Monoarticular juvenile idiopathic arthritis as a distinct clinical entity A proof-of-concept study

Background: Currently, monoarticular Juvenile Idiopathic Arthritis (monoJIA) is included in the ILAR classification as oligoarticular subtype although various aspects, from clinical practice, suggest it as a separate entity. Objectives: To describe the clinical characteristics of persistent monoJIA. Methods: Patients with oligoJIA and with at least two years follow-up entered the study. Those with monoarticular onset and persistent monoarticular course were compared with those with oligoJIA. Variables considered were: sex, age at onset, presence of benign joint hypermobility (BJH), ANA, uveitis, therapy and outcome. Patients who had not undergone clinical follow-up for more than 12 months were contacted by structured telephone interview. Results: Of 347 patients with oligoJIA, 196 with monoarticular onset entered the study and 118 (60.2%), identified as persistent monoJIA, were compared with 229 oligoJIA. The mean follow-up was 11.4 years. The switch from monoarticular onset to oligoarticular course of 78 patients (38.8%) occurred by the first three years from onset. In comparison with oligoJIA, the most significant features of monoJIA were later age at onset (6.1 vs. 4.7 years), lower female prevalence (70.3 vs. 83.4%), higher frequency of BJH (61.9 vs. 46.3%), lower frequency of uveitis (14.4 vs. 34.1%) and ANA+ (68.6 vs. 89.5%) and better long-term outcome. Conclusions: MonoJIA, defined as persistent arthritis of unknown origin of a single joint for at least three years, seems to be a separate clinical entity from oligoJIA. This evidence may be taken into consideration for its possible inclusion into the new classification criteria for JIA and open new therapeutic perspectives

An individualized approach to sustained inflation duration at birth improves outcomes in newborn preterm lambs

A sustained first inflation (SI) at birth may aid lung liquid clearance and aeration, but the impact of SI duration relative to the volume-response of the lung is poorly understood. We compared three SI strategies: 1) variable duration defined by attaining volume equilibrium using real-time electrical impedance tomography (EIT; SIplat); 2) 30 s beyond equilibrium (SIlong); 3) short 30-s SI (SI30); and 4) positive pressure ventilation without SI (no-SI) on spatiotemporal aeration and ventilation (EIT), gas exchange, lung mechanics, and regional early markers of injury in preterm lambs. Fifty-nine fetal-instrumented lambs were ventilated for 60 min after applying the allocated first inflation strategy. At study completion molecular and histological markers of lung injury were analyzed. The time to SI volume equilibrium, and resultant volume, were highly variable; mean (SD) 55 (34) s, coefficient of variability 59%. SIplat and SIlong resulted in better lung mechanics, gas exchange and lower ventilator settings than both no-SI and SI30. At 60 min, alveolar-arterial difference in oxygen was a mean (95% confidence interval) 130 (13, 249) higher in SI30 vs. SIlong group (two-way ANOVA). These differences were due to better spatiotemporal aeration and tidal ventilation, although all groups showed redistribution of aeration towards the nondependent lung by 60 min. Histological lung injury scores mirrored spatiotemporal change in aeration and were greatest in SI30 group (P < 0.01, Kruskal-Wallis test). An individualized volume-response approach to SI was effective in optimizing aeration, homogeneous tidal ventilation, and respiratory outcomes, while an inadequate SI duration had no benefit over positive pressure ventilation alone

ANTI AGING CLOVE ESSENTIAL OIL MICROPARTICLES

Radicais livres são capazes de aumentar o fenômeno natural de dano à pele, estresse oxidativo e peroxidação de ácidos graxos da bicamada lipídica. Para impedir este processo, a pele possui o seu próprio mecanismo de defesa. No entanto esta habilidade de proteção natural diminui com o avanço da idade. As propriedades antioxidantes do óleo essencial de cravo-da-índia (Caryophyllus aromaticus Teysm) encapsulado em micropartículas de alginato de sódio foram utilizadas no desenvolvimento de formulações   dermatológicas para cuidados com a pele

Centro de Informação e Assistência Toxicológica de Santa Catarina: relatório anual 2015

