Revisión sistemática de la literatura: efecto de los rellenos inyectables en la región periorbitaria

Introducción: El conocimiento actual de la fisiopatología del envejecimiento periorbitario justifica la aplicación de materiales de relleno inyectables, dado que se enfocan en la restauración del volumen perdido en esta zona, convirtiéndose en una excelente alternativa a procedimientos quirúrgicos que remueven el tejido excedente. Sin embargo los efectos y la seguridad de esta naciente tendencia terapéutica aún no se sustentan en una sólida base científica. El objetivo de esta revisión es identificar el material de relleno inyectable más adecuado para el manejo de los defectos volumétricos estéticos de la región periorbitaria. Metodología: Se realizó una búsqueda exhaustiva de los artículos indexados publicados del 1º de enero de 2.000 al 30 de septiembre de 2.013, en diversas bases de datos electrónicas, se seleccionaron catorce publicaciones, se extrajo la información referente a datos demográficos, la intervención, el seguimiento y los desenlaces y se realizó un análisis de 14 estudios que cumplieron los criterios. Resultados: Todos los artículos incluidos poseían un bajo nivel de evidencia y del grado de recomendación. Todos los materiales de relleno se asociaron a altos niveles de satisfacción para el paciente, adecuada mejoría de la apariencia estética y similares efectos colaterales, el ácido hialurónico fue el material de relleno inyectable más utilizado en la región periorbitaria. Discusión: Los materiales de relleno inyectable mejoran los defectos volumétricos estéticos de la región periorbitaria pero es necesaria mayor evidencia para determinar el tipo relleno más apropiado para esta condición.

