Adherence in Rheumatoid Arthritis patients assessed with a validated Italian version of the 5-item compliance questionnaire for rheumatology

OBJECTIVES: The 5-item Compliance Questionnaire for Rheumatology (CQR5) proved reliability and validity in respect of identification of patients likely to be high adherers (HAs) to anti-rheumatic treatment, or low adherers (LAs), i.e. taking<80% of their medications correctly. The objective of the study was to validate an Italian version of CQR5 (I-CQR5) in rheumatoid arthritis (RA) patients and to investigate factors associated with high adherence. METHODS: RA patients, undergoing treatment with ≥1 self-administered conventional synthetic disease-modifying anti-rheumatic drug (csDMARD) or biological DMARD (bDMARD), were enrolled. The cross-cultural adaptation and validation of I-CQR5 followed standardised guidelines. I-CQR5 was completed by patients on one occasion. Data were subjected to factor analysis and Partial Credit model Parametrisation (PCM) to assess construct validity of I-CQR5. Analysis of factors associated with high adherence included demographic, social, clinical and treatment information. Factors achieving a p<0.10 in univariate analysis were included in multivariable analysis. RESULTS: Among 604 RA patients, 274 patients were included in the validation and 328 in the analysis of factors associated with adherence. Factor analysis and PCM confirmed the construct validity and consistency of I-CQR5. HAs were found to be 109 (35.2%) of the patients. bDMARD treatment and employment were found to be independently associated with high adherence: OR 2.88 (1.36-6.1), p=0.006 and OR 2.36 (1.21-4.62), p=0.012, respectively. CONCLUSIONS: Only one-third of RA patients were HAs according to I-CQR5. bDMARDs and employment status increased by almost 3-fold the likelihood of being highly adherent to the anti-rheumatic treatment.Peer reviewe

Levantamento e identificação de espécies de moscas-das-frutas no Estado do Ceará.

As mosacas brancas das frutas pertencentes a especie Ceratitis capitata e ao genero Anastrepha sao reconhecidas como as pragas mais devastadoras da fruticultura em todo o mundo ...bitstream/CNPAT-2010/5391/1/Pa-062.pd

Is domestic agricultural production sufficient to meet national food nutrient needs in Brazil?

Acknowledgements: We are grateful for the valuable comments and suggestions made by Dr. James Gerber, as well as by the anonymous reviewers, which enhanced significantly the manuscript. Data Availability: All relevant data are uploaded to the PANGAEA database and publicly accessible via the following URL: https://doi.pangaea.de/10.1594/PANGAEA.911574. Funding: J. P. received his doctorate scholarship from Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES). J. P., J. G. and J. O. were funded by the Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP), in the scope of the Belmont Forum FACCE-JPI 2013 (process 2014/50627-2). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.Peer reviewedPublisher PD

TNFα blockers and infectious risk in rheumatoid arthritis

Patients suffering from rheumatoid arthritis have increased risk of infections when compared with general population. The risk depends directly from disease activity and severity. Furthermore, risk increases with aging, immunosuppressive agents and comorbidities such as diabetes, pulmonary and cardiac diseases. In particular corticosteroids, even at low doses, are a major risk factor. Due to disease related risk it is difficult to separate the risk deriving from the use of TNF alpha blockers. Data from clinical trials, meta-analysis and national registers are somewhat contradictory. In patients with rheumatoid arthritis on routine follow-up, treatment with TNF alpha blockers seems to carry an increased risk of infections compared to traditional DMARDs but not associated with increased risk of overall serious infection. Physicians should carefully monitor for signs of infection when using TNF alpha blockers, particularly shortly after treatment initiation

Using Geotechnology to Estimate Annual Soil Loss Rate in the Brazilian Cerrado

Soil erosion is a serious environmental problem that has adversely affected the world’s food production through the reduction of land productivity and water availability. The present study estimated annual soil loss rate and its spatial distribution in the most important Brazil’s agricultural region, the Brazilian Cerrado, using Revised Soil Loss Equation (RUSLE) model into Geographic Information System (GIS) framework. For this purpose, the soil erosion annual rate was determined in function of RUSLE model factors: rainfall erosivity (R), soil erodibility (K), topography (LS), crop management (C) and supporting conservation practice (P). All factors were obtained from literature. They were processed and integrated into a GIS, resulting in a map of annual soil loss rate. The methodology applied showed acceptable precision and it was possible to identify the most susceptible areas to water erosion. The average estimated rate of soil loss for the entire Cerrado was 12.8 t∙ha−1∙yr−1. Large part of the Cerrado is under low soil loss zone corresponding to 79.91% of total surface area, while 15.70%, 3.74%, and 0.66% are under moderate, high, and very high, respectively. The average estimated rate of soil loss in areas used for silviculture was 52.1 t∙ha−1∙yr−1. In semi-perennial, perennial, and annual crops cultivation were 29.3, 23.9, and 9.8 t∙ha−1∙yr−1, respectively, while in the pasture was 13.3 t∙ha−1∙yr−1. Except for annual crops, all farm and silviculture areas showed average soil loss ranging from moderate to high rate. These results suggest that the implementation of more effective management techniques and conservation practices are necessary for the Cerrado to maintain and to improve land productivity by ensuring national and international food demands

Objective quantification of vitreous haze on optical coherence tomography scans: no evidence for relationship between uveitis and inflammation in multiple sclerosis

BACKGROUND AND PURPOSE: The occurrence of intermediate uveitis, which is characterized by the presence of vitreous haze (VH), in patients with multiple sclerosis (MS) may be a sign of coexistent inflammatory central nervous system (CNS) disease activity. Using an automated algorithm to quantify VH on optical coherence tomography (OCT) scans, the aim was to investigate whether VH in MS patients is associated with signs of inflammatory CNS disease activity. METHODS: Vitreous haze was quantified on OCT macular volume scans of 290 MS patients and 85 healthy controls (HCs). The relationship between VH and clinical, retinal OCT and magnetic resonance imaging parameters of inflammatory disease activity was investigated using generalized estimating equations. RESULTS: Mean VH scores did not differ between patients and HCs (P = 0.629). Six patients (2.1%) showed values higher than the highest of the controls by HCs. VH scores did not differ between the different disease types or between eyes with and without a history of optic neuritis (P = 0.132). VH was not associated with inner nuclear layer volume on OCT (P = 0.233), cerebral T2 lesion load on magnetic resonance imaging (P = 0.416) or the development of new relapses (P = 0.205). CONCLUSION: In this study, OCT-based automated VH estimation did not detect increased vitreous inflammation in MS patients compared to HCs and did not find an association with CNS inflammatory burden