Thermoregulatory profile of neurodegeneration-induced dementia of the Alzheimer's type using intracerebroventricular streptozotocin in rats.

AIM: Here, we have extensively investigated the relationship between thermoregulation and neurodegeneration-induced dementia of the Alzheimer's type using intracerebroventricular injections of streptozotocin (icv-STZ). METHODS: Male Wistar rats were treated with bilateral injections of icv-STZ, and their thermoregulatory profiles (core body temperature, tail-skin temperature, cold and heat defence responses and thermal place preference) were evaluated. Spatial memory, locomotor activity, social interaction, brain ventricular volume, and Aß1-42 and tau protein levels in the brain were analysed to characterize the effects of STZ on the brain and behaviour. RESULTS: In addition to deficits in spatial memory, reduced social interaction and an increased brain ventricular volume, icv-STZ rats presented a pattern of hyperthermia, as demonstrated by an increased core body temperature. Hyperthermia was due to the activation of both autonomic heat conservation and behavioural cold avoidance, as STZ-treated rats presented tail-cutaneous vasoconstriction and an altered thermal preference. They also showed a distinct cold defence response when exposed to cold. CONCLUSION: Our data bring evidence that icv-STZ in rats causes hyperthermia, with activation of both autonomic and behavioural thermoregulatory defence responses when challenged at colder temperatures, leading us to hypothesize that they are more efficient in preventing hypothermia. These data are relevant for a better understanding of neurodegenerative disease mechanisms.

Barium sulphate aspiration pneumonia in a cat with megaesophagus and dextroposition of the aortic arch: case report / Pneumonia aspirativa por sulfato de barrio em gato com megaesôfago e destroposição de arco da aorta: relato de caso

A six-month-old female cat suffered aspiration of an abundant amount of barium sulfate during a radiographic procedure for the diagnosis of megaesophagus. Latero-lateral contrast radiography revealed severe dilation of the thoracic esophagus cranial to the base of the heart. Persistence of the right aortic arch was suspected and later confirmed during corrective surgery. Accumulation of barium sulfate, used as a contrast agent, was clearly observed in the lumen of the bronchi, bronchioles, and alveoli in the radiographic image. Days after the surgery, the animal developed severe respiratory distress, which resulted in death. Cytology results and histology analysis using polarized light demonstrated that the lumen of bronchi, bronchioles, and alveoli exhibited evident histiocytic infiltration with cytoplasm filled by abundant amorphous refractive granular material consistent with barium sulfate. In this report, we describe the anatomical, cytological, histopathological (using polarized light), and x-ray findings of a case of barium sulfate aspiration pneumonia in a cat resulting from the use of this contrast medium for the diagnosis of megaesophagus secondary to persistent right aortic arch.(AU)

Uma gata de seis meses aspirou grande quantidade de sulfato de bário durante procedimento radiográfico para diagnóstico de megaesôfago. Contraste radiográfico látero-lateral revelou dilatação de esôfago torácico até a base do coração. Persistência do arco aórtico direito foi confirmada durante cirurgia corretiva. Acúmulo de sulfato de bário, utilizado como agente de contraste, foi observado no lúmen de brônquios, bronquíolos e alvéolos à imagem radiográfica. Dias após a cirurgia o animal desenvolveu insuficiência respiratória grave e evoluiu para óbito. Resultado de citologia e histologia utilizado luz polarizada demonstrou que lúmen de brônquios, bronquíolos e alvéolos mostraram infiltração histológica com citoplasma cheio de material refratário granular amorfo compatível com sulfato de bário. Nesse relatório, descrevemos achados anatômicos, citológicos, histopatológicos e radiográficos de um caso de pneumonia aspirativa em gata resultante do uso desse meio de contraste para diagnóstico de megaesôfago secundário a persistência do arco aórtico direito.(AU)

Barium sulphate aspiration pneumonia in a cat with megaesophagus and dextroposition of the aortic arch: case report / Pneumonia aspirativa por sulfato de barrio em gato com megaesôfago e destroposição de arco da aorta: relato de caso

