Tratamiento de Artritis reumatoide con antagonistas del factor de necrosis tumoral alfa y su asociación con el desarrollo de melanoma cutáneo: revisión sistemática de la literatura y meta-análisis.

Introducción: El tratamiento con antagonistas del factor de necrosis tumoral alfa (anti TNF) ha impactado el pronóstico y la calidad de vida de los pacientes con artritis reumatoide (AR) positivamente, sin embargo, se interroga un incremento en el riesgo de desarrollar melanoma. Objetivo: Conocer la asociación entre el uso de anti TNF y el desarrollo de melanoma maligno en pacientes con AR. Metodología: Se realizó una búsqueda sistemática en MEDLINE, EMBASE, COCHRANE LIBRARY y LILACS para ensayos clínicos, estudios observacionales, revisiones y meta-análisis en pacientes adultos con diagnóstico de AR y manejo con anti TNF (Certolizumab pegol, Adalimumab, Etanercept, Infliximab y Golimumab). Resultados: 37 estudios clínicos cumplieron los criterios de inclusión para el meta-análisis, con una población de 16567 pacientes. El análisis de heterogeneidad no fue significativo (p=1), no se encontró diferencia en el riesgo entre los grupos comparados DR -0.00 (IC 95% -0.001; -0.001). Un análisis adicional de los estudios en los que se reportó al menos 1 caso de melanoma (4222 pacientes) tampoco mostró diferencia en el riesgo DR -0.00 (IC 95% -0.004 ; -0.003). Conclusión: En la evidencia disponible a la fecha no encontramos asociación significativa entre el tratamiento con anti TNF en pacientes con diagnóstico de AR y el desarrollo de melanoma cutáneo.

Artificial diet for aphids - thirty years' experience

Myzus persicae (Sulzer) was reared continuously for over thirty years (until it died out in December 2008) on a totally defined synthetic artificial diet, the procedure for which is described. Development time was extended on diet compared with rearing on Brussels sprout plants (Brassica oleracea L. var. gemmifera L.), and generation time was further increased by an added pre-reproductive period of 4 days. Fecundity was reduced by about two-thirds, and mean relative growth rate in weight (MRGR) was only 60% in comparison with plant-reared aphids. Applying 2 kg/cm(2) pressure to a 10% sucrose solution extended the adult longevity of Aphis fabae Scopoli by less than I day. In contrast, a short experience of half-strength diet Caused a sharp rise in honeydew excretion by A. fabae for several hours, and alternating full-strength diet with diluted diets (including water) Caused a greater weight increase. The poor performance of aphids on diet thus seems to have a behavioural rather than a mechanical explanation. The diet, designed to give optimal performance of the aphids, has proved not to be useful for nutritional studies, as any change is deleterious. Areas of aphid research where the diet has been useful, however, are studies on repellents/attractants/toxins, role of symbionts, maintenance of genotype collections, work on parasitoid behaviour in relation to plant chemistry, and collection of aphid saliva.

The impact of large scale atmospheric circulation patterns on wind power generation and its potential predictability: a case study over the UK

Over recent years there has been an increasing deployment of renewable energy generation technologies, particularly large-scale wind farms. As wind farm deployment increases, it is vital to gain a good understanding of how the energy produced is affected by climate variations, over a wide range of time-scales, from short (hours to weeks) to long (months to decades) periods. By relating wind speed at specific sites in the UK to a large-scale climate pattern (the North Atlantic Oscillation or "NAO"), the power generated by a modelled wind turbine under three different NAO states is calculated. It was found that the wind conditions under these NAO states may yield a difference in the mean wind power output of up to 10%. A simple model is used to demonstrate that forecasts of future NAO states can potentially be used to improve month-ahead statistical forecasts of monthly-mean wind power generation. The results confirm that the NAO has a significant impact on the hourly-, daily- and monthly-mean power output distributions from the turbine with important implications for (a) the use of meteorological data (e.g. their relationship to large scale climate patterns) in wind farm site assessment and, (b) the utilisation of seasonal-to-decadal climate forecasts to estimate future wind farm power output. This suggests that further research into the links between large-scale climate variability and wind power generation is both necessary and valuable.

SANS/WANS time-resolving neutron scattering studies of polymer phase transitions using NIMROD

We use new neutron scattering instrumentation to follow in a single quantitative time-resolving experiment, the three key scales of structural development which accompany the crystallisation of synthetic polymers. These length scales span 3 orders of magnitude of the scattering vector. The study of polymer crystallisation dates back to the pioneering experiments of Keller and others who discovered the chain-folded nature of the thin lamellae crystals which are normally found in synthetic polymers. The inherent connectivity of polymers makes their crystallisation a multiscale transformation. Much understanding has developed over the intervening fifty years but the process has remained something of a mystery. There are three key length scales. The chain folded lamellar thickness is ~ 10nm, the crystal unit cell is ~ 1nm and the detail of the chain conformation is ~ 0.1nm. In previous work these length scales have been addressed using different instrumention or were coupled using compromised geometries. More recently researchers have attempted to exploit coupled time-resolved small-angle and wide-angle x-ray experiments. These turned out to be challenging experiments much related to the challenge of placing the scattering intensity on an absolute scale. However, they did stimulate the possibility of new phenomena in the very early stages of crystallisation. Although there is now considerable doubt on such experiments, they drew attention to the basic question as to the process of crystallisation in long chain molecules. We have used NIMROD on the second target station at ISIS to follow all three length scales in a time-resolving manner for poly(e-caprolactone). The technique can provide a single set of data from 0.01 to 100Å-1 on the same vertical scale. We present the results using a multiple scale model of the crystallisation process in polymers to analyse the results.

