Consenso em reumatologia pediátrica: parte I - definição dos critérios de doença inativa e remissão em artrite idiopática juvenil/artrite reumatóide juvenil

Não há critérios universalmente aceitos para a remissão clínica em artrite idiopática juvenil/artrite reumatóide juvenil (AIJ/ARJ). OBJETIVO: formar consenso sobre estes critérios. MÉTODOS: foi utilizado um inquérito pelo método Delphi para reunir os critérios vigentes e utilizados por especialistas em reumatologia pediátrica (RP) no mundo todo. A análise dos resultados constituiu a base para uma Consensus Conference utilizando a nominal group technique (NGT) para alcançar o consenso nas questões não resolvidas após a análise dos questionários deste inquérito. Cento e trinta RP de 34 países responderam ao inquérito e 20 RP de nove países elegeram os critérios durante dois dias, em processo de discussão estruturada, para formar consenso pela NGT. RESULTADOS: os critérios de doença inativa deveriam incluir: 1) nenhuma articulação com artrite em atividade; 2) ausência de febre, rash, serosite, esplenomegalia ou linfadenopatia generalizada atribuída à AIJ/ARJ; 3) ausência de uveíte em atividade; 4) VHS ou PCR negativas (se ambos forem testados, ambos devem ser normais); 5) a avaliação global pelo médico deve indicar o melhor escore possível, indicando doença inativa. CONCLUSÕES: de acordo com o voto de consenso, seis meses contínuos de doença inativa são necessários para se considerar um paciente em estado de remissão com medicação; 12 meses contínuos de doença inativa e sem medicação são necessários para considerar um paciente em estado de remissão sem medicação. O critério para remissão sem medicação deve prever com acurácia de 95% a probabilidade inferior a 20% de recaída em cinco anos.

An improved mouth-piece to prevent environmental contamination during radioaerosol inhalation procedures

The literature suggests that environmental contamination is common during labeled aerosol inhalation procedures in nuclear medicine. We have tested an adherent mask to prevent environmental contamination in 70 procedures. Two groups of patients were evaluated, Group 1 (60 inhalation cases in which the mask was used) presented no environmental contamination in 95% of the procedures (means of 553 dpm and 596 dpm before and after inhalation, p > 0.05, mean of the differences before/after inhalation 6.95, SD = 21.2 dpm) and the only 3 cases in which contamination did occur concerned bearded men; Group 2 (10 inhalation cases in which the mask was not used) showed large increases of environmental radioactive levels in 70% of the procedures (means of 601 dpm and 2,756 dpm before and after inhalation, p < 0.05, mean of the differences 3,066, SD = 2,98 dpm), We conclude that such a mask is very helpful in avoiding environmental contamination during radioaerosol inhalation procedures.

Degeneration of salivary glands of males of the tick Rhipicephalus sanguineus (Latreille, 1806) (Acari, Ixodidae)

The present study examined the salivary glands of Rhipicephalus sanguineus males at days 0, 3, and 7 post-detachment from the host. Degeneration of this organ occurred in the three stages and it advanced as time away from the host progressed. Thus, characteristics of degeneration were more prominent in males at day 7 post-detachment than in males at day 0 post-detachment. In males at day 0 post-detachment, type I acini were intact; while in other stages these acini exhibited signs of degeneration. In type 11 acini of individuals at day 0 post-detachment, cells a, c1-c5, c8, and indeterminate were identified. Only c I and c8 were intact. The remaining cell types were undergoing degeneration, as well as all cells d-f in type III acini, and all g in type IV acini.In males at day 3 post-detachment from the host, all cells (a, c1-c5, c8 and indeterminate) of type 11 acini, cells d and e in type III acini, and g in type IV were undergoing degeneration. In some Indeterminate acini, the boundaries of cells still could be distinguished, while in others, only a cytoplasmic mass was observed. At day 3 post-detachment, apoptotic bodies were present.In males at day 7 post-detachment from the host, the degeneration process progressed. All cells a, cl, c3-c5, c8 and indeterminate in type II, and d and e in type III acini were undergoing degeneration. Type IV acini still contained remnants of secretion and in Indeterminate acini, only a cytoplasmic mass could be observed. At this stage, apoptotic bodies were also present.The present study still revealed that cells of salivary glands of R. sanguineus males when degenerating undergo the following changes: (a) decrease in secretion production with or without granule breakage, (b) changes in nuclear morphology, (c) cytoplasm shrinkage, (d) loss of cell shape, (e) loss of cell boundaries, and (e) cytoplasmic vacuolation. Together, these changes result in cell fragmentation with release of apoptotic bodies. (C) 2008 Elsevier B.V. All rights reserved.

Cutoff-independent regularization of four-fermion interactions for color superconductivity

We implement a cutoff-independent regularization of four-fermion interactions to calculate the color-superconducting gap parameter in quark matter. The traditional cutoff regularization has difficulties for chemical potentials mu of the order of the cutoff Lambda, predicting in particular a vanishing gap at mu similar to Lambda. The proposed cutoff-independent regularization predicts a finite gap at high densities and indicates a smooth matching with the weak coupling QCD prediction for the gap at asymptotically high densities.

Effective theory for trapped few-fermion systems

We apply the general principles of effective field theories to the construction of effective interactions suitable for few- and many-body calculations in a no-core shell model framework. We calculate the spectrum of systems with three and four two-component fermions in a harmonic trap. In the unitary limit, we find that three-particle results are within 10% of known semianalytical values even in small model spaces. The method is very general, and can be readily extended to other regimes, more particles, different species (e.g., protons and neutrons in nuclear physics), or more-component fermions (as well as bosons). As an illustration, we present calculations of the lowest-energy three-fermion states away from the unitary limit and find a possible inversion of parity in the ground state in the limit of trap size large compared to the scattering length. Furthermore, we investigate the lowest positive-parity states for four fermions, although we are limited by the dimensions we can currently handle in this case.

Flavor changing interaction models and strictly massless neutrinos

It is well known that experimental data, coming from solar and atmospheric neutrino detectors and also from experiments which look for neutrino oscillations. strongly suggest that neutrinos must have a mass different from zero. However at least the solar and/or the atmospheric neutrino data can be related to new flavor changing interactions beyond the standard model instead to the finite mass of neutrinos. This new physics may induce i) extra effects in neutrino-matter interactions, ii) CP violation in pion and lepton decays and, iii) muonium to antimuonium transition. We give two examples of models in which all those effects arise even with strictly massless neutrinos: the 331 model and multi-Higgs doublet extension of the standard model (mHDM) with flavor changing neutral currents in the charged lepton sector. It means that in this kind of models if neutrino masses were eventually needed, they will be independent of the parameters of the new interactions.