Profile of patients with rheumatic diseases undergoing treatment with anti-TNF agents in the Brazilian Public Health System (SUS), Belo Horizonte - MG

The aim of this study was to describe the baseline demographic and clinical characteristics as well as the functional status of a prospective cohort of patients with rheumatic diseases assisted by the Brazilian Public Health System (SUS). Data for 302 patients receiving tumor necrosis factor α inhibitors (anti-TNF agents) was collected through a standard form. Among patients, 229 (75.8%) were female and 155 (51.3%) were Caucasian; the mean age was 50.3 ± 12.8 years, and the mean disease duration was 9.9 ± 8.7 years. Among them 214 patients (70.9%) received adalimumab, 72 (23.8%) etanercept, and 16 (5.3%) infliximab. Mean Health Assessment Questionnaire-Disability Index (HAQ-DI) was 1.37 ± 0.67 for all participants. Poor functional response was associated with female gender, married patients and with a score of < 0.6 on the EuroQoL-5 dimensions (EQ-5D). Significant correlation was found between the HAQ-DI values, disease activity and quality of life (QOL). The results obtained in this study contribute to a better understanding of the clinical and demographic characteristics of patients with rheumatic diseases at the beginning of anti-TNF-agent treatment by SUS. Furthermore, our findings are consistent with another Brazilian and foreign cross-sectional investigations. This knowledge can be of great importance for further studies evaluating the effectiveness of biological agents, as well as, to contribute to improve the well-being of the patients with rheumatic diseases

Undiagnosed Phenylketonuria Can Exist Everywhere: Results From an International Survey

peer reviewedMany countries do not have a newborn screening (NBS) program, and immigrants from such countries are at risk for late diagnosis of phenylketonuria (PKU). In this international survey, 52 of 259 patients (20%) with late diagnosed PKU were immigrants, and 145 of the 259 (55%) were born before NBS or in a location without NBS. © 2021 The Author

Morbidity and survival in advanced AIDS in Rio de Janeiro, Brazil Morbidade e sobrevida em AIDS avançada no Rio de Janeiro, Brasil

Opportunistic diseases (OD) are the most common cause of death in AIDS patients. To access the incidence of OD and survival in advanced immunodeficiency, we included 79 patients with AIDS treated at Hospital Evandro Chagas (FIOCRUZ) from September 1997 to December 1999 with at least one CD4 count <=100 cells/mm³. The incidence of OD was analyzed by Poisson's regression, and survival by Kaplan Meier and Cox analysis, considering a retrospective (before CD4 <=100 cells/mm³) and a prospective (after CD4 <=100 cells/mm³) period, and controlling for demographic, clinical and laboratory characteristics. The confidence interval estipulated was 95%. Mean follow-up period was 733 days (CI = 683-782). During the study 9 (11.4%) patients died. Survival from AIDS diagnosis was a mean of 2589 days (CI = 2363-2816) and from the date of the CD4 count CD4 <=100 cells/mm³ was a mean of 1376 (CI = 1181-1572) days. Incidence of OD was 0.51 pp/y before CD4 <= 100 cells/mm³ and 0.29 pp/y after CD4 <= 100 cells/mm³. A lower number of ODs before CD4 < 100 cells/mm³ was associated with lower incidence rates after CD4 <= 100 cells/mm³. AIDS diagnosis based on CD4+ counts <= 200 cells/mm³ was associated with lower incidence rates after CD4 <= 100 cells/mm³. Baseline CD4 counts above 50 cells/mm³ (HR = 0.13) and restoration of baseline CD4+ counts above 100 cells/mm³ (HR = 0.16) were associated with a lower risk of death. Controling both variables, only restoration of baseline counts was statistically significant (HR = 0.22, p = 0.04). We found a very low incidence of OD and long survival after CD4 < 100 cells/mm³. Survival was significantly associated with restoration of baseline CD4 counts above 100 cells/mm³.<br>As doenças oportunistas (DO) são a causa mais comum de morte em pacientes com AIDS. Para acessar a incidência de DO e a sobrevida na imunodeficiência avançada, foram incluídos 79 pacientes com AIDS tratados no Hospital Evandro Chagas (FIOCRUZ) no período de Setembro de 1997 a Dezembro de 1999, com ao menos uma contagem de células CD4 <= 100/mm³. A incidência de DO foi analisada pela regressão de Poisson e a sobrevida pela analise de Kaplan Meier e Cox, considerando um período retrospectivo (anterior à contagem de CD4 <= 100 cels/mm³) e um prospectivo (após a contagem de CD4 <= 100 cels/mm³) e controlando-se características demográficas clínicas e laboratoriais. O intervalo de confiança estipulado foi o de 95%. O período médio de acompanhamento foi de 733 dias (IC = 683 - 782). Durante o estudo, nove (11,4%) pacientes morreram. A sobrevida a partir do diagnóstico de AIDS foi em média de 2589 dias (IC = 2363 - 2816) e da data da contagem de CD4 <= 100 cels/mm³ foi em média de 1376 dias (IC = 1181 - 1572). A incidência de DO foi de 0,51 pp/ano no período pré-CD4 <= 100 cels/mm³ e 0,29 pp/ano no período pós-CD4 <= 100 cels/mm³. Um menor número de DO acumuladas no período pré-CD4 <= 100 cels/mm³ foi associado com taxas de incidência menores no período pós-CD4 <= 100 cels/mm³.O diagnóstico de AIDS baseado em contagem de CD4+ <= 200 cels/mm³ foi associado com menores taxas de incidência durante o período pós-CD4 <= 100 cels/mm³. As contagens basais de células CD4 acima de 50 cel/mm³ (HR = 0,16) foram associadas a um menor risco de morte assim como a restauração da contagem basal acima de 100 cels/mm³ (HR = 0,16). Controlando-se ambas, somente a restauração da contagem basal manteve sua significância estatística (HR = 0,22, p = 0,04) Encontramos uma baixa incidência de DO durante o período pós-CD4 <= 100 cels/mm³ e uma sobrevida longa após CD4 <= 100 cels/mm³. A sobrevida foi significativamente associada com a restauração das contagens de CD4 basais

Properties and performance of the prototype instrument for the Pierre Auger Observatory

Copyright © 2003 Elsevier B.V. All rights reserved.Construction of the first stage of the Pierre Auger Observatory has begun. The aim of the Observatory is to collect unprecedented information about cosmic rays above 1018 eV. The first phase of the project, the construction and operation of a prototype system, known as the engineering array, has now been completed. It has allowed all of the sub-systems that will be used in the full instrument to be tested under field conditions. In this paper, the properties and performance of these sub-systems are described and their success illustrated with descriptions of some of the events recorded thus far.Auger Collaboration, ..., J. A. Bellido, ..., R. W. Clay, ..., B. R. Dawson, ..., G. J. Thornton, ..., N. R. Wild, et al.http://www.elsevier.com/wps/find/journaldescription.cws_home/505701/description#descriptio

AUGER FD: Detector response to simulated showers and real event topologies

The performance of the Auger Fluorescence telescope is discussed on the basis of a mass production chain. In order to get a realistic estimate of the detector resolution, a large number of fully simulated CORSIKA showers have been used for this study. The propagation through the atmosphere and the detector response are taken into account and simulated in detail. Results for the the case of monocular reconstruction are presented here. No quality cuts for the event reconstruction have been applied so far. Finally, a schematic overview of the expected event topologies is given together with the display of a real event recently collected