Desempenho funcional de crianças com paralisiacerebral diparéticas e hemiparéicas

The definition ideal of cerebral palsy (PC) is to associate the functional performance with topographical characteristics and alterations of tonus. However, most of the bibliography describes this pathology and its consequences, when they evaluate the functional performance and doesn´t consider the existing differences in these types or uses only one type of PC. In literature, only one bibliography was differentiate the self-care between diplegic and hemiplegic. Evaluating the relation of the functional performance of children with diplegic and hemiplegic P.C. Transversal study with children of three to seven years old who have diplegic and hemiplegic spastics P.C., in both the sexes, and did under physitherapy. Children who didn’t walk and/or had any cognitive deficit were excluded from the research. Guardians were interviewed using part I (functional performance in the areas of self-care and mobility) of the Pediatric Evaluation of Disability Inventory (PEDI), as well as questionnaire with personal datas of the children. The program BioEstat 4,0 was used, statistical test Mann-Whitney, to verification of the association purpose. α 0,05 was used as statistics inference. The sample was composed for 40 children, 22 diplegic and 18 hemiplegic. The feminine sex participation (53%) was the biggest and carried through treatment associated with the physitherapy (88%). The self-care area (p=0,16) didn´t present difference between the groups, however, mobility, (p=0,02) suggests that the hemiplegic group had a better functional performance. The hemiplegic had better mobility that the diplegic, while in the self-care it was not observed statistic difference between the groups.Na Paralisia Cerebral (PC), o ideal é associar o desempenho funcional com características topográficas e alterações de tônus. Entretanto, grande parte da bibliografia descreve apenas a doença e suas conseqüências, e, quando se avalia o desempenho funcional, não se consideram as diferenças existentes nos tipos de PC ou se utiliza apenas um tipo. Na literatura, foi encontrada apenas uma referência bibliográfica que diferencia diparéticos e hemiparéticos quanto ao seu autocuidado, e nenhuma que compare a mobilidade entre eles. Este trabalho teve por objetivo avaliar a relação do desempenho funcional de crianças com PC diparéticas e hemiparéticas. Para tanto, fez-se um estudo transversal com portadores de PC diparéticos e hemiparéticos espásticos, de ambos os sexos, de três a sete anos, que estavam realizando fisioterapia. Excluíram-se crianças que não andavam e (ou) com déficit cognitivo. Foram realizadas entrevistas com cuidadores, utilizando-se a parte 1 (desempenho funcional nas áreas de autocuidado e mobilidade) do Inventário de Avaliação Pediátrica de Incapacidade (PEDI), assim como um questionário com dados pessoais das crianças. Utilizou-se programa BioEstat 4.0, e o teste estatístico Mann-Whitney, para verificação da associação proposta. Aceitou-se α 0,05 como inferência estatística. A amostra foi composta de 40 crianças, 22 diparéticas e 18 hemiparéticas. A maioria era do sexo feminino (53%) e realizava tratamento associado à fisioterapia (88%). A área de autocuidado (p=0,16) não apresentou diferença entre os grupos. Todavia mobilidade, (p=0,02) sugere que o grupo hemiparético possui melhor desempenho funcional. Concluiu-se que os hemiparéticos possuem melhor mobilidade que os diparéticos, enquanto que, no autocuidado, não se observou diferença estatística entre os grupos

In vitro epithelial-to-mesenchymal transformation in human adult epicardial cells is regulated by TGFβ-signaling and WT1

Adult epicardial cells are required for endogenous cardiac repair. After myocardial injury, they are reactivated, undergo epithelial-to-mesenchymal transformation (EMT) and migrate into the injured myocardium where they generate various cell types, including coronary smooth muscle cells and cardiac interstitial fibroblasts, which contribute to cardiac repair. To understand what drives epicardial EMT, we used an in vitro model for human adult epicardial cells. These cells have an epithelium-like morphology and markedly express the cell surface marker vascular cell adhesion marker (VCAM-1). In culture, epicardial cells spontaneously undergo EMT after which the spindle-shaped cells now express endoglin. Both epicardial cells before and after EMT express the epicardial marker, Wilms tumor 1 (WT1). Adding transforming growth factor beta (TGFβ) induces loss of epithelial character and initiates the onset of mesenchymal differentiation in human adult epicardial cells. In this study, we show that TGFβ-induced EMT is dependent on type-1 TGFβ receptor activity and can be inhibited by soluble VCAM-1. We also show that epicardial-specific knockdown of Wilms tumor-1 (WT1) induces the process of EMT in human adult epicardial cells, through transcriptional regulation of platelet-derived growth factor receptor alpha (Pdgfrα), Snai1 and VCAM-1. These data provide new insights into the process of EMT in human adult epicardial cells, which might provide opportunities to develop new strategies for endogenous cell-based cardiac repair

Sexual transmission of American trypanosomiasis in humans : a new potential pandemic route for Chagas parasites

Background: the Trypanosoma cruzi infection endemic in Latin America has now spread to several countries across four continents; this endemic involves triatomine vector-free protists. We hypothesised that the sexual transmission of T. cruzi contributes to the ongoing spread of Chagas disease. Objectives: a short-term longitudinal study was conducted to evaluate this hypothesis. Methods: the study population comprised 109 subjects from four families, among whom 21 had been diagnosed with acute Chagas disease by direct parasitological analysis. Blood mononuclear cells and serum samples were obtained from each study subject once per year for three consecutive years. Enzyme-linked immunosorbent assay (ELISA) and indirect immunofluorescence serological examinations were used to detect specific T. cruzi antibodies. Polymerase chain reaction of T. cruzi DNA revealed 188-nucleotide bands, which hybridised to a specific radiolabelled probe and were confirmed by cloning and sequencing. Results: three independent assessments at different time points revealed T. cruzi nuclear DNA footprints in 76% (83/109) of the study population with active infection. In contrast, the ELISA and indirect immunofluorescence assays detected the T. cruzi antibody in 28.4% (31/109) of the study samples. Moreover, the semen from 82.6% (19/23) of subjects people revealed harboured the 188- bp base pair T. cruzi footprint. Interestingly, the ejaculates of nuclear DNA-positive Chagas patient transmitted the T. cruzi upon peritoneal injection or infusion in the vagina of mice, and amastigotes were detected in the skeletal muscle, myocardium, vas deferens, and uterine tube. Main conclusions: T. cruzi infections can be transmitted from females or males to naïve mates through intercourse, and progeny showed discrepancies between the ratios of nuclear DNA footprints and specific antibody that can be explained by the tolerance attained during early embryo growth. Additional studies are needed to develop drugs to eradicate the infections. Additionally, the importance of a vigorous education, information, and communication program to prevent sexually transmitted Chagas disease in humans cannot be underemphasised