A six-month-old female cat suffered aspiration of an abundant amount of barium sulfate during a radiographic procedure for the diagnosis of megaesophagus. Latero-lateral contrast radiography revealed severe dilation of the thoracic esophagus cranial to the base of the heart. Persistence of the right aortic arch was suspected and later confirmed during corrective surgery. Accumulation of barium sulfate, used as a contrast agent, was clearly observed in the lumen of the bronchi, bronchioles, and alveoli in the radiographic image. Days after the surgery, the animal developed severe respiratory distress, which resulted in death. Cytology results and histology analysis using polarized light demonstrated that the lumen of bronchi, bronchioles, and alveoli exhibited evident histiocytic infiltration with cytoplasm filled by abundant amorphous refractive granular material consistent with barium sulfate. In this report, we describe the anatomical, cytological, histopathological (using polarized light), and x-ray findings of a case of barium sulfate aspiration pneumonia in a cat resulting from the use of this contrast medium for the diagnosis of megaesophagus secondary to persistent right aortic arch.(AU)

Uma gata de seis meses aspirou grande quantidade de sulfato de bário durante procedimento radiográfico para diagnóstico de megaesôfago. Contraste radiográfico látero-lateral revelou dilatação de esôfago torácico até a base do coração. Persistência do arco aórtico direito foi confirmada durante cirurgia corretiva. Acúmulo de sulfato de bário, utilizado como agente de contraste, foi observado no lúmen de brônquios, bronquíolos e alvéolos à imagem radiográfica. Dias após a cirurgia o animal desenvolveu insuficiência respiratória grave e evoluiu para óbito. Resultado de citologia e histologia utilizado luz polarizada demonstrou que lúmen de brônquios, bronquíolos e alvéolos mostraram infiltração histológica com citoplasma cheio de material refratário granular amorfo compatível com sulfato de bário. Nesse relatório, descrevemos achados anatômicos, citológicos, histopatológicos e radiográficos de um caso de pneumonia aspirativa em gata resultante do uso desse meio de contraste para diagnóstico de megaesôfago secundário a persistência do arco aórtico direito.(AU)

Coordinated brain development: exploring the synchrony between changes in grey and white matter during childhood maturation.

Brain development during childhood and early adolescence is characterized by global changes in brain architecture. Neuroimaging studies have revealed overall decreases in cortical thickness (CT) and increases in fractional anisotropy (FA). Furthermore, previous studies have shown that certain cortical regions display coordinated growth during development. However, there is significant heterogeneity in the timing and speed of these developmental transformations, and it is still unclear whether white and grey matter changes are co-localized. In this multimodal neuroimaging study, we investigated the relationship between grey and white matter developmental changes and asynchronous maturation within brain regions in 249 normally developing children between the ages 7-14. We used structural magnetic resonance imaging (MRI) and diffusion tensor imaging (DTI) to analyze CT and FA, respectively, as well as their covariance across development. Consistent with previous studies, we observed overall cortical thinning with age, which was accompanied by increased FA. We then compared the coordinated development of grey and white matter as indexed by covariance measures. Covariance between grey matter regions and the microstructure of white matter tracts connecting those regions were highly similar, suggesting that coordinated changes in the cortex were mirrored by coordinated changes in their respective tracts. Examining within-brain divergent trajectories, we found significant structural decoupling (decreased covariance) between several brain regions and tracts in the 9- to 11-year-old group, particularly involving the forceps minor and the regions that it connects to. We argue that this decoupling could reflect a developmental pattern within the prefrontal region in 9- and 11-year-old children, possibly related to the significant changes in cognitive control observed at this age.

Gene expression alterations related to mania and psychosis in peripheral blood of patients with a first episode of psychosis.

Psychotic disorders affect ~3% of the general population and are among the most severe forms of mental diseases. In early stages of psychosis, clinical aspects may be difficult to distinguish from one another. Undifferentiated psychopathology at the first-episode of psychosis (FEP) highlights the need for biomarkers that can improve and refine differential diagnosis. We investigated gene expression differences between patients with FEP-schizophrenia spectrum (SCZ; N=53) or FEP-Mania (BD; N=16) and healthy controls (N=73). We also verified whether gene expression was correlated to severity of psychotic, manic, depressive symptoms and/or functional impairment. All participants were antipsychotic-naive. After the psychiatric interview, blood samples were collected and the expression of 12 psychotic-disorder-related genes was evaluated by quantitative PCR. AKT1 and DICER1 expression levels were higher in BD patients compared with that in SCZ patients and healthy controls, suggesting that expression of these genes is associated more specifically to manic features. Furthermore, MBP and NDEL1 expression levels were higher in SCZ and BD patients than in healthy controls, indicating that these genes are psychosis related (independent of diagnosis). No correlation was found between gene expression and severity of symptoms or functional impairment. Our findings suggest that genes related to neurodevelopment are altered in psychotic disorders, and some might support the differential diagnosis between schizophrenia and bipolar disorder, with a potential impact on the treatment of these disorders.

