The recommendations proposed by the Sjögren's Syndrome Committee of the Brazilian Society of Rheumatology for the treatment of Sjögren's syndrome were based on a systematic review of literature in Medline (PubMed) and the Cochrane databases until October 2014 and on expert opinion in the absence of studies on the subject. 131 items classified according to Oxford & Grade were included. These recommendations were developed in order to guide the appropriate management and facilitate the access to treatment for those patients with an appropriate indication, considering the Brazilian socioeconomic context and pharmacological agents available in this country.
Reinforcement of tungsten by tungsten fibers (Wf) is considered an attractive option to mitigate the intrinsic brittleness of this material and to possibly extend the operational temperature window to ensure safe operation of the plasma facing component. By now, it has been demonstrated that tungsten fiber-reinforced tungsten composites (Wf/W)acquire pseudo ductility even at room temperature, and crack propagation is determined by the interaction of the fibers with the propagating crack. In view of strong temperature oscillations, expected during operation in the fusion plasma, the mechanical properties of tungsten fibers annealed at different temperatures (up to 2300°C) were assessed, and the role of potassium (K) doping on the modification of the mechanical properties of asannealed wires was studied. While K-doping was found to delay the brittleness induced by heat exposure at least up to 1600°C, still a strong reduction of the fiber strength was observed in tests performed at elevated temperatures. In this work, we investigate the reasons for this effect by performing scanning electron microscopy coupled with electron backscatter diffraction measurements. The longitudinal and transversal cross-sections of W fibers were analyzed to deduce the morphology and size distribution of the grains. Consistent with the mechanical data, we found that annealing at 2100°C resulted in the full recrystallization of the elongated grains, otherwise formed due to the extrusion fabrication process. Even at 1900°C, the longitudinal cross-section still exhibits elongated grains. The transversal shape of the grains undergoes a change from needle-like fine structure to equiaxed grain shape upon annealing above 1600°C. Few scans done for 2300°C annealed wire revealed that the microstructure contains one or several grains with a dimension of 70-150 µm. The obtained results are discussed and analyzed in the frame of mechanistic model connecting microstructure with the mechanical response.
Sjogren's syndrome (SS) is an autoimmune disease characterized by lymphocytic infiltration of the exocrine glands and other organs. Women with SS often experience gynecological symptoms due to the disease and need extra care regarding their sexual activity, reproductive health and during pregnancy, conditions that are not properly conducted in the clinical practice. To cover this gap, a panel of experts from the Brazilian Society of Rheumatology conducted a systematic review and meta-analysis on the identification of symptoms, diagnosis, monitoring, prognosis, and treatment of these manifestations. A Focus Group meeting was held and included experts in the field and methodologists, based on a previously developed script, with themes related to the objective of the study. The most important topics were summarized and 11 recommendations were provided.
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