Associação do reflexo vermelho em recém-nascidos com variáveis neonatais

Objetivou-se investigar o resultado do teste do reflexo vermelho, conhecido como teste do olhinho, e associar as impressões do reflexo com variáveis neonatais. Este é um estudo descritivo, quantitativo, realizado com 190 recém-nascidos de uma maternidade pública, dos quais 187 apresentaram resultado não alterado e três suspeitos. Observaram-se diferentes nuances de coloração do reflexo: em 50 (26,3%) a coloração do reflexo apresentou-se vermelha; 34 (17,9%) laranja-avermelhado; 92 (48,4%) alaranjado; 11 (5,8%) amarelo claro e três (1,6%) com manchas esbranquiçadas. Encontraram-se associações estatisticamente significantes entre o instrumento gradiente de cores e variáveis neonatais: peso (p=0,03), idade gestacional (p=0,019) e oxigenoterapia (p=0,024). Enfermeiros capacitados para prática e avaliação desse teste podem se tornar profissionais em potencial para a prevenção da cegueira infantil.The aim of this study was to investigate the results of the red reflex test and to associate these results with neonatal variables. This descriptive study was conducted with 190 newborns in a public maternity hospital. A total of 187 infants presented no alteration and three presented suspect results. Different shades of reflex color were observed: 50 (26.3%) presented red; 34 (17.9%) orange-red, 92 (48.4%) orange, 11 (5.8%) light yellow and three (1.6%) milky white spots. Statistically significant associations between the color gradient instrument and neonatal variables were found: weight (p=0.03), gestational age (p=0.019) and oxygen therapy (p=0.024). Nurses trained to practice and evaluate this test may become professionals in the potential for the prevention of childhood blindness.Se objetivó investigar el resultado de la prueba del reflejo rojo, conocido como prueba del ojito, y asociar las impresiones del reflejo con variables neonatales. Se trata de un estudio descriptivo, cuantitativo, realizado con 190 recién nacidos de una maternidad pública; de los cuales 187 presentaron resultados no alterados y tres sospechosos. Se observaron diferentes matices de coloración del reflejo: en 50 (26,3%) se presentó rojo; 34 (17,9%) naranja rojizo; 92 (48,4%) anaranjado; 11 (5,8%) amarillo claro y tres (1,6%) con manchas blanquecinas. Se encontraron asociaciones estadísticamente significativas entre el instrumento gradiente de colores y las variables neonatales: peso (p=0,03), edad de gestación (p=0,019) y oxigenoterapia (p=0,024). Enfermeros capacitados para la práctica y evaluación de esa prueba pueden tornarse profesionales en potencial para la prevención de la ceguera infantil

Activation of EGFR/ERBB2 via Pathways Involving ERK1/2, P38 MAPK, AKT and FOXO Enhances Recovery of Diabetic Hearts from Ischemia-Reperfusion Injury

This study characterized the effects of diabetes and/or ischemia on epidermal growth factor receptor, EGFR, and/or erbB2 signaling pathways on cardiac function. Isolated heart perfusion model of global ischemia was used to study the effect of chronic inhibition or acute activation of EGFR/erbB2 signaling on cardiac function in a rat model of type-1 diabetes. Induction of diabetes with streptozotocin impaired recovery of cardiac function (cardiac contractility and hemodynamics) following 40 minutes of global ischemia in isolated hearts. Chronic treatment with AG825 or AG1478, selective inhibitors of erbB2 and EGFR respectively, did not affect hyperglycemia but led to an exacerbation whereas acute administration of the EGFR ligand, epidermal growth factor (EGF), led to an improvement in cardiac recovery in diabetic hearts. Diabetes led to attenuated dimerization and phosphorylation of cardiac erbB2 and EGFR receptors that was associated with reduced signaling via extracellular-signal-regulated kinase 1/2 (ERK1/2), p38 mitogen activated protein (MAP) kinase and AKT (protein kinase B). Ischemia was also associated with reduced cardiac signaling via these molecules whereas EGF-treatment opposed diabetes and/or ischemia induced changes in ERK1/2, p38 MAP kinase, and AKT-FOXO signaling. Losartan treatment improved cardiac function in diabetes but also impaired EGFR phosphorylation in diabetic heart. Co-administration of EGF rescued Losartan-mediated reduction in EGFR phosphorylation and significantly improved cardiac recovery more than with either agent alone. EGFR/erbB2 signaling is an important cardiac survival pathway whose activation, particularly in diabetes, ischemia or following treatment with drugs that inhibit this cascade, significantly improves cardiac function. These findings may have clinical relevance particularly in the treatment of diabetes-induced cardiac dysfunction

CD4(+) T-lymphocytes mediate ischemia/reperfusion-induced inflammatory responses in mouse liver.