Correlation between the Modified Systemic Lupus Erythematosus Disease Activity Index 2000 and the European Consensus Lupus Activity Measurement in juvenile systemic lupus erythematosus.

Objective The objective of this study was to assess Modified Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI-2K) and European Consensus Lupus Activity Measurement (ECLAM) disease activity correlation in addition to their respective correlation to Pediatric Systemic Lupus International Collaborative Clinics/American College of Rheumatology (SLICC/ACR) Damage Index (Ped-SDI), in juvenile systemic lupus erythematosus (JSLE). Methods The activity indices were scored retrospectively and summarized by adjusted means during follow-up. The Ped-SDI was scored during the last visit for those with more than six months follow-up. Pearson correlation between the Modified SLEDAI-2K and ECLAM, as well as Spearman correlations between the Modified SLEDAI-2K, ECLAM, and Ped-SDI were calculated. The receiver operating characteristic (ROC) curve was calculated for both activity indices discriminating damage measured by Ped-SDI. Results Thirty-seven patients with mean age at diagnosis 11 ± 2.9 years and mean follow-up time 3.2 ± 2.4 years were studied. The Modified SLEDAI-2K and ECLAM adjusted means were highly correlated ( r = 0.78, p < 0.001). Similarly, Spearman correlation between the activity indices was also high ( rs > 0.7, p < 0.001), but Modified SLEDAI-2K and ECLAM correlation with Ped-SDI was only moderate. ROC analysis discriminant performance for both activity indices resulted in area under curve (AUC) of 0.74 and 0.73 for Modified SLEDAI-2K and ECLAM, respectively. Conclusion The high correlation found between the Modified SLEDAI-2K and ECLAM adjusted means indicated that both tools can be equally useful for longitudinal estimates of JSLE activity.

PARASITOS INTESTINAIS DE JAVALIS (Sus scrofa) CRIADOS NA REGIÃO SUL DO BRASIL

O objetivo do presente trabalho foi identificar a fauna parasitária intestinal de javalis de abate comercial, criados no Sul do Brasil. Foram coletados em matadouro-frigorífico, intestinos de 40 animais, para avaliação de cada segmento intestinal separadamente e amostras fecais foram coletadas da porção final do intestino grosso e processados por dois métodos coproparasitológicos. À necropsia foram identificados parasitos adultos em 14 (35%) javalis, Ascaris suum (17,5%) e Trichuris suis (25%); ao exame coprológico 10 (25%) animais foram positivos para, Trichuris suis (5%), Isospora suis (20%) e Giardia intestinalis (10%). Este relato representa o primeiro caso confirmado de Giardia intestinalis em javalis no Rio Grande do Sul e Trichuris suis foi o helminto que apresentou maior número de espécimes.

Intestinal parasites of wild boar (Sus scrofa) raised in Southern Brazil / Parasitos intestinais de javalis (Sus scrofa) criados na região sul do Brasil

The aim of the present study was to identify the intestinal parasites that infect wild boars destined for slaughter in Southern Brazil. The intestines of 40 wild boars were collected from a slaughtering and meat-packing facility for evaluation of each intestinal segment and fecal samples were collected from the final portion of the large intestine and processed by two methods of parasitological diagnosis. The necropsy revealed adult parasites in 14 (35%) wild boars, Ascaris suum (17.5%) and Trichuris suis (25%); and the stool analysis indicated the presence of parasites in 10 (25%) animals, Trichuris suis (5%), Isospora suis (20%), and Giardia spp. (10%). This is the first report of Giardia intestinalis in wild boars in the State of Rio Grande do Sul, which also showed that Trichuris suis was present in most samples.(AU)

O objetivo do presente trabalho foi identificar a fauna parasitária intestinal de javalis de abate comercial, criados no Sul do Brasil. Foram coletados em matadouro-frigorífico, intestinos de 40 animais, para avaliação de cada segmento intestinal separadamente e amostras fecais foram coletadas da porção final do intestino grosso e processados por dois métodos coproparasitológicos. À necropsia foram identificados parasitos adultos em 14 (35%) javalis, Ascaris suum (17,5%) e Trichuris suis (25%); ao exame coprológico 10 (25%) animais foram positivos para, Trichuris suis (5%), Isospora suis (20%) e Giardia intestinalis (10%). Este relato representa o primeiro caso confirmado de Giardia intestinalis em javalis no Rio Grande do Sul e Trichuris suis foi o helminto que apresentou maior número de espécimes.(AU)

