Airborne Measurements of Gravity Wave Breaking at the Tropopause

2000 FLORIDA AVE NW, WASHINGTON, DC, 2000

Metilfenidato: influência da notificação de receita A (cor amarela) sobre a prática de prescrição por médicos brasileiros

Four hundred and sixty three brazilian neurologists and 411 brazilian psychiatrists answered a questionnaire aimed at to obtain information on the prescription of methylphenidate for the treatment of the Attention Deficit and Hyperactivity Disorder. The majority of the doctors reported the erratic occurrence of a few non serious adverse reactions such as headache, weight loss, inapetence, hyperexcitability and tachycardia. On the other hand, only six doctors reported cases that cold raise a suspicion of drug dependence, although none of these six cases satisfied the ICD-10 criteria for dependence. The vast majority of the medical doctors manifested the opinion that the especial prescriptions the Notifications A of yellow color, the same used for opiates also, as demanded by the Brazilian Health Authorities, is inadequate as it raises misconceptions in relation to the real patient disease and frightens the parents and relatives. The doctors also claimed the such especial prescription form encumbers the prescription of the medicament making methylphenidate the second choice for the treatment and, for this reason, less available in pharmacies and drugstores. As a consequence the adherence to the treatment is more difficult to attain. The neurologists and psychiatrists agree that a certain control over methylphenidate is necessary, but as it is prescribed mostly by specialists and does not possess an evident abuse potential, the Prescription Notification B, of blue color, would be enough for efficient control. In fact, according to the doctors, the scheduling in Brazil of methylphenidate in the same list as the amphetamines and dronabinol (the active principle of Cannabis sativa) should be reviewed.Oitocentos e noventa e dois médicos, entre eles neurologistas (463) e psiquiatras (411), responderam a um questionário sobre a prescrição do metilfenidato para o transtorno do déficit de atenção e hiperatividade (TDAH). A maioria dos médicos relatou a ocorrência esporádica de reações adversas não-sérias, tais como dor de cabeça, emagrecimento, inapetência, hiperexcitabilidade, taquicardia, etc; apenas seis médicos, entretanto, relataram casos que poderiam levar à suspeita de dependência, embora nenhum deles satisfizesse os critérios da CID-10 para tal. A grande maioria opinou que a exigência da notificação de receita A (amarela) é inadequada, criando preconceitos em relação à condição dos pacientes e amedrontando seus parentes. Relatam ainda que tal classificação dificulta a prescrição do medicamento, fazendo muitas vezes com que o metilfenidato se torne a segunda opção para o tratamento de TDAH, além de tornar o produto pouco disponível nas farmácias e dificultar o trabalho dos profissionais. Isso faz com que a adesão ao tratamento se torne mais difícil, pois, além dos vários entraves burocráticos para se adquirir o medicamento, há também o medo por parte dos familiares e do próprio paciente de estar tomando tal medicação. Neurologistas e psiquiatras argumentam que o controle do metilfenidato deve existir, mas, em se tratando de um medicamento prescrito por especialistas e de não possuir grande potencial de dependência, o receituário azul já seria suficiente para o controle adequado. A classificação do metilfenidato, juntamente com as anfetaminas e com o princípio ativo da maconha (dronabinol), é uma outra questão levantada, sendo tal fato para grande parte dos profissionais uma total incoerência.UNIFESP-EPM Departamento de Psicobiologia Centro Brasileiro de Informações sobre Drogas PsicotrópicasNovartis BiociênciasUNIFESP, EPM, Depto. de Psicobiologia Centro Brasileiro de Informações sobre Drogas PsicotrópicasSciEL

How should eosinophilic cystitis be treated in patients with chronic granulomatous disease?

