ABSTRACT
En nuestro país existen pocos datos acerca de los patrones de tratamiento y la sobrevida de las Drogas Modificadoras de la Artritis Reumatoidea biológicas (DMARb) en pacientes con Artritis Reumatoidea (AR). El objetivo de nuestro estudio fue estimar la sobrevida del 1° y 2° agente biológico, determinar sus causas de suspensión y evaluar factores que influyan en la sobrevida de estos agentes. Material y métodos: Se realizó un estudio multicéntrico retrospectivo. Se incluyeron pacientes ≥18 años de edad que cumplieran con criterios ACR/EULAR 2010 para AR y que iniciaron su 1° y/o 2° DMARb entre 01/2006 y 06/2017, la recolección de datos se realizó mediante la revisión de historias clínicas. Se consignaron variables sociodemográficas y clínicas. Resultados: Se incluyeron 347 pacientes con edad mediana de 57,8 años, 89,6% mujeres, 96,5% tenían Factor Reumatoideo (FR) positivo. El 53,9% de los pacientes discontinuaron el tratamiento con la 1°DMARb, treinta y ocho pacientes (41,3%) discontinuaron el 2° DMARb. La causa más frecuente de suspensión del primer biológico fue la falta de provisión, mientras que la del segundo biológico fue la ineficacia. Las supervivencias medianas fueron: para la 1° DMARb 31 meses (IC 95%: 21,8-40,1) y para 2° DMARb 11 meses (IC 95%: 4-17,9), no observamos diferencias significativas en la supervivencia entre los distintos agentes, los factores independientemente asociados a menor supervivencia del 1° DMARb fueron el tabaquismo y menor edad y del 2° DMARb fue haber discontinuado el primer agente biológico debido a evento adverso. Conclusión: Las supervivencias medianas del 1° DMARb y del 2° DMARb fueron 2,6 años y menor a 1 año, respectivamente. A diferencia de otras cohortes de países desarrollados, la causa más frecuente de suspensión del primer biológico fue la falta de provisión de la medicación por parte del pagador, mientras que la del segundo biológico fue la ineficacia.
In our country there are few data about the treatment patterns and the survival of the Biologic Disease Modifying Antirheumatic Drugs (bDMARD) in patients with Rheumatoid Arthritis (RA). The objective of our study was to evaluate the survival of the 1st and 2nd biological agent, determine the causes of suspension and factors that influence on the survival of these agents. Material and methods: A retrospective multicenter study was conducted. We included patients ≥18 years of age who met the ACR/EULAR 2010 criteria for RA and who started in 1st and/or 2nd bDMARD between 01/2006 and 06/2017, the data collection was done by reviewing clinical charts The sociodemographic and clinical variables were recorded. Results: We included 347 patients with a median age of 57.8 years, 89.6% women, 96.5% had positive Rheumatoid Factor (RF). 53.9% of patients discontinued treatment with 1st bDMARD, thirty-eight patients (41.3%) discontinued the 2nd bDMARD. The most frequent cause of suspension of the first biological was the lack of provision, while the second biological was inefficacy. The median survivals were: for the 1st bDMARD 31 months (95% CI: 21.8-40.1) and for the 2nd bDMARD 11 months (95% CI: 4-17.9), we did not observe significant differences in survival between the different agents. The independent factors associated with lower survival of the 1st bDMARD were smoking and lower age and the 2nd bDMARD was to have discontinued the first biological agent due to an adverse event. Conclusion: The median survivals of the 1st bDMARD and the 2nd bDMARD were 2.6 years and less than 1 year, respectively. Unlike other cohorts of developed countries the most frequent cause of suspension of the first biological was the lack of provision of the drug by the payer, while the second biological was inefficacy.