Intestinal parasites of wild boar (Sus scrofa) raised in Southern Brazil / Parasitos intestinais de javalis (Sus scrofa) criados na região sul do Brasil

The aim of the present study was to identify the intestinal parasites that infect wild boars destined for slaughter in Southern Brazil. The intestines of 40 wild boars were collected from a slaughtering and meat-packing facility for evaluation of each intestinal segment and fecal samples were collected from the final portion of the large intestine and processed by two methods of parasitological diagnosis. The necropsy revealed adult parasites in 14 (35%) wild boars, Ascaris suum (17.5%) and Trichuris suis (25%); and the stool analysis indicated the presence of parasites in 10 (25%) animals, Trichuris suis (5%), Isospora suis (20%), and Giardia spp. (10%). This is the first report of Giardia intestinalis in wild boars in the State of Rio Grande do Sul, which also showed that Trichuris suis was present in most samples.

O objetivo do presente trabalho foi identificar a fauna parasitária intestinal de javalis de abate comercial, criados no Sul do Brasil. Foram coletados em matadouro-frigorífico, intestinos de 40 animais, para avaliação de cada segmento intestinal separadamente e amostras fecais foram coletadas da porção final do intestino grosso e processados por dois métodos coproparasitológicos. À necropsia foram identificados parasitos adultos em 14 (35%) javalis, Ascaris suum (17,5%) e Trichuris suis (25%); ao exame coprológico 10 (25%) animais foram positivos para, Trichuris suis (5%), Isospora suis (20%) e Giardia intestinalis (10%). Este relato representa o primeiro caso confirmado de Giardia intestinalis em javalis no Rio Grande do Sul e Trichuris suis foi o helminto que apresentou maior número de espécimes.

Chronic active disease pattern predicts early damage in juvenile systemic lupus erythematosus.

OBJECTIVE: The objective of this article is to assess disease activity patterns and their relationship to damage, death and growth failure in a cohort of juvenile lupus. METHODS: Chronic active, relapsing-remitting and long quiescent activity patterns were retrospectively classified according to longitudinal scores of both the Modified SLEDAI-2K and ECLAM. The Pediatric SLICC/ACR Damage Index (Ped-SDI) was scored at the last visit in patients followed more than six months. Survival analysis was performed considering death, damage and growth failure, and stratified according to disease activity patterns. Cox model analysis identified predictors for damage and growth failure among onset clinical variables. RESULTS: Thirty-seven patients with 11 years mean age at diagnosis and 3.2 years mean follow-up were studied. According to the Modified SLEDAI-2K, activity pattern was 67.5% relapsing-remitting, 29.8% chronic active and 2.7% long quiescent and by ECLAM, 45.9%, 48.7% and 5.4%, respectively. The five-year survival was 90%. Damage accrued in 62.5% and growth failure in 31.3%. Chronic active cases progressed to damage earlier than relapsing-remitting (log-rank test, p < 0.05). Damage was associated with disease duration (p < 0.0001), thrombocytopenia (p < 0.05) and alopecia (p < 0.004). Growth failure was associated with disease duration (p < 0.007) and renal failure (p < 0.007). CONCLUSION: Damage was observed in nearly two-thirds of patients, and occurred earlier in the chronic active pattern. Disease duration, thrombocytopenia and alopecia at onset predicted damage.

Avaliação de dieta formulada com subprodutos de mandioca na produção de sêmen de coelhos / Evaluation of diet formulated with cassava by-products in the rabbit semen production

Avaliaram-se as características quantitativas e qualitativas do sêmen de coelhos alimentados com uma ração referência e outra ração formulada com 79,83% de subprodutos de mandioca. Utilizaram-se 20 reprodutores da raça Nova Zelândia Branco, com idade média inicial de sete meses, alojados individualmente em gaiolas e distribuídos em delineamento experimental inteiramente ao acaso, com duas dietas e dez repetições. Realizaram-se dez colheitas de sêmen por animal durante seis meses. Avaliaram-se o volume de sêmen sem gel e volume de gel, cor do sêmen, pH, motilidade espermática progressiva, vigor espermático, concentração espermática, número de espermatozoides no ejaculado, espermatozoides normais, anormais e anormalidades primárias e secundárias. O volume de sêmen sem gel, o índice de normalidade, as anormalidades primárias e secundárias foram iguais (P>0,05) para os animais alimentados com a ração referência e a com subprodutos de mandioca. Os demais parâmetros do sêmen foram melhores (P<0,05) nos animais tratados com a ração com subprodutos de mandioca. Os resultados das características quali-quantitativas do sêmen dos coelhos da Raça Nova Zelândia Branco demonstram que é possível utilizar ração com 79,83% do volume da formulação com subprodutos de mandioca, na dieta de reprodutores, sem prejuízos nas características do sêmen, desde que observados os níveis reduzidos de taninos e ácido cianídrico.(AU)

