The Pediatric Rheumatology International Trials Organization American-College-of-Rheumatology provisional criteria for the evaluation of response to therapy in juvenile systemic lupus erythematosus: Prospective validation of the definition of improvement

Objective. To use the Pediatric Rheumatology International Trials Organization (PRINTO) core set of outcome measures to develop a validated definition of improvement for the evaluation of response to therapy in juvenile systemic lupus erythematosus (SLE).Methods. Thirty-seven experienced pediatric rheumatologists from 27 countries, each of whom had specific experience in the assessment of juvenile SLE patients, achieved consensus on 128 patient profiles as being clinically improved or not improved. Using the physicians' consensus ratings as the gold standard measure, the chi-square, sensitivity, specificity, false-positive and false-negative rates, area under the receiver operating characteristic curve, and kappa level of agreement for 597 candidate definitions of improvement were calculated. Only definitions with a kappa value greater than 0.7 were retained. The top definitions were selected based on the product of the content validity score multiplied by its kappa statistic.Results. The definition of improvement with the highest final score was at least 50% improvement from baseline in any 2 of the 5 core set measures, with no more than 1 of the remaining worsening by more than 30%.Conclusion. PRINTO proposes a valid and reproducible definition of improvement that reflects well the consensus rating of experienced clinicians and that incorporates clinically meaningful change in core set measures in a composite end point for the evaluation of global response to therapy in patients with juvenile SLE. The definition is now proposed for use in juvenile SLE clinical trials and may help physicians to decide whether a child with SLE responded adequately to therapy.

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.

Negociações comerciais internacionais e democracia: o contencioso Brasil x EUA das patentes farmacêuticas na OMC

Dans cet article, on cherche la viabilité analytique du Jeu à Deux Niveaux - JDN pour examiner la situation brésilienne dans l'Organisation Mondiale du Commerce - OMC. on cherche à voir, en même temps, si le perfectionnement des institutions démocratiques brésiliennes en ce qui concerne le processus de formulation de la politique extérieure sera capable d'améliorer la réponse aux demandes des groupes d'intérêt et d'élargir la compétence technique de la diplomatie brésilienne dans les négociations commerciales internationales. on cherche aussi à savoir si ce perfectionnement peut faire monter la crédibilité et la légitimité internationale des démarches brésiliennes au sein de l'OMC, dans le sens de tourner en leur faveur les régimes internationaux. Pour cela, on analyse le contentieux des brevets pharmaceutiques mené contre les États-Unis au sein de l'OMC.

Origens dos instrumentos de formação da política comercial norte-americana

L'objectif de cet article est de montrer l'existence de traces historiques permettant de lier les concepts de libre-échange et protectionnisme, tous les deux employés dans la politique de commerce extérieur des Etats-Unis. Parallèlement, on cherche à souligner l'importance de la législation et des principes formulés dans ce pays et leur rôle explicatif concernant les motivations de la structure du commerce international après 1945. Ce rôle a en effet contribué à qu'on puisse mieux comprendre les tournées de négociations du GATT (General Agreement on Tariffs and Trade) jusqu'à la création de l'OMC (Organisation Mondiale du Commerce), en 1995. on traite également des raisons pour lesquelles le commerce international aux Etats-Unis est non seulement une question d'Etat mais encore une question de la société.

Política externa brasileira e cultivares: impactos dos direitos de propriedade intelectual

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

O dumping e as normas internas de proteção à concorrência empresarial

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Contratos de concessão entre o estado brasileiro e empresas transnacionais de telecomunicações: casos da EMBRATEL/MCI e TELESP/Telefônica Internacional

Pós-graduação em Direito - FCHS

A eficiência e a eficácia das normas antidumping na OMC e suas repercussões no direito concorrencial brasileiro

Pós-graduação em Direito - FCHS

Patentes e licenciamentos compulsórios de medicamentos: o marco regulatório internacional e a ação dos países em desenvolvimento

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

O fim do acordo de têxteis e vestuário: impactos sobre o setor têxtil-vestuário brasileiro

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Rotulagem ambiental: estudo de critérios para a concessão do selo verde para produtos manufaturados de couro

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Aplicação de meta-heurísticas na resolução do problema de balanceamento e designação de trabalhadores com deficiência em linha de produção

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

A influência do lobby do etanol na definição da política agrícola e energética dos Estados Unidos (2002-2011)

Pós-graduação em Relações Internacionais (UNESP - UNICAMP - PUC-SP) - FFC

Conhecimentos tradicionais, propriedade intelectual e política externa brasileira

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Criador e criatura: os Estados Unidos e a Organização Mundial do Comércio (OMC)

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)