Subject(s)
Arthritis, Rheumatoid , Biological FactorsABSTRACT
Objetivos: Evaluar y comparar la eficacia y la sobrevida a largo plazo de las Drogas Modificadoras de la Enfermedad-biológicas (DME-b) en Espondiloartritis Axial (EsPax) mediante el índice LUNDEX y determinar las variables asociadas a la discontinuación de las mismas. Material y métodos: Estudio multicéntrico de corte transversal. Se incluyeron pacientes con EsPax en tratamiento con DME-b. Se registraron variables sociodemográficas, terapéuticas y clínicas. Se consignaron fechas de inicio del tratamiento con DME-b, tratamiento concomitante, suspensión o cambio de tratamiento, y causas de suspensión. La eficacia terapéutica se definió según BASDAI a los 6, 12 meses y luego anualmente a partir del inicio de la DME-b. Se calculó el índice LUNDEX en estos períodos. Análisis estadístico: Estadística descriptiva. Test de Student y test Chi² o test exacto de Fisher. Curvas de Kaplan-Meier y Log-Rank. Análisis de regresión proporcional de Cox. Resultados: Se estudiaron 101 pacientes con EsPax, 80,2% varones, con una edad mediana de 42 años (RIC 35-54,5) y un tiempo mediano de evolución de la enfermedad de 19,3 años (RIC 9,4-28,8). El 26,7% de los pacientes no tenían seguro de salud. Los agentes anti-TNFα utilizados como 1º DME-b en orden de frecuencia fueron: Etanercept (ETN) 44,6%, Adalimumab (ADA) 41,6%, Infliximab 7,9% y Certolizumab 5,9%. En el 32,7% de los casos, la DME-b se administró en combinación con una droga modificadora de enfermedad convencional. La sobrevida media fue de 66,2 meses (IC 95%: 51,8-80,5). Debido a que ETN y ADA se utilizaron en el 85% de los pacientes estudiados, se realizaron comparaciones solamente entre estos agentes. El tiempo medio de supervivencia acumulada fue significaticamente menor para ETN versus ADA (X 53,18±8,8 vs X 74,8±8,9, Log-Rank p=0,02), siendo la causa principal de suspensión, la falta de provisión de la medicación. El tiempo promedio de supervivencia para aquellos que no tenían seguro de salud fue significativamente menor X 31,9 meses (IC 95%: 19-45) con respecto a aquellos pacientes con dicho seguro X 72,3 meses (IC 95%: 55,3-89,3), p=0,03. Luego de ajustar por factores confundidores, la falta de un seguro de salud fue la única variable asociada en forma independiente con menor supervivencia del DME-b (HR 2,54, IC 95%: 1,18-5,75). El LUNDEX global fue del 52,7% a los 6 meses y del 46,9% a los 12 meses. Conclusiones: La sobrevida promedio del 1º DME-b fue de 5,5 años. La falta de cobertura de salud fue la única variable que influyó negativamente en la sobrevida del tratamiento con el 1º DME-b en pacientes con EsPax.
Objectives: To evaluate and compare the efficacy and long-term survival of biological disease-modifying drugs (b-DMARDs) in Axial Spondyloarthritis (axSpA) using the LUNDEX index and to determine the variables associated with the discontinuation of these drugs. Material and methods: Cross-sectional multicenter study. Patients with axSpA in treatment with b-DMARDs were included. Sociodemographic, therapeutic and clinical variables were recorded. The dates of initiation of treatment with b-DMARDs, concomitant treatment, suspension or change of treatment, and causes of suspension were recorded. Therapeutic efficacy was defined according to BASDAI at 6, 12 months and then annually from the initiation of b-DMARDs. The LUNDEX index was calculated in these periods. Statistical analysis: Descriptive statistics. Student's test and Chi² test or Fisher's exact test. Curves of Kaplan-Meier and Log-Rank. Proportional regression analysis of Cox. Results: 101 patients with axSpA were studied, 80.2% men, with a median age of 42 years (IQR 35-54.5) and a median disease duration of 19.3 years (IQR 9.4-28.8). 26.7% of patients didn´t have health insurance. The frequency of the anti-TNFα agent used as 1st b-DMARD was: Etanercept (ETA) 44.6%, Adalimumab (ADA) 41.6%, Infliximab 7.9%, and Certolizumab 5.9%. In 32.7% of the cases, the b-DMARD was administered in combination with a c-DMARD (conventional disease-modifying drug). The mean survival was 66.2 months (95% CI: 51.8-80.5). As ETA and ADA were used in 85% of the patients, comparisons were made only between these two agents. The mean survival time was significantly lower for ETA vs ADA (X 53.18 ±8.8 vs X 74.8±8.9, Log-Rank p=0.02), being the main cause of suspension, the lack of drug provision. The average survival time for those who didn´t have health insurance was significantly lower X 31.9 months (95% CI: 19-45) in comparison to those patients who had health insurance X 72.3 months (95% CI: 55.3-89.3), p=0.03. After adjusting for confounding factors, the lack of health insurance was the only variable independently associated with a lower survival of the b-DMARD (HR 2.54, 95% CI: 1.18 to 5.75). The global LUNDEX was 52.7% at 6 months and 46.9% at 12 months. Conclusions: The average survival of the 1st b-DMARD was 5.5 years. The lack of health insurance was the only variable that negatively influenced the survival of the treatment with the 1st b-DMARD in patients with axSpA.
