COMPLICAÇÕES CARDIOVASCULARES DA DOENÇA DE KAWASAKI: REVISÃO INTEGRATIVA

Kawasaki Disease corresponds to a primary vasculitis that mainly affects preschool children, with a slight predominance of males and Asian ethnicity. It is the main vasculitis in developed countries and the 2nd in underdeveloped countries. The diagnosis is essentially clinical, characterized by the presence of fever lasting 5 days or more, associated with conjunctivitis, cervical lymphadenopathy, mucositis, changes in the extremities and rash. Treatment is essentially carried out with immunoglobulin and AAS. Diagnosis and treatment must be carried out effectively and in an ideal time in order to reduce the chance of progression to the main complication of the pathology: coronary artery aneurysm.A Doença de Kawasaki corresponde a uma vasculite primária que afeta, principalmente, crianças em idade pré-escolar, com leve predominância do sexo masculino e etnia asiática. É a principal vasculite em países desenvolvidos e a 2ª em países subdesenvolvidos. O diagnóstico é essencialmente clínico, caracterizado pela presença de febre com duração igual ou superior a 5 dias, associada a conjuntivite, linfadenopatia cervical, mucosite, alterações em extremidades e exantema. O tratamento é realizado essencialmente com imunoglobulina e AAS. O diagnóstico e o tratamento devem ser realizados de forma eficaz e em tempo ideal com o intuito de diminui a chance de evolução para principal complicação da patologia: aneurisma de artéria coronariana

Impact of COVID-19 on cardiovascular testing in the United States versus the rest of the world

Objectives: This study sought to quantify and compare the decline in volumes of cardiovascular procedures between the United States and non-US institutions during the early phase of the coronavirus disease-2019 (COVID-19) pandemic. Background: The COVID-19 pandemic has disrupted the care of many non-COVID-19 illnesses. Reductions in diagnostic cardiovascular testing around the world have led to concerns over the implications of reduced testing for cardiovascular disease (CVD) morbidity and mortality. Methods: Data were submitted to the INCAPS-COVID (International Atomic Energy Agency Non-Invasive Cardiology Protocols Study of COVID-19), a multinational registry comprising 909 institutions in 108 countries (including 155 facilities in 40 U.S. states), assessing the impact of the COVID-19 pandemic on volumes of diagnostic cardiovascular procedures. Data were obtained for April 2020 and compared with volumes of baseline procedures from March 2019. We compared laboratory characteristics, practices, and procedure volumes between U.S. and non-U.S. facilities and between U.S. geographic regions and identified factors associated with volume reduction in the United States. Results: Reductions in the volumes of procedures in the United States were similar to those in non-U.S. facilities (68% vs. 63%, respectively; p = 0.237), although U.S. facilities reported greater reductions in invasive coronary angiography (69% vs. 53%, respectively; p < 0.001). Significantly more U.S. facilities reported increased use of telehealth and patient screening measures than non-U.S. facilities, such as temperature checks, symptom screenings, and COVID-19 testing. Reductions in volumes of procedures differed between U.S. regions, with larger declines observed in the Northeast (76%) and Midwest (74%) than in the South (62%) and West (44%). Prevalence of COVID-19, staff redeployments, outpatient centers, and urban centers were associated with greater reductions in volume in U.S. facilities in a multivariable analysis. Conclusions: We observed marked reductions in U.S. cardiovascular testing in the early phase of the pandemic and significant variability between U.S. regions. The association between reductions of volumes and COVID-19 prevalence in the United States highlighted the need for proactive efforts to maintain access to cardiovascular testing in areas most affected by outbreaks of COVID-19 infection

Metodologia de caracterização dinâmica de pontes em concreto armado : modelo físico escalonado: estudo teórico e experimental