Mecanismes cel·lulars en la curació de ferides a Hirudo medicinalis

S'estudia la histologia normal de la paret corporal d'Hirudo medicinalis i els canvis morfogenètics que es donen durant el procés de cicatrització de ferides per incisió, cauterització i nitrat de plata. El procés de curació de ferides a Hirudo medicinalis consta d'una fase de formació d'un tap cel·lular, el pseudoblastema, d'un procés de reepitelització i de la formació d'un teixit cicatricial, com en els altres hirudinis estudiats (Myers, 1935; LeGore i Sparks, 1971; Cornec, 1984). Hem observat també el fenomen de la contracció de la ferida que permet l'acostament dels marges de la ferida. Formació i evolució del pseudoblastema El pseudoblastema, a diferència d'altres espècies estudiades, està format per un sol tipus cel·lular: les cèl·lules vasocentrals, provinents del teixit vasofibrós, una especialització del teixit connectiu. Aquestes cèl·lules estan capacitades per realitzar les diferents funcions que en espècies rincobdèl·lides realitzen diferents tipus cel·lulars. En concret: taponament de la ferida a través de la formació del pseudoblastema, fagocitosi dels teixits necrosats i regeneració, almenys d'una part, de la matriu connectiva cicatricial. També són responsables de la contracció de la ferida. Les cèl·lules vasocentrals en el seu estadi de repòs es troben en el teixit vasofibrós formant agrupacions coherents, però sense mostrar unions intercel·lulars especialitzades visibles en ME. La coherència del grup queda assegurada per les interdigitacions entre les cèl·lules vasocentrals i probablement per unions tipus adherens o especialitzades. Les unions amb la matriu són de tipus adherens. Aquestes cèl·lules vasocentrals presenten feixos de filaments d'actina força conspicus. En produir-se una ferida les cèl·lules vasocentrals s'activen, desconnecten les unions intercel·lulars i amb la matriu i migren cap a la zona afectada, on s'acumulen. El pseudoblastema actua com un tap cel·lular que funciona de forma eficient per tancar la ferida en un plaç de temps relativament curt. El pseudoblastema forma un teixit coherent amb unions intercel·lulars tipus adherens, caracteritzades per material electrodens en la cara intracitoplasmàtica, feixos de filaments d'actina que hi convergeixen i espais intercel·lulars petits, de 17-20 mm, atravessats per petites fibril·les. Un cop finalitzat el procés de reepitelització, es produeix una contracció de la ferida. Es produeix per la retracció del pseudoblastema cap a l'interior de l'animal. El pseudoblastema disminueix la seva amplària i arrossega els teixits contigus provocant un tancament. La força motriu que provoca la retracció i l'arrossegament dels teixits vindria donada per la presència dels filaments d'actina a les cèl·lules del pseudoblastema, els quals durant aquesta fase es tornen mes conspicus. La presència d'unions intercel·lulars especialitzades característiques de la fase de contracció, està relacionada amb la transmissió de la força de tensió. Aquestes unions connecten els feixos de filaments d'actina de les cèl·lules amb la matriu o d'una cèl·lula a altre a través d'espais intercel·lulars força amples en els que s'observa material electrodens. Reepitelització L'epitelització s'inicia quan el pseudoblastema està consolidat i segueix el mateix patró que la reepitelització de ferides en epitelis monoestratificats de vertebrats (Stem i DePalma, 1983, és a dir, per migració de tota la capa per sobre del substrat, segons l'anomenat model de lliscament. Les glàndules unicel·lulars mucoses del tegument degeneren abans de produir-se la migració epitelial i posteriorment, un cop consolidat l'epiteli a sobre de la ferida, es diferencien a partir de les cèl·lules epitelials. Durant l'epitelització es produeixen canvis importants en el citosquelet i les unions basals de les cèl·lules epitelials. En canvi, el complex d'unió lateral es manté durant tot el procés. En iniciar-se la migració els tonofilaments es desconnecten dels hemidesmosomes cuticulars i dèrmics i es reagrupen al voltant del nucli, a la vegada que els hemidesmosomes dèrmics es desconnecten de la làmina basal. Un cop acabada la migració, les cèl·lules epitelials estableixen unions basals amb les cèl·lules del pseudoblastema. Aquestes unions no són hemidesmosomes sinó que presenten el mateix aspecte que les unions intercel·lulars del pseudoblastema. Els hemidesmosomes no es tornen a formar fins que les cèl·lules epitelials han restablert la membrana basal. La regeneració de la membrana basal no s'inicia fins que no s'ha començat a regenerar matriu connectiva a la zona cicatricial. Regeneració de la cicatriu Al mateix temps que es dona el fenomen de contracció, s'observa regeneració de la matriu connectiva entre les cèl·lules del pseudoblastema. Aquestes cèl·lules són responsables almenys del recobriment fibrós que presenten en aquest estadi, durant el qual mostren sàculs del reticle endoplasmàtic rugós molt dilatats, característics de cèl·lules que secreten constituents de la matriu. A més, s'observa infiltració de matriu connectiva i processos citoplasmàtics dels fibròcits en els marges del pseudoblastema. En la matriu del teixit connectiu normal s'observen fibres que estan constituïdes per un còrtex de fibril·les col·làgenes organitzades al voltant dels processos citoplasmàtics dels fibròcits. Les fibres del teixit connectiu peridigestiu, d'uns 1,2-1,9 mm de diàmetre, presenten el còrtex prim, amb les fibril·les organitzades paral·lelament a l'eix de la fibra. En canvi, les fibres de la dermis i teixit connectiu intramuscular, d'uns 2,5-7,1 mm de diàmetre, tenen el còrtex gruixut, amb fibril·les que s'organitzen paral·lelament en la zona proximal a la medul·la i de forma desorganitzada en la part més distal. Als 8 mesos la cicatriu encara és detectable. La matriu cicatricial presenta fibres connectives del tipus prim i força material fibril·lar desorganitzat disposat laxament. S'observa colonització per part de fibròcits, cromatòfors, petites fibres musculars i nervis.