Subject(s)
Biological Factors , SpondylarthritisABSTRACT
Objetivos: Evaluar los patrones de tratamiento de las DME-b (Drogas Modificadoras de la Enfermedad-biológicas), su sobrevida acumulada y su eficacia a largo plazo en pacientes con Artritis Psoriásica (APs) utilizando el índice LUNDEX. Materiales y métodos: Estudio multicéntrico retrospectivo. Se incluyeron pacientes con diagnóstico de APs que hayan iniciado tratamiento con DME-b. Se recolectaron datos sociodemográficos y clínicos. Se consignaron fechas de inicio de DME-b, tratamiento concomitante, suspensión o cambio de tratamiento, y razones de suspensión. La respuesta terapéutica se definió acorde a MDA (Minimal Disease Activity), a los 6, 12 meses y anualmente a partir del inicio de DME-b. Análisis estadístico: Test de Student y Chi². Curvas de Kaplan Meier y Log Rank. Análisis de regresión de Cox. Resultados: Se incluyeron 72 pacientes con APs, 39 (54,2%) de sexo masculino. La edad mediana fue de 54,5 años (RIC 45-61) y el tiempo mediano de evolución de la enfermedad de 11 años (RIC 6-15). 71,2% (n=42) presentaron comorbilidades. El primer DME-b fue en orden decreciente de frecuencia: Adalimumab (45,8%), Etanercept (36,1%), Certolizumab (5,6%), Infliximab (4,2%), Ustekinumab (4,2%), Abatacept (2,7%) y Golimumab (1,4%). 15 pacientes (25,4%) recibieron DME-b en monoterapia. La sobrevida media fue de 82 meses (DE±7,4). El LUNDEX del primer biológico fue 24,7% a los 6 meses y 44,3% al año. La sobrevida media de Adalimumab fue de 90 meses (DE±10,4) y de Etanercept 79 meses (DE±12). Los pacientes añosos presentaron menor sobrevida de la droga [≥55 años: X59,8 (DE±10,5) vs <55 años: X101,2 (DE±9,7), p=0,006]. Luego de ajustar por diferentes confundidores, la edad ≥55 años se mantuvo significativamente a menor sobrevida [HR=1,064 (IC=1,01-1,11) p=0,005]. El LUNDEX fue menor en obesos vs no obesos (16% vs 66% al año, p=0,89; 10,5 vs 74,9% a los 2 años, p=0,011 y 5,9 vs 81,8% a los 3 años, p=0,005). Conclusiones: La sobrevida promedio del primer DME-b fue de 6,8 años. La única variable asociada a menor sobrevida fue la mayor edad.
Objectives: To evaluate the treatment patterns of DME-b (Disease-Modifying Drugs-biological), their accumulated survival and their long-term efficacy in patients with psoriatic arthritis (PsA) using the LUNDEX index. Materials and methods: Retrospective multicentre study. We included patients diagnosed with PsA who started treatment with DME-b. Sociodemographic and clinical data were collected. BMI-D start dates, concomitant treatment, suspension or change of treatment, and reasons for suspension were recorded. The therapeutic response was defined according to MDA (Minimal Disease Activity), at 6, 12 months and annually from the beginning of DME-b. Statistical analysis: Student test and Chi². Curves of Kaplan Meier and Log Rank. Cox regression analysis. Results: We included 72 patients with PsA, 39 (54.2%) male. The median age was 54.5 years (IQR 45-61) and the median time of evolution of the disease was 11 years (IQR 6-15). 71.2% (n=42) presented comorbidities. The first DME-b was in decreasing order of frequency: Adalimumab (45.8%), Etanercept (36.1%), Certolizumab (5.6%), Infliximab (4.2%), Ustekinumab (4.2%), Abatacept (2.7%) and Golimumab (1.4%). 15 patients (25.4%) received DME-b monotherapy. The mean survival was 82 months (SD±7.4). The LUNDEX of the first biological was 24.7% at 6 months and 44.3% per year. The mean survival of Adalimumab was 90 months (SD±10.4) and Etanercept 79 months (SD±12). Older patients had a lower survival of the drug [≥55 years: X59.8 (SD±10.5) vs <55 years: X101.2 (SD±9.7), p=0.006]. After adjusting for different confounders, age ≥55 years was significantly maintained at lower survival [HR=1.064 (CI=1.01-1.11) p=0.005]. The LUNDEX was lower in obese vs. non-obese (16% vs. 66% per year, p=0.89, 10.5 vs 74.9% at 2 years, p=0.011 and 5.9 vs 81.8% at 3 years, p=0.005). Conclusions: The average survival of the first DME-b was 6.8 years. The only variable associated with lower survival was the older age.
