Risk factors for amenorrhea in juvenile systemic lupus erythematosus (JSLE): a Brazilian multicentre cohort study

We evaluated the prevalence and clinical associations of amenorrhea in 298 female juvenile systemic lupus erythematosus (JSLE) patients (ACR criteria) followed in 12 Brazilian Paediatric Rheumatology centres. Amenorrhea was observed in 35 patients (11.7%) with a mean duration of 7.2 +/- 3.6 months. The hormones were performed in 32/35 patients and none of them had FSH and LH levels above and estradiol below the normal range according to pubertal changes. JSLE patients with amenorrhea were younger (15.04 +/- 2.5 versus 17.8 +/- 3.1 years; P = 0.001), and had a shorter period of time between menarche and current age (3.4 +/- 2.9 versus 6.7 +/- 5.4 years; P = 0.001). Interestingly, the frequency, cumulative dose, number of pulses and duration of intravenous cyclophosphamide treatment were alike in patients with and without amenorrhea (P > 0.05). In contrast, patients with amenorrhea had significantly higher SLEDAI (P = 0.01) and SLICC/ACR-DI (P = 0.024) scores compared to those without this condition. Independent risk factors identified by multivariate analysis were higher SLEDAI (OR=1.059; CI=1.004-1.116; P=0.034) and SLICC/ACR-DI (OR=2.125; IC = 1.373-3.291; P = 0.001) scores. Our data suggest that in spite of imummosuppressive therapy, JSLE patients have an adequate ovarian follicular reserve and amenorrhea is particularly associated with disease activity and damage.

Use of ideal protein concept for precision formulation of amino acid levels in fish-meal-free diets for juvenile Nile tilapia (Oreochromis niloticus L.)

This study was undertaken in a closed system with Nile tilapia (Oreochromis niloticus) to examine the effects of total replacement of fish meal (FM) by soybean meal. Nile tilapia fingerlings with an average weight of 5.34+/-0.08 g were hand-fed one of the five isoenergetic (approximate to13.5 MJ digestible energy kg(-1)) and isoproteic (approximate to31% of digestible protein) experimental diets to satiation, six times a day during 85 days in eight replicate fibreglass tanks (six fish per tank). The control diet containing FM was substituted by soybean meal, with and without essential amino acids (lysine, methionine and threonine) or dicalcium phosphate supplementation. The supplemental amino acids were added at levels to simulate the reference amino acid profile of Nile tilapia carcass protein, based on the ideal protein concept. The results showed that soybean meal diet supplemented only with dicalcium phosphate was inferior to the control diet with FM and soybean meal diets supplemented with dicalcium phosphate and essential amino acids. Multiple essential amino acids and dicalcium phosphate incorporation in soybean meal diets was associated with performance, whole-body composition and carcass yield equal to that of the fish fed with the control diet containing FM. These data suggest that a diet with all plant protein source, supplemented with essential amino acids, based on tissue amino acid profile, can totally replace FM in a diet for Nile tilapia, without adverse effects on the growth performance, carcass yield and composition.

Proxy-reported health-related quality of life of patients with juvenile idiopathic arthritis: Pediatric rheumatology international trials organization multinational quality of life cohort study