The quantitative and qualitative rabbit semen characteristics fed with a reference diet and a diet formulated with 79.83% of cassava by-products were evaluated. 20 New Zealand White rabbit bucks, with initial average age of seven months were used, individually allocated and distributed in a completely ramdomized design, with two diets (treatments) and ten replications. The ten semen collections per animal were taken during six months. The evaluated parameters were: semen volume without gel and gel volume, color of semen, pH, spermatic progressive motility, spermatic vigor, spermatic concentration, spermatozoa number in the ejaculation, normal spermatozoa, abnormal and primary and secondary abnormalities spermatozoa. The semen volume without gel, the normal spermatozoa, primary and secondary abnormalities spermatozoa were similar (P>0.05) to the animals fed with cassava by-products diet and reference diet. Other semen parameters were better (P<0.05) in the animals fed with the cassava by-products diet. The results of the quali-quantitative characteristics of the semen from New Zealand White rabbits showed that it is possible to use diets containing 79.83% of inclusion of cassava by-products in the diet of rabbit bucks, without affecting semen characteristics, since we observed the reduced level of tannins and hydrocyanic acid.(AU)

Avaliação de dieta formulada com subprodutos de mandioca na produção de sêmen de coelhos / Evaluation of diet formulated with cassava by-products in the rabbit semen production

Avaliaram-se as características quantitativas e qualitativas do sêmen de coelhos alimentados com uma ração referência e outra ração formulada com 79,83% de subprodutos de mandioca. Utilizaram-se 20 reprodutores da raça Nova Zelândia Branco, com idade média inicial de sete meses, alojados individualmente em gaiolas e distribuídos em delineamento experimental inteiramente ao acaso, com duas dietas e dez repetições. Realizaram-se dez colheitas de sêmen por animal durante seis meses. Avaliaram-se o volume de sêmen sem gel e volume de gel, cor do sêmen, pH, motilidade espermática progressiva, vigor espermático, concentração espermática, número de espermatozoides no ejaculado, espermatozoides normais, anormais e anormalidades primárias e secundárias. O volume de sêmen sem gel, o índice de normalidade, as anormalidades primárias e secundárias foram iguais (P>0,05) para os animais alimentados com a ração referência e a com subprodutos de mandioca. Os demais parâmetros do sêmen foram melhores (P<0,05) nos animais tratados com a ração com subprodutos de mandioca. Os resultados das características quali-quantitativas do sêmen dos coelhos da Raça Nova Zelândia Branco demonstram que é possível utilizar ração com 79,83% do volume da formulação com subprodutos de mandioca, na dieta de reprodutores, sem prejuízos nas características do sêmen, desde que observados os níveis reduzidos de taninos e ácido cianídrico.

The quantitative and qualitative rabbit semen characteristics fed with a reference diet and a diet formulated with 79.83% of cassava by-products were evaluated. 20 New Zealand White rabbit bucks, with initial average age of seven months were used, individually allocated and distributed in a completely ramdomized design, with two diets (treatments) and ten replications. The ten semen collections per animal were taken during six months. The evaluated parameters were: semen volume without gel and gel volume, color of semen, pH, spermatic progressive motility, spermatic vigor, spermatic concentration, spermatozoa number in the ejaculation, normal spermatozoa, abnormal and primary and secondary abnormalities spermatozoa. The semen volume without gel, the normal spermatozoa, primary and secondary abnormalities spermatozoa were similar (P>0.05) to the animals fed with cassava by-products diet and reference diet. Other semen parameters were better (P<0.05) in the animals fed with the cassava by-products diet. The results of the quali-quantitative characteristics of the semen from New Zealand White rabbits showed that it is possible to use diets containing 79.83% of inclusion of cassava by-products in the diet of rabbit bucks, without affecting semen characteristics, since we observed the reduced level of tannins and hydrocyanic acid.

Healthy individuals treated with clomipramine: an fMRI study of brain activity during autobiographical recall of emotions.

