Juvenile localized scleroderma: Clinical and epidemiological features in 750 children. An international study

Objective. Juvenile localized scleroderma (JLS) includes a number of conditions often grouped together. With the long-term goal of developing uniform classification criteria, we studied the epidemiological, clinical and immunological features of children with JLS followed by paediatric rheumatology and dermatology centres. Methods. A large, multicentre, multinational study was conducted by collecting information on the demographics, family history, triggering environmental factors, clinical and laboratory features, and treatment of patients with JLS. Results. Seven hundred and fifty patients with JLS from 70 centres were enrolled into the study. The disease duration at diagnosis was 18 months. Linear scleroderma (LS) was the most frequent subtype (65%), followed by plaque morphea (PM) (26%), generalized morphea (GM) (7%) and deep morphea (DM) (2%). As many as 15% of patients had a mixed subtype. Ninety-one patients (12%) had a positive family history for rheumatic or autoimmune diseases; 100 (13.3%) reported environmental events as possible trigger. ANA was positive in 42.3% of the patients, with a higher prevalence in the LS-DM subtype than in the PM-GM subtype. Scl70 was detected in the sera of 3% of the patients, anticentromere antibody in 2%, anti-double-stranded DNA in 4%, anti-cardiolipin antibody in 13% and rheumatoid factor in 16%. Methotrexate was the drug most frequently used, especially during the last 5 yr. Conclusion. This study represents the largest collection of patients with JLS ever reported. The insidious onset of the disease, the delay in diagnosis, the recognition of mixed subtype and the better definition of the other subtypes should influence our efforts in educating trainees and practitioners and help in developing a comprehensive classification system for this syndrome. © 2006 Oxford University Press.

Abordagem initial do paciente com mielopatia aguda não compressiva

Acute myelopathy are characterized by spinal cord dysfunction, developing sensitive, motor and autonomic signs and symptons. Since they are relatively rare, there are some difficulties to early diagnosis and to the beginning of the treatment. So, literature was reviewed to describe the main aetiologies of acute non compressive myelopathy: 1) demyelinating diseases; 2) systemic disease; 3) parainfectious; 4) delayed radiation myelopathy; 5) vascular myelopathy; 6) idiopatic and 7) vitamin B12 deficiency. Besides, we suggest an algorithm to initial approach of these patients and further aethiologic investigation. © Copyright Morelra Jr. Editora.

Advances in sickle cell disease treatment: From drug discovery until the patient monitoring

Sickle Cell Disease (SCD) is one of the most prevalent hematological diseases in the world. Despite the immense progress in molecular knowledge about SCD in last years few therapeutical sources are currently available. Nowadays the treatment is performed mainly with drugs such as hydroxyurea or other fetal hemoglobin inducers and chelating agents. This review summarizes current knowledge about the treatment and the advancements in drug design in order to discover more effective and safe drugs. Patient monitoring methods in SCD are also discussed. © 2011 Bentham Science Publishers Ltd.

Aparecimento de psoríase durante o tratamento das doenças inflamatórias intestinais com infliximabe: A terapia biológica deve ser suspensa?

Context - Several paradoxical cases of infliximab-induced or-exacerbated psoriatic lesions have been described in the recent years. There is disagreement regarding the need to discontinue infliximab in order to achieve the resolution of these adverse cutaneous reactions specifically in inflammatory bowel disease (IBD) patients. Objective - To systematically review the literature to collect information on IBD patients that showed this adverse cutaneous reaction, focusing mainly on the therapeutic approach. Methods - A systematic literature review was performed utilizing Medline, Embase, SciELO and Lilacs databases. Published studies were identified, reviewed and the data were extracted. Results - Thirty-four studies (69 IBD patients) met inclusion criteria for review. There was inconsistency in reporting of some clinical and therapeutic aspects. Most patients included had Crohn's disease (89.86%), was female (47.83%), had an average age of 27.11 years, and no reported history of psoriasis (84.05%). The patients developed primarily plaque-type psoriasis (40.58%). There was complete remission of psoriatic lesions in 86.96% of IBD patients, existing differences in the therapeutic approaches; cessation of infliximab therapy led to resolution in 47.83% of cases and 43.48% of patients were able to continue infliximab therapy. Conclusion - As increasing numbers of IBD patients with psoriasis induced or exacerbated by infliximab, physicians should be aware of its clinical manifestations so that appropriate diagnosis and treatment are properly established. The decision whether to continue or discontinue infliximab should be individualized.

