Patient global assessment and radiographic progression in early arthritis: 3‐year results from the ESPOIR cohort

International audienceObjectives: To determine if patient global assessment (PGA), as part of Boolean-based definition of remission and individually considered, over the first year of disease course had a significant relationship with structural progression over 3 years in patients with early arthritis (EA).Methods: Prospective, observational study using ESPOIR cohort data. Remission states were defined as (a) 4v-remission: tender (TJC28), swollen 28-joint counts (SJC28), C-Reactive protein (mg/dL), and PGA (0-10) all ≤1; (b) PGA-near-remission: same parameters with only PGA>1/10; (c) 3v-remission (sum of previous groups) or (d) non-remission. The strictest status satisfied both at 6- and 12-months was considered. Radiographic progression was determined as a change in total Sharp-van der Heijde score from baseline to 3 years (ΔSHS) ≥5 points. The predictive capacities for radiographic damage of different remission definitions were assessed by Odds Ratio (OR). The association between each individual component of remission with ΔSHS was tested through multivariate linear regression analyses.Results: Among 520 patients, 7% achieved 4v-remission and 12% PGA-near-remission. Radiographic progression was observed in 29% of patients in 4v-remission (OR versus non-remission, OR=0.32 [95%CI:0.15-0.68]) and in 45% of patients in PGA-near-remission (OR=0.65 [0.38-1.11]); the comparison was not statistically different (OR=0.49 [0.20-1.18]). In 3v-remission it was observed in 39%. Of the individual components, only SJC28 and CRP were associated with radiographic progression.Conclusion: All definitions of remission led to low structural degradation in EA: 4v-remission led to less progression than PGA-near-remission but without a statistically significant difference. Both 4v-remission and 3v-remission appear useful targets when aiming at structural non-progression

Reexamining remission definitions in rheumatoid arthritis: Considering the Twenty-Eight–Joint Disease Activity Score, C-reactive protein level, and patient global assessment: Comment on the article by Felson et al

International audienc

Duration of hydrothermal treatment and peeling of 'Murcott' tangor

Hydrothermal treatment facilitates the peeling of 'Pera' sweet orange fruit and does not alter its quality. The aim of this work was to adapt the technology of peeling for the use of hydrothermal treatment in 'Murcott' tangor and to evaluate its influence in the CO2 production and the physicochemical, microbiologic and sensorial characteristics of fruits. The peeling time, the yield of marketable fruits and the internal temperature of fruits during the treatment were also evaluated. The hydrothermal treatment consisted of placing the fruits in a water-bath at 50 ºC for 5, 10, 15, 20, 25 and 30 min. Fruits were peeled by first opening a gap in the peduncle region with a knife and then manually removing the flavedo and albedo. Fruits were stored at 5 ºC for six days. Hydrothermal treatment caused changes in the fruits' CO2 production for only the first few hours after processing. Internal fruit temperature after 30 min of treatment reached 35 ºC. There were no changes in the physicochemical and microbiologic characteristics of the fruits. The treatment did not change the flavor, improved the fruits' appearance, decreased the peeling time of the treated fruits by 57 % and increased the yield of marketable fruits. In conclusion, the hydrothermal treatment accomplished from 5 to 30 min at 50 ºC can be used as part of the peeling process for 'Murcott' tangor

2018 update of the EULAR recommendations for the role of the nurse in the management of chronic inflammatory arthritis

© Author(s) (or their employer(s)) 2019. No commercial re-use. See rights and permissions. Published by BMJ. To update the European League Against Rheumatism (EULAR) recommendations for the role of the nurse in the management of chronic inflammatory arthritis (CIA) using the most up to date evidence. The EULAR standardised operating procedures were followed. A task force of rheumatologists, health professionals and patients, representing 17 European countries updated the recommendations, based on a systematic literature review and expert consensus. Higher level of evidence and new insights into nursing care for patients with CIA were added to the recommendation. Level of agreement was obtained by email voting. The search identified 2609 records, of which 51 (41 papers, 10 abstracts), mostly on rheumatoid arthritis, were included. Based on consensus, the task force formulated three overarching principles and eight recommendations. One recommendation remained unchanged, six were reworded, two were merged and one was reformulated as an overarching principle. Two additional overarching principles were formulated. The overarching principles emphasise the nurse's role as part of a healthcare team, describe the importance of providing evidence-based care and endorse shared decision-making in the nursing consultation with the patient. The recommendations cover the contribution of rheumatology nursing in needs-based patient education, satisfaction with care, timely access to care, disease management, efficiency of care, psychosocial support and the promotion of self-management. The level of agreement among task force members was high (mean 9.7, range 9.6-10.0). The updated recommendations encompass three overarching principles and eight evidence-based and expert opinion-based recommendations for the role of the nurse in the management of CIA