Objective. To investigate the proxy-reported health-related quality of life (HRQOL) and its determinants in patients with juvenile idiopathic arthritis (JIA).Methods. In this multinational, multicenter, cross-sectional study, HRQOL of patients with JIA was assessed through the Child Health Questionnaire (CHQ) and was compared with that of healthy children of similar age from the same geographic area. of joint inflammation, Childhood Health Assessment Questionnaire (CHAQ), and erythrocyte sedimentation rate.Results. A total of 6,639 participants (3,324 with JIA and 3,315 healthy) were enrolled from 32 countries. The mean SD physical and psychosocial summary scores of the CHQ were significantly lower in patients with JIA than in healthy children (physical: 44.5 +/- 10.6 versus 54.6 +/- 4.0, P < 0.0001; psychosocial: 47.6 +/- 8.7 versus 51.9 +/- 7.59 P < 0.0001), with the physical well-being domain being most impaired. Patients with persistent oligoarthritis had better HRQOL compared with other subtypes, whereas HRQOL was similar across patients with systemic arthritis, polyarthritis, and extended oligoarthritis. A CHAQ score > 1 and a pain intensity rating > 3.4 cm on a 10-cm visual analog scale were the strongest determinants of poorer HRQOL in the physical and psychosocial domains, respectively.Conclusion. We found that patients with JIA have a significant impairment of their HRQOL compared with healthy peers, particularly in the physical domain. Physical well-being was mostly affected by the level of functional impairment, whereas the intensity of pain had the greatest influence on psychosocial health.

Paediatric rheumatology - A global perspective

This chapter aims to give a global perspective to paediatric rheumatology. The main points covered are the incidence, recognition of paediatric autoimmune diseases, and ethnic/geographic distribution. The most prevalent disease is juvenile idiopathic arthritis; robust data are still required for childhood-onset systemic lupus erythematosus, dermatomyositis, and scleroderma. Mimicking or overlapping infections are a major challenge in developing countries, and immunization policies in our patients in these areas need specific attention. The delivery of paediatric rheumatology care is also overviewed. Discrepancies in health-care resources and priorities are found in developing countries. Although most anti-rheumatic treatments are available worldwide, they are prohibitively expensive in many countries. For more traditional antirheumatic drugs there is still an ongoing need for good core outcome data across the world to ensure valid comparisons. Parent/patient education has been implemented worldwide in paediatric rheumatology through the power of the Internet. Physician and undergraduate training goals must be met to facilitate competent musculoskeletal assessment, a proper understanding of age-dependent variations, diagnosis, referral to specialists, and improved standards of care.

Growth and juvenile development of Uca maracoani Latreille 1802-1803 in laboratory conditions (Crustacea, Decapoda, Brachyura, Ocypodidae).

The life cycle of decapod crustaceans can be classified into three distinct morphological phases: larval, juvenile and adult. Despite its recognized importance, studies of the juvenile phase have been neglected. The present Study aimed to analyze the growth of juveniles from a single population of Uca maracoani under laboratory conditions, and also to describe the morphological differentiation of pleopods in each sex. Megalopae and juvenile crabs or U. maracoani obtained on a Mud beach at Jabaquara, Paraty, on the southern coast of the state of Rio de Janeiro (Brazil), were reared in the laboratory. The specimens were checked daily for molts and deaths. The carapace widths (CW) of intact exuviae and dead individuals were measured under a stereoscopic microscope provided with a micrometer rule. These data allowed the definition of a growth equation as well as the stages related to the beginning of pleopod development, which begins when females reach 3.0 mill CW (6th juvenile developmental stage), similar to the sizes reported for other species of the genus. In males, however, pleopods appear when the crabs reach 3.5 mm CW, equivalent to the 7th developmental stage. This difference may be related to differential growth between sexes. It also may be a consequence of laboratory rearing, or may represent an actual feature of the species.

Effects of ambient colour on colour preference and growth of juvenile rainbow trout Oncorhynchus mykiss (Walbaum)

Colour preference of individual juvenile rainbow trout Oncorhynchus mykiss was tested at 1 and 12 degrees C, and also at 12 degrees C after a 42 day growth experiment under white, blue, green, yellow or red ambient colour. All experiments were carried out under controlled laboratory conditions and the preference was assessed by the location of the fish in a preference tank with four chambers. Rainbow trout showed a preference for blue and green at 1 degrees C and for green at 12 degrees C. After the growth experiment the fish reared in blue tanks preferred blue and green but green was the most preferred colour for the fish reared in green, yellow and red tanks. Yellow and especially red chambers were avoided, irrespective of the ambient colour during the growth trial. The final mass of fish reared in the red aquaria was significantly smaller than that of the fish in green tanks. In addition, when the data of the preference tests were correlated with the data of the growth experiment using mean values of the four tested colours, a very good linear relationship was observed between the preference (i.e. visit frequency in coloured compartments) and growth rate as well as food intake. When considering the results both from the preference and growth trials it is suggested that green is the best environmental colour for rearing juvenile rainbow trout while rearing in a red environment cannot be recommended. (c) 2008 The Authors Journal compilation (c) 2008 The Fisheries Society of the British Isles.