Greater Amman: metropolitan growth and scenarios for sustainable urban development

This paper reviews the development of Greater Amman, Jordan noting that the vast urban expansion that has occurred over the last fifty years has led to the desertification of rare fertile lands, following the fragmented and scattered territorial expansion of the city. The future scenario for planning in Greater Amman is analyzed in respect of proposals outlined in the Metropolitan Growth Plan of 2008, which assumes a rapid population growth from 2,200,000 persons in 2006, to approximately 6,500,000 by 2025. The concentration of more than 39 per cent of the national population of Jordan in Greater Amman threatens the transformation of former distinct settlement pattern into a distinctive continuous urban zone, aggravating problems of infrastructural provision, water needs, agricultural lands, and leaving unresolved problems of land inflation, poor urban standards and housing shortages. In conclusion, the environmental implications of the Amman Metropolitan Growth Plan are analysed, and it is suggested that an alternative approach is needed, based on clear principles of sustainable urban development.

Combined use of satellite estimates and rain gauge observations to generate high-quality historical rainfall time series over Ethiopia

Climate data are used in a number of applications including climate risk management and adaptation to climate change. However, the availability of climate data, particularly throughout rural Africa, is very limited. Available weather stations are unevenly distributed and mainly located along main roads in cities and towns. This imposes severe limitations to the availability of climate information and services for the rural community where, arguably, these services are needed most. Weather station data also suffer from gaps in the time series. Satellite proxies, particularly satellite rainfall estimate, have been used as alternatives because of their availability even over remote parts of the world. However, satellite rainfall estimates also suffer from a number of critical shortcomings that include heterogeneous time series, short time period of observation, and poor accuracy particularly at higher temporal and spatial resolutions. An attempt is made here to alleviate these problems by combining station measurements with the complete spatial coverage of satellite rainfall estimates. Rain gauge observations are merged with a locally calibrated version of the TAMSAT satellite rainfall estimates to produce over 30-years (1983-todate) of rainfall estimates over Ethiopia at a spatial resolution of 10 km and a ten-daily time scale. This involves quality control of rain gauge data, generating locally calibrated version of the TAMSAT rainfall estimates, and combining these with rain gauge observations from national station network. The infrared-only satellite rainfall estimates produced using a relatively simple TAMSAT algorithm performed as good as or even better than other satellite rainfall products that use passive microwave inputs and more sophisticated algorithms. There is no substantial difference between the gridded-gauge and combined gauge-satellite products over the test area in Ethiopia having a dense station network; however, the combined product exhibits better quality over parts of the country where stations are sparsely distributed.

On the clustering of winter storm loss events over Germany

During the last decades, several windstorm series hit Europe leading to large aggregated losses. Such storm series are examples of serial clustering of extreme cyclones, presenting a considerable risk for the insurance industry. Clustering of events and return periods of storm series for Germany are quantified based on potential losses using empirical models. Two reanalysis data sets and observations from German weather stations are considered for 30 winters. Histograms of events exceeding selected return levels (1-, 2- and 5-year) are derived. Return periods of historical storm series are estimated based on the Poisson and the negative binomial distributions. Over 4000 years of general circulation model (GCM) simulations forced with current climate conditions are analysed to provide a better assessment of historical return periods. Estimations differ between distributions, for example 40 to 65 years for the 1990 series. For such less frequent series, estimates obtained with the Poisson distribution clearly deviate from empirical data. The negative binomial distribution provides better estimates, even though a sensitivity to return level and data set is identified. The consideration of GCM data permits a strong reduction of uncertainties. The present results support the importance of considering explicitly clustering of losses for an adequate risk assessment for economical applications.

Gli studi italiani sulla regina Cristina di Svezia negli ultimi cinquant'anni

Queen Christina of Sweden (1626-1689)) is probably the most important individual to directly link the cultures of Sweden and Italy, and thus fascinate scholars over the last four centuries. In the last fifty years, research on and interest in this monarch has been particularly intense. This has led to current international scientific debate concerning all the different cultural expressions in which Queen Cristina was particularly involved. However, until now there has been lacking a comprehensive work to illustrate the development of scientific research in Italian on Queen Christina. This article, therefore, without claiming to be exhaustive, aims to fill this gap by identifying the main direction of current research. The article, after briefly introducing previous works (both Italian and Swedish), demonstrates how the first major renaissance of international studies on Queen Cristina took place in Sweden in the early 1960s. Even more important was the subsequent turning point in 1989, when the tercentenary of the death of Queen Christina was celebrated and the Azzolino Collection at the Biblioteca Comunale in Jesi was opened. The article focuses on the studies in Italian during this latter period. To make the exposition more organic and, importantly, more accessible to those readers interested in only one particular aspect of the scientific studies about Queen Christina, the studies in Italian since 1689 are divided into different subject areas.

