Portuguese recommendations for the use of biological therapies in patients with psoriatic arthritis - 2015 update

OBJECTIVE: To update recommendationsforthe treatment of psoriatic arthritis with biological therapies, endorsed by the Portuguese Society of Rheumatology (SPR). METHODS: These treatment recommendations were formulated by Portuguese rheumatologists based on literature evidence and consensus opinion. At a national meeting the 16 recommendations included in this document were discussed and updated. The level of agreement among Portuguese Rheumatologists was assessed using an online survey. A draft of the full text of the recommendations was then circulated and suggestions were incorporated. A final version was again circulated before publication. RESULTS: A consensus was achieved regarding the initiation, assessment of response and switching biological therapies in patients with psoriatic arthritis (PsA). Specific recommendations were developed for several disease domains: peripheral arthritis, axial disease, enthesitis and dactylitis. CONCLUSION: These recommendations may be used for guidance in deciding which patients with PsA should be treated with biological therapies. They cover a rapidly evolving area oftherapeutic intervention.Asmore evidence becomes available and more biological therapies are licensed, these recommendations will have to be updated

Influence of sense of coherence on adolescents' self-perceived dental aesthetics:a cross-sectional study

Background Sense of coherence (SOC) is a psychosocial factor capable of influencing perception of health, improving one’s ability to manage life. It is the central construct of salutogenesis. SOC allows for identification and mobilization of resources to effectively manage or solve problems, promoting health and quality of life. Using Wilson-Cleary’s conceptual model we hypothesized that SOC might contribute to self-perception of dental aesthetics. The aim of this study was to investigate whether SOC levels were related to self-perception of dental aesthetics against assessed normative orthodontic treatment need among adolescents. Methods A cross-sectional study was conducted with 615 male and female adolescents aged 12 to 15 years. Data collection comprised socio-demographic and socio-economic characteristics, SOC (SOC 13), self-perceived dental aesthetics (Oral Aesthetic Subjective Impact Scale), and assessment of orthodontic treatment need (Dental Aesthetic Index). Statistical analysis involved Pearson’s chi-square test, Kruskal-Wallis test, Mann-Whitney test and multiple linear regression. Spearman’s correlation coefficient was calculated for the determination of the strength of correlations among the numerical variables. The level of significance was set at 5% (p < 0.05). Results 50.1% of the participants were classified as having a high SOC (≥ median). Overall, SOC was associated with self-perceived dental aesthetics (p = 0.048). In the adolescents with no orthodontic treatment need, those with a low SOC perceived their dental aesthetics more negatively than those with high levels of SOC. The multiple regression analysis demonstrated an inverse relationship between SOC and: 1) age (p = 0.007), SOC being higher in the younger age group; 2) self-perceived dental aesthetics (p = 0.001), a higher SOC being associated with those who had a positive dental self-perception. Conclusions SOC was associated with self-perceived dental aesthetics and adolescents with a high SOC were more likely to perceive their dental aesthetics more positively. SOC did not seem to influence self-perception of dental aesthetics in adolescents who were clinically assessed as having an orthodontic treatment need, however, in those where there was no orthodontic treatment need, a low SOC was associated with a negative self-perception of dental appearance

Screening of conditions controlling spectrophotometric sequential injection analysis

<p>Abstract</p> <p>Background</p> <p>Despite its potential benefits over univariate, chemometrics is rarely utilized for optimizing sequential injection analysis (SIA) methods. Specifically, in previous vis-spectrophotometric SIA methods, chemometrically optimized conditions were confined within flow rate and reagent concentrations while other conditions were ignored.</p> <p>Results</p> <p>The current manuscript reports, for the first time, a comprehensive screening of conditions controlling vis-spectrophotometric SIA. A new diclofenac assay method was adopted. The method was based on oxidizing diclofenac by permanganate (a major reagent) with sulfuric acid (a minor reagent). The reaction produced a spectrophotometrically detectable diclofenac form. The 2⁶full-factorial design was utilized to study the effect of volumes of reagents and sample, in addition to flow rate and concentrations of reagents. The main effects and all interaction order effects on method performance, i.e. namely sensitivity, rapidity and reagent consumption, were determined. The method was validated and applied to pharmaceutical formulations (tablets, injection and gel).</p> <p>Conclusions</p> <p>Despite 64 experiments those conducted in the current study were cumbersome, the results obtained would reduce effort and time when developing similar SIA methods in the future. It is recommended to critically optimize effective and interacting conditions using other such optimization tools as fractional-factorial design, response surface and simplex, rather than full-factorial design that used at an initial optimization stage. In vis-spectrophotometric SIA methods those involve developing reactions with two reagents (major and minor), conditions affecting method performance are in the following order: sample volume > flow rate ≈ major reagent concentration >> major reagent volume ≈ minor reagent concentration >> minor reagent volume.</p