Pedro Wagner Gonçalves

Development of amyloidosis in patients with rheumatoid arthritis under TNF-blocking agents

Sir,We have read with great interest the article by Nakamuraet al. [1] describing the beneficial effect of etanercept inpatients with renal amyloidosis secondary to rheumatoidarthritis (RA). Sustained chronic inflammation favors theoccurrence of systemic amyloid A (AA) amyloidosis in RApatients [2] and the control of the inflammatory process isof crucial importance for amyloidosis prevention, as oncethis condition is established, its treatment is often disap-pointing. Some recent reports, including the one byNakamura, have demonstrated a beneficial effect of anti-TNF [3, 4], anti-IL-6 [5], and B cell depletion [6] therapiesin AA amyloidosis. These therapies could thereforerepresent a hope for patients with AA amyloidosissecondary to RA. Unfortunately, biologic agents do notprevent amyloidosis progression or even its development inall patients.We would like to report the onset of AA amyloidosis intwo patients with RA while under TNF-blocking therapy,despite an acceptable inflammatory control.The first case is a 69-year-old male with RA since theage of 64, in whom infliximab was started 1 year after RAdiagnosis, given the inadequate disease control withmethotrexate (20 mg once a week) and prednisolone(5 mg/day). A good EULAR response was achieved andmaintained for the subsequent 3 years, when the investiga-tion of a persistently elevated erythrocyte sedimentationrate (ESR) lead to the diagnosis of secondary amyloidosis33 months after being started on infliximab (Table 1). Thepresence of AAwas histologically confirmed by abdominalfat biopsy. There was no evidence of renal, cardiac, orgastrointestinal involvement. The patient continued on anti-TNF therapy and after 18 months remains free of majororgan involvement.The second patient is a 66-year-old female with RAsince the age of 50. Amyloidosis was diagnosed 14 yearsafter RA onset, while on treatment with etanercept andmethotrexate for 88 months and with a good EULARresponse (Table 1). Also in this case, the suspicion of AAamyloidosis was raised due to a persistently increased ESRdespite the absence of joint or other complaints. Sheunderwent an abdominal fat biopsy that confirmed thepresence of amyloid A.These two cases highlight the possibility of AAamyloidosis development in patients under TNF-blockingagents and with an adequate control of the inflammatorydisease according to the disease activity score (28-jointcount) DAS28. Both patients pursued biological treatmentwithout any relevant adverse events, and without clinicalevidence of AA amyloidosis progression. To date, bothremain free of renal, intestinal, or cardiac impairment. Eventhough TNF-blocking agents did not prevent AA amyloid-osis, their use was safe and might have contributed topatients’ clinical stability and the absence of major organinvolvement.

Indicadores da presença de conteúdos de História e Filosofia da Ciência em livro de texto de Geologia Introdutória

Articles on the teaching of science and Geology defend the importance of integrating historical and philosophical aspects in educational processes (History and Philosophy of Science approach or HPS), we call it the methodological approach of science (MAS). On the other hand, several works suggest that textbooks are important into selecting and organizinge programs of scientific disciplines overall in Brazil. These books seriously generate important influence on the formation of geologists, geographers, biologists, etc. These elements lead to research in the methodological contents in didactic books of Introductory Geology. The study demonstrates the presence of James Huttons and Charles Lyells thought in an textbook used in Brazilian undergraduate courses, as well as other historical aspects which suggests certain pedagogical importance of MAS inon the examined didactic material.

História da química e da geologia: Joseph Black e James Hutton como referências para educação em ciências

The second half of eighteenth century is marked by the advancement of chemistry and geology. The first science acquired the law of conservation of mass and this science represented a important support to geology and mineralogy. We say that both became modern science that time. Our aim is to show up some interrelations between history of chemistry and history of geology by means of the study of Joseph Blacks and James Huttons works. We defend that it is positive to science education to understand and approach the relations among different and disciplinary areas of science.

Relações entre conteúdo e forma de conhecimentos e práticas pedagógicas em Geociências: imaginário de futuros professores numa disciplina de licenciatura

Researches and studies about teaching, history and epistemology of Earth Sciences have been developed strongly associated with teacher/researcher undergraduate teaching practices. At the same way, in this work we aimed to comprehend the relationships that geography undergraduate students establish between the content/shape developed within a scientific undergraduate discipline and the professional content/shape, i.e., as it has thought in relation to the basic school, to being teacher. The students’ answers to a question we made indicated that they represent a n activity developed at that course in the relation with their imaginary about being a teacher. The analysis showed that the meanings were produced in different ways by the students, making work different imaginaries from which those meanings were produced, and different aspects of their memory as basic school students and the way they represent the content and teaching practices of school geography. The analysis showed that the activity is not transparent about its teaching content, because those meanings were the product of different discursive memories, related to different student-positions. This study point out the importance to consider and the possibility to work with future teachers imaginaries about teaching in relations that they establish to the content/shapes of their undergraduate scientific disciplines. Key-words: imaginary; discourse; memory; teaching formation; Earth Sciences

Relations between shape and content of Geoscience pedagogical knowledge and practice: imaginary of future teachers at an undergraduate teaching license discipline

Researches and studies about teaching, history and epistemology of Earth Sciences have been developed strongly associated with teacher/researcher undergraduate teaching practices. At the same way, in this work we aimed to comprehend the relationships that geography undergraduate students establish between the content/shape developed within a scientific undergraduate discipline and the professional content/shape, i.e., as it has thought in relation to the basic school, to being teacher. The students’ answers to a question we made indicated that they represent a n activity developed at that course in the relation with their imaginary about being a teacher. The analysis showed that the meanings were produced in different ways by the students, making work different imaginaries from which those meanings were produced, and different aspects of their memory as basic school students and the way they represent the content and teaching practices of school geography. The analysis showed that the activity is not transparent about its teaching content, because those meanings were the product of different discursive memories, related to different student-positions. This study point out the importance to consider and the possibility to work with future teachers imaginaries about teaching in relations that they establish to the content/shapes of their undergraduate scientific disciplines. Key-words: imaginary; discourse; memory; teaching formation; Earth Sciences

A marca química da doutrina natural e espiritual de James Hutton

The British naturalist James Hutton (1726-1797) is known among geologists. Even though, his works dealt with diverse areas of thought which were called Natural Philosophy and Moral Philosophy in the eighteenth century. This paper analyses relations between his natural and moral studies. It rejects common ideas that this author was a theoretical thinker and unaware of practical questions. It shows that his chemical explanations were strategic in building his thought and above all his geological doctrine.The British naturalist James Hutton (1726-1797) is known among geologists. Even though, his works dealt with diverse areas of thought which were called Natural Philosophy and Moral Philosophy in the eighteenth century. This paper analyses relations between his natural and moral studies. It rejects common ideas that this author was a theoretical thinker and unaware of practical questions. It shows that his chemical explanations were strategic in building his thought and above all his geological doctrine.