Decrease in Mycobacterium tuberculosis specific immune responses in patients with untreated psoriasis living in a tuberculosis endemic area

Tuberculosis has emerged as a major concern in patients with immuno-mediated diseases, including psoriasis, undergoing treatment with biologicals. However, it is not known whether the chronically activated immune system of psoriasis patients interferes with their Mycobacterium tuberculosis (Mtb)-specific immunity, especially in tuberculosis-endemic areas like Brazil. We evaluated T-cell responses to a Mtb lysate and to the recombinant Mtb proteins ESAT-6 and Ag85B of tuberculin skin test (TST) positive and TST negative patients with severe or mild/moderate, untreated psoriasis in three different assays: lymphocyte proliferation, enzyme immunoassay for interferon (IFN)-gamma and interleukin (IL)-10 production by peripheral blood mononuclear cells and overnight enzyme immunospot (ELISpot) for enumerating IFN-gamma-secreting cells. In our cohort, a low proportion (29%) of the severe psoriasis patients tested were TST-positive. IFN-gamma and IL-10 secretion and T-cell proliferation to Mtb antigens were reduced in TST-negative but not in TST-positive patients with severe psoriasis when compared to healthy controls with the same TST status. Similarly, severe psoriasis patients had decreased cytokine secretion and proliferative response to phytohemagglutinin. However, most psoriasis patients and healthy controls showed detectable numbers of IFN-gamma-secreting effector-memory T-cells in response to Mtb antigens by ELISpot. TST-negative, mild/moderate psoriasis patients had responses that were mostly intermediary between TST-negative controls and severe psoriasis patients. Thus, patients with severe psoriasis possess decreased anti-Mtb central memory T-cell responses, which may lead to false-negative results in the diagnosis of TB infection, but retain T-cell memory-effector activity against Mtb antigens. We hypothesize that the latter may confer some protection against tuberculosis reactivation.

Pain Relief and Functional Recovery in Patients with Complex Regional Pain Syndrome after Motor Cortex Stimulation

In addition to pain and neurovegetative symptoms, patients with severe forms of complex regional pain syndrome (CRPS) develop a broad range of symptoms, including sensory disturbances, motor impairment and dystonic posturing. While most patients respond to medical therapy, some are considered refractory and become surgical candidates. To date, the most commonly used surgical procedure for CRPS has been spinal cord stimulation. This therapy often leads to important analgesic effects, but no sensory or motor improvements. We report on 2 patients with pain related to CRPS and severe functional deficits treated with motor cortex stimulation (MCS) who not only had significant analgesic effects, but also improvements in sensory and motor symptoms. In the long term (27 and 36 months after surgery), visual analog scale pain scores were improved by 60-70% as compared to baseline. There was also a significant increase in the range of motion in the joints of the affected limbs and an improvement in allodynia, hyperpathia and hypoesthesia. Positron emission tomography scan in both subjects revealed that MCS influenced regions involved in the circuitry of pain. Copyright (C) 2011 S. Karger AG, Basel

Evaluation of the prognostic significance of serum galectin-3 in American Joint Committee on Cancer stage III and stage IV melanoma patients

Galectin-3 (Gal-3) is a member of the P-galactoside-binding lectins family and has been implicated in angiogenesis, tumor invasion, and metastatic process in vitro and in vivo. As we showed recently that advanced melanoma patients presented high serum level of Gal-3, we investigated the association of this protein with the outcome of melanoma patients. Whether this protein could be a biomarker has riot been assessed, and we compared the prognostic value of serum Gal-3 in multivariate analysis with lactate dehydrogenase, C-reactive protein and S100B. We conclude that Gal-3 could be of prognostic value in melanoma patients; more precisely, this protein has a strong independent prognostic signification with a cut-off value of 10 ng/ml. After these data, we believe that serum Gal-3 measurement can have an important role in the follow-up and management of advanced American Joint Commission on Cancer stage III and stage IV melanoma patients. Further studies will uncover whether Gal-3 will be able to open new therapeutic perspectives. Melanoma Res 19:316-320 (C) 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins.