Subject(s)
Biological Factors , Arthritis, PsoriaticABSTRACT
Abstract The objective of this study was to describe the embryonic and larval development of Brycon amazonicus, featuring the main events up to 50 hours after fertilization (AF). The material was provided by the Aquaculture Training, Technology and Production Center, Presidente Figueiredo (AM). The characterization was based on stereomicroscopic examination of the morphology of eggs, embryos and larvae and comparison with the literature. Matrinxã eggs are free, transparent, and spherical, with a perivitelline space of 0.56 ± 0.3 mm. The successive divisions give rise to cells with 64 blastomeres during the first hour AF. The gastrula stage, beginning 02 h 40 min AF, was characterized by progressive regression cells and the formation of the embryonic axis, leading to differentiation of the head and tail 05 h 30 min AF. From 06 to 09 h AF the somites, notochord, otic and optic vesicles and otoliths were observed, in addition to heart rate and the release of the tail. The larvae hatched at 10 h 30 min AF (29.9 °C), with a total length of 3.56 ± 0.46 mm. Between 19 and 30 h AF, we observed 1) pigmentation and gut formation, 2) branchial arches, 3) pectoral fins, 4) a mouth opening and 5) teeth. Cannibalism was initiated earlier (34 h AF) which was associated with rapid yolk absorption (more than 90% until 50 h AF), signaling the need for an exogenous nutritional source. The environmental conditions (especially temperature) influenced the time course of some events throughout the embryonic and larval development, suggesting the need for further studies on this subject.
Resumo O objetivo deste trabalho foi descrever o desenvolvimento embrionário e larval do Brycon amazonicus, caracterizando os principais eventos ocorridos até 50 h Após Fertilização (AF). O material é proveniente do Centro de Treinamento, Tecnologia e Produção em Aqüicultura em Presidente Figueiredo (AM). A caracterização foi feita com base na análise estereomicroscópica da morfologia dos ovos, embriões e larvas e comparação bibliográfica. Os ovos da matrinxã são livres, transparentes, esféricos com espaço perivitelínico de 0,56 ± 0,3 mm. As sucessivas clivagens originam células com 64 blastômeros na primeira hora AF. A gástrula, iniciada 02 h e 40 min AF caracterizou-se por progressiva involução celular e formação do eixo embrionário, culminando com diferenciação de cabeça e cauda com 05 h 30 min AF. De 06 às 09h AF foi observada a formação de somitos, notocorda, vesículas óptica, ótica e otólitos, além de batimentos cardíacos e liberação da cauda. As larvas eclodiram com 10 h 30 min AF (29,9 °C), com 3,56 ± 0,46 mm de comprimento total. Entre 19 e 30 h AF foram observadas: 1) pigmentação e formação do tubo digestivo 2) surgimento de arcos branquiais 3) nadadeira peitoral 4) abertura da boca e 5) surgimento dos dentes. O canibalismo iniciou mais precocemente (34 h AF), em relação aos trabalhos existentes com o gênero, o que associado à rápida absorção do vitelo (mais de 90% até 50 h AF), sinaliza a necessidade de ofertar recurso alimentar exógeno. As condições ambientais (especialmente temperatura e pH) influenciaram na abreviação de alguns eventos ao longo do desenvolvimento embrionário e larval, sugerindo a necessidade de estudos complementares a esse respeito.