Various functional magnetic resonance imaging studies addressed the effects of antidepressant drugs on brain functioning in healthy subjects; however, none specifically investigated positive mood changes to antidepressant drug. Sixteen subjects with no personal or family history of psychiatric disorders were selected from an ongoing 4-week open trial of small doses of clomipramine. Follow-up interviews documented clear positive treatment effects in six subjects, with reduced irritability and tension in social interactions, improved decision making, higher self-confidence and brighter mood. These subjects were then included in a placebo-controlled confirmatory trial and were scanned immediately after 4 weeks of clomipramine use and again 4 weeks after the last dose of clomipramine. The functional magnetic resonance imaging (fMRI) scans were run during emotion-eliciting stimuli. Repeated-measures analysis of variance of brain activity patterns showed significant interactions between group and treatment status during induced irritability (P<0.005 cluster-based) but not during happiness. Individuals displaying a positive subjective response do clomipramine had higher frontoparietal cortex activity during irritability than during happiness and neutral emotion, and higher temporo-parieto-occipital cortex activity during irritability than during happiness. We conclude that antidepressants not only induce positive mood responses but also act upon autobiographical recall of negative emotions.

Probability of remission of juvenile idiopathic arthritis following treatment with steroid joint injection.

OBJECTIVES: Steroid joint injection is indicated as starting treatment for juvenile idiopathic arthritis, but its effect as single treatment has not been explored. Our aim was to estimate arthritis remission probability after single or repeated injections. METHODS: Conduct a retrospective analysis of inactive arthritis status, remission on medication and remission off medication, estimating cumulative probability and mean time to survival, from the first joint injection session to the last follow-up visit or disease-modifying anti-rheumatic drugs initiation. Remission and time to achieve remission status after single or repeated injections were compared. RESULTS: Seventy-seven patients with 4-year medium follow-up and 254 treated joints, were reviewed. Eighty-three percent of the individuals had oligoarticular subtype and 57% had persistent oligoarticular course. Overall, 26% achieved remission off medication status, 4% remission on medication and 38% initiated disease-modifying anti-rheumatic drugs. Survival analysis resulted in mean time of achieving inactive disease status, remission on medication and off medication of 8, 11 and 56 months, respectively. The cumulative probability of remission off medication was 2% at 12 months, 8% at 24 months and 18% at 36 months. Frequency of inactive disease, remission on medication and remission off medication status decreased proportionally following repeated joint injections in comparison with the frequency of the same status for those receiving single treatment. CONCLUSIONS: The dropout rates due to anti-rheumatic drugs initiation indicated limited long-term benefits of intra-articular steroids for juvenile idiopathic arthritis.

Validation of the Portuguese Simple Measure of Impact of Lupus Erythematosus in Youngsters (SMILEY) in Brazil.

BACKGROUND AND OBJECTIVE: Simple Measure of the Impact of Lupus Erythematosus in Youngsters (SMILEY) is a health-related quality of life (HRQOL) assessment tool for pediatric systemic lupus erythematosus (SLE), which has been translated into Portuguese for Brazil. We are reporting preliminary data on cross-cultural validation and reliability of SMILEY in Portuguese (Brazil). METHODS: In this multi-center cross-sectional study, Brazilian children and adolescents 5-18 years of age with SLE and parents participated. Children and parents completed child and parent reports of Portuguese SMILEY and Portuguese Pediatric Quality of Life Inventory (PedsQL™) Generic and Rheumatology modules. Parents also completed the Childhood Health Assessment Questionnaire (CHAQ). Physicians completed the SLE disease activity index (SLEDAI), Physician's Global Assessment of disease activity (PGA) and Systemic Lupus Erythematosus International Collaborating Clinics ACR Damage Index (SDI). RESULTS: 99 subjects (84 girls) were enrolled; 93 children and 97 parents filled out the SMILEY scale. Subjects found SMILEY relevant and easy to understand and completed SMILEY in 5-15 minutes. Brazilian SMILEY was found to have good psychometric properties (validity and reliability), and the child-parent agreement was moderate. CONCLUSION: SMILEY may eventually be used routinely as a research/clinical tool in Brazil. It may be also adapted for other Portuguese-speaking nations offering critical information regarding the effect of SLE on HRQOL for children with SLE.

PP043. Do women know what pre-eclampsia is? What is the level of knowledge of the disease in a small population connected to a social net?