Age related changes in speed and mechanism of adult skeletal muscle stem cell migration

Skeletal muscle undergoes a progressive age-related loss in mass and function. Preservation of muscle mass depends in part on satellite cells, the resident stem cells of skeletal muscle. Reduced satellite cell function may contribute to the age-associated decrease in muscle mass. Here we focused on characterising the effect of age on satellite cell migration. We report that aged satellite cells migrate at less than half the speed of young cells. In addition, aged cells show abnormal membrane extension and retraction characteristics required for amoeboid based cell migration. Aged satellite cells displayed low levels of integrin expression. By deploying a mathematical model approach to investigate mechanism of migration, we have found that young satellite cells move in a random ‘memoryless’ manner whereas old cells demonstrate superdiffusive tendencies. Most importantly, we show that nitric oxide, a key regulator of cell migration, reversed the loss in migration speed and reinstated the unbiased mechanism of movement in aged satellite cells. Finally we found that although Hepatocyte Growth Factor increased the rate of aged satellite cell movement it did not restore the memoryless migration characteristics displayed in young cells. Our study shows that satellite cell migration, a key component of skeletal muscle regeneration, is compromised during aging. However, we propose clinically approved drugs could be used to overcome these detrimental changes.

Gap junctions and connexin hemichannels underpin hemostasis and thrombosis

BACKGROUND: Connexins are a widespread family of membrane proteins that assemble into hexameric hemichannels, also known as connexons. Connexons regulate membrane permeability in individual cells or couple between adjacent cells to form gap junctions and thereby provide a pathway for regulated intercellular communication. We have now examined the role of connexins in platelets, blood cells that circulate in isolation, but upon tissue injury adhere to each other and the vessel wall to prevent blood loss and facilitate wound repair. METHODS AND RESULTS: We report the presence of connexins in platelets, notably connexin37, and that the formation of gap junctions within platelet thrombi is required for the control of clot retraction. Inhibition of connexin function modulated a range of platelet functional responses prior to platelet-platelet contact, and reduced laser induced thrombosis in vivo in mice. Deletion of the Cx37 gene (Gja4) in transgenic mice reduced platelet aggregation, fibrinogen binding, granule secretion and clot retraction indicating an important role for Cx37 hemichannels and gap junctions in platelet thrombus function. CONCLUSIONS: Together, these data demonstrate that platelet gap junctions and hemichannels underpin the control of haemostasis and thrombosis and represent potential therapeutic targets.

The syntax-semantics of bare and definite plural subjects in the L2 Spanish of English natives

This study investigates the extent to which advanced native-English L2 learners of Spanish come to acquire restrictions on bare plural preverbal subjects in L2 Spanish (e.g. gatos “cats” vs. definite plurals such as los gatos “the cats”). It tests L2 knowledge of available semantic readings of bare plurals and definite plurals in Spanish, where [+specific] and [+generic] interpretations are syntactically represented differently from English. Assuming L1 transfer, and in view of a potential subset/superset relationship of the two grammars, the learning task in this domain is not a straightforward one. Target acquisition requires both grammatical expansion and retraction; Spanish definite plural subjects require the addition of an L1-unavailable [+generic] reading, while a loss of an L1-available [+generic] reading for preverbal subject bare plurals is required. The results and analysis show that advanced L2 learners of Spanish (English L1) can circumvent a superficial subset/superset learnability problem by means of feature resetting in line with the Nominal Mapping Parameter.

Rap1-Rac1 circuits potentiate platelet activation.