Subject(s)
Animals , Characidae/embryology , Characidae/growth & development , Embryonic Development , Embryo, Nonmammalian/embryologyABSTRACT
En el año 2008 fueron publicadas las recomendaciones para eltratamiento hacia el objetivo en artritis reumatoidea (treat to target:T2T). Originalmente diseñadas como recomendaciones para guiar areumatólogos en el tratamiento de la AR, en el año 2011 se publicóla primera versión para pacientes de estas recomendaciones eninglés.Objetivo: validar la versión para pacientes de las recomendacionesT2T para su uso en Argentina a través de la adaptación transculturalde la versión original.Método: Se realizó un proceso de adaptación transcultural a partirde la versión original. De este proceso de traducción y retraduccióny del análisis por parte de un comité de expertos, se obtuvo unaversión prefinal.Esta versión fue sometida a una prueba de campo mediante unaentrevista a pacientes alfabetos consecutivos con diagnósticode AR en diferentes centros de Buenos Aires, Ciudad de BuenosAires y Santa Fe. En esta entrevista se evaluó validez de forma,equivalencia conceptual, interpretabilidad y aceptabilidad. Elresultado obtenido de estas entrevistas fue discutido con el comitédesignado de investigadores para desarrollar una versión final dela pieza validada.Durante la entrevista se permitió leer la versión en español prefinaly se invitó a calificar de 0 a 10 cada oración de acuerdo al gradode comprensión del texto. A su vez se exploró el grado de acuerdoy de adaptabilidad a su problema de salud y se reemplazaron laspalabras que ofrecieron mayores dificultades...
In 2008 recommendations for the treatment towards the targetin rheumatoid arthritis (treat to target: T2T) were published.Originally designed as recommendations to guide rheumatologistsin the treatment of RA, in 2011 the first patient version of theserecommendations was published in English.Objective: To validate the Spanish version of the patient version ofthe T2T recommendations through cross-cultural adaptation of theoriginal version.Method: A cross-cultural adaptation process was made from theoriginal version. In this process of translation and back translationand analysis by a committee of experts, a prefinal version wasobtained.This version was subjected to a field test by interviewing alphabetsconsecutive patients diagnosed with RA at different centers inBuenos Aires, CABA and Santa Fe. Construct validity, cross-culturaladaptability, interpretation and acceptability were evaluated andlater discussed with the committee to get the final version.After reading patients had to point each sentence from 0 to 10according to the degree of understanding of the text. The degreeof agreement and adaptability to their health problem was exploredand words that offered greater difficulties were replaced...
Subject(s)
Humans , Arthritis, Rheumatoid , Arthritis, Rheumatoid/therapy , Rheumatology , ArgentinaABSTRACT
The anesthetics effects of aqueous extract of Ottonia martiana leaves were studied on the ocular surface of healthy beagle dogs. The dogs were divided in three groups (n=15): control group (CG), proxymetacaine group (PG) and Ottonia group (OG), which were treated with 0.9% saline, 0.5% proxymetacaine hydrochloride ophthalmic solution and O. martiana extract respectively. An oftalmic evaluation was performed before the treatments. Eye drops were instilled at time 0 (T0) and 3 minutes later (T3). Axial corneal sensitivity was evaluated by esthesiometry 5 and 10 minutes after T0. Tear production and intraocular pressure were evaluated 10 minutes after T0. Slit lamp biomicroscopy was performed 10 and 20 minutes after T0 and the eyes were stained with fluorescein 20 minutes after T0. The STT was reduced in PG. Conjunctival hyperemia was observed in 13 animals from PG and constituted the only ocular alteration observed during the study. Esthesiometry revealed a decreased corneal sensitivity for PG and OG. Those results show that the O. martiana extract acts reducing corneal sensitivity in dogs. Moreover, its use does not decrease the tear production and does not cause any clinical ophthalmic alteration.
Estudaram-se os efeitos do extrato das folhas de Ottonia martiana sobre a superfície ocular de cães hígidos da raça Beagle. Compuseram-se três grupos de tratamento (n=15): grupo controle (GC), grupo proximetacaína (GP) e grupo Ottonia (GO), tratados, respectivamente, com solução fisiológica, colírio de cloridrato de proximetacaína a 0,5% e extrato de O. martiana. Após avaliação oftálmica inicial, os tratamentos foram realizados no tempo 0 (T0) e decorridos 3min (T3). Avaliaram-se a sensibilidade axial da córnea por estesiometria (T5 e T10) e a produção lacrimal e a pressão ocular (T10). Realizaram-se a biomicroscopia com lâmpada em fenda (T10 e T20), e o teste do tingimento pela fluoresceína (T20). Relativamente ao teste de Schirmer, observou-se diminuição nos cães do GP. Houve alteração clínica somente nos do GP, em que 13 animais apresentaram hiperemia conjuntival. Relativamente à estesiometria, houve diminuição da sensibilidade corneal nos animais do GP e do GO. Admite-se que o extrato de O. martiana age diminuindo a sensibilidade corneal em cães e que sua utilização não diminui a produção lacrimal, tampouco causa alterações clínicas oftálmicas.