Chronic granulomatous disease (CGD) is a primary immunodeficiency resulting from the absence or malfunction of oxidative mechanism in phagocytic cells. The disease is due to a mutation in one of four genes that encode subunits of the nicotinamide adenine dinucleotide phosphate (NADPH) oxidase complex. Affected patients experience severe infections and granuloma formation due to exuberant inflammatory responses. Some evidence suggests that eosinophilic cystitis (EC) is included in the spectrum of inflammatory manifestations. EC is an inflammatory disease, rare in childhood, which may require different, nonstandardized therapeutic approaches, ranging from antihistamines to cyclosporine

High-sensitivity C-reactive protein is a predictive factor of adiposity in children : results of the Identification and prevention of Dietary- and lifestyle-induced health Effects in Children and InfantS (IDEFICS) study

Background-Whereas cross-sectional studies have shown that obesity is associated with increased C-reactive protein (CRP) levels in children, little is known about the impact of low-grade inflammation on body mass changes during growth. Methods and Results-We assessed cross-sectionally and longitudinally the association of high-sensitivity (hs)-CRP levels with overweight/obesity and related cardiometabolic risk factors in the Identification and prevention of Dietary-and lifestyle-induced health Effects in Children and InfantS (IDEFICS) cohort. 16 224 children from 8 European countries (2 to 9 years) were recruited during the baseline survey (T0). After the exclusion of 7187 children because of missing hs-CRP measurements and 2421 because of drug use during the previous week, the analysis was performed on 6616 children (Boys=3347; Girls=3269; age=6.3 +/- 1.7 years). Of them, 4110 were reexamined 2 years later (T1). Anthropometric variables, blood pressure, hs-CRP, blood lipids, glucose and insulin were measured. The population at T0 was divided into 3 categories, according to the baseline hs-CRP levels. Higher hs-CRP levels were associated with significantly higher prevalence of overweight/obesity, body mass index (BMI) z-score and central adiposity indices (P values all <0.0001), and with higher blood pressure and lower HDL-cholesterol levels. Over the 2-year follow-up, higher baseline hs-CRP levels were associated with a significant increase in BMI z-score (P<0.001) and significantly higher risk of incident overweight/obesity. Conclusions-Higher hs-CRP levels are associated to higher body mass and overweight/obesity risk in a large population of European children. Children with higher baseline levels of hs-CRP had a greater increase in BMI z-score and central adiposity over time and were at higher risk of developing overweight/obesity during growth

Short GRBs at the dawn of the gravitational wave era

We derive the luminosity function and redshift distribution of short Gamma Ray Bursts (SGRBs) using (i) all the available observer-frame constraints (i.e. peak flux, fluence, peak energy and duration distributions) of the large population of Fermi SGRBs and (ii) the rest-frame properties of a complete sample of Swift SGRBs. We show that a steep $\phi(L)\propto L^{-a}$ with a>2.0 is excluded if the full set of constraints is considered. We implement a Monte Carlo Markov Chain method to derive the $\phi(L)$ and $\psi(z)$ functions assuming intrinsic Ep-Liso and Ep-Eiso correlations or independent distributions of intrinsic peak energy, luminosity and duration. To make our results independent from assumptions on the progenitor (NS-NS binary mergers or other channels) and from uncertainties on the star formation history, we assume a parametric form for the redshift distribution of SGRBs. We find that a relatively flat luminosity function with slope ~0.5 below a characteristic break luminosity ~3$\times10^{52}$ erg/s and a redshift distribution of SGRBs peaking at z~1.5-2 satisfy all our constraints. These results hold also if no Ep-Liso and Ep-Eiso correlations are assumed. We estimate that, within ~200 Mpc (i.e. the design aLIGO range for the detection of GW produced by NS-NS merger events), 0.007-0.03 SGRBs yr$^{-1}$ should be detectable as gamma-ray events. Assuming current estimates of NS-NS merger rates and that all NS-NS mergers lead to a SGRB event, we derive a conservative estimate of the average opening angle of SGRBs: $\theta_{jet}$~3-6 deg. Our luminosity function implies an average luminosity L~1.5$\times 10^{52}$ erg/s, nearly two orders of magnitude higher than previous findings, which greatly enhances the chance of observing SGRB "orphan" afterglows. Efforts should go in the direction of finding and identifying such orphan afterglows as counterparts of GW events.Comment: 13 pages, 5 figures, 2 tables. Accepted for publication in Astronomy & Astrophysics. Figure 5 and angle ranges corrected in revised versio