Longer wavelengths of light improve the growth, intake and feed efficiency of individually reared juvenile pikeperch Sander lucioperca (L.)

We tested the effects of monochromatic light on the specific growth rate (SGR), feed intake and feed efficiency (FE) of juvenile pikeperch, Sander lucioperca (L.). Pikeperch were reared individually for 42 days in aquaria covered with blue, green, yellow or red gelatin filters or white paper (control; n=5). Linear regression analysis indicated a significant positive effect of longer wavelengths of light on the condition factor (CF), FE and SGR. The final weight, SGR and CF were significantly higher in fish reared under red than under white light, and FE was better under green, yellow and red light than under white light (Dunnett's post hoc test, P < 0.05) while blue was comparable to white light in terms of the measured parameters. After the growth trial, the spectral sensitivity of photoreceptor cells in the retina was tested using microspectrophotometry, which revealed the presence of rods with lambda(max) at ca. 530 nm and two cone classes, absorbing maximally at ca. 535 and 603 nm, all containing a porphyropsin-based pigment. These results suggest that the presence of mid and long wavelength-sensitive cones enhances visual sensitivity under mid-wavelength and long-wavelength environments, and thus supports the finding that longer wavelengths of incoming light can improve FE and SGR of the cultivated pikeperch.

Abatacept in children with juvenile idiopathic arthritis: a randomised, double-blind, placebo-controlled withdrawal trial

Background Some children with juvenile idiopathic arthritis either do not respond, or are intolerant to, treatment with disease-modifying antirheumatic drugs, including anti-tumour necrosis factor (TNF) drugs. We aimed to assess the safety and efficacy of abatacept, a selective T-cell costimulation modulator, in children with juvenile idiopathic arthritis who had failed previous treatments.Methods We did a double-blind, randomised controlled withdrawal trial between February, 2004, and June, 2006. We enrolled 190 patients aged 6-17 years, from 45 centres, who had a history of active juvenile idiopathic arthritis; at least five active joints; and an inadequate response to, or intolerance to, at least one disease-modifying antirheumatic drug. All 190 patients were given 10 mg/kg of abatacept intravenously in the open-label period of 4 months. of the 170 patients who completed this lead-in course, 47 did not respond to the treatment according to predefined American College of Rheumatology (ACR) paediatric criteria and were excluded. of the patients who did respond to abatacept, arthritis, and 62 were randomly assigned to receive placebo at the same dose and timing. The primary endpoint was time to flare of arthritis. Flare was defined as worsening of 30% or more in at least three of six core variables, with at least 30% improvement in no more than one variable. We analysed all patients who were treated as per protocol. This trial is registered, number NCT00095173.Findings Flares of arthritis occurred in 33 of 62 (53%) patients who were given placebo and 12 of 60 (20%) abatacept patients during the double-blind treatment (p=0.0003). Median time to flare of arthritis was 6 months for patients given placebo (insufficient events to calculate IQR); insufficient events had occurred in the abatacept group for median time to flare to be assessed (p=0.0002). The risk of flare in patients who contined abatacept was less than a third of that for controls during that double-blind period (hazard ratio 0.31, 95% CI 0.16-0.95). During the double-blind period, the frequency of adverse events did not differ in the two treatment groups, Adverse events were recorded in 37 abatacept recipients (62%) and 34 (55%) placebo recipients (p=0.47); only two serious adverse events were reported, bouth in controls (p=0.50).Interpretation Selective modulation of T-cell costimulation with abatacept is a rational alternative treatment for children with juvenile idiopathic arthritis.Funding Bristol-Myers Squibb.

