Isogeometric analysis for fluid shear stress in cancer cells

Este trabalho foi financiado pelo Concurso Anual para Projetos de Investigação, Desenvolvimento, Inovação e Criação Artística (IDI&CA) 2018 do Instituto Politécnico de Lisboa. Código de referência IPL/2018/IGACFC_ISELThe microenvironment of the tumor is a key factor regulating tumor cell invasion and metastasis. The effects of physical factors in tumorigenesis is unclear. Shear stress, induced by liquid flow, plays a key role in proliferation, apoptosis, invasion, and metastasis of tumor cells. The mathematical models have the potential to elucidate the metastatic behavior of the cells’ membrane exposed to these microenvironment forces. Due to the shape configuration of the cancer cells, Non-uniform Rational B-splines (NURBS) lines are very adequate to define its geometric model. The Isogeometric Analysis allows a simplified transition of exact CAD models into the analysis avoiding the geometrical discontinuities of the traditional Galerkin traditional techniques. In this work, we use an isogeometric analysis to model the fluid-generated forces that tumor cells are exposed to in the vascular and tumor microenvironments, in the metastatic process. Using information provided by experimental tests in vitro, we present a suite of numerical experiments which indicate, for standard configurations, the metastatic behavior of cells exposed to such forces. The focus of this paper is strictly on geometrical sensitivities to the shear stress’ exhibition for the cell membrane, this being its innovation.info:eu-repo/semantics/publishedVersio

Brazilian multicenter study of 71 patients with juvenile-onset Takayasu's arteritis: clinical and angiographic features

Objective: To describe the clinical and angiographic characteristics of Takayasu's arteritis in Brazilian children and adolescents. Methods: A retrospective data collection was performed in 71 children and adolescents followed in 10 Brazilian reference centers in Pediatric Rheumatology. The evaluation was carried out in three different time points: from onset of symptoms to diagnosis, from the 6th to 12th month of diagnosis, and in the last visit. Results: Of 71 selected patients, 51 (71.8%) were girls. The mean age of onset of symptoms and of time to diagnosis was 9.2 (+/- 4.2) years and 1.2 (+/- 1.4) years, respectively. At the end of the study, 20 patients were in a state of disease activity, 39 in remission and 5 had evolved to death. The most common symptoms in baseline assessment, second evaluation, and final evaluation were, respectively: constitutional, musculoskeletal, and neurological symptoms. A decrease in peripheral pulses was the most frequent cardiovascular signal, and an increase in erythrocyte sedimentation rate was the most frequent laboratory finding in all three evaluation periods. The tuberculin test was positive in 41% of those tested. Stenosis was the most frequent angiographic lesion, abdominal artery was the most affected segment, and angiographic type IV the most frequent. Most (90%) participants were treated with glucocorticoids, 85.9% required another immunosuppressive drug, and 29.6% underwent angioplasty. Conclusion: This is the largest study on juvenile-onset Takayasu arteritis, and a high number of patients under the age of 10 years, with predominance of constitutional symptoms early in the disease, was observed. (C) 2016 Elsevier Editora Ltda. All rights reserved.Univ Fed Sao Paulo, Dept Pediat, Sect Pediat Rheumatol, Sao Paulo, SP, BrazilUniv Sao Paulo, Inst Crianca, Pediat Rheumatol Sect, Sao Paulo, SP, BrazilSanta Casa Misericordia Sao Paulo, Sao Paulo, SP, BrazilUniv Sao Paulo, Sch Med, Ribeirao Preto, SP, BrazilUniv Estado Rio de Janeiro, BR-20550011 Rio De Janeiro, RJ, BrazilUniv Fed Rio de Janeiro, Inst Pediat Martagao Gesteira, Rio De Janeiro, RJ, BrazilUniv Fed Rio de Janeiro, Rheumatol Unit, Rio De Janeiro, RJ, BrazilUniv Fed Pernambuco, Rheumatol Unit, Recife, PE, BrazilUniv Fed Bahia, Salvador, BA, BrazilHosp Pequeno Principe, Curitiba, Parana, BrazilUniv Fed Sao Paulo, Dept Pediat, Sect Pediat Rheumatol, Sao Paulo, SP, BrazilWeb of Scienc

Profile of paediatric rheumatology specialists and services in the state of São Paulo

