114 research outputs found
Recomendação de Curvas de Crescimento para Crianças Nascidas Pré-Termo
Em 2013, a Secção de Neonatologia da Sociedade Portuguesa de Pediatria, face Ă existĂȘncia de vĂĄrias curvas de avaliação
de crescimento para crianças nascidas pré-termo e à falta de homogeneidade de critérios na sua escolha, nomeou um grupo
de peritos que procedeu Ă revisĂŁo crĂtica das curvas disponĂveis e recomenda as que considera mais adequadas para
utilização na prĂĄtica clĂnica em fases especĂficas da vida: ao nascimento (Fenton 2013), durante o internamento na unidade
de Neonatologia (Fenton 2013 e Ehrenkranz 1999) e a longo prazo (OMS 2006). As decisÔes foram tomadas com base na
classificação sistemĂĄtica do nĂvel de evidĂȘncia e do grau de recomendação.
A presente recomendação: Ă© vĂĄlida enquanto nĂŁo forem publicados os resultados do estudo do consĂłrcio multicĂȘntrico
INTERGROWTH-21st, recentemente incumbido da construção de valores de referĂȘncia, mais prĂłximos do padrĂŁo, de crianças nascidas prĂ©-termo; tem o propĂłsito de auxiliar os clĂnicos na decisĂŁo clĂnica, mas nĂŁo ser o Ășnico instrumento de avaliação do crescimento das crianças nascidas prĂ©-termo; pode nĂŁo proporcionar elementos suficientes para orientação
do crescimento de todas estas crianças
Chronic interstitial pneumonitis
A patologia pulmonar intersticial compreende um grupo de doenças crĂłnicas caracterizadas por alteraçÔes das paredes alveolares e perda das unidades funcionais alveolocapilares. SĂŁo doenças raras nas crianças, na sua maioria de causa desconhecida e revestindo-se habitualmente de uma elevada morbimortalidade, dada a pouca eficĂĄcia da terapĂȘutica actualmente disponĂvel.
Os autores descrevem o caso clĂnico de uma
criança de 3 anos, previamente saudĂĄvel, que no contexto de uma infecção respiratĂłria desenvolve um quadro de sibilĂąncia e insuficiĂȘncia respiratĂłria grave, na investigação do qual Ă© diagnosticada uma
pneumonite intersticial crĂłnica. Foram tentadas diversas terapĂȘuticas (corticoterapia sistĂ©mica, hidroxicloroquina, N-acetilcisteĂna) sem melhoria evidente.Interstitial lung disease includes a group of chronic diseases characterized by alterations in alveolar
walls and loss of functional alveolar-capillary units. These are rare diseases in children, mostly with an unknown cause and associated with a high morbidity and mortality due to insufficient therapeutic
effectiveness. The authors report a case of a previously healthy 3 years old child who presented with wheezing and severe respiratory insufficiency following a respiratory infection. The investigation performed led to
the diagnosis of chronic interstitial pneumonitis. Several treatments have been tried (corticosteroids,hydroxychloroquine, N-acetylcysteine) without any obvious improvement
Anålise numérica do comportamento de fundaçÔes superficiais tipo sapata
Neste trabalho estuda-se o comportamento de fundaçÔes superficiais em sapata de um
edifĂcio localizado em Ăguas Claras/DF, atravĂ©s da modelagem numĂ©rica tridimensional do sistema
estrutural solo-fundação superficial, utilizando o programa de elementos finitos Plaxis 3D
Foundation, como os seguintes objetivos: determinar os recalques e as tensÔes desenvolvidas no
solo de fundação; avaliar a influĂȘncia recĂproca entre as sapatas da fundação, bem como influĂȘncia
das etapas de construção das fundaçÔes. Os resultados são apresentados sob a forma de tabelas e
gråficos, onde os recalques obtidos pela modelagem numérica foram comparados com valores
previstos atravĂ©s da teoria da elasticidade. As anĂĄlises demonstraram a influĂȘncia do efeito de grupo
entre as fundaçÔes superficiais e do processo construtivo na configuração final dos recalques. Além
disso, a comparação numĂ©rico-analĂtica mostrou que os recalques previstos pelos mĂ©todos
numĂ©ricos foram maiores que os valores obtidos pelo mĂ©todo analĂtico, porĂ©m com valores menores que o limite tolerĂĄvel de 65 mm (NBR 6122)2016-12-30Artigo submetido e aceito no COBRAMSEG (2016
Nod2 Suppresses Borrelia burgdorferi Mediated Murine Lyme Arthritis and Carditis through the Induction of Tolerance
The internalization of Borrelia burgdorferi, the causative agent of Lyme disease, by phagocytes is essential for an effective activation of the immune response to this pathogen. The intracellular, cytosolic receptor Nod2 has been shown to play varying roles in either enhancing or attenuating inflammation in response to different infectious agents. We examined the role of Nod2 in responses to B. burgdorferi. In vitro stimulation of Nod2 deficient bone marrow derived macrophages (BMDM) resulted in decreased induction of multiple cytokines, interferons and interferon regulated genes compared with wild-type cells. However, B. burgdorferi infection of Nod2 deficient mice resulted in increased rather than decreased arthritis and carditis compared to control mice. We explored multiple potential mechanisms for the paradoxical response in in vivo versus in vitro systems and found that prolonged stimulation with a Nod2 ligand, muramyl dipeptide (MDP), resulted in tolerance to stimulation by B. burgdorferi. This tolerance was lost with stimulation of Nod2 deficient cells that cannot respond to MDP. Cytokine patterns in the tolerance model closely paralleled cytokine profiles in infected Nod2 deficient mice. We propose a model where Nod2 has an enhancing role in activating inflammation in early infection, but moderates inflammation after prolonged exposure to the organism through induction of tolerance
Cognitive Dysfunction Is Sustained after Rescue Therapy in Experimental Cerebral Malaria, and Is Reduced by Additive Antioxidant Therapy
Neurological impairments are frequently detected in children surviving cerebral malaria (CM), the most severe neurological complication of infection with Plasmodium falciparum. The pathophysiology and therapy of long lasting cognitive deficits in malaria patients after treatment of the parasitic disease is a critical area of investigation. In the present study we used several models of experimental malaria with differential features to investigate persistent cognitive damage after rescue treatment. Infection of C57BL/6 and Swiss (SW) mice with Plasmodium berghei ANKA (PbA) or a lethal strain of Plasmodium yoelii XL (PyXL), respectively, resulted in documented CM and sustained persistent cognitive damage detected by a battery of behavioral tests after cure of the acute parasitic disease with chloroquine therapy. Strikingly, cognitive impairment was still present 30 days after the initial infection. In contrast, BALB/c mice infected with PbA, C57BL6 infected with Plasmodium chabaudi chabaudi and SW infected with non lethal Plasmodium yoelii NXL (PyNXL) did not develop signs of CM, were cured of the acute parasitic infection by chloroquine, and showed no persistent cognitive impairment. Reactive oxygen species have been reported to mediate neurological injury in CM. Increased production of malondialdehyde (MDA) and conjugated dienes was detected in the brains of PbA-infected C57BL/6 mice with CM, indicating high oxidative stress. Treatment of PbA-infected C57BL/6 mice with additive antioxidants together with chloroquine at the first signs of CM prevented the development of persistent cognitive damage. These studies provide new insights into the natural history of cognitive dysfunction after rescue therapy for CM that may have clinical relevance, and may also be relevant to cerebral sequelae of sepsis and other disorders
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