The success of orthotopic liver transplantation is dependent on multiple factors including MHC tissue compatibility and ischemic/reperfusion injury. Ischemic/reperfusion (I/R) injury in the liver occurs in a biphasic pattern consisting of both acute phase (oxygen free radical mediated) and subacute phase (neutrophil-mediated) damage. Although numerous studies have given insights into the process of neutrophil recruitment after I/R injury to the liver, the exact mechanism that initiates this subacute response remains undefined. Using a T cell-deficient mouse model, we present data that suggests that T-lymphocytes are key mediators of subacute neutrophil inflammatory responses in the liver after ischemia and reperfusion. To this end, using a partial lobar liver ischemia model, we compared the extent of reperfusion injury between immune competent BALB/c and athymic nu/nu mice. Studies evaluating the extent of liver damage as measured by serum transaminases (GPT) demonstrate similar acute (3-6 h) post-I/R responses in these two mouse models. In contrast, the subacute phase (16-20 h) of liver injury, as measured by both serum GPT levels and percent hepatocellular necrosis, was dramatically reduced in T cell-deficient mice as compared with those with an intact immune system. This reduction in liver injury seen in nu/nu mice was associated with a 10-fold reduction in hepatic neutrophil infiltration. Adoptive transfer of T cell-enriched splenocytes from immune competent mice was capable of reconstituting the neutrophil-mediated subacute inflammatory response within T cell-deficient nu/nu mice. Furthermore, in vivo antibody depletion of CD4+ T-lymphocytes in immune competent mice resulted in a reduction of subacute phase injury and inflammation as measured by serum GPT levels and neutrophil infiltration. In contrast, depletion of CD8+ T-lymphocytes had no effect on these indexes of subacute inflammation. Kinetic analysis of T cell infiltration in the livers of BALB/c mice demonstrated a fivefold increase in the number of hepatic CD4+ T-lymphocytes within the first hour of reperfusion with no significant change in the number of CD8+ T-lymphocytes. In summary, these results implicate CD4+ T- lymphocytes as key regulators in initiating I/R-induced inflammatory responses in the liver. Such findings have implications for therapy directed at the early events in this inflammatory cascade that may prove useful in liver transplantation

The visual communication in the optonometric scales La comunicación visual en las escalas optométricas A comunicação visual nas escalas optométricas

Communication through vision involves visual apprenticeship that demands ocular integrity, which results in the importance of the evaluation of visual acuity. The scale of images, formed by optotypes, is a method for the verification of visual acuity in kindergarten children. To identify the optotype the child needs to know the image in analysis. Given the importance of visual communication during the process of construction of the scale of images, one presents a bibliographic, analytical study aiming at thinking about the principles for the construction of those tables. One considers the draw inserted as an optotype as a non-verbal symbolic expression of the body and/or of the environment constructed based on the caption of experiences by the individual. One contests the indiscriminate use of images, for one understands that there must be previous knowledge. Despite the subjectivity of the optotypes, the scales continue valid if one adapts images to those of the universe of the children to be examined.<br>La comunicación que ocurre a través de la visión abarca el aprendizaje visual que depende de la integridad ocular, por eso es relevante la evaluación de su acuidad. La escala de figuras, formada por optotipos, es un método usado para verificar la acuidad visual en preescolares. Para identificar el opto-tipo, el niño necesita conocer la figura en análisis. Debido a la importancia de la comunicación visual durante el proceso de construcción de las escalas de figuras, se presenta un estudio bibliográfico analítico, cuyo objetivo es el de reflexionar sobre los principios de construcción de estas tablas. El dibujo inserido como opto-tipo se considera una expresión no verbal del cuerpo y/o del ambiente, construido mediante captación de experiencias por el individuo. Se cuestiona el uso indiscriminado de las figuras, pues conforme se entiende debe existir un conocimiento previo de las mismas. A pesar de la subjetividad de los optotipos, las escalas siguen siendo válidas, siempre que se adecuen las figuras o sea aquellas del universo de los niños que serán examinados.<br>A comunicação que ocorre por meio da visão envolve o aprendizado visual, que depende da integridade ocular; daí a relevância da avaliação da sua acuidade. Um dos métodos para a verificação da acuidade visual em pré-escolares é a escala de figuras, formada por optótipos. Para identificar o optótipo, a criança precisa conhecer a figura em análise. Dada a importância da comunicação visual, durante o processo de construção das escalas de figuras, apresenta-se um estudo bibliográfico analítico, objetivando refletir sobre os princípios de construção dessas tabelas. Considera-se o desenho inserido como optótipo uma expressão simbólica não-verbal do corpo e/ou do ambiente, construído mediante captação de experiências pelo indivíduo. Contesta-se o uso indiscriminado das figuras, pois, conforme se entende, deve haver um conhecimento prévio. Apesar da subjetividade dos optótipos, as escalas continuam válidas, desde que se adequem as figuras àquelas do universo das crianças a serem examinadas