ABSTRACT
Los anticuerpos anticitoplasma de neutrófilos (ANCA) han cobrado relevancia en distintas patologías. Recientemente se ha reportado un elevado porcentaje (79%) de ANCAp en pacientes con Artropatía Psoriática (APs). Los objetivos de este estudio fueron evaluar la prevalencia ANCAp en pacientes con APs y compararlo con pacientes con artritis reumatoidea (AR), espondilitis anquilosante (EA), psoriasis cutánea (Ps) y controles sanos (CS). Material y métodos: Se incluyeron pacientes consecutivos con APs según criterios CASPAR, AR (criterios ACR 87), EA (criterios de NY modificados); los CS fueron personas de la población general sin antecedentes o evidencias de enfermedades inmunológicas. Se excluyeron pacientes con antecedentes oncológicos, infecciosos, sarcoidosis u otras enfermedades del tejido conectivo y/o vasculitis. Se consignaron datos demográficos, clínicos, radiológicos, antecedentes familiares y terapéutica actual. Se realizaron cuestionarios de actividad de enfermedad y capacidad funcional: BASDAI, BASFI, PASI y HAQ. Se extrajeron muestras de sangre para determinación de ANCA por IFI en etanol que posteriormente fueron confirmadas por IFI en formol. Se realizó además laboratorio general de rutina. Análisis estadístico: Las variables continuas fueron comparadas por ANOVA o test Student y las variables categóricas por Chi-cuadrado o test de Fisher. Resultados: Se incluyeron 148 pacientes (APs = 43, EA = 22, AR = 41, Controles = 38, Psoriasis cutánea = 4). La mediana de edad fue de 52 años (RIQ: 39,5-59), 66% eran mujeres. En el análisis intergrupo, las EA eran más jóvenes y más frecuentemente (87%) de sexo masculino. El resto de los grupos eran comparables para todas las variables demográficas. 57 pacientes mostraron fluorescencia positiva en etanol: AR: 25 (61%), APs: 14 (32,6%), EA: 11 (50%), CS: 6 (15,8%) y Ps: 1 (25%).
Antibodies ANCA are important diagnostic tools in different diseases. Recently it has been shown that these antibodies can be observed in 79% of patients with Psoriatic Arthritis (PsA). The purpose of our study was to determine the prevalence of ANCA in patients with PsA and compared to patients with Rheumatoid Arthritis (RA), Ankylosing Spondylitis (AS), Psoriasis (Ps) and healthy controls (HC). Material and methods: Consecutive patients with PsA (CASPAR criteria), RA (ACR 87) and AS (New York criteria) were included. HC were people of the general population without evidence of immunological diseases. Patients with a previous history of oncologic, infectious diseases and sarcoidosis were excluded. Demographic, clinical, radiological and therapeutic data were collected. Disease activity and functional capacity were evaluated using validated and specific questionnaires (BASDAI, BASFI, PASI, and HAQ). ANCAs were determined by indirect immunofluorescence (IIF) on ethanol. Then, the positive ones were confirmed by IIF on formol. Student test, ANOVA, Chi square and Fisher exact test were used for Statistical analysis. Results: 148 patients were included (PsA = 43, AS = 22, RA = 41, Ps = 4 y HC = 38). Median age was 52 years (IQR: 39.5 59), 66% were women. AS patients were younger and more frequently men. Other variables were comparable between groups. 57 patients exhibited positive ethanol fluorescence: RA: 25 (61%), PsA: 14 (32.6%), AS: 11 (50%), HC: 6 (15.8%) and Ps: 1 (25%). However only 5 patients showed formol fluorescence: AS: 4/22 (ANCAp = 2, ANCAc = 2) y RA: 1/41 (ANCAp). The frequency of positive ANCA was significantly greater in AS vs. RA (p = 0.046).