Orientador: Prof. Roberto Dalledone Machado, D.Eng.Dissertação (mestrado) - Universidade Federal do Paraná, Setor de Tecnologia, Programa de Pós-Graduação em Engenharia de Construção Civil. Defesa : Curitiba, 29/08/2019Inclui referências: p. 201-208Resumo: As pontes e viadutos são de grande importância no cenário socioeconômico brasileiro. Com o desenvolvimento de materiais cada vez mais resistentes, foi possível a execução de estruturas mais esbeltas. Além disso, fatores como o aumento de volume e peso dos veículos ocasionaram um aumento de problemas relacionados a dinâmica. Tendo isto em vista, o objetivo principal deste trabalho é investigar o comportamento, sob carregamento dinâmico, de uma ponte através do uso de modelo físico escalonado aplicando métodos experimentais e numéricos. Neste estudo, foi dimensionada uma ponte de referência conforme normas vigentes e dimensões adotadas em pontes da malha rodoviária brasileira. Com esta estrutura hipotética, modelos numéricos em escala real e reduzida (esc. 1:50) foram desenvolvidos, alterando geometria e material. Com base no modelo numérico em escala reduzida desenvolveu-se um modelo físico em escala reduzida para comparação. A partir destes, torna-se possível a identificação da correlação entre modelos, evidenciando o potencial de aplicação de modelos físicos escalonados para caracterização dinâmica. Adicionalmente, uma caracterização de materiais foi realizada neste trabalho, com intuito de escolher um material para a fabricação do modelo físico em escala reduzida e identificar propriedades como módulo de elasticidade, densidade, fluência e coeficientes de amortecimento. Realizou-se uma avaliação das frequências naturais e modos de vibração dos modelos da ponte, de forma a evidenciar potenciais problemas em função de vento, impacto ou até mesmo tráfego. Em conclusão, foi possível comparar os modelos, viabilizando o uso do método através de modelos escalonados para identificar as frequências mais significativas do sistema (naturais e naturalmente amortecidas) e os modos de vibração. Palavras-chave: Dinâmica, Ponte de concreto armado, modelo físico escalonado.Abstract: Structures as bridges and viaducts have a major role in the Brazilian socioeconomic background. The development of resistance materials made possible that construct structures become slimmer despite the increase of the traffic volume and vehicle load. These two facts induce dynamic problems. The main goal of this work is investigating the behavior, applying a dynamic load, of a reinforced concrete bridge using experimental studies applied on reduce scaled modelling. In these Project, a real scale bridge was design according to standards and common characteristics found in Brazilian reinforced concrete bridges. Numerical simulations were made in real and reduced scales (1:50) models to compare the dynamic behavior of both models. Through these results, it was possible to have correlations between models in addition to better understand the mechanical behavior of reinforced concrete bridges under dynamic loads. In addition, a material characterization has been done in order to collect additional information about the material properties, such as damping factor. Natural frequencies and modal shapes were evaluated on the bridge models, in order to see potential problems related to the kinds of loads such as wind loads and traffic load. In conclusion, it was possible to compare the studied bridge models, being identified that physical model can expose resonant frequency ranges, vibration modes and other dynamic behavior. Keywords : Dynamic, Reinforced concrete bridge, scaled physical mode

The novel calpain inhibitor A-705253 prevents stress-induced tau hyperphosphorylation in vitro and in vivo

Calcium-mediated pathologic activation of the cysteine protease calpain has been linked to neurodegenerative disorders such as Alzheimer's disease (AD) through the cleavage of proteolytic substrates that negatively affect neuronal function. Hyperphosphorylation of the microtubule-associated protein tau and the subsequent aggregation of tau filaments resulting in the intracellular formation of neurofibrillary tangles are recognized as key etiological factors in AD pathology. Cyclin-dependent kinase 5 (Cdk5), a major kinase responsible for tau hyperphosphorylation in the AD brain, becomes hyperactivated through calpain-mediated cleavage-conversion of the Cdk5 regulatory protein p35 to p25. In the present study, we examined the effects of the novel small-molecule calpain inhibitor A-705253 in acute models of tau hyperphosphorylation in vitro and in vivo. In hippocampal slices in vitro, lowering medium temperature to 33 °C increased tau phosphorylation in which incubation with A-705253 blocked low temperature-induced tau phosphorylation as measured by Western blot analysis. Pentobarbital-induced hypothermia or acute systemic LPS treatment in normal mice increased tau phosphorylation in hippocampal CA3 mossy fibers, as measured by immunohistochemistry, whereas acute A-705253 pretreatment prevented the stress-induced tau hyperphosphorylation in both models. In support of a Cdk5-mediated mechanism, A-705253 administered for two weeks in the drinking water of six month-old prepathogenic 3x Tg-AD mice resulted in decreased expression of the calpain proteolytic p25 fragment. Taken together, results of these studies suggest that calpain inhibition has potential utility in reducing tau hyperphosphorylation and may represent a novel disease-modifying approach in the treatment of AD