INTRODUCTION: Pre-eclampsia is responsible for a great number of maternal deaths in our country. Even in urban areas that, theoretically, has more access to information and more medical assistance possibilities, much more women have very severe cases that could be avoided. Many initiatives to reduce this problem include effective women participation in that item, making us to believe that actual information access would allow precocious detection of the problem, leading to reduction of the maternal and perinatal risks. OBJECTIVES: To investigate a specific female population about how much they understand about the disease and its risks. METHODS: Using the social net Facebook®, a survey was developed for online use, where direct questions related to pre-eclampsia were made. The questions involved information about age, times of pregnancy, knowledge about pre-eclampsia and their risks. It was considered an inclusion criterion the women who decided to participate in the survey spontaneously, and their identity was preserved. This form was sent to 1000 women, and 120 fully answered the questions and they were put under analysis. RESULTS: The studied group had average age between 22 and 35years. From the total, 107 (89.6%) had at least initiated high school, and the rest (11%) said that they had at least finished elementary school. From the analyzed data, it was found that 60 (50%) of the interviewed women, did not know anything about the subject. The rest said that they had some knowledge about the topic. From those, 14 (23%) had already heard about pre-eclampsia, but did not know what was it, 44 (73%) had a vaguely notion but did not know about the risks, and just 2 (4%) gave the entirely correct definition and knew about its implications. From all, 24 (20%) from the interviewed had at least once been pregnant, and 15 from those, had never heard about the pathology. CONCLUSION: Despite of the impact that pre-eclampsia represents on mother and baby's health, our results show that information in the studied group, is poor. The studied group has naturally more access to information, showing us that the situation is even more concerning. We believe that it is necessary to apply instruments that could redefine, in a greater way, the real information level to the female population in all levels of assistance. To enlarge the health politics, and increase its efficiency through informed women, seem to us, a fundamental strategy to qualify assistance and enhance maternal and prenatal safety. In an era that social nets had changed human behavior, why should not we use it as an efficient tool to promote life quality?

PP090. The contribution of podocyturia to the evaluation of ongoing glomerular disorder in pregnant women with kidney graft (preliminary results).

INTRODUCTION: Progressive proteinuria and glomerulosclerosis characterize chronic allograft nephropathy. However, the causes are not fully elucidated. Injury of parietal epithelial cells in glomeruli, the podocytes, is the initiating cause of many renal diseases, leading to proteinuria with possible progression to glomerulosclerosis. Podocytes are highly specialized cells, with an important role in maintaining the glomerular filtration barrier and producing growth factor for mesangial cells and endothelial cells. With their foot processes they cover the glomerular basement membrane, and form slit diaphragms with neighboring podocytes. The potential role of podocytes in the failing transplanted kidney is unknown. OBJECTIVES: To evaluate podocyturia as a functional marker in pregnant women with kidney grafts. METHODS: Twenty pregnant women with kidney grafts had their urine samples cytocentrifugated and evaluated by indirect immunofluorescence. The slide was incubated for 45' at room temperature with fluorescein (FITC) anti-rabbit IgG secondary antibody (Sigma-Aldrich, EUA). Then Vectashield (mounting medium for fluorescence) with DAPI (4'6-diamino-2-fenilindol dihidrocloreto) were applied H-1200 (Vector laboratories, inc, USA). The podocytes and the total number of cells were counted in 15 fields photographed under 400x magnification with a digital camera coupled to an epifluorescence microscope DM1000 (Leica, Germany) connected to a computer. The results were expressed as podocyte/total cells (%) per area of higher cell concentration (hot spots) in the field of 400x detected by staining of nuclei and cytoplasm. (Grant FAPESP 08/56338-1). RESULTS: The mean age of the women was 26years. The urinalysis was performed at the third trimester of gestation; 11 did not exhibit urinary podocytes and 9 had podocyturia. There was also a relationship between blood pressure levels, proteinuria and the excretion of podocytes. CONCLUSION: Urinary podocyte number, blood pressure and proteinuria were associated. We observed that urinary podocyte excretion occurs in pregnant women with kidney transplant almost synchronously with higher systolic and diastolic blood pressure and higher mean levels of proteinuria. The detection of podocyturia in these women could be useful for early diagnosis and follow-up of glomerular injury, eventually preeclampsia. It may be also associated to its severity or activity, although additional studies are necessary to confirm these aspects.

PP176. SFLT-1: A possibility of precocious diagnosis of preeclampsia.