OBJECTIVE: The goal of this study was to investigate the potential crosstalk between Rap1 and Rac1, 2 small GTPases central to platelet activation, particularly downstream of the collagen receptor GPVI. METHODS AND RESULTS: We compared the activation response of platelets with impaired Rap signaling (double knock-out; deficient in both the guanine nucleotide exchange factor, CalDAG-GEFI, and the Gi-coupled receptor for ADP, P2Y12), to that of wild-type platelets treated with a small-molecule Rac inhibitor, EHT 1864 (wild-type /EHT). We found that Rac1 is sequentially activated downstream of Rap1 on stimulation via GPVI. In return, Rac1 provides important feedback for both CalDAG-GEFI- and P2Y12-dependent activation of Rap1. When analyzing platelet responses controlled by Rac1, we observed (1) impaired lamellipodia formation, clot retraction, and granule release in both double knock-out and EHT 1864-treated wild-type platelets; and (2) reduced calcium store release in EHT 1864-treated wild-type but not double knock-out platelets. Consistent with the latter finding, we identified 2 pools of Rac1, one activated immediately downstream of GPVI and 1 activated downstream of Rap1. CONCLUSIONS: We demonstrate important crosstalk between Rap1 and Rac1 downstream of GPVI. Whereas Rap1 signaling directly controls sustained Rac1 activation, Rac1 affects CalDAG-GEFI- and P2Y12-dependent Rap1 activation via its role in calcium mobilization and granule/ADP release, respectively.

Connexin40 regulates platelet function

The presence of multiple connexins was recently demonstrated in platelets, with notable expression of Cx37. Studies with Cx37-deficient mice and connexin inhibitors established roles for hemichannels and gap junctions in platelet function. It was uncertain, however, whether Cx37 functions alone or in collaboration with other family members through heteromeric interactions in regulation of platelet function. Here we report the presence and functions of an additional platelet connexin, Cx40. Inhibition of Cx40 in human platelets or its deletion in mice reduces platelet aggregation, fibrinogen binding, granule secretion and clot retraction. The effects of the Cx37 inhibitor 37,43Gap27 on Cx40-/- mouse platelets and of the Cx40 inhibitor 40Gap27 on Cx37-/- mouse platelets revealed that each connexin is able to function independently. Inhibition or deletion of Cx40 reduces haemostatic responses in mice, indicating the physiological importance of this protein in platelets. We conclude that multiple connexins are involved in regulating platelet function, thereby contributing to haemostasis and thrombosis.

Postglacial vegetation, fire and climate dynamics at Central Chilean Patagonia (Lake Shaman, 44ºS)

A 19 cal ka BP pollen and charcoal record from Lake Shaman (44°S; 71°W, Chile) was analyzed to establish vegetation, fire and climate dynamics of the forest-steppe ecotone in Central Chilean Patagonia. Lake Shaman record indicates that the upper Río Cisnes valley was free of ice at around 19 cal ka BP. From this date and until 14.8 cal ka BP, a grass steppe with high proportions of shrubs associated to colder and drier conditions than present developed in this area. A continuous increase of Nothofagus accompanied by a decline in the steppe shrubs and sudden dominance of paludal over aquatic plants from 11 cal ka BP was associated to effective moisture increase but still under modern values. The replacement of the cold-dry grass-shrub steppe by a similar-than-present forest-steppe ecotone suggests an increase in temperature indicating the onset of the Holocene. At the same time, moderate fire activity suggested by the charcoal record could be related to major fuel availability as consequence of Nothofagus forest expansion. Between 8 and 3 cal ka BP, the record indicates the easternmost position of the forest-steppe ecotone suggesting the highest effective moisture with the establishment of seasonality between 5 and 3 cal ka BP. From 3 cal ka BP, the record indicates a retraction of the forest-steppe ecotone accompanied by a high pollen record variability and an increased fire activity. These late changes suggest decreased effective moisture associated with a high climatic variability. At regional and extra-regional scale, climatic changes at Lake Shaman's record are mostly associated to changes (latitudinal shifts and/or strengthening/weakening) of past Southern Westerlies that were previously recorded along Patagonia from the Lateglacial to the mid-Holocene. During the Late Holocene, a regional pattern characterized by high record variability emerges throughout Central Chilean Patagonia. This variability would be related to (1) low magnitude Southern Westerlies changes probably associated to ENSO and/or SAM or (2) the complex relationships between vegetation, fire and human occupations during the last 3 cal ka.