Subject(s)
Arthritis, Psoriatic , Arthritis, Rheumatoid , Antibodies, Antineutrophil Cytoplasmic , Psoriasis , Spondylitis, AnkylosingABSTRACT
Dimorphandra mollis Benth., Composita e, falso barbatimão, é utilizada topicamente como cicatrizante, adstringente e antimicrobiano. No presente estudo, verificou-se a atividade antibacteriana de sabonete líquido contendo extrato glicólico de D. mollis (EGD) em diferentes concentrações (8, 15 e 20%) e em diferentes pHs (6 e 8). Foram preparadas cinco formulações (F) de sabonete: F1 - triclosan (0,1%), F2 - EGD (8%), F3- EGD (15%), F4 - EGD (20%) e F5 - sem conservante. Cascas de D. mollis foram secas em estufa de ar circulante e pulverizadas. Os extratos brutos foram preparados por turbo-extração utilizando-se etanol. Após filtração, os extratos foram concentrados em evaporador rotatório, liofilizados e ressuspendidos em propilenoglicol para a obtenção do extrato glicólico. A atividade antibacteriana foi verificada pelo método de difusão em ágar, empregando cilindros em placa. Placas contendo Staphylococcus aureus, Pseudomonas aeruginosa e Escherichia coli foram incubadas a 37ºC durante 24 horas. Após incubação, as leituras foram realizadas com paquímetro, observando-se o diâmetro do halo de inibição de crescimento bacteriano. Verificou-se que o sabonete líquido contendo triclosan provocou inibição do crescimento bacteriano em ambos os pHs; já os sabonetes sem conservante e contendo EGD, independente da concentração e do pH empregados, não apresentaram atividade antibacteriana.
Dimorphandra mollis Benth., Compositae, false barbatimão, has been used topically as a healing, astringent and antibacterial. In this study, antibacterial activity was verified on liquid soap containing glycolic extract of D. mollis (DGE) at different concentrations (8, 15 and 20%) and at different pH levels (6 and8). Five soap formulations (F) were prepared: F1 -tryclosan (0.1%), F2 - DGE (8%), F3 - DGE (15%),F4 - DGE (20%) and F5 - without preservatives. Bark of D. mollis were dried in a circulating air oven and ground. The rude extracts were prepared by turboextraction with ethanol. After screening, the extract were concentrated in rotating evaporator, lyophilized and resuspended in propileneglycol to obtain the glycolic extract. The antimicrobial activity was verified by diffusion in agar method, using cylinder in plate. Plates containing Staphylococcus aureus, Pseudomonas aeruginosa and Escherichia coli were incubated at 37ºC for 24 hours. After incubation, the results were analysed with a pachy meter, observing the bacterial grouth inhibition halo diameter. It was verified that the liquid soap containing tryclosan caused on inhibition of bacterial growth at both pH levels; the soaps without preservatives and containing DGE, independently of the concentration and pH levels used, did not present antibacterial activity.
Subject(s)
Products with Antimicrobial Action , Immunodiffusion/methodsABSTRACT
A crescente demanda por produtos cosméticos estáveis, seguros e eficazes tem exigido da comunidade científica estudos cada vez mais complexos e utilização de técnicas mais eficientes para determinação da estabilidade dos produtos. O uso de ativos da biodiversidade brasileira levou ao desenvolvimento de inúmeros produtos, nas mais diferentes formas cosméticas, o que dificulta, ainda mais, a padronização de protocolos experimentais para atestara estabilidade das preparações cosméticas. Embora não exista no Brasil um protocolo que padronize os ensaiosa serem realizados para se determinar a estabilidade dos produtos, vários estudos foram realizados nos meios acadêmicos para determinação da estabilidadede matérias-primas específicas. As características reológicas são propriedades importantes a serem consideradas na fabricação, estocagem e aplicação de produtos de uso tópico. Além de ensaios comumente empregados, a determinação do comportamento reológico da formulação auxilia na avaliação da natureza físico-química do veículo, de tal forma que torna possível detectar sinais precoces de instabilidade física, possibilitando o controle de qualidade dos constituintes, das formulações teste e dos produtos finais. A análise térmica também é usada para auxiliar o estudo da estabilidade de produtos cosméticos e, de modo geral, a calorimetria exploratória diferencial para orientar o desenvolvimento de novos produtos. Outras ferramentas, como a fluorimetria e a granulometria a laser podem auxiliar o estudo e o desenvolvimento de sistemas, emulsionados ou não. O objetivo deste estudo é o desenvolvimento de protocolo para o estudo da estabilidade físico-química de fitocosméticos - sistemas contendo ativos da biodiversidade brasileira.
