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.

Effects of flunixin meglumine, recombinant bovine somatotropin and/or human chorionic gonadotropin on pregnancy rates in Nelore cows

The objective was to compare pharmacological strategies aiming to inhibit prostaglandin F2 alpha (PGF(2 alpha)) synthesis (flunixin meglumine; FM), stimulate growth of the conceptus (recombinant bovine somatotropin; bST) and progesterone (P(4)) synthesis (human chorionic gonadotropin; hCG), as well as their combinations, regarding their ability to improve pregnancy rates in beef cattle. Lactating Nelore cows (N = 975), 35 to 70 days postpartum, were synchronized and inseminated by timed artificial insemination (TAT) on Day 0. on Day 7, cattle were allocated into eight groups and received one of the following treatments: saline (S) on Days 7 and 16 (Group Control); S on Day 7 and FM on Day 16 (Group FM); bST on Day 7 and S on Day 16 (Group bST); bST on Day 7 and FM on Day 16 (Group bST + FM); hCG on Day 7 and S on Day 16 (Group hCG); hCG on Day 7 and FM on Day 16 (Group hCG + FM); bST and hCG on Day 7 and S on Day 16 (Group bST + hCG), or bST and hCG on Day 7 and FM on Day 16 (Group bST + hCG + FM). The aforementioned treatments were administered at the following doses: 2.2 mg/kg FM (Banamine (R); Intervet Schering-Plough, Cotia, SP, Brazil), 500 mg bST (Boostin (R); Intervet Schering-Plough), and 2500 IU hCG (Chorulon (R); Intervet Schering-Plough). Pregnancy diagnosis was performed 40 days after TAI by transrectal ultrasonography. Pregnancy rates were not significantly different among treatments. However, there was a main effect of hCG treatment to increase pregnancy rates (63.0 vs. 55.4%; P = 0.001). Concentrations of P(4) did not differ significantly among groups on Day 7 or on Day 16. However, consistent with the higher pregnancy rates, hCG increased P(4) concentrations on Day 16 (10.6 vs. 9.6 ng/mL, respectively; P = 0.05). We concluded that hCG treatment 7 days after TAI improved pregnancy rates of lactating Nelore cows, possibly via a mechanism leading to induction of higher P(4) concentrations, or by reducing the luteolytic stimulus during maternal recognition of pregnancy. (C) 2011 Elsevier B.V. All rights reserved.

Sedimentation rates of tripton in Jurumirim Reservoir (São Paulo, Brazil)

Sedimentation rates of particulate material and some physicochemical parameters of water were determined in October, January, April and July 1990-91 at seven stations in the Jurumirim Reservoir (São Paulo, Brazil), three located in the Paranapanema arm, three in the Taquari arm and one near the dam. Higher sedimentation rates of tripton were found in the Paranapanema arm, followed by those from the Taquari arm and the dam. Suspended matter (2.5-48.7 mg · 1-1) and chlorophyll-a (0.7-8.1 mg · m-3) concentrations in the Paranapanema arm were in general higher resulting in lower water transparency (0.3-1.7m) than in the Taquari arm. Temporal and spatial variations in the tripton sedimentation rates were mainly influenced by allochthonous input at the stations near the river mouth. The settling fluxes at station near the dam of the reservoir were affected rather by a small autochthonous production (65 g C ass m-2 ;yr-1), indicated by a higher organic content (64-87%). Therefore, sedimentation rates measured by bottom traps were affected by sediment ressuspension especially at isothermal conditions. With respect to sedimentation, the riverine, the transition and the lacustrine zones commonly found in reservoires could be distinguished. The extent of the riverine zone in each arm of the Jurumirim Reservoir depends on the seasonal change of allochthonous input.

Dynamical calculation of direct muon-transfer rates from thermalized muonic hydrogen to C6+ and O8+

Moun-transfer reactions from muonic hydrogen to carbon and oxygen nuclei employing a full quantum-mechanical few-body description of rearrangement scattering were studied by solving the Faddeev-Hahn-type equations using close-coupling approximation. The application of a close-coupling-type ansatz led to satisfactory results for direct muon-transfer reactions from muonic hydrogen to C6+ and O8+.

