Preliminary Criteria for Global Flares in Childhood-Onset Systemic Lupus Erythematosus

Objective. To develop widely acceptable preliminary criteria of global flare for childhood-onset systemic lupus erythematosus (cSLE).Methods. Pediatric rheumatologists (n = 138) rated a total of 358 unique patient profiles with information about the cSLE flare descriptors from 2 consecutive visits: patient global assessment of well-being, physician global assessment of disease activity (MD-global), health-related quality of life, anti-double-stranded DNA antibodies, disease activity index scores, protein: creatinine (P:C) ratio, complement levels, and erythrocyte sedimentation rate (ESR). Based on 2,996 rater responses about the course of cSLE (baseline versus followup), the accuracy (sensitivity, specificity, and area under the receiver operating characteristic curve) of candidate flare criteria was assessed. An international consensus conference was held to rank these candidate flare criteria as per the American College of Rheumatology recommendations for the development and validation of criteria sets.Results. The highest-ranked candidate criteria considered absolute changes (Delta) of the Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) or British Isles Lupus Assessment Group (BILAG), MD-global, P:C ratio, and ESR; flare scores can be calculated (0.5 x Delta SLEDAI + 0.45 x Delta P:C ratio + 0.5 x Delta MD-global + 0.02 x Delta ESR), where values of >= 1.04 are reflective of a flare. Similarly, BILAG-based flare scores (0.4 x Delta BILAG + Delta 0.65 x Delta P:C ratio + 0.5 + Delta MD-global + 0.02 x Delta ESR) of >= 1.15 were diagnostic of a flare. Flare scores increased with flare severity.Conclusion. Consensus has been reached on preliminary criteria for global flares in cSLE. Further validation studies are needed to confirm the usefulness of the cSLE flare criteria in research and for clinical care.

Fenologia de Caryocar brasiliense Camb. (Caryocaraceae) no Alto Rio Grande, sul de Minas Gerais

Phenological studies are important to understand the dynamics in forest ecosystems and also to enable adequate management of their native species. In the Cerrado regions of the high Rio Grande river (south of Minas Gerais State), Caryocar brasiliense species is found in highly distinct morphological forms with variable phenology. The aim of this study was to investigate phenological patterns within and between populations of both the tree and shrub forms of the individuals and to determine any correlation with abiotic factors. Thirty-five observations of the phenophases of the vegetative and reproductive stages were recorded ever), two weeks for 18 months. The activity index was analyzed for each stage and further analyzed to see if there were associations with the climate data by using Spearman linear correlation. The species was deciduous but leaf growth became retarded during the dry season, at which point leaf flushing stopped and total leaf fall occurred throughout the rainy season. The flowering and the fruit production occurred in the rainy season. The reproductive phase can be either annual or sub-annual. The activity index showed high synchronism within populations during the first flowering in all populations studied (> 80%). Flowering and mature fruits were highly synchronized according to Spearman correlations. Tree and shrub individuals of C. brasiliense had very similar times for their phenophases. The best period for collecting mature fruits in these regions is between February and March.

Indices de atividade da doença inflamatória do intestino: indicadores clínicos e laboratoriais.

The quantification of the degree of activity of inflammatory bowel disease is assuming growing importance nowadays. The activity index of the disease can be attained by clinical and laboratorial indicators. For ulcerative colitis the mostly used clinical parameters are daily bowel movements and presence of bloody diarrhea whereas albumin, hemoglobin, ESR and positive acute phase protein measurements are the laboratory parameters. For Crohn's disease activity besides the daily bowel movements the presence of abdominal pain and discomfort sensation are also frequently used whereas the C-reactive protein is the most used laboratory test which is able to detect the disease reactivation even before the appearance of any clinical sign. The combinations of clinical signs with the laboratory tests earned the sympathy of the specialists and the set of ensembled indicators has been recognized by the author's name. In this sense, the classification of the ulcerative colitis activity originally proposed by Truelove and Witts deserves presently a wide acceptance whereas such agreement is still lacking for Crohn's disease activity. In the mean time, the Bristol index is clinically the most feasible, once the Crohn's disease activity index and the Van Hees index are considered too complex. However the latter indexes are still useful mainly for comparisons among multicentric data. It seems that the currently existing clinical signs used for Crohn's disease activity would be quantitatively improved by adding some easily made laboratory tests such as C-reactive protein.