The Polar Legionella Icm/Dot T4SS Establishes Distinct Contact Sites with the Pathogen Vacuole Membrane

Legionella pneumophila, the causative agent of Legionnaires disease, is a facultative intracellular pathogen that survives inside phagocytic host cells by establishing a protected replication niche, termed the "Legionella-containing vacuole" (LCV). To form an LCV and subvert pivotal host pathways, L pneumophila employs a type IV secretion system (T4SS), which translocates more than 300 different effector proteins into the host cell. The L. pneumophila T4SS complex has been shown to span the bacterial cell envelope at the bacterial poles. However, the interactions between the T4SS and the LCV membrane are not understood. Using cryo-focused ion beam milling, cryo-electron tomography, and confocal laser scanning fluorescence microscopy, we show that up to half of the intravacuolar L. pneumophila bacteria tether their cell pole to the LCV membrane. Tethering coincides with the presence and function of T4SSs and likely promotes the establishment of distinct contact sites between T4SSs and the LCV membrane. Contact sites are characterized by indentations in the limiting LCV membrane and localize juxtaposed to T4SS machineries. The data are in agreement with the notion that effector translocation occurs by close membrane contact rather than by an extended pilus. Our findings provide novel insights into the interactions of the L. pneumophila T4SS with the LCV membrane in situ. IMPORTANCE Legionnaires disease is a life-threatening pneumonia, which is characterized by high fever, coughing, shortness of breath, muscle pain, and headache. The disease is caused by the amoeba-resistant bacterium L. pneumophila found in various soil and aquatic environments and is transmitted to humans via the inhalation of small bacteria-containing droplets. An essential virulence factor of L pneumophila is a so-called "type IV secretion system" (T4SS), which, by injecting a plethora of "effector proteins" into the host cell, determines pathogen-host interactions and the formation of a distinct intracellular compartment, the "Legionella-containing vacuole" (LCV). It is unknown how the T4SS makes contact to the LCV membrane to deliver the effectors. In this study, we identify indentations in the host cell membrane in close proximity to functional T4SSs localizing at the bacterial poles. Our work reveals first insights into the architecture of Legionella-LCV contact sites.Funding Agencies|Swedish Research CouncilSwedish Research CouncilEuropean Commission [2014-396]; ETH Zurich Postdoctoral fellowship; European Research CouncilEuropean Research Council (ERC)European Commission [679209]; Swiss National Science Foundation (SNF)Swiss National Science Foundation (SNSF) [31003A_179255]; NOMIS Foundation; SNF [31003A_175557]</p

Avaliação dos padrões de morfologia e inserção dos freios labiais em pacientes da clínica-escola de odontologia do Centro Universitário de João Pessoa - PB

ResumoIntroduçãoA investigação dos padrões estruturais dos freios labiais é importante para o estabelecimento da frequência com que ocorrem as variações, sejam estas de normalidade ou prejudiciais à função.ObjetivoAvaliar os padrões de morfologia e inserção dos freios labiais de pacientes atendidos na Clínica-Escola de Odontologia do Centro Universitário de João Pessoa-PB.Material e métodoAvaliaram-se 385 pacientes atendidos no período de agosto de 2012 a abril de 2013, de ambos os sexos. Os dados foram analisados no software IBM SPSS (20.0).ResultadoA morfologia de prevalência foi do tipo simples tanto para o freio labial superior (82,6%) quanto para o inferior (100,0%). A inserção de maior prevalência foi a “mucosa alveolar”, tanto nos superiores (75,8%) quanto nos inferiores (99,0%). Não houve diferença entre os sexos masculino e feminino para morfologia e inserção superiores (p=0,673 e p=0,582, respectivamente), bem como para a inserção inferior (p=0,599). Note-se que o mesmo ocorreu para as diferentes cores de pele – leucoderma, melanoderma e faioderma, com p=0,343; p=0,269; p=0,134, respectivamente. Verificou-se diferença (p=0,011) entre as médias de idade para as variantes de inserção do freio labial superior.ConclusãoA morfologia predominante tanto para freios labiais superiores quanto para inferiores é o tipo simples, havendo maior número de variantes morfológicas para os superiores. A inserção do tipo mucosa alveolar é a de maior ocorrência tanto para freios superiores quanto inferiores. Não há relação entre os padrões de morfologia e inserção com o sexo e a cor da pele, mas observa-se relação entre o padrão de inserção dos freios labiais superiores e a idade dos indivíduos