Biomass fire consumption and carbon release rates of rainforest-clearing experiments conducted in northern Mato Grosso, Brazil

Biomass consumption and carbon release rates during the process of forest clearing by fire in five test plots are presented and discussed. The experiments were conducted at the Caiabi Farm near the town of Alta Floresta, state of Mato Grosso, Brazil, in five square plots of 1 ha each designated A, B, C, D, and E, with different locations and timing of fire. Plot A was located in the interface with a pasture, with three edges bordering on the forest, and was cut and burned in 1997. Plots B,C, D, and E were located inside the forest. Plot B was cut and burned in 1997. Plot C was inside a deforested 9-ha area, which was cut and burned in 1998. Plot D was inside a deforested 4-ha area, which was cut in 1998 and burned in 1999. Plot E was inside a deforested 4-ha area which was cut and burned in 1999. Biomass consumption was 22.7%, 19.5%, 47.5%, 61.5% and 41.8%, for A, B, C, D, and E, respectively. The effects of an extended curing period and of increasing the deforested area surrounding the plots could be clearly observed. The consumption for areas cut and burned during the same year, tended toward a value of nearly 50% when presented as a function of the total area burned. The aboveground biomass of the test site and the amount of carbon before the fire were 496 Mg ha-1 and 138 Mg ha-1, respectively. Considering that the biomass that remains unburned keeps about the same average carbon content of fresh biomass, which is supported by the fact that the unburned material consists mainly of large logs and considering the value of 50% for consumption, the amount of carbon released to the atmosphere as gases was 69 Mg ha-1. The amounts of CO2 and CO released to the atmosphere by the burning process were then estimated as 228 Mg ha-1 and 15.9 Mg ha-1, respectively. Observations on fire propagation and general features of the slash burnings in the test areas complete the paper. Copyright 2001 by the American Geophysical Union.

Embryo recovery and pregnancy rates after the delay of ovulation and fixed time insemination in superstimulated beef cows

The aim of this study was to evaluate the effect of delaying ovulation subsequent to superstimulation of follicular growth in beef cows (Bos indicus) on embryo recovery rates and the capacity of embryos to establish pregnancies. Ovulation was delayed by three treatments using either progesterone (CIDR-B®) or a GnRH agonist (deslorelin). Multiparous Nelore cows (n = 24) received three of four superstimulation treatments in an incomplete block design (n = 18 per group). Cows in Groups CTRL, P48 and P60 were treated with a CIDR-B device plus estradiol benzoate (EB, 4 mg, i.m.) on Day-5, while cows in Group D60 were implanted with deslorelin on Day-7. Cows were superstimulated with FSH (Folltropin-V® 200 mg), from Day 0 to 3, using twice daily injections in decreasing amounts. All cows were treated with a luteolytic dose of prostaglandin on Day 2 (08:00 h). CIDR-B devices were removed as follows: Group CTRL, Day 2 (20:00 h); Group P48, Day 4 (08:00 h); Group P60, Day 4 (20:00 h). Cows in Group CTRL were inseminated at 10, 20 and 30 h after first detected estrus. Ovulation was induced for cows in Group P48 (Day 4, 08:00 h) and Groups P60 and D60 (Day 4, 20:00 h) by injection of LH (Lutropin®, 25 mg, i.m.), and these cows were inseminated 10 and 20 h after treatment with LH. Embryos were recovered on Days 11 or 12, graded and transferred to synchronized recipients. Pregnancies were determined by ultrasonography around Day 100. Data were analyzed by mixed procedure, Kruskal-Wallis and Chi-square tests. The number of ova/embryos, transferable embryos (mean ± S.E.M.) and pregnancy rates (%) were as follows, respectively: Group CTRL (10.8 ± 1.8, 6.1 ± 1.3, 51.5), P48 (12.6 ± 1.9, 7.1 ± 1.0, 52.3), P60 (10.5 ± 1.6, 5.7 ± 1.3, 40.0) and D60 (10.3 ± 1.7, 5.0 ± 1.2, 50.0). There were no significant differences among the groups (P > 0.05). It was concluded that fixed time AI in association with induced ovulation did not influence embryo recovery. Furthermore, pregnancy rates in embryos recovered from cows with delayed ovulation were similar to those in embryos obtained from cows treated with a conventional superstimulation protocol. © 2002 Elsevier B.V. All rights reserved.

Uso e conservação de Piper cernuum Vell. (Piperaceae) na Mata Atlântica: I. Fenologia reprodutiva e dispersão de sementes

The pariparoba (Piper cernuum Vell.), a native plant from the Atlantic Tropical Forest (ATF), has been commonly used in folk medicine. Works seeking the exploitation of P. cernuum natural populations need to be accomplished, seeking compatibility in obtaining income rates and preservation of ATF. The present work aimed to study the reproductive phenology and seed dispersal in P. cernuum natural population in the counties of Sete Barras/SP (Parque Estadual Intervales - PEI). The population of P. cernuum studied in PEI presented continuously bud-inflorescences, green-infrutescences and bud-inflorescence emission, with variation among individuals. Fruit-set average was of 9.1%, varying among individuals. Shading and foliar damage presented negative effect on the fruit-set. Three species of bats were identified as potential dispersors of the P. cernuum seeds: Carollia perspicillata, Anoura geoffroyi and Artibeus sp. The foragement strategy observed was the withdrawal of some seeds per infrutescence per flight. This strategy increases the potential in establishing new plants as well as in increase the potential of gene flow in comparison with the entire infrutescence plant eaten at the night perches. In consequence, the results of reproductive phenology and seed dispersal ecology presented in this work can help to establish management and conservation strategies of P. cernuum natural populations in the ATF.