INTRODUCTION: Preeclampsia (PE) affects 5-8% of all pregnant women and can trigger a severe gestational hypertension framework and eventually develop into eclampsia and HELLP syndrome. Anticipating the damage would be important in order to establish procedures that can reduce adverse outcomes. For this reason, many researches are undertaken to identify ways to make a diagnosis of preeclampsia as early as possible. It has been highlighted in literature the study: the sFlt1 (soluble fms-like tyrosine kinase-1) has been implicated in the precocious diagnosis of pre eclampsia. The sFlt1 is an anti-angiogenic factor produced in response to oxidative stress derived from the deleterious effects of pre-eclampsia. OBJECTIVES: The objective of the study was to evaluate the role of Soluble fms-like tyrosine kinase-1 in the diagnosis of preeclampsia. METHODS: This is a review conducted in the database PubMed and Lilacs. For this purpose, we used the following MeSH, "Vascular Endothelial Growth Factor Receptor-1" OR "FLT1 protein, human" AND "Pre-Eclampsia/diagnosis" in PubMed and "Pre-eclampsia" AND "SFLT1A" in Lilacs, resulting in 84 papers. After reading the abstracts of these studies, we selected the articles analyzed taking into consideration the criteria for inclusion and exclusion. We excluded publications that were not in the period under study (2008 to July 2011) and by study design. Including only case-control, cohort and prospective observational. For a critical analysis of the material, we used the following indicators: researcher, years, central theme, participants, study design and primary outcome. RESULTS: The final results of this study were composed of seven articles and are shown for each target outcome. These vary according to gestational age at which PE is installed and the marker studied (sFlt1 alone or its relation to PlGF - sFlt1/PIGF). Six studies showed greater levels of sFlt1 for the preeclampsia groups when compared to the control group. Significantly differences in antiangiogenic factors seric levels were not found among preeclamptic and eclamptic patients. When associated with another factor, like PIGF, a greater efficacy in the diagnosis of early preeclampsia is shown. Of the studies analyzed, only one (Lynch et al) showed no significant difference between the values of sFlt-1 in groups of early PE, late PE and control for gestational ages between 10 and 15 weeks. As for the relation sFlt-1/PIGF, five studies have considered it even better for PE diagnosis when compared to sFlt-1 isolated. CONCLUSION: The dosage of sFlt1 may be a relevant resource for the early diagnosis of preeclampsia before the installation of target organ damage, especially if measured in the period between 12 and 28 weeks of gestational age. Whereas sFlt-1 manifests itself before the 20th week, that may be interesting clinical point of view since it is this phase that settles the most severe cases, when the adoption of care could prevent further risks. The relationship sFlt1/PIGF, was more appropriate than the measurement of sFlt1 alone. Additional studies are needed to: amplification of the number of women evaluated, establishing gestational age appropriate for study, serum standard and need to consider the relationship between sFlt1 and other factors pro and/or anti-angiogenic.

Clinical presentation and salivary gland histopathology of paediatric primary Sjögren's syndrome.

OBJECTIVES: Explore the presentation, diagnostic criteria and exocrine gland histopathology of paediatric primary Sjögren's syndrome (PPSjS). METHODS: A case series of 8 children is reported and American-European Consensus Group (AECG-2002) criteria were examined, as well as minor labial salivary and lachrymal gland biopsies, which were scored by a pathologist blinded to outcome. For all cases, connective tissue diseases and parotid-related infectious disease were excluded. RESULTS: Age at onset varied from 5-13 years old; 6 were females, all followed from diagnosis up to the last visit (1-10 years). The main features at presentation were recurrent tender parotid swelling and sialectasis imaging, with decreased salivary function assessed by Tc-99 scintigraphy. Mild sicca symptoms were observed in 4/8 cases. Systemic features, including fatigue, myalgia, arthritis, tenosynovitis, joint contractures, transient Raynaud's and high ESR, were recorded at onset. Autoantibody profile was unremarkable for diagnosis, while lymphocytic infiltration of labial salivary glands and sialectasis were observed in all biopsies (8/8). In lachrymal glands, massive lymphocytic infiltration and lymphocytic gastritis were observed during complementary assessment. Flares were treated with low dose steroids and long-term use of hydroxychloroquine (5/8), although only 3/8 fulfilled AECG-2002 diagnostic criteria, throughout the disease course. CONCLUSIONS: PPSjS is rare, slowly progressive and its early presentation is variable. Standardised diagnostic algorithms should include recurrent parotid swelling and early diagnosis should rely mostly on salivary and lachrymal gland histopathology in this age group.