Relatório Anual 2015. Secretaria de Estado da Saúde de Santa Catarina; Universidade Federal de Santa Catarina, Centro de Informação e Assistência Toxicológica de Santa Catarina,O Centro de Informação e Assistência Toxicológica de Santa Catarina (CIATox/SC) realizou aproximadamente 200.000 atendimentos para suporte ao diagnóstico e tratamento de intoxicações, desde que iniciou suas atividades em 1984. No ano de 2015 foram 11.832 atendimentos, dos quais 11.229 (94,9%) casos de exposição humana, 96 (0,8%) casos de exposição animal e 507 (4,3%) solicitações de informação, sem a existência de uma vítima exposta. Além disso, foram realizados 25.792 acompanhamentos de casos até a evolução final. Os grupos de agentes responsáveis pelo maior número de atendimentos foram os Animais Peçonhentos/Venenosos (28,2%) e os Medicamentos (25,9%). A maioria das solicitações foi proveniente do estado de Santa Catarina, sendo 29,6 % da Macrorregião da Grande Florianópolis. Os meses quentes são os de maior ocorrência de atendimentos, principalmente em decorrência do aumento do número de casos de animais peçonhentos. A maior parte das solicitações foi realizada por profissionais da área da saúde (85,2%), principalmente médicos (74,9%) provenientes de Hospitais (61,6%), Unidades de Pronto Atendimento (15,8%) e Unidades Básicas de Saúde (6,8%). Nos casos humanos a exposição ocorreu principalmente nas residências (72,4%) em zona urbana (68,7%). A distribuição dos casos humanos por sexo é semelhante entre o sexo feminino (51,0%) e masculino (49%). Observa-se predominância das exposições na faixa etária das crianças de 1 a 4 anos (15,8%), nos adultos jovens de 20 a 29 anos (17,4%) e de 30 a 39anos (15,9%). A principal circunstância de exposição foi acidental (54,6%), seguida das tentativas de suicídio (23,0%) e do acidente ocupacional (8,3%). A via oral foi a mais comum em 42,1% dos casos; seguida da mordida, picada ou contato com animais (29,5%). A maior parte das exposições humanas atendidas em 2015 foram exposições em que o paciente apresentou manifestações clínicas leves (57,4%). Ocorreram 64 óbitos em um total de 11.229 casos atendidos (0,6%). Destes, 51 casos (0,5%) foram óbitos relacionados à intoxicação e 13 casos (0,1%) foram óbitos por outra causa. As substâncias mais frequentes envolvidas nas exposições, excluindo os Animais e Diagnóstico Diferencial, foram os medicamentos da classe dos Benzodiazepínicos (Clonazepam e Diazepam), Antidepressivos (Amitriptilina) e Analgésicos e Antipiréticos (Paracetamol). Os principais animais responsáveis pelos acidentes foram as aranhas com 53,5%, em seguida as serpentes (17,7%), as lagartas (16,5%) e os escorpiões (5,7%). Dos 51 óbitos decorrentes de intoxicação 18 foram causados por Medicamentos (35,3%), 14 por Agrotóxicos (27,5%), oito por Drogas de Abuso (15,7%), dois por Produtos Químicos (3,9%), um por Animais Peçonhentos (2,0%), um por Alimentos (2,0%) e sete (13,7%) pela Associação de Grupos. A circunstância mais frequente foi a tentativa de suicídio com 35 casos (67,3%). Na distribuição dos óbitos de acordo com o sexo do paciente houve predominância do sexo masculino com 30 casos (59%) e 21 casos feminino (41%). A faixa etária de maior ocorrência foi de 40 a 49 anos (15 casos).ABSTRACT: The Centro de Informação e Assistência Toxicológica de Santa Catarina (CIATox/SC) carried out approximately 200,000 cases to support treatment and diagnostic of intoxications, since had begun the activities in 1984. In the year of 2015 there were 11.832 calls, those 11,229 (94.9%) cases of human exposure, 96 (0.8%) cases of animal exposure and 507 (4.3%) solicitation of information, without the existence of an exposure victim. Besides that, there was done the monitoring of 25.792 cases until the final evolution. The agents groups responsible to the majority attending were Venomous Animals (28.2%) and Medication (25.9%). The most part of the solicitations was coming from the state of Santa Catarina, of those 29.6% from the Macroregion of Greater Florianópolis. The warm months are the ones with greater occurrence of attendiments, principally because the increase in the number of cases with venomous animals. Most part of the requests was done by health professionals (85.2%), mostly doctors (74.9%) from Hospitals (61.6%), emergency care unit (15.8%) and health centers (6.8%). In human cases, the exposure occurred mainly in the residences (72.4%) in urban zone (68.7%). The distribution of humans cases by gender is similar between female (51%) and male (49%) gender. There is a predominance of exposure in the age range of children aged 1 to 4 years (15.8%), young adults aged 20 to 29 years (17.4%) and 30 to 39 years (15.9%). The main event of exposure was accidental (54.6%), followed by the suicide attempts (23.0%) and the accident occupational (8.3%). The oral route was the most common in 42.1% of cases; followed by the bite, sting or contact with animals (29.5%). Most of the human exposure attended in 2015 was those in which the patient had mild clinical manifestations (57.4%). There were 64 deaths in a total of 11,229 cases treated (0.6%). Of these, 51 cases (0.5%) were deaths related to intoxication and 13 cases (0.1%) were deaths from other causes. The substances most frequently involved in exposure, excluding animals and differential diagnosis, were the drugs of the class of benzodiazepines (clonazepam and diazepam), antidepressants (amitriptyline) and analgesics and antipyretics (acetaminophen). The main animals responsible for accidents were the spiders with 53.5%, then snakes (17.7%), the larvae (16.5%) and the scorpions (5.7%). Of the 51 deaths due to poisoning 18 were caused by drugs (35.3%), 14 by pesticides (27.5%), eight by drugs of abuse (15.7%), two by Chemicals (3.9%), one by poisonous animals (2.0%), one for food (2.0%) and seven (13.7%) by the association of groups. The fact most frequent was the attempted suicide with 35 cases (67.3%). In the distribution of deaths according to the patient's gender there was a predominance of males in 30 cases (59%) and 21 cases were female (41%). The age range of major occurrence was 40 to 49 years (15 cases)