Fatores pré-operatórios associados à injúria renal aguda após cirurgia cardíaca: estudo prospectivo

OBJECTIVES. To evaluate the clinical characteristics and co-morbidities associated with development of Acute kidney injury (AKI) after cardiac surgery in patients of a predominantly tertiary care university hospital.METHODS. One hundred and fifty cardiac surgery patients were prospectively studied at the Botucatu School of Medicine, University Hospital- UNEP, using a protocol which started 48h before and finished 48h after surgery, AKI was defined as a 30% increase in baseline serum creatinine.RESULTS. Were expressed as mean +/- standard deviation or median, with a significance level of 5%. Results: There was a slight male predominance (57%); mean age of the studied population, was 56 +/- 14 years. Sixty-five per cent of patients underwent myocardial revascularization. AKI was diagnosed in 34% of cases, Multivariate analysis showed that age over 60 years and peripheral vascular disease were significant associated with AKI developmentCONCLUSION. AKI was a common complication in cardiac surgery patients at this hospital, AKI was associated with age over 60 years and presence of peripheral vascular disease.

Considerations about enamel microabrasion after 18 years

Purpose: To review of the current status of enamel microabrasion method and its results 18 years after the development and application of this method. Methods: A technique performing enamel microabrasion with hydrochloric acid mixed with pumice and other techniques employing a commercially available compound of hydrochloric acid and fine-grit silicon carbide particles in a water-soluble paste have been described. Much has been learned about the application of this esthetic technique, long-term treatment results and microscopic changes to the enamel surface that has significant clinical implications. The latest treatment protocol is presented and photographic case histories document the treatment results. Clinical observations made over 18 years are discussed. Results: According to our findings, the dental enamel microabrasion technique is a highly satisfactory, safe and effective procedure.

O uso das pregas cutâneas e da circunferência muscular do braço no diagnóstico de desnutrição energético-protéica em pacientes adultos: estudo crítico.

The use of anthropometric measurements of triceps (TSF) and subscapular skinfolds (SSF) and mid-upper arm muscle circumference (MAMC) was examined as far as the diagnosis of energy-protein malnutrition (EPM) is concerned. The study was undertaken in five groups of patients (n = 231): arterial hypertension (AH, n = 63), chronic obstructive pulmonary disease (COPD, n = 17), hemodialyzed chronic renal failure (CRF, n = 19), critically ill patients with an acute event (CA, n = 42) and critically ill patients with chronic diseases (CCD, n = 90). The results were compared to those obtained in a group of healthy individuals (control group, n = 102). The control group and the group of patients were allocated in subgroups according to sex and age (less than 50 and more than 50 years). It was expected that significant differences would be found for the anthropometric values between the control subgroups and the COPD, the CRF and the CCD subgroups of patients. For the skinfold thicknesses (TSF and SSF), significant differences were found between CRF, CCD subgroups and the control subgroups under fifty years of age; however, the differences were not significant when the subgroups over fifty were analyzed. Concerning the MAMC, significant differences were found: 1 degree) between the CRF subgroups (males and females) and the control subgroups under fifty years of age; 2 degrees) between the CCD male subgroups (younger and older subgroups) and the respective control subgroups and 3 degrees) between the COPD and the control subgroups.(ABSTRACT TRUNCATED AT 250 WORDS)

The natural history of carpal tunnel syndrome: A study of 20 hands evaluated 4 to 9 years after initial diagnosis

Carpal tunnel syndrome (CTS) is the most frequent entrapment neuropathy. In the last decade several papers have been published on epidemiology, clinical aspects, diagnosis, and treatment, but little is known about its natural history. The objective of this work was to study the natural history of CTS syndrome. From 358 patients with clinical and conduction study diagnosis of CTS, 12 cases were identified that had refused surgical treatment, had not used anti-inflammatory medications, and had not undergone orthopaedic procedures, such as immobilization or anaesthetic infiltration. These 12 patients have 20 compromised hands which have been followed up for between 4 and 9 years. In all cases sensory and motor conduction studies were performed on the median nerve, at the beginning and end of follow-up period. Electrical improvement was marked in 5 hands and slight in 3; there was no significant change in 10, and deterioration in 2. As 8 hands (7 patients) showed improved clinical symptoms and conduction studies over several years, this brings the universally accepted procedure of surgical treatment into doubt.

Women's contribution to equality in Latin America and the Caribbean

Includes bibliography

The United Nations and ECLAC at the half-century mark of the Organization

Includes bibliography

Um dispositivo mecânico para avaliação da rigidez de tornozelo

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)