Energetic cost of predation: Aerobic metabolism during prey ingestion by juvenile rattlesnakes, Crotalus durissus

We investigated the cost of prey ingestion in the South American rattlesnake, Crotalus durissus, to see if the capacity to generate energy aerobically could be a constraint on the size of the prey that can be ingested. To accomplish this goal, we measured time and aerobic metabolism (inferred from oxygen consumption) of juvenile C. durissus ingesting prey ranging from 10 to 50% of their own body mass. Time needed for prey ingestion increased with prey size, with prey representing 10 and 20% of snake size being ingested with the same effort. Whole animal rates of oxygen consumption increased linearly with prey size, but at a slower pace for snakes ingesting prey larger than 30% of their body mass. Aerobic factorial power input necessary for prey ingestion increased with prey size, and for snakes ingesting prey representing 50% of their body mass it equaled the aerobic factorial scope for exercise. For the maximum prey size tested, the aerobic derived energy necessary for prey ingestion represented 0.02% of the total energy content of the prey. Within the prey size range we studied, the cost of ingestion did not constitute any constraint on the size of the prey that can be ingested. These constraints are set by morphological (gape size), ecological (predation risk), and, probably, by physiological parameters, as suggested by the tendency of V̇O2 during ingestion to increase at a slower pace at relative larger prey sizes.

Experimental control of the effect of extra doses of juvenile hormone on bee development: The case of the wax glands of Apis mellifera (Hymenoptera: Apidae)

Experiments on the effect of topical application of the synthetic juvenile hormone (JH-III) and of the solvent used to dissolve the hormone on the development of the wax glands of workers of Apis mellifera, were made. The results show that it was impossible to determine the effect of the juvenile hormone (JH) apart from its solvent (acetone), which also alters the developmental pattern of the gland. Most of the experiments reported in scientific literature do not consider the effect of the solvent, analyzing the results by only comparing the treatment with the hormone plus solvent to a control without any treatment. The data presented suggests that this kind of procedure compromises the evaluation of the real JH effect.

Alterations induced by juvenile hormone in glandular cells of the Apis mellifera venom gland I - Application on the larvae (Hymenoptera: Apidae)

Histological analyses were made in order to evaluate the effects of the topic application of a synthetic juvenile hormone (JH-III Sigma) on the development of the venom glands in workers of Apis mellifera. Three experimental groups were used: the first received 1 μl of a dilution of the juvenile hormone in hexane (2μg/μl); the second group received 1 μl of hexane; and the third group, the control, did not receive any kind of treatment. The application was made on larvae at the beginning of the fifth instar and the glands were collected at different developmental stages. The results showed that the application of the diluted hormone, as well as the hexane alone, accelerated gland development in relation to the control group at all developmental stages studied. These data suggest that the juvenile hormone acts on the development of the venom gland; nevertheless, this action could be amplified by the effect of the solvent used in the present work, as well as in other studies concerning this matter.

Juvenile hormone promotes changes in the expression of hypopharyngeal gland proteins of worker Apis mellifera (Hymenoptera: Apidae)

The present investigation compares the protein electrophoreses profiles of the hypopharyngeal glands of 12 and 25 day old Apis mellifera workers, some of which were experimentally treated with an analogue of juvenile hormone in the moment of the emergence while others were not treated. According to the evaluation of the presented variations by four main bands, it is concluded that the analogue juvenile hormone changes the glandular genetic expression pattern, promoting the disappearance of two from the four main bands in 25 day old workers. The effect of this hormone is discussed as an hypopharyngeal maturation inductor, in synergetic action with the bee age acting early in the glandular cycle.