How Political Events Can Motivate Some Risk Mitigation Activities for Climate Change

Aim: To stem the risks of future climate change, more people need to be motivated to take actions that will mitigate the release of greenhouse gases into the environment. Important to this discussion was that these actions include both public and private sphere behaviors. Duration of Study: April 2016 to March 2017. Methodology: We surveyed individual’s beliefs about climate change and their stated willingness to take different actions to mitigate the risks of climate change. Results: Public sphere behaviors affect the environment only indirectly by influencing either public policies or other private sphere behaviors. Private sphere behaviors have direct environmental consequences but the consequences are small. Individual private sphere behaviors have environmentally significant impacts only in the aggregate when many people independently do similar things. Conclusion: Our study replicated many of the results from the literature, in particular, that individuals are most willing to engage in small private actions to mitigate climate change, and that at least for large private acts and public acts, individuals who describe themselves as Democrats are also more willing to engage in more costly acts. Our survey also showed an important effect from the 2016 election of President of USA. Following the election, Democrats stated an increased willingness to engage in public sphere acts over time. If more individuals engaging in more public acts can influence public policy and can convert other individuals to engage in more private acts over time, then electing leadership who is negative toward climate change can ultimately result in motivating more individual mitigation activity for climate change. Summary: This work shows that electing leaders who are negative toward climate change could provide a strong motivation for some individuals to be more willing to engage in public sphere acts over time to mitigate climate change.

Uso de rituximab en lupus eritematoso sistémico / Use of rituximab in systemic lupus erythematosus

Objetivos: Evaluar la evolución en el transcurso de dos años en pacientes con Lupus Eritematoso Sistémico (LES) refractarios al tratamiento inmunosupresor convencional, que recibieron Rituximab (RTX). Pacientes y métodos: Se estudiaron retrospectivamente 14 pacientes con diagnóstico de LES que recibieron tratamiento con RTX, atendidos en los servicios de Reumatología del Hospital Córdoba, Sanatorio Allende y Hospital Italiano de la ciudad de Córdoba, desde el año 2006. Se recabaron datos demográficos, diagnósticos, motivos de indicación de RTX, tasas de respuestas y eventos adversos. La dosis del mismo fue de 1 gramo día 1 y 15, luego cada 6 meses. Todos los pacientes habían recibido tratamiento con inmunosupresores: 12 ciclofosfamida, azatioprina, micofenolato mofetil y esteroides y 2 azatioprina y micofenolato mofetil. La actividad de la enfermedad fue medida por SELENA SLEDAI basalmente, a los 6, 12 y 24 meses postratamiento. El daño acumulado fue medido por SLICC solo basalmente. En los pacientes con nefropatía según clasificación ISN/RPS 2003, se analizó la proteinuria basal, a los 6, 12 y 24 meses, sedimento urinario y función renal medida por clearance de creatinina. Un valor de p <0,05 fue considerada significativa. Resultados: El número total de pacientes incluidos con diagnóstico de LES fue de 14, de los cuales 12 eran de sexo femenino (85,7%) y 2 de sexo masculino (14,3%). La edad promedio fue de 33,64 ± 10,33 años. Del total de pacientes, 9 presentaban compromiso renal, 3 compromiso hematológico (anemia hemolítica autoinmune, leucopenia, (trombocitopenia), 1 compromiso pulmonar (neumonitis lúpica aguda) y 1 artritis refractaria. De los pacientes con nefropatía, la clase histológica más frecuente fue la clase IV (proliferativa difusa) 77,8% (IC 95% 44,4-100%)

Objective: To evaluate the clinical response of RTX in refractory toother immunosuppressive drugs SLE patients. Patients and Methods: We retrospectively studied SLE patients who were treated with rituximab (RTX) at Rheumatology Units of Córdoba Hospital, Italiano Hospital and Sanatorium Allende in Córdoba city, since 2006. We studied demographic data, indication to RTX therapy, response, and adverse events. The disease activity was measured by SLEDAI and ECLAM and organ damage by SLICC at baseline andat 6, 12 and 24 months post-treatment. Patients with SLE and renal disease were analyzed baseline proteinuria, urinary sediment, renal function was measured by creatinine clearance. p <0.05 was considered statistically significant. Results:The number of patients was 14, 85.7% female with meanage of 33.64 ± 10.33 years old. 9 patients had renal involvement, 3 haematological, 1 lung involvement and severe arthritis. The basal SLEDAI was 15.93 ± 9.05, and 5.86 ± 5.57 and 2.8 ± 3.29 1 at 6and 24 months respectively (p <0,001).The level of proteinuria decreased from the baseline to 6, 12, 24 months (p=0.011), (p=0.028),(p=0.018). The main adverse reactions were infections in 3 patients(cutaneous infection, oral candidiasis, and pneumonia) and infusionsreactions in 2 cases. Conclusion: RTX could be a therapeutic option in SLE patients re-fractory to other immunosuppressive treatment.