INTRODUCTION: Paediatric rheumatology (PR) is an emerging specialty, practised by a limited number of specialists. Currently, there is neither a record of the profile of rheumatology patients being treated in Brazil nor data on the training of qualified rheumatology professionals in the country. OBJECTIVE: To investigate the profile of PR specialists and services, as well as the characteristics of paediatric patients with rheumatic diseases, for estimating the current state of rheumatology in the state of São Paulo. PATIENTS AND METHODS: In 2010, the scientific department of PR of the Paediatric Society of São Paulo administered a questionnaire that was answered by 24/31 accredited specialists in PR practising in state of São Paulo and by 8/21 institutions that provide PR care. RESULTS: Most (91%) of the surveyed professionals practise in public institutions. Private clinics (28.6%) and public institutions (37.5%) reported not having access to nailfold capillaroscopy, and 50% of the private clinics reported not having access to acupuncture. The average duration of professional practise in PR was 9.4 years, and 67% of the physicians had attended postgraduate programmes. Seven (87.5%) public institutions perform teaching activities, in which new paediatric rheumatologists are trained, and five (62.5%) offer postgraduate programmes. Two-thirds of the surveyed specialists use immunosuppressants and biological agents classified as restricted use by the Health Secretariat. The disease most frequently reported was juvenile idiopathic arthritis (29.1-34.5%), followed by juvenile systemic lupus erythematosus (JSLE) (11.6-12.3%) and rheumatic fever (9.1-15.9%). The incidence of vasculitis (including Henoch-Schönlein purpura, Wegener's granulomatosis, and Takayasu's arteritis) and autoinflammatory syndromes was higher in public institutions compared to other institutions (P = 0.03, P = 0.04, P = 0.002, and P < 0.0001, respectively). Patients with JSLE had the highest mortality rate (68% of deaths), mainly due to infection. CONCLUSION: The field of PR in the state of São Paulo has a significant number of specialists with postgraduate degrees who mostly practise at teaching institutions with infrastructures appropriate for the care of high-complexity patients.INTRODUÇÃO: A reumatologia pediátrica (RP) é uma especialidade emergente, com número restrito de especialistas, e ainda não conta com uma casuística brasileira sobre o perfil dos pacientes atendidos e as informações sobre a formação de profissionais capacitados. OBJETIVO: Estudar o perfil dos especialistas e dos serviços em RP e as características dos pacientes com doenças reumáticas nessa faixa etária a fim de estimar a situação atual no estado de São Paulo (ESP). PACIENTES E MÉTODOS: No ano de 2010 o departamento científico de RP da Sociedade de Pediatria de São Paulo encaminhou um questionário respondido por 24/31 especialistas com título de especialização em RP que atuam no ESP e por 8/12 instituições com atendimento nesta especialidade. RESULTADOS: A maioria (91%) dos profissionais exerce suas atividades em instituições públicas. Clínicas privadas (28,6%) e instituições (37,5%) relataram não ter acesso ao exame de capilaroscopia e 50% das clínicas privadas não tem acesso à acupuntura. A média de tempo de prática profissional na especialidade foi de 9,4 anos, sendo 67% deles pós-graduados. Sete (87,5%) instituições públicas atuam na área de ensino, formando novos reumatologistas pediátricos. Cinco (62,5%) delas têm pós-graduação. Dois terços dos especialistas utilizam imunossupressores e agentes biológicos de uso restrito pela Secretaria da Saúde. A doença mais atendida foi artrite idiopática juvenil (29,1%-34,5%), seguida de lúpus eritematoso sistêmico juvenil (LESJ) (11,6%-12,3%) e febre reumática (9,1%-15,9%). Vasculites (púrpura de Henoch Schönlein, Wegener, Takayasu) e síndromes autoinflamatórias foram mais incidentes nas instituições públicas (P = 0,03; P = 0,04; P = 0,002 e P < 0,0001, respectivamente). O LESJ foi a doença com maior mortalidade (68% dos óbitos), principalmente por infecção. CONCLUSÃO: A RP no ESP conta com um número expressivo de especialistas pós-graduados, que atuam especialmente em instituições de ensino, com infraestrutura adequada ao atendimento de pacientes de alta complexidade.34635

Inquérito sobre a qualidade de vida relacionada à saúde em crianças e adolescentes portadores de artrites idiopáticas juvenis

Objective: to study the impact of chronic arthritis on health related quality of life by means of two self-reported tools: the parents' version of the Childhood Health Assessment Questionnaire (CHAQ) and the Childhood Health Questionnaire PF50® (CHQ). Methods: both tools were filled in after proper instructions by 36 parents, during 1-2 clinic visits. The Disability Index (CHAQ) and the Physical and Psychosocial scores (CHQ) were compared to the core set of outcome measures, namely 1) physician's global assessment, 2) parents' global assessment, both scored by 10 cm visual analogue scale, 3) number of joints with active arthritis, 4) number of joints with limited range of motion, 5) erythrocyte sedimentation rate. Results: there was significant difference for all measures of disease activity, being higher in the polyarticular as compared to oligoarticular except for erythrocyte sedimentation rate, parents' global assessment, and psychosocial score. This leads to different parents' perceptions of disease activity and outcome. The responsiveness of the outcome measures during two follow-up visits of patients receiving active treatment indicated better responsiveness of physicians' global assessment among the subjective measures, and intermediate responsiveness of the self-reported measures in comparison to the number of active and limited joints, and erythrocyte sedimentation rate. Conclusions: the responsiveness of two health related quality of life tools indicates their relative sensitivity for assessing clinical improvement during active treatment in Juvenile Idiopathic Arthritis patients. Copyright © 2003 by Sociedade Brasileira de Pediatria