Increased implantation and pregnancy rates obtained by placing the tip of the transfer catheter in the central area of the endometrial cavity

The influence of endometrial cavity length (ECL) on implantation and pregnancy rates after 400 embryo transfers was studied prospectively in a population with the indication of IVF/intracytoplasmic sperm injection (ICSI). The tip of the transfer catheter was placed above or below the half point of the ECL in a randomized manner. Two analyses were performed: (i) absolute position (AP); embryo transfers were divided into three groups according to the distance between the end of the fundal endometrial surface and the catheter tip (DTC - distance tip catheter): AP 1 (n = 212), 10-15 mm; AP 2 (n = 158), 16-20 mm; and AP 3 (n = 30), ≥21 mm. (ii) relative position (RP) - embryo transfers were divided into four groups according to their RP [RP = (DTC/ECL) × 100]: RP 1 (n = 23), ≤40%; RP 2 (n = 177), 41-50%; RP 3 (n = 117), 51-60%; and RP 4 (n = 83), ≥61%. Analysis based on relative distance revealed significantly higher implantation and pregnancy rates (P < 0.05) in more central areas of the ECL. However, analysis based on absolute position did not reveal any difference. In conclusion, the present results demonstrated that implantation and pregnancy rates are influenced by the site of embryo transfer, with better results being obtained when the catheter tip is positioned close to the middle area of the endometrial cavity. In this respect, previous analysis of the ECL is the fundamental step in establishing the ideal site for embryo transfers.

Sedimentation rates in the Corumbataí River basin, Brazil, derived from 210Pb measurements

Activity profiles of excess 210Pb measured in four sediment cores from the Corumbataí River basin, São Paulo State, Brazil, provided an opportunity to evaluate sedimentation rates that are helpful for defining appropriate management strategies for the hydrological resources in the basin. This is because Rio Claro city and other municipalities make extensive use of surface waters for drinking water supply. The radiochemical analysis of the sediment cores yielded apparent sediment mass accumulation rates of between 406 and 1014 mg cm-2 year-1 for secondary drainage lines, whereas an intermediate value of 546 mg cm-2 year-1 was found in the Corumbataí River, the main drainage system of the studied area. These values provided estimates of average linear sedimentation rates of between 3.1 and 16.2 mm year-1 that are compatible with field evidence, with the highest value corresponding with an area characterized by accumulation of sediment.

Potassium leaching from millet straw as affected by rainfall and potassium rates

Pearl millet (Penisetum glaucum) is an interesting species to be used as cover crop in tropical areas, showing a high ability in potassium uptake. Potassium (K) is not linked to organic compounds in the plant, and can easily be released from decaying straw becoming available for subsequent crops. This experiment evaluated K leaching from millet straw grown under potassium rates (0, 100, 200, and 300 mg dm-3), and submitted to five levels of simulated rain (5, 10, 20, 40, and 80 mm). Plants were grown in soil filled pots in a greenhouse. On the 50th day after emergence, the plants were desiccated with glyphosate. Artificial rain was applied over the straw. Potassium deficiency speeds up millet dehydration after herbicide application and increases lightly rain water retention in the straw. The amount of K leached right after plant desiccation is correlated with the residue nutrient content and can be as high as 64 kg ha-1 considering a mulch of 8 t ha -1. Although well-nourished millet plants release considerable amounts of K with the first rains, a large percentage of the nutrient is still retained in the straw. Copyright © Taylor & Francis, Inc.

Desenvolvimento de alevinos de trairão (Hoplias lacerdae) na ausência de luz

Sixty-six trairão (Hoplias lacerdae) fingerlings (average weight of 2.0±0.5 g and total length of 5.8±0.2 cm), trained to accept dry rations, were allotted to six 15-L aquariums, with aeration and controlled temperature (24.0±0.5°C), in a density of 0.7 juveniles/L, aiming to evaluate the effects of darkness on fish productive performance. The treatments consisted of two photoperiods: 12 hours light: 12 hours dark (12L:12D) and 0 hour light: 24 hours dark (OL:24D), with three replicates. Fingerlings were fed ad libitum a commercial extruded diet (42% CP), twice a day. The aquariums were cleaned daily for excrement withdrawal through siphoning, exchanging 1/4 total volume. At the end of the experiment (30 days), weight gain, feed:gain ratio and survival and cannibalism rates were evaluated. The results showed that darkness did not affect the productive performance of trairão juveniles.

