Characteristics of 1555 childhood-onset lupus in three groups based on distinct time intervals to disease diagnosis: a Brazilian multicenter study.

Objective The objective of this study was to compare demographic data, clinical/laboratorial features and disease activity at diagnosis in three different groups with distinct time intervals between onset of signs/symptoms and disease diagnosis. Methods A multicenter study was performed in 1555 childhood-onset systemic lupus erythematosus (American College of Rheumatology criteria) patients from 27 pediatric rheumatology services. Patients were divided into three childhood-onset systemic lupus erythematosus groups: A: short time interval to diagnosis (<1 month); B: intermediate time interval (≥1 and <3 months); and C: long time interval (≥3 months). An investigator meeting was held to define the protocol. Demographic data, SLICC classification criteria and SLEDAI-2 K were evaluated. Results The number of patients in each group was: A = 60 (4%); B = 522 (33.5%); and C = 973 (62.5%). The median age at diagnosis (11.1 (4.2-17) vs. 12 (1.9-17.7) vs. 12.5 (3-18) years, P = 0.025) was significantly lower in group A compared with groups B and C. The median number of diagnostic criteria according to SLICC (7 (4-12) vs. 6 (4-13) vs. 6 (4-12), P < 0.0001) and SLEDAI-2 K (18 (6-57) vs. 16 (2-63) vs. 13 (1-49), P < 0.0001) were significantly higher in group A than the other two groups. The frequency of oral ulcers in the palate (25% vs. 15% vs. 11%, P = 0.003), pleuritis (25% vs. 24% vs. 14%, P < 0.0001), nephritis (52% vs. 47% vs. 40%, P = 0.009), neuropsychiatric manifestations (22% vs. 13% vs. 10%, P = 0.008), thrombocytopenia (32% vs. 18% vs. 19%, P = 0.037), leucopenia/lymphopenia (65% vs. 46% vs. 40%, P < 0.0001) and anti-dsDNA antibodies (79% vs. 66% vs. 61%, P = 0.01) were significantly higher in group A compared with the other groups. In contrast, group C had a less severe disease characterized by higher frequencies of synovitis (61% vs. 66% vs. 71%, P = 0.032) and lower frequencies of serositis (37% vs. 33% vs. 25%, P = 0.002), proteinuria >500 mg/day (48% vs. 45% vs. 36%, P = 0.002) and low complement levels (81% vs. 81% vs. 71%, P < 0.0001) compared with groups A or B. Conclusions Our large Brazilian multicenter study demonstrated that for most childhood-onset systemic lupus erythematosus patients, diagnosis is delayed probably due to mild disease onset. Conversely, the minority has a very short time interval to diagnosis and a presentation with a more severe and active multisystemic condition.

Evaluation of polymorphic variants in apoptotic genes and their role in susceptibility and clinical progression to systemic lupus erythematosus.

Background Systemic lupus erythematosus (SLE) is an autoimmune disease marked by the disruption of the immune homeostasis. Patients exhibit a wide range of clinical manifestations, and environmental and genetic factors are involved in SLE pathogenesis. Evidence suggests that abnormalities in the cellular and molecular events that coordinate apoptosis may favour the generation of autoantigens involved in autoimmunity. In this way, the apoptotic deregulation may be affected by polymorphic variants in apoptotic-related genes. Methods We analyzed FAS, FASL, BCL-2 and BAX polymorphisms in order to correlate to SLE susceptibility and clinical features. A total of 427 SLE patients from the Hospital de Clínicas de Porto Alegre and 543 controls from southern Brazil were evaluated. Results We observed higher frequencies of the FASL -844CC genotype and -844C allele, as well as of the FASL-844C/IVS2nt-124A haplotype in African-derived SLE patients when compared to controls ( P < 0.001). FASL -844C, which is related to high FasL expression, could contribute to increased apoptosis and to the breakdown of immunological tolerance, favouring autoantibody production and inflammation. On the other hand, the BAX -248GA genotype and the -248A allele , related to low protein expression, were observed as a protective factor against SLE in this same population. The rate of apoptosis and cell death was evaluated in peripheral lymphocytes, and SLE patients presented a higher percentage of dead lymphocytes (CD3+Annexin V+ 7-AAD+) compared to the control group. Conclusion Our data support a role for apoptosis in SLE susceptibility.

Detection of Vaccinia virus during an outbreak of exanthemous oral lesions in Brazilian equids.

REASONS FOR PERFORMING STUDY: In August 2014, an outbreak of oral exanthematous disease in equids was reported in Brazil, affecting 11 donkeys and 3 mules. OBJECTIVES: To investigate if Vaccinia virus (VACV) was the aetiological agent in this outbreak. STUDY DESIGN: Investigation of clinical cases using serological, molecular and phylogenetic approaches. METHODS: To analyse the presence of neutralising antibodies against VACV, samples were submitted in triplicate to a plaque-reduction neutralisation test (PRNT50% ). On the basis of previous studies which detected VACV DNA in sera, we submitted extracted DNA samples to different polymerase chain reaction (PCR) platforms targeting Orthopoxvirus (OPV) genes (C11R, A56R and A26L). The PCR products were directly sequenced in both orientations using specific primers and capillary electrophoresis. The alignment and phylogenetic analysis of the A26L and A56R nucleotide sequences (maximum likelihood) were prepared with the obtained nucleotide fragments. RESULTS: Serological and molecular data suggested VACV as the aetiological agent. The neutralising antibodies against OPV were detected in 5 (55.5%) of the equids, with titres ≥40 neutralising u/ml. Based on the results obtained from all PCR platforms, all samples were positive for OPV: 9 (100%) for A56R, 4 (44.4%) for C11R and 3 (33.3%) for A26L. The alignment of the nucleotide sequences of the A26L and A56R fragments revealed that the samples were highly similar to the homologous genes from other Brazilian VACV Group 1 isolates (98.8% identity on average). Furthermore, both the A26L and A56R sequences showed signature deletions also present in the sequences of Group 1 VACV isolates from Brazil. CONCLUSIONS: Our data raises questions about the role of equids in the chain of VACV epidemiology. The surveillance of equids in VACV-affected areas worldwide is relevant.