Fósforo em solos representativos do estado da paraíba: I- isotermas de adsorção e medidas do fator capacidade de fósforo Phosphorus in representative soils of the state of paraíba: I- adsorption isotherms and indicators of the phosphorus capacity factor

O conhecimento do fator capacidade de P (FCP) dos solos do Estado da Paraíba é importante para tornar mais eficiente a interpretação do teor de P disponível e a recomendação de adubação fosfatada em solos desse Estado. Os objetivos deste trabalho foram avaliar os parâmetros das isotermas de adsorção de P (Langmuir e Freundlich), por meio das técnicas de regressão não linear e de linearização, em amostras de solos do Estado da Paraíba, e verificar a correlação dos valores desses parâmetros com características químicas e físicas desses solos. Foram coletadas amostras de doze solos na camada de 0-30 cm de profundidade, sendo seis solos mais intemperizados e seis menos intemperizados, de modo a ter ampla variação de valores de características físicas e químicas de cada grupo de solos. O modelo hiperbólico da isoterma de Langmuir foi ajustado por meio da técnica de regressão não linear (região única) e por meio da técnica de linearização (região única e segunda região). Foram realizadas análises de correlação entre os valores dos parâmetros das isotermas e características do solo que refletem o FCP. Em todos os solos, o modelo ajustado por meio da técnica de regressão não linear apresentou melhor ajuste aos dados observados, em comparação ao mesmo modelo ajustado por meio da técnica de linearização. No grupo de solos mais intemperizados, os valores de capacidade máxima de adsorção de fosfato (CMAP) apresentaram correlação elevada com os valores de P remanescente (r = -0,95**), teor de oxihidróxidos de Fe (r = 0,90**) e equivalente de umidade (r = 0,88**), mas não se correlacionaram com o teor de argila (r = 0,64ns). Dentro do grupo de solos menos intemperizados, os valores de CMAP correlacionaram-se com os valores de P remanescente (r = -0,99**), equivalente de umidade (r = 0,93**) e teor de argila (r = 0,97**), mas não se correlacionaram com o teor de oxi-hidróxidos de Fe livre (r = 0,10ns).<br>Knowledge on the phosphorus capacity factor (PCF) of soils of the state of Paraíba is important to improve the interpretation of the available phosphorus (P) content and the recommendation of phosphate fertilization in soils of the State. The objective of this study was to evaluate the parameters of P adsorption isotherms (Langmuir and Freundlich) by the techniques of non-linear regression and linearization, in soil samples of the state of Paraíba, and to correlate the values of these parameters with chemical and physical soil properties. Samples of 12 representative soils of the state of Paraíba were collected in the 0-30 cm layer (six soils with a higher and six with a lower weathering degree), with a wide variation of values of physical and chemical properties within each group of six soils. The hyperbolic model of the Langmuir isotherm was adjusted by the technique of non-linear regression (single region) and of linearization (first region and second region). Correlation analyses were performed with the values of isotherm parameters and soil properties that reflect the FCP. In all soils, the model adjusted by non-linear regression fitted the data best, in comparison with the same model adjusted by linearization. In the most weathered soil group, the values of maximum adsorption capacity of phosphate (CMAP) were highly correlated with the contents of remaining (equilibrium) phosphorus (r = -0.95**), free Fe oxyhydroxides (r = 0.90**) and water retention (r = 0.88**), but did not correlate with the clay content (r = 0.64ns). Within the group of less weathered soils, the CMAP values were correlated with the contents of equilibrium phosphorus (r = -0.99**), water retention (r = 0.93**) and clay content (r = 0.97**), but did not correlate with free Fe oxyhydroxides (r = 0.10ns)