Unveiling the population of orphan Gamma Ray Bursts

Gamma Ray Bursts are detectable in the gamma-ray band if their jets are oriented towards the observer. However, for each GRB with a typical theta_jet, there should be ~2/theta_jet^2 bursts whose emission cone is oriented elsewhere in space. These off-axis bursts can be eventually detected when, due to the deceleration of their relativistic jets, the beaming angle becomes comparable to the viewing angle. Orphan Afterglows (OA) should outnumber the current population of bursts detected in the gamma-ray band even if they have not been conclusively observed so far at any frequency. We compute the expected flux of the population of orphan afterglows in the mm, optical and X-ray bands through a population synthesis code of GRBs and the standard afterglow emission model. We estimate the detection rate of OA by on-going and forthcoming surveys. The average duration of OA as transients above a given limiting flux is derived and described with analytical expressions: in general OA should appear as daily transients in optical surveys and as monthly/yearly transients in the mm/radio band. We find that ~ 2 OA yr^-1 could already be detected by Gaia and up to 20 OA yr^-1 could be observed by the ZTF survey. A larger number of 50 OA yr^-1 should be detected by LSST in the optical band. For the X-ray band, ~ 26 OA yr^-1 could be detected by the eROSITA. For the large population of OA detectable by LSST, the X-ray and optical follow up of the light curve (for the brightest cases) and/or the extensive follow up of their emission in the mm and radio band could be the key to disentangle their GRB nature from other extragalactic transients of comparable flux density.Comment: 9 pages, 4 figures, 2 tables. Accepted for publication by Astronomy and Astrophysic

Gender-Related Differences in the Relationships Between Blood Pressure, Age, and Body Size in Prepubertal Children

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Surviving crack: a qualitative study of the strategies and tactics developed by Brazilian users to deal with the risks associated with the drug

<p>Abstract</p> <p>Background</p> <p>Due to marginalization, trafficking violence, conflicts with the police and organic and social psychological problems associated with the drug, crack is one of the most devastating drugs currently in use. However, there is evidence that some users manage to stay alive and active while using crack cocaine for many years, despite the numerous adversities and risks involved with this behavior. In this context, the aim of the present study was to identify the strategies and tactics developed by crack users to deal with the risks associated with the culture of use by examining the survival strategies employed by long-term users.</p> <p>Method</p> <p>A qualitative research method was used involving semi-structured, in-depth interviews. Twenty-eight crack users fulfilling a pre-defined enrollment criterion were interviewed. This criterion was defined as the long-term use of crack (i.e., at least four years). The sample was selected using information provided by key informants and distributed across eight different supply chains. The interviews were literally transcribed and analyzed via content analysis techniques using NVivo-8 software.</p> <p>Results</p> <p>There was diversity in the sample with regard to economic and education levels. The average duration of crack use was 11.5 years. Respondents believed that the greatest risks of crack dependence were related to the drug's psychological effects (e.g., cravings and transient paranoid symptoms) and those arising from its illegality (e.g., clashes with the police and trafficking). Protection strategies focused on the control of the psychological effects, primarily through the consumption of alcohol and marijuana. To address the illegality of the drug, strategies were developed to deal with dealers and the police; these strategies were considered crucial for survival.</p> <p>Conclusions</p> <p>The strategies developed by the respondents focused on trying to protect themselves. They proved generally effective, though they involved risks of triggering additional problems (e.g., other dependencies) in the long term.</p