Recombinant LH supplementation to recombinant FSH during induced ovarian stimulation in the GnRH-antagonist protocol: A meta-analysis

This study aims to compare the efficacy of recombinant LH (rLH) supplementation for ovarian stimulation in gonadotrophin-releasing hormone-antagonist protocol for IVF/intracytoplasmic sperm injection cycles. Search strategies included online surveys of databases. The fixed effects model was used for odds ratio (OR) and effect size (weighted mean difference, WMD). Five trials fulfilled the inclusion criteria. When the meta-analysis was carried out, advantages were observed for the LH supplementation protocol with respect to higher serum oestradiol concentrations on the day of human chorionic gonadotrophin administration (P < 0.0001; WMD: 514, 95% CI 368, 660) and higher number of mature oocytes (P = 0.0098; WMD: 0.88, 95% CI 0.21, 1.54). However, these differences were not observed in the total amount of recombinant FSH (rFSH) administered, days of stimulation, number of oocytes retrieved, the clinical pregnancy rate per oocyte retrieval, the implantation rate and miscarriage rate. This result demonstrates that the association of rLH with rFSH may prevent any decrease in oestradiol after antagonist administration and that a significantly higher number of mature oocytes was available for laboratory work. Nevertheless, it failed to show any statistically significant difference in clinically significant end-points in IVF (implantation and pregnancy rates). Additional randomized controlled trials are needed to confirm these results further. © 2007 Published by Reproductive Healthcare Ltd.

Spontaneous resolution rates of vesicoureteral reflux in Brazilian children: A 30-year experience

Objective: We evaluated clinical characteristics of primary vesicoureteral reflux (VLJR) in infants in a 30-year period in Brazil with special reference to the relation of renal parenchymal damage to urinary tract infection and gender. Materials and Methods: From 1975 through 2005, 417 girls (81.6%) and 94 boys (18.4%) with all grades of reflux were retrospectively reviewed. Patients were categorized by the worst grade of reflux, maintained on antibiotic prophylaxis and underwent yearly voiding cystourethrography until the reflux was resolved. VUR was considered resolved when a follow-up cystogram demonstrated no reflux. Surgical correction was recommended for those who fail medical therapy, severe renal scarring or persistent VUR. Results: Grades I to V VUR resolved in 87.5%, 77.6%, 52.8%, 12.2% and 4.3%, respectively. Renal scars were present at presentation in 98 patients (19.2%). Neither gender nor bilaterality versus unilaterality was a helpful predictor of resolution. The significant difference was found among the curves using the log rank (p < 0.001) or Wilcoxon (p < 0.001) test. Conclusion: Despite the current use of screening prenatal ultrasound, many infants are still diagnosed as having vesicoureteral reflux only after the occurrence of urinary tract infection in our country. Scarring may be associated to any reflux grade and it may be initially diagnosed at any age but half of the scars are noted with higher grades of reflux (IV and V). The incidence of reflux related morbidity in children has significantly diminished over the last three decades.

Effects of gender on stroke rates, critical speed and velocity of a 30-min swim in young swimmers

Our objective was to analyze the effect of gender on the relationship between stroke rates corresponding to critical speed (SRCS) and maximal speed of 30 min (SRS30) in young swimmers. Twenty two males (GM1) (Age = 15.4 ± 2.1 yr., Body mass = 63.7 ± 12.9 kg, Stature = 1.73 ± 0.09 m) and fourteen female (GF) swimmers (Age = 15.1 ± 1.6 yr., Body mass = 58.3 ± 8.8 kg, Stature = 1.65 ± 0.06 m) were studied. A subset of males (GM2) was matched to the GF by their velocity for a 30 min swim (S30). The critical speed (CS) was determined through the slope of the linear regression line between the distances (200 and 400 m) and participant's respective times. CS was significantly higher than S30 in males (GM1 - 1.25 and 1.16 and GM2 - 1.21 and 1.12 m·s-1) and females (GF - 1.15 and 1.11 m·s-1). There was no significant difference between SRCS and SRS30 in males (GM1 - 34.16 and 32.32 and GM2 - 34.67 and 32.46 cycle·s-1, respectively) and females (GF - 34.18 and 33.67 cycle·s-1-1, respectively). There was a significant correlation between CS and S30 (GM1 - r = 0.89, GF - r = 0.94 and GM2 - r = 0.90) and between SRCS and SRS30 (GM1 - r = 0.89, GF - r = 0.80 and GM2 - r = 0.88). Thus, the relationship between SRCS and SRS30 is not influenced by gender, in swimmers with similar and different aerobic capacity levels. ©Journal of Sports Science and Medicine (2007).