The Interpretation of Verbal Probability Expressions Used in the IAS/IFRS: the auditors Rrgistered with the portuguese securities market commission

One of the main arguments in favour of the adoption and convergence with the international accounting standards published by the IASB (i.e. IAS/IFRS) is that these will allow comparability of financial reporting across countries. However, because these standards use verbal probability expressions (v.g. “probable”) when establishing the recognition and disclosure criteria for accounting elements, they require professional accountants to interpret and classify the probability of an outcome or event taking into account those terms and expressions and to best decide in terms of financial reporting. This paper reports part of a research we carried out on the interpretation of “in context” verbal probability expressions used in the IAS/IFRS by the auditors registered with the Portuguese Securities Market Commission, the Comissão do Mercado de Valores Mobiliários (CMVM). Our results provide support for the hypothesis that culture affects the CMVM registered auditors’ interpretation of verbal probability expressions through its influence on the accounting value (or attitude) of conservatism. Our results also suggest that there are significant differences in their interpretation of the term “probable”, which is consistent with literature in general. Since “probable” is the most frequent verbal probability expression used in the IAS/IFRS, this may have a negative impact on financial statements comparability.

Evaluation system in the European Commission : DEVCO’S evaluation methodology

Mestrado em Economia e Políticas Públicas

Explaining Variation in Organizational Change: The Reform of Human Resource Management in the European Commission and the OECD

In this article we investigate the reforms of human resource management in the European Commission and the OECD by analyzing comparatively to what extent both organizations have adjusted their respective structures towards the ideal type of the so-called New Public Management (NPM). The empirical findings show that reforms towards NPM are more pronounced in the Commission than in the OECD. These findings are surprising for two reasons: First, it seems rather paradoxical that the OECD as central promoter of NPM at the international level lags behind the global trend when it comes to reforming its own structures. Second, this result is in contradiction with theoretical expectations, as they can be derived from theories of institutional isomorphism. To nevertheless account for the surprising results, it is necessary to modify and complement existing theories especially with regard to the scope conditions of their causal mechanisms.

IPH response to EU Commission consultation on EU role in global health

The European Commission launced a public consultation iin October 2009 on stakeholder views regarding the rationale, scope and strategic objectives for an EU role in global health. The Institute of Public Health in Ireland (IPH) aims to improve health on the island of Ireland by working to combat health inequalities and influence public policies in favour of health.  The Institute promotes cooperation between Northern Ireland and the Republic of Ireland in public health research, training and policy advice. IPH also contributes to a number of European networks and projects and is a member of the International Association of National Public Health Institutes (IANPHI). IPH welcomes the opportunity to respond to the European Commission consultation on the role of the EU in global health.

Anaesthetics, Pain Relief and Critical Care Follow Up (PDF 797 KB)

In 2003/2004 the Department of Health, Social Services and Public Safety commissioned a value for money follow-up audit of Anaesthetics, Pain Relief and Critical Care (APRCC) services at twelve Trusts and covering fourteen hospital sites. The original study had reported in 1999/2000. Detailed follow-up reports, together with action plans have been agreed locally with Trusts. The objectives of the follow-up review were to: • Ascertain the progress made in implementing recommendations from the original study; • Provide data to compare performance across Trusts in areas such as: - Pre-operative assessments; - Organisation of post-operative pain relief; - Organisation of chronic pain services; - Levels of admissions to critical care units; - Occupancy in critical care units; and åÊ • Assess the extent of progress made by Trusts in the implementation of the Chief Medical Officer’s (CMO) recommendations from ‘Facing the Future –Building on the Lessons of Winter 1999/2000’. To enable comparisons across Trusts, data was collected for the financial year 2002/2003. In addition, relevant findings from the Audit Commission’s Acute Hospitals Portfolio have also been included. The Acute Hospital Portfolio is a collection of reviews that are undertaken at acute and specialist Trusts. They focus on key service areas and are reported along the key performance criteria of patient experience, efficiency and capacity. åÊ

Anaesthetics, Pain Relief and Critical Care Services in Northern Ireland - Regional Summary (May 2002)

Anaesthetics, Pain Relief and Critical Care Services in Northern Ireland - Regional Summary (May 2002) Pages 1 to 7 (PDF 276 KB)åÊ Pages 8 to 14 (PDF 392 KB)åÊ Pages 15 to 20 (PDF 265 KB)

Special investigation of the Area XV Regional Planning Commission located in Ottumwa, Iowa for the period July 1, 2000 through June 30, 2006

Special investigation of the Area XV Regional Planning Commission located in Ottumwa, Iowa for the period July 1, 2000 through June 30, 2006