Subject(s)
Cosmetic Stability , Cosmetics , BiodiversityABSTRACT
Para determinar qual o modelo de crescimento que melhor se ajusta ao tambaqui Colossoma macropomum Cuvier, 1818, foram utilizados 249 e 256 observações de comprimento-idade obtidos por meio de leituras de anéis em otólitos e em escamas, respectivamente, para os mesmos indivíduos. Para tanto, foi utilizado o modelo de Schnute, modelo genérico em que vários modelos tradicionais de crescimento estão incluídos. Com esse procedimento constatou-se que o modelo de von Bertalanffy realmente é o mais adequado, pois se mostrou altamente estável para o conjunto de dados, sendo pouco sensível aos valores iniciais adotados para as estimativas dos parâmetros. Os valores de F' estimados a partir de cinco conjuntos diferentes de dados apresentaram CV = 4.78%, o que não é preocupante, pois as discrepâncias numéricas entre esses valores são conseqüência da alta correlação negativa entre k e L¥ , visto que quando um aumenta o outro diminui e o resultado final expresso por F' permanece praticamente inalterado
Subject(s)
Animals , Fishes/growth & development , Models, Biological , Age Factors , Biometry , Fishes/anatomy & histologyABSTRACT
Glial heterotopia or the occurrence of isolated non-teratomatous extracranial glial tissue is rare. We report a neonate with extensive extranasal glial heterotopia involving the left buccopharyngeal region, palate and base of the skull and presenting with respiratory distress and a bleeding oral mass. A staged operative approach was adopted to excise the lesion. The literature on the subject is briefly reviewed.
Subject(s)
Brain , Choristoma/pathology , Female , Head and Neck Neoplasms/pathology , Humans , Infant, Newborn , Jaw Neoplasms/pathology , Mouth Neoplasms/pathology , Neoplasms, Multiple Primary , Neuroglia/pathology , Pharyngeal Neoplasms/pathology , Skull Base Neoplasms/pathology , Tomography, X-Ray ComputedABSTRACT
La traqueobroncopatía osteocondroplástica o traqueopatía osteoplástica es una enfermedad benigna de origen desconocido caracterizada por el depósito de tejido osteocartilaginoso en la submucosa del tracto respiratorio inferior provocando una estrechez de la vía aérea. Presentamos aspectos relevantes de esta patología y un caso clínico de un paciente, que al ser sometido a un procedimiento quirúrgico por parte de otorrinolaringología, se detecta una alteración de la vía aérea durante la inducción anestésica
Subject(s)
Tracheal Neoplasms/diagnosis , Tracheal Neoplasms/etiology , Tracheal Neoplasms/therapyABSTRACT
En los últimos años se ha identificado un aumento de la sinusitis fúngica aguda invasiva (mucormicosis), se puede pensar que se debe a la inmunosupresión de la población o por los adelan-tos científicos, que han proporcionado un diagnóstico precoz. Con este artículo se busca realizar, una revisión acerca del manejo de la mucormicosis, la cual se presenta con mayor frecuencia en pacientes con cetoacidosis, determinando los nuevos avances en el tratamiento, sus imitaciones y la posible prevención
Subject(s)
Mucor , SinusitisABSTRACT
La importancia fisiologica de la hiperlipidemia del embarazo no ha sido completamente explicada. No hay evidencias de un incremento en la incidencia de enfermedades coronarias durante la gestacion.En este estudio se describen los cambios en las concentraciones de colesterol, trigliceridos y fosfolipidos sericos en 77 gestantes en los tres trimestres. Se observo incremento en todas las fracciones lipidicas durante el embarazo; el incremento de colesterol fue mayor del primero al segundo trimestre mientras el de trigliceridos alcanzo su valor mas alto, del segundo al tercero. Se encontro una correlacion negativa (r= -0,49; p < 0,001) entre el colesterol inicial y el incremento del mismo durante el embarazo, lo que indica que aquellas mujeres que comenzaron con niveles mas altos tuvieron incrementos menores
Subject(s)
Pregnancy , Humans , Female , Hyperlipidemias , Lipids , Pregnancy , Longitudinal StudiesSubject(s)
Adolescent , Adult , Middle Aged , Humans , Male , Female , Pipemidic Acid , Urinary Tract InfectionsABSTRACT
Os autores apresentam um caso de ectopia testicular cruzada em um jovem de 13 anos, enfatizam a sua extrema raridade, sua ocorrencia na maioria dos casos a direita, e sua associacao com hernia inguinal, hipospadia, pequeno utero infantil na bolsa ou cisto de vesicula seminal