Capilaroscopia panorâmica periungueal e sua aplicação em doenças reumáticas

Universidade Federal de São Paulo (UNIFESP) Escola Paulista de Medicina Disciplina de ReumatologiaUNIFESP, EPM, Disciplina de ReumatologiaSciEL

Identification of M4 Gamma Irradiated Maize Mutant Based on Rapd Markers

Gamma irradiation to induce mutation in plant has been used intensively since several decades ago. On maize, 275 Gy gamma irradiation have been known to increase genetic variability indicated by their morphological variation. Identification on genetic changes by molecular technique is important to answer whether there is mutation happening on DNA level of the plants. The objective of this research was to identify RAPD marker polymorphism on gamma irradiation mutants compared to their parents. The initial step of the research was to select random primers could positively amplify the maize DNA. The result showed that selection on 60 random primers yielded 15 primers that positively amplified the maize DNA. Amplification on both mutants and their parents by those 15 selected primers indicated that only 5 primers yielding polymorphism between mutants and their parents. Polymorphisms on mutant G1, G3 and G6 were detected on one locus, meanwhile on mutant G7, G8 and G9 were on two loci

Pediatric Antifungal Prescribing Patterns Identify Significant Opportunities to Rationalize Antifungal Use in Children.

OBJECTIVE: The need for pediatric antifungal stewardship programs has been driven by an increasing consumption of antifungals for prophylactic and empirical use. Drivers and rational of antifungal prescribing need to be identified to optimize prescription behaviors. METHODS: A prospective modified weekly Point Prevalence Survey capturing antifungal prescriptions for children (> 90 days to < 18 years of age) in 12 centers in England during 26 consecutive weeks was performed. Demographic, diagnostic and treatment information was collected for each patient. Data were entered into an online REDCap database. RESULTS: One thousand two hundred fifty-eight prescriptions were included for 656 pediatric patients, 44.9% were girls, with a median age of 6.4 years (interquartile range, 2.5-11.3). Most common underlying condition was malignancy (55.5%). Four hundred nineteen (63.9%) received antifungals for prophylaxis, and 237 (36.1%) for treatment. Among patients receiving antifungal prophylaxis, 40.2% did not belong to a high-risk group. In those receiving antifungal treatment, 45.9%, 29.4%, 5.1% and 19.6% had a diagnosis of suspected, possible, probable of proven invasive fungal disease (IFD), respectively. Proven IFD was diagnosed in 78 patients, 84.6% (n = 66) suffered from invasive candidiasis and 15.4% (n = 12) from an invasive mold infection. Liposomal amphotericin B was the most commonly prescribed antifungal for both prophylaxis (36.6%) and empiric and preemptive treatment (47.9%). Throughout the duration of the study, 72 (11.0%) patients received combination antifungal therapy. CONCLUSIONS: Antifungal use in pediatric patients is dominated by liposomal amphotericin B and often without evidence for the presence of IFD. A significant proportion of prophylactic and empiric antifungal use was seen in pediatric patients not at high risk for IFD

Chemotherapy followed by low dose radiotherapy in childhood Hodgkin's disease: retrospective analysis of results and prognostic factors

PURPOSE: To report the treatment results and prognostic factors of childhood patients with Hodgkin's disease treated with chemotherapy (CT) followed by low dose radiotherapy (RT). PATIENTS AND METHODS: This retrospective series analyzed 166 patients under 18 years old, treated from January 1985 to December 2003. Median age was 10 years (range 2–18). The male to female ratio was 2,3 : 1. Lymphonode enlargement was the most frequent clinical manifestation (68%), and the time of symptom duration was less than 6 months in 55% of the patients. In histological analysis Nodular Sclerosis was the most prevalent type (48%) followed by Mixed Celularity (34.6%). The staging group according Ann Arbor classification was: I (11.7%), II (36.4%), III (32.1%) and IV (19.8%). The standard treatment consisted of chemotherapy multiple drug combination according the period of treatment protocols vigent: ABVD in 39% (n-65) of the cases, by VEEP in 13 %(n-22), MOPP in 13 %(n-22), OPPA-13 %(n-22) and ABVD/OPPA in 22 %(n-33). Radiotherapy was device to all areas of initial presentation of disease. Dose less or equal than 21 Gy was used in 90.2% of patients with most part of them (90%) by involved field (IFRT) or mantle field. RESULTS: The OS and EFS in 10 years were 89% and 87%. Survival according to clinical stage as 94.7%, 91.3%, 82.3% and 71% for stages I to IV(p = 0,005). The OS was in 91.3% of patients who received RT and in 72.6% of patients who did not (p = 0,003). Multivariate analysis showed presence of B symptoms, no radiotherapy and advanced clinical stage to be associated with a worse prognosis. CONCLUSION: This data demonstrating the importance of RT consolidation with low dose and reduced volume, in all clinical stage of childhood HD, producing satisfactory ten years OS and EFS. As the disease is highly curable, any data of long term follow-up should be presented in order to better direct therapy, and to identify groups of patients who would not benefit from radiation treatment