EphB2 regulates contact-dependent and independent signalling to control platelet function

The Eph kinases, EphA4 and EphB1 and their ligand, ephrinB1 have been previously reported to be present in platelets where they contribute to thrombus stability. While thrombus formation allows for Eph-ephrin engagement and bidirectional signalling, the importance specifically of Eph kinase or ephrin signalling in regulating platelet function remained unidentified. In the present study, a genetic approach was used in mice to establish the contribution of signalling orchestrated by the cytoplasmic domain of EphB2 (a newly discovered Eph kinase in platelets) in platelet activation and thrombus formation. We conclude that EphB2 signalling is involved in the regulation of thrombus formation and clot retraction. Furthermore, the cytoplasmic tail of this Eph kinase regulates initial platelet activation in a contact-independent manner in the absence of Eph-ephrin ligation between platelets. Together these data demonstrate that EphB2 signalling not only modulates platelet function within a thrombus but is also involved in the regulation of the function of isolated platelets in a contact-independent manner.

Regulation of cell migration in cancer: investigation into the regulation of cancer cell blebbing in the extracellular matrix

Cell migration is a highly coordinated process and any aberration in the regulatory mechanisms could result in pathological conditions such as cancer. The ability of cancer cells to disseminate to distant sites within the body has made it difficult to treat. Cancer cells also exhibit plasticity that makes them able to interconvert from an elongated, mesenchymal morphology to an amoeboid blebbing form under different physiological conditions. Blebs are spherical membrane protrusions formed by actomyosin-mediated contractility of cortical actin resulting in increased hydrostatic pressure and subsequent detachment of the membrane from the cortex. Tumour cells use blebbing as an alternative mode of migration by squeezing through preexisting gaps in the ECM, and bleb formation is believed to be mediated by the Rho-ROCK signaling pathway. However, the involvement of transmembrane water and ion channels in cell blebbing has not been examined. In the present study, the role of the transmembrane water channels, aquaporins, transmembrane ion transporters and lipid signaling enzymes in the regulation of blebbing was investigated. Using 3D matrigel matrix as an in vitro model to mimic normal extracellular matrix, and a combination of confocal and time-lapse microscopy, it was found that AQP1 knockdown by siRNA ablated blebbing of HT1080 and ACHN cells, and overexpression of AQP1-GFP not only significantly increased bleb size with a corresponding decrease in bleb numbers, but also induced bleb formation in non-blebbing cell lines. Importantly, AQP1 overexpression reduces bleb lifespan due to faster bleb retraction. This novel finding of AQP1-facilitated bleb retraction requires the activity of the Na+/H+ pump as inhibition of the ion transporter, which was found localized to intracellular vesicles, blocked bleb retraction in both cell lines. This study also demonstrated that a differential regulation of cell blebbing by AQP isoforms exists as knockdown of AQP5 had no effect on bleb formation. Data from this study also demonstrates that the lipid signaling PLD2 signals through PA in the LPA-LPAR-Rho-ROCK axis to positively regulate bleb formation in both cell lines. Taken together, this work provides a novel role of AQP1 and Na+/H+ pump in regulation of cell blebbing, and this could be exploited in the development of new therapy to treat cancer.

Ibrutinib inhibits platelet integrin αIIbβ3 outside-in signaling and thrombus stability but not adhesion to collagen