Safety and efficacy of infliximab and adalimumab for refractory uveitis in juvenile idiopathic arthritis : 1-year followup data from the Italian Registry

To evaluate safety and efficacy of adalimumab (ADA) and infliximab (IFX) for the treatment of juvenile idiopathic arthritis-related anterior uveitis (JIA-AU).Starting January 2007, patients with JIA-AU treated with IFX and ADA were managed by a standard protocol and data were entered into the National Italian Registry (NIR). At baseline, all patients were refractory to standard immunosuppressive treatment and/or were corticosteroid-dependent. Data recorded every 3 months included uveitis course, number/type of ocular complications, drug-related adverse events (AE), treatment change or withdrawal, and laboratory measures. Data of patients treated for at least 1 year were retrieved from the NIR and analyzed using descriptive statistics. Treatment efficacy was based on change in uveitis course and in number of ocular complications.Up to December 2009, data for 108 patients with JIA-AU treated with anti-tumor necrosis factor-\u3b1 agents were recorded in the NIR and data from 91, with at least 12 months' followup, were included in the study. Forty-eight patients were treated with IFX, 43 with ADA. Forty-seven patients (55.3%) achieved remission of AU, 28 (32.9%) had recurrent AU, and 10 (11.8%) maintained a chronic course. A higher remission rate was observed with ADA (67.4% vs 42.8% with IFX; p = 0.025). Ocular complications decreased from 0.47 to 0.32 per subject. Five patients experienced resolution of structural complications. No patient reported serious AE; 8 (8.8%) experienced 11 minor AE (9 with IFX, 2 with ADA).IFX and ADA appear to be effective and safe for treatment of refractory JIA-related uveitis, with a better performance of ADA in the medium-term period

TERRE project : interplay between unsaturated soil mechanics and low-carbon geotechnical engineering

The geotechnical construction industry is a major component of the overall construction sector and is strategically important in infrastructure development (transportation, flood and landslide protection, building foundations, waste disposal). Although industry and research in the overall construction sector have been investing significantly in recent years to produce innovative low-carbon technologies, little innovation has been created in geotechnical construction industry, which is lagging behind other construction industry sectors. This paper discusses the interplay between low-carbon geotechnical engineering and unsaturated soil mechanics based on the research carried out within the project TERRE (Marie Skłodowska-Curie Innovative Training Networks funded by the European Commission, 2015-2019,H2020-MSCA-ITN-2015-675762)