Evaluation of tibial dyschondroplasia development in broiler chickens fed diets containing 25 hydroxicolecalciferol

This research was carried out to evaluate the development of tibial dyschondroplasia (TD) in broilers from 1 to 21 days. Four hundred forty day-old male chickens, from broiler breeders aged 60-62 weeks, were randomly distributed in a 3×3+2 factorial arrangement, resulting in 11 treatments with four replicates of 10 birds each. The factors evaluated were: bird strains (Ross 308, Cobb 500, and Hybro), levels and sources of vitamin D (1250UI D3/kg without 25-(OH)D3; 1250UI D3/kg with 69mg 25-(OH)D3/ton, and 3000UI D3/kg with 69mg 25-(OH)D3/ton), and two control treatments containing calcium and phosphorus levels with 3000UI D3/kg without 25-(OH)D3 and 3000UI D3/kg with 69mg 25- (OH)D3/ton of feed. Bone characteristics were evaluated. From 1 to 21 days, the results showed that bone calcium and phosphorus concentrations were not influenced by the treatments, however, feed intake was higher for factorial than control treatments. Bone breaking resistance was not influenced by the treatments and there were no typical lesions of TD. In conclusion, it was not observed TD development in broilers from 1 to 21 days according to experimental procedures of this research.

Cardiac remodeling induced by smoking: Concepts, relevance, and potential mechanisms

Cardiac or ventricular remodeling is characterized by molecular, cellular, and interstitial alterations that lead to changes in heart size, mass, geometry and function in response to a given insult. Currently, tobacco smoke exposure is recognized as one of these insults. Indeed, tobacco smoke exposure induces the enlargement of the left-sided cardiac chambers, myocardial hypertrophy, and ventricular dysfunction. Potential mechanisms for these alterations include hemodynamic and neurohormonal changes, oxidative stress, inflammation, nitric oxide bioavailability, matrix metalloproteinases and mitogen-activated protein kinase activation. This review will focus on the concepts, relevance, and potential mechanisms of cardiac remodeling induced by tobacco smoke. © 2012 Bentham Science Publishers.

Does excess weight interfere with bone mass accumulation during adolescence?

Obesity and osteoporosis are important global health problems characterized by increasing prevalence with high impact on morbidity and mortality. The objective of this review was to determine whether excess weight during adolescence interferes with bone mass accumulation. If bone mineral gain can be optimized during puberty, adults are less likely to suffer from the devastating complications of osteoporosis. The increased fracture risk in obese children has also been attributed to a lower bone mass for weight compared to non-obese children. Thus, adiposity present in this age group may not result in the protection of bone mass, in contrast to what has been observed in adults. However, studies involving adolescents have reported both protective and detrimental effects of obesity on bone. The results and mechanisms of these interactions are controversial and have not been fully elucidated, a fact highlighting the extreme relevance of this topic and the need to monitor intervening and interactive variables. © 2013 by the authors; licensee MDPI, Basel, Switzerland.

Impacto do tratamento anti-retroviral na ocorrência de macrocitose em pacientes com HIV/Aids do município de Maringá - Paraná

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Avaliação genética de pacientes com osteoporose

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Suplementação de vitamina B6 em dietas práticas e purificadas no desempenho produtivo e resposta hemática da Tilápia do Nilo submetida a estímulo térmico

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Suplementação da vitamina d3 (colecalciferol) e 25-ohd3 (25-hidroxi-colecalciferol) e problemas locomotores e qualidade óssea em frangos de corte

Pós-graduação em Zootecnia - FMVZ

Encefalomalácia nutricional em Gallus gallus domesticus: estudo sobre a patogenia e a participação de astrócitos

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Efeito da suplementação de vitamina D3 (25-Hidroxicolecalciferol) na fase final sobre o cálcio sanguíneo e qualidade da carne em frangos de corte

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Influência da restrição alimentar de vitamina A sobre o coração de ratas adultas

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Vitamina A em dietas para tilápia do Nilo

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)