Comprimento da peça intermediária de espermatozóides bovinos e suas relações com características do sêmen e fertilidade

With the objective of identifying predictors of fertility in bulls, the correlation coefficients of the midpiece length of bovine spermatozoa with semen traits and fertility were estimated. Data were obtained from semen samples of 50 crossbred bulls submitted to a progeny test. The midpiece length was determined in 40 midpieces of each bull through a image analysis system (Videoplan). Besides the physical traits before and after semen freezing, the oxygen consumption rate and the cytochemical activity index were observed. The correlation coefficients were low and non-significant (P> 0.05), indicating that the midpiece length is not a good predictor of fertility.

Validation of the portuguese simple measure of impact of lupus erythematosus in youngsters (SMILEY) in Brazil

Background and Objective: Simple Measure of the Impact of Lupus Erythematosus in Youngsters (SMILEY) is a health-related quality of life (HRQOL) assessment tool for pediatric systemic lupus erythematosus (SLE), which has been translated into Portuguese for Brazil. We are reporting preliminary data on cross-cultural validation and reliability of SMILEY in Portuguese (Brazil). Methods: In this multi-center cross-sectional study, Brazilian children and adolescents 5-18 years of age with SLE and parents participated. Children and parents completed child and parent reports of Portuguese SMILEY and Portuguese Pediatric Quality of Life Inventory (PedsQLTM) Generic and Rheumatology modules. Parents also completed the Childhood Health Assessment Questionnaire (CHAQ). Physicians completed the SLE disease activity index (SLEDAI), Physician's Global Assessment of disease activity (PGA) and Systemic Lupus Erythematosus International Collaborating Clinics ACR Damage Index (SDI). Results: 99 subjects (84 girls) were enrolled; 93 children and 97 parents filled out the SMILEY scale. Subjects found SMILEY relevant and easy to understand and completed SMILEY in 5-15 minutes. Brazilian SMILEY was found to have good psychometric properties (validity and reliability), and the child-parent agreement was moderate. Conclusion: SMILEY may eventually be used routinely as a research/clinical tool in Brazil. It may be also adapted for other Portuguese-speaking nations offering critical information regarding the effect of SLE on HRQOL for children with SLE. © The Author(s), 2012.

Biomassa, teores de nutrientes, espilantol e atividade antioxidante em plantas de jambu (Acmella ciliata Kunth) sob adubações mineral e orgânica

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

O percurso gerativo de sentido aplicado à análise documental de textos narrativos de ficção: perspectivas de utilização em bibliotecas universitárias

Pós-graduação em Ciência da Informação - FFC

Fungos poróides (Agaricomycetes) na Floresta Nacional de Caxiuanã: fenologia e relação com o substrato, topografia e fatores micrometeorológicos

O estudo foi desenvolvido em um dos sítios do Programa de Biodiversidade da Amazônia (PPBio) localizado na Floresta Nacional de Caxiuanã (PA) e teve como objetivos: apresentar os fungos poróides com ênfase nos novos registros; analisar a relação destes fungos com o substrato lenhoso e examinar a associação entre variáveis micrometeorológicas (temperatura do ar, umidade relativa e pluviosidade) durante um ano, em relação às variáveis ambientais produzidas pela topografia, com a riqueza, densidade, e a fenologia destes fungos. Foram identificadas 76 espécies de fungos poróides, distribuídas em 27 gêneros e cinco famílias. Cerrena sclerodepsis, Phellinus dependens e Trametes pavonia representam primeiro registros para o estado do Pará. A espécie Microporellus iguazuensis é citada pela primeira vez para o Brasil e é apresentada a proposição de uma de nova espécie para a ciência denominada Microporellus hirsuta. A maioria das espécies foi considerada rara e apresentou preferência por substratos nos primeiros estágios de decomposição. O número de ocorrências de basidioma e de espécies de fungos foi maior em troncos de plantas das famílias Caesalpinaceae, Sapotaceae, Annonaceae, Mimosaceae e Lecythidaceae, respectivamente, e em substrato com diâmetro menor. Era esperado que as diferenças no microclima gerado por diferentes altitudes, em um pequeno gradiente topográfico, fossem o suficiente para gerar diferenças na comunidade de fungos poróides. No entanto, embora tenha sido encontrado um maior número de espécies na região denominada de intermediária, esta diferença não foi significativa. O maior número de indivíduos foi encontrado quando das primeiras chuvas na estação chuvosa e a riqueza esteve diretamente correlacionada com a pluviosidade. O índice de atividade de produção de basidioma das espécies mais abundantes foi maior no período das primeiras chuvas após o período seco. Este estudo representa avanços no entendimento das relações dos fungos com o meio em que eles se desenvolvem principalmente nas regiões tropicais. No entanto muitos estudos ainda precisam ser desenvolvidos para o esclarecimento destas relações.