Inquérito sobre a qualidade de vida relacionada à saúde em crianças e adolescentes portadores de artrites idiopáticas juvenis

Objetivo: estudar o impacto da artrite crônica na qualidade de vida relacionada à saúde, por meio de dois instrumentos autoaplicáveis: a versão destinada aos pais do Childhood Health Assessment Questionnaire (CHAQ) e do Child Health Questionnaire (CHQ) PF50®. Método: os dois questionários foram respondidos por 36 pais, após instruções durante 1 a 2 visitas clínicas, sendo os índices da Capacidade Funcional (CHAQ), Físico e Psicossocial (CHQ) comparados com as medidas essenciais de atividade da doença: (1) a avaliação global pelo médico, (2) a avaliação global pelos pais, ambas em escala analógica visual de 10 cm, (3) o número de articulações ativas, (4) o numero de articulações com limitação dos movimentos, (5) a velocidade de hemossedimentação. Resultados: houve diferença significante entre os grupos oligoarticular e poliarticular, sendo os índices de atividade maiores no poliarticular, com exceção da velocidade de hemossedimentação, avaliação global pelos pais e índice psicossocial, confirmando diferentes níveis de percepção pelos pais sobre a atividade e prognóstico. A melhor responsividade estatística frente à intervenção terapêutica, em duas visitas consecutivas, foi a medida da avaliação global pelo médico entre as subjetivas, tendo as medidas avaliadas por instrumentos de responsividade intermediária, quando comparadas com o número de articulações ativas, número de articulações com limitação dos movimentos e a velocidade de hemossedimentação. Conclusão: a medida da responsividade de dois instrumentos de avaliação funcional e da qualidade de vida indicou a sua sensibilidade relativa para estimar a melhora clínica em pacientes com artrites idiopáticas juvenis, recebendo tratamento específico.Objective: to study the impact of chronic arthritis on health related quality of life by means of two self-reported tools: the parents’ version of the Childhood Health Assessment Questionnaire (CHAQ) and the Childhood Health Questionnaire PF50® (CHQ). Methods: both tools were filled in after proper instructions by 36 parents, during 1-2 clinic visits. The Disability Index (CHAQ) and the Physical and Psychosocial scores (CHQ) were compared to the core set of outcome measures, namely 1) physician’s global assessment, 2) parents’ global assessment, both scored by 10 cm visual analogue scale, 3) number of joints with active arthritis, 4) number of joints with limited range of motion, 5) erythrocyte sedimentation rate. Results: there was significant difference for all measures of disease activity, being higher in the polyarticular as compared to oligoarticular except for erythrocyte sedimentation rate, parents’ global assessment, and psychosocial score. This leads to different parents’ perceptions of disease activity and outcome. The responsiveness of the outcome measures during two follow-up visits of patients receiving active treatment indicated better responsiveness of physicians’ global assessment among the subjective measures, and intermediate responsiveness of the self-reported measures in comparison to the number of active and limited joints, and erythrocyte sedimentation rate. Conclusions: the responsiveness of two health related quality of life tools indicates their relative sensitivity for assessing clinical improvement during active treatment in Juvenile Idiopathic Arthritis patients.Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP

Risk factors for wheezing in children - the role of respiratory viruses

Background: Infections with respiratory viruses, particularly human rhinovirus (HRV) and respiratory syncytial virus (RSV), are major causes of lower respiratory tract (LTR) illnesses associated with wheezing in children. Asthma is the most common chronic disease in children, and it is thought that environmental factors acting early in life, including respiratory viral infections, interacting with specific genes, are key events for the development of chronic disease. Infections with both RSV and rhinovirus early in life have been associated with persistent wheezing and asthma in children, and are a known cause of exacerbations of asthma in those with established disease.Methods/Data base: A review of the literature and own studies.Results: Studies performed in different areas of the world indicate that there are differences in the distribution of viruses and in the association of viruses with wheezing in temperate areas as compared to subtropical environments.Conclusions: Preventive treatment for infections with RSV or rhinoviruses, when available, will probably have a major impact on childhood wheezing and asthma.Univ São Paulo, Sch Med, Dept Internal Med, BR-14049900 Ribeirao Preto, BrazilUniv São Paulo, Sch Med, Dept Cell Biol, BR-14049900 Ribeirao Preto, BrazilUniv São Paulo, Sch Med, Dept Pediat, BR-14049900 Ribeirao Preto, BrazilSanta Lydia Hosp, Ribeirao Preto, BrazilWeb of Scienc