Vitrification of Rattus norvegicus immature cumulus-oocyte complexes using hyaluronic acid.

The aim of this study was to assess in vitro meiosis resumption and nuclear maturation of Rattus norvegicus oocytes after vitrification with different cryoprotective solutions. Cumulus-oocyte complexes (COCs) were exposed to an equilibration solution for 4 min placed in cryoprotective solutions for 1 min and vitrified in open pulled straws. Cryoprotective solutions were prepared with 15% ethylene glycol + 15% dimethyl sulfoxide + 0.5 M sucrose and different supplements, to form the following groups: G1, 20% fetal bovine serum in modified phosphate-buffered saline (mPBS); G2, 0.4% bovine serum albumine in mPBS; G3, 1% hyaluronic acid in mPBS; and G4, 0.4% polyvinyl alcohol in mPBS. Seven days after vitrification, the COCs from G1 to G4 were warmed and in vitro matured for 30 h along with the control group. Hoechst staining was performed to assess meiosis resumption and nuclear maturation rates. Control group showed higher meiosis resumption (77.88%) and nuclear maturation rates (55.75%) compared to all vitrified groups. Among the vitrified COCs, G3 showed the highest meiosis resumption and nuclear maturation rates (G1, 26.5 and 15.38%; G2, 22.12 and 11.54%; G3, 34.55 and 20%; G4, 20.17 and 9.24%). Supplementation of the vitrification solution with 1% hyaluronic acid provided better results, compared to the other supplements. Hyaluronic acid can be useful to vitrify rat COCs associated with other cryoprotectant agents.

The synthesis and structural characterisation of [Ru(eta-Cp)(dppf)SnBr3].

The reaction of [Ru(eta-Cp)(dppf)N(3)] (1) with equimolar amount of SnBr(2) yielded an interesting heterotrimetallic compound [Ru(eta-Cp)(dppf)SnBr(3)] (2) (dppf: 1,1'-bis-diphenylphosphinoferrocene). Compounds 1 and 2 were characterised by IR, NMR (1H, 13C, 31P and 119Sn), and 2, additionally, by 57Fe and 119Sn Mössbauer spectroscopy and X-ray crystallography. The latter results were as follows: monoclinic, C2/c, a = 32.8879(4)A, b = 11.9888(2)A, c = 20.8986(3)A, beta = 92.545(1)degrees, V = 8231.9(2)A(3), Z =8.

[Nursing training in Brazil in the 1970's]. / A formação de enfermeiros no Brasil na década de 70.

The objective of this study is to revisit the period of time between 1975 and 1979, and, within it, the history of the implantation of nursing graduation courses in federal universities and in geo-educational districts. It presents the development of a project called Projeto de Enfermagem no Grupo Setorial de Saúde--(Nursing Project in Health) SESU/DAU/MEC (ministry of culture and education), and points out the social and political determinants of the, so planned, qualitative and quantitative development of the courses mentioned before. The research clarifies the proposal, process and accomplishments of the Superior Nursing Project of Education, which was predominantly private until 1974 and became predominantly public from 1976 on. Furthermore, it also indicates implications such as: the Commission of Nursing Education Specialists (CEEEnfermagem), which was linked to ABEn and was the first collective proposal of Areas and Lines of Research in Nursing (CNPq/CAPES/DAU/ABEn); as well as the introduction of institutionalized study fields in the academic institutions.

Lectin-induced nitric oxide production.

Considering that nitric oxide (NO) may be involved in anti-tumoral and anti-parasite lectin effects, in this report we investigated whether lectin induces NO production. Lectins from Canavalia brasiliensis, Dioclea grandiflora, Pisum arvense (PAA), and concanavalin A induced murine peritoneal cells to produce NO in vitro. PAA induced similar levels to that obtained with lipopolysaccharide plus interferon-gamma. NO production by adherent cells was significantly lower than that of unfractionated cells, suggesting a combination of lectin stimuli directly on macrophages and via lymphocyte stimulation. Ex vivo experiments showed that cells stimulated in vivo could maintain NO production in vitro without further stimuli. NO synthesis blockage in vivo can significantly increase cell numbers in draining lymph nodes after lectin injection compared to unblocked controls, suggesting an in vivo association of lectin stimuli and NO production. Taken together these data show that lectins can induce NO production both in vitro and in vivo.

[Is nursing a science or a profession?]. / Enfermagem ciência ou profissão?

Traditionally, human knowledge has been considered in the context of disciplines which can be divided in two groups: Academics and professionals. The aim of academic disciplines is the knowledge and their theories are descriptive in nature. For this reason they are named science. In contrast, professional disciplines are move comprehensive, directed toward practical aims and there is a need to and to work. Nursing as a professional discipline has been influenced by four school of thought named; service, administration, academic and practice. Currently the nursing practice is developed based on three different theoretic and philosophic branches.