What is the purpose of the Joint Alignment and Motion Scale?

ESCOLA PAULISTA MED,DEPT MED,DIV RHEUMATOL,DISCIPLINA REUMATOL,RUA BOTUCATU 740,BR-04023 SAO PAULO,SP,BRAZILESCOLA PAULISTA MED,DEPT MED,DIV RHEUMATOL,DISCIPLINA REUMATOL,RUA BOTUCATU 740,BR-04023 SAO PAULO,SP,BRAZILWeb of Scienc

Low dose methotrexate with leucovorin rescue in AS

ESCOLA PAULISTA MED SCH,DIV RHEUMATOL,RUA BOTUCATU 740,BR-04023 SAO PAULO,BRAZILESCOLA PAULISTA MED SCH,DIV RHEUMATOL,RUA BOTUCATU 740,BR-04023 SAO PAULO,BRAZILWeb of Scienc

Genital ulceration in a 4 year old--a case of safeguarding? From social services to pathology...

This case of genital ulceration and social concerns in a preschool aged child was highly suspicious for child sexual abuse. However, the lesions presumed to be herpes simplex did not respond to antiviral medication. Specialist input from paediatric oncology and endocrinology resulted in a rare diagnosis of langerhans cell histiocytosis. Furthermore, the complication of diabetes insipidus later developed, making this the youngest child described to our knowledge with vulval lesions of langerhans cell histiocytosis and a central nervous system complication

Fibromyalgia versus rheumatoid arthritis: a longitudinal comparison of the quality of life

Objective. To evaluate and compare the quality of life of patients with fibromyalgia (FM) and rheumatoid arthritis (RA).Methods. Forty-four women with FM and 41 with RA were studied. There were 3 evaluations, with a 3-month interval. Besides special and general clinical examinations, the following tests were applied: pain numerical scale (PNS), Health Assessment Questionnaire (HAQ), Fibromyalgia Impact Questionnaire (FIQ), Arthritis Helplessness Index (AHI), Modified Post-Sleep Inventory (PST), and questions about sleep disorders and socioeconomic impact.Results. Results include the following: tender points (TP): FM = 13.9, RA = 2.9; PNS: FM = 7.2, RA = 6.8; HAQ: FM = 0.90, RA = 1.22; FIQ: FM = 47.2, RA = 42.5; AHI: FM = 32.7, RA = 31.8; sleep quality - mean duration of daily sleep: FM = 6.7 h, RA = 6.1; PSI scores: FM = 64.6, RA = 57.2. On questioning regarding economic impact, there was a decrease in family income for 65% of patients with FM and 75.1% for those with RA. Fifty-five percent of patients with FM and 66.6% of those with RA received social security aid. At followup evaluation, there was a statistically significant improvement in the following items for the patients with FM: TP count, HAQ, and AHI. The patients with RA improved in number of TP and AHI.Conclusion. FM has a negative impact on quality of life, similar to RA. Clinical, functional, and economic problems related to the disease were observed. The alteration observed remained relatively stable during the study period, except for physical disability.ESCOLA PAULISTA MED,DIV RHEUMATOL,SAO PAULO,BRAZILESCOLA PAULISTA MED,DIV RHEUMATOL,SAO PAULO,BRAZILWeb of Scienc