipitation method at constant pH followed by hydrothermal treatment for 72 h. The materials were characterized by PXRD, C-13 CP-MAS NMR, TGA, and ESR. The basal spacing found by PXRD technique is coincident with the formation of bilayers of the intercalated anions. The solid state C-13 NMR showed that the interlayered anions remain identical after intercalation. ESR data suggest that the monomers connect each other in a limited number of guests when a thermal treatment is applied. The inorganic LDH sheets delay the temperature of degradation of the monomers. (c) 2006 Elsevier Ltd. All rights reserved.

Local and global magnetic properties of Zn1-xCoxO and Mn-doped GaAs thin films

Amorphous and crystalline thin films of Mn-doped(0.5%-10%) GaAs and crystalline thin films of Zn1-xCoxO(x = 3%-20%) were investigated by means of magnetic susceptibility and electron spin resonance (ESR). For the Mn-doped GaAs samples, our results show the absence of ferromagnetic ordering for the amorphous films in the 300 > T > 2 K temperature range, in contrast to the ferromagnetism found in crystalline films for T-C < 110 K. A single ESR line with a temperature independent g-value (g similar to 2) is observed for the amorphous films, and the behavior of this ESR linewidth depends on the level of crystallinity of the film. For the Mn-doped GaAs crystalline films, only a ferromagnetic mode is observed for T < TC when the film is ferromagnetic. Turning now the Zn1-xCoxO films, ferromagnetic loops were observed at room temperature for these films. The magnetization data show an increasing of the saturation magnetization M. as a function of x reaching a maximum value for x approximate to 10%. ESR experiments at T = 300 K in the same films show a strong anisotropic ferromagnetic mode (FMR) for x = 0.10.

Durango apatite fission-track dating using length-based age corrections and neutron fluence measurements by natural thorium thin films and natural U-doped glasses calibrated through natural uranium thin films

In this work, we present an approach for neutron fluence measurements based on natural thorium thin films and natural uranium-doped glasses calibrated through natural uranium thin films to be used for dating with the Fission-Track Method (FTM). This neutron dosimetry approach allows the employment of FTM even when dating is carried out using low neutron themalization facilities. Besides, it makes possible the determination of the Th/U ratio of the mineral to be dated. Durango apatite which is often employed in FTM as an age standard was analyzed. This apatite presented a fairly high Th/U ratio, 29.9 +/- 1.7. Th fissions were 18%, 12% and 10% of the total for irradiations where thermal to fast neutron flux ratios were 2.4, 4.4 and 5,2, respectively. These results show that Th fission must be considered for this apatite, when not well-thermalized irradiation facilities are used. The ratio between spontaneous and induced track length, L(S)/L(1), close to 0.89, indicates a certain amount of rejuvenation of the age of Durango apatite. Therefore, its apparent age should be corrected, the application of a technique based on track-length measurements produced a corrected age of 29.7 +/- 1.1 Ma, consistent with the independent reference age of this apatite (31.4 +/- 0.5 Ma). This result represents a support for viability of the neutron dosimetry approach studied in this work for FTM.(C) 2002 Elsevier B.V. B.V. All rights reserved.

Long-term accumulation of uranium in bones of Wistar rats as a function of intake dosages

Groups of Wistar rats were fed with ration doped with uranyl nitrate at concentration A ranging from 0.5 to 100 ppm, starting after the weaning period and lasting until the postpuberty period when the animals were sacrificed. Uranium in the ashes of bones was determined by neutron activation analysis. It was found that the uranium concentration in the bones. as a function of A, exhibits a change in its slope at similar to20 ppm-a probable consequence of the malfunctioning of kidneys. The uranium transfer coefficient was obtained and an analytical expression was fitted into the data. thus allowing extrapolation down to low doses. Internal and localized doses were calculated. Absorbed doses exceeded the critical dose. even for the lowest uranium dosage.

CHOLESTEROL MODULATION OF LIPID PROTEIN INTERACTIONS IN LIVER MICROSOMAL MEMBRANE - A SPIN LABEL STUDY

ESR spectra of spin probes were used to monitor lipid-protein interactions in native and cholesterol-enriched microsomal membranes. In both systems composite spectra were obtained, one characteristic of bulk bilayer organization and another due to a motionally restricted population, which was ascribed to lipids in a protein microenvironment. Computer spectral subtractions revealed that cholesterol modulates the order/mobility of both populations in opposite ways, i.e., while the lipid bilayer region gives rise to more anisotropic spectra upon cholesterol enrichment, the spectra of the motionally restricted population become indicative of increased mobility and/or decreased order. These events were evidenced by measurement of both effective order parameters and correlation times. The percentages of the motionally restricted component were invariant in native and cholesterol-enriched microsomes. Variable temperature studies also indicated a lack of variation of the percentages of both spectral components, suggesting that the motionally restricted one was not due to protein aggregation. The results correlate well with the effect of cholesterol enrichment on membrane-bound enzyme kinetics and on the behavior of fluorescent probes [Castuma & Brenner (1986) Biochemistry 25, 4733-4738]. Several hypothesis are put forward to explain the molecular mechanism of the cholesterol-induced spectral changes.

Two-phase separation observed in thermally treated pellets of ClO4- doped poly(3-methylthiophene) from electron spin resonance measurements

A pressed pellet of CIO (-)(4) poly (3-methylthiophene) (P3MT) was heated for two hours at 85 degrees C and suddenly dropped in liquid nitrogen. A change was observed around 220 K in the Electron Spin Resonance (ESR) spectra when the sample was slowly cooled from room temperature. ESR line asymmetry parameter (A/B) showed two spatially separated phases. One was identified as a small metallic-like phase. The other phase, the larger one, makes a transition to a semiconducting Charge-Density Wave (CDW) state.

Role of oxygen vacancies in the magnetic and dielectric properties of the high-dielectric-constant system CaCu3Ti4O12: An electron-spin resonance study

We report experiments of electron spin resonance (ESR) of Cu2+ in polycrystalline samples of CaCu3Ti4O12 post-annealed in different atmospheres. After being synthesized by solid state reaction, pellets of CaCu3Ti4O12 were annealed for 24 h at 1000 degrees C under air, Ar or O-2. Our temperature dependent ESR data revealed for all samples nearly temperature independent g value (2.15(1)) and linewidth for T > T-N approximate to 25 K. However, the values of ESR linewidth are strongly affected by the oxygen content in the sample. For instance, argon post-annealed samples show a much larger linewidth than the O-2 or air post-annealed samples. We attribute this broadening to an increase of the dipolar homogeneous broadening of the Cu2+ ESR lines due to the presence of oxygen vacancies which induce an S=1/2 spin inside the TiO6 octahedra. Correlation between a systematic dependence of the ESR linewidth on the oxygen content and the high dielectric constant of these materials is addressed. Also, ESR, magnetic susceptibility, and specific heat data for a single crystal of CaCu3Ti4O12 and for polycrystals of CdCu3Ti4O12 are reported.