Influência do estado nutricional e da composição corporal na evolução clínica dos pacientes com doença inflamatória intestinal

Pós-graduação em Fisiopatologia em Clínica Médica - FMB

An analysis of publications on invasive macrophytes in aquatic ecosystems

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Qualidade de vida relacionada à saúde em pacientes acometidos por doença inflamatória intestinal tratados com terapia biológica

Pós-graduação em Bases Gerais da Cirurgia - FMB

Qualidade de vida e capacidade funcional em pacientes com doenças inflamatórias intestinais

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

N-acetilcisteína e trolox na conservação de células espermáticas epididimárias de cães

Pós-graduação em Medicina Veterinária - FCAV

Sexualidade e doenças inflamatórias intestinais

Pós-graduação em Fisiopatologia em Clínica Médica - FMB

Juvenile onset systemic lupus erythematosus: a possible role for vitamin D in disease status and bone health

Purpose: In juvenile onset systemic lupus erythematosus (JoSLE), evidence for the association between vitamin D status, lupus activity, and bone health is very limited and not conclusive. The aim of this study was, therefore, to assess in JoSLE patients the possible relevance of vitamin D deficiency in disease and bone parameters. Methods: Fifty-seven JoSLE patients were initially compared to 37 age, race and body mass index (BMI) -matched healthy controls. The serum concentration of 25 hydroxyvitamin D (25OHD) was determined by radioimmunoassay. Patients with 25OHD deficiency (acurrency sign20 ng/mL) were compared to those with levels > 20 ng/mL. Disease activity was evaluated by SLE Disease Activity Index (SLEDAI). Bone mineral density (BMD) and body composition (BC) were measured using dual-energy X-ray absorptiometry (DXA). Results: 25OHD levels were similar in patients and controls (21.44 +/- 7.91 vs 22.54 +/- 8.25 ng/mL, p = 0.519), regardless of supplementation (65% of patients and none in controls). Thirty-one patients with 25OHD deficiency (acurrency sign20 ng/mL) were further compared to the 26 JoSLE patients with levels > 20 ng/mL. These two groups were well-balanced regarding vitamin D confounding variables: age (p = 0.100), ethnicity (p = 1.000), BMI (p = 0.911), season (p = 0.502), frequency of vitamin D supplementation (p = 0.587), creatinine (p = 0.751), renal involvement (p = 0.597), fat mass (p = 0.764), lean mass (p = 0.549), previous/current use of glucocorticoids(GC) (p = 1.0), immunosuppressors (p = 0.765), and mean current daily dose of GC (p = 0.345). Patients with vitamin D deficiency had higher SLEDAI (3.35 +/- 4.35 vs 1.00 +/- 2.48, p = 0.018), lower C4 levels (12.79 +/- 6.78 vs 18.38 +/- 12.24 mg/dL, p = 0.038), lower spine BMD (0.798 +/- 0.148 vs 0.880 +/- 0.127 g/cm2, p = 0.037) and whole body BMD (0.962 +/- 0.109 vs 1.027 +/- 0.098 g/cm2, p = 0.024). Conclusion: JoSLE vitamin D deficiency, in spite of conventional vitamin D supplementation, affects bone and disease activity status independent of therapy and fat mass reinforcing the recommendation to achieve adequate levels. Lupus (2012) 21, 1335-1342.