OBJECTIVE: Ibrutinib is an irreversible Bruton tyrosine kinase inhibitor approved for treatment of Waldenstrom macroglobulinemia, chronic lymphocytic leukemia, and mantle cell lymphoma that increases the risk of bleeding among patients. Platelets from ibrutinib-treated patients exhibit deficiencies in collagen-evoked signaling in suspension; however, the significance of this observation and how it relates to bleeding risk is unclear, as platelets encounter immobile collagen in vivo. We sought to clarify the effects of ibrutinib on platelet function to better understand the mechanism underlying bleeding risk. APPROACH AND RESULTS: By comparing signaling in suspension and during adhesion to immobilized ligands, we found that the collagen signaling deficiency caused by ibrutinib is milder during adhesion to immobilized collagen. We also found that platelets in whole blood treated with ibrutinib adhered to collagen under arterial shear but formed unstable thrombi, suggesting that the collagen signaling deficiency caused by ibrutinib may not be the predominant cause of bleeding in vivo. However, clot retraction and signaling evoked by platelet adhesion to immobilized fibrinogen were also inhibited by ibrutinib, indicating that integrin αIIbβ3 outside-in signaling is also effected in addition to GPVI signaling. When ibrutinib was combined with the P2Y12 inhibitor, cangrelor, thrombus formation under arterial shear was inhibited additively. CONCLUSIONS: These findings suggest that (1) ibrutinib causes GPVI and integrin αIIbβ3 platelet signaling deficiencies that result in formation of unstable thrombi and may contribute toward bleeding observed in vivo and (2) combining ibrutinib with P2Y12 antagonists, which also inhibit thrombus stability, may have a detrimental effect on hemostasis.

Large deviations of Rouse polymer chain: first passage problem

The purpose of this paper is to investigate several analytical methods of solving first passage (FP) problem for the Rouse model, a simplest model of a polymer chain. We show that this problem has to be treated as a multi-dimensional Kramers' problem, which presents rich and unexpected behavior. We first perform direct and forward-flux sampling (FFS) simulations, and measure the mean first-passage time $\tau(z)$ for the free end to reach a certain distance $z$ away from the origin. The results show that the mean FP time is getting faster if the Rouse chain is represented by more beads. Two scaling regimes of $\tau(z)$ are observed, with transition between them varying as a function of chain length. We use these simulations results to test two theoretical approaches. One is a well known asymptotic theory valid in the limit of zero temperature. We show that this limit corresponds to fully extended chain when each chain segment is stretched, which is not particularly realistic. A new theory based on the well known Freidlin-Wentzell theory is proposed, where dynamics is projected onto the minimal action path. The new theory predicts both scaling regimes correctly, but fails to get the correct numerical prefactor in the first regime. Combining our theory with the FFS simulations lead us to a simple analytical expression valid for all extensions and chain lengths. One of the applications of polymer FP problem occurs in the context of branched polymer rheology. In this paper, we consider the arm-retraction mechanism in the tube model, which maps exactly on the model we have solved. The results are compared to the Milner-McLeish theory without constraint release, which is found to overestimate FP time by a factor of 10 or more.

Multi-sensory treatment for children with developmental motor speech disorders

What this paper adds? What is already known on the subject? Multi-sensory treatment approaches have been shown to impact outcome measures positively, such as accuracy of speech movement patterns and speech intelligibility in adults with motor speech disorders, as well as in children with apraxia of speech, autism and cerebral palsy. However, there has been no empirical study using multi-sensory treatment for children with speech sound disorders (SSDs) who demonstrate motor control issues in the jaw and orofacial structures (e.g. jaw sliding, jaw over extension, inadequate lip rounding/retraction and decreased integration of speech movements). What this paper adds? Findings from this study indicate that, for speech production disorders where both the planning and production of spatiotemporal parameters of movement sequences for speech are disrupted, multi-sensory treatment programmes that integrate auditory, visual and tactile–kinesthetic information improve auditory and visual accuracy of speech production. The training (practised in treatment) and test words (not practised in treatment) both demonstrated positive change in most participants, indicating generalization of target features to untrained words. It is inferred that treatment that focuses on integrating multi-sensory information and normalizing parameters of speech movements is an effective method for treating children with SSDs who demonstrate speech motor control issues.

The Tnt1 family member Retrosol copy number and structure disclose retrotransposon diversification in different Solanum species

Eukaryotic genome expansion/retraction caused by LTR-retrotransposon activity is dependent on the expression of full length copies to trigger efficient transposition and recombination-driven events. The Tnt1 family of retrotransposons has served as a model to evaluate the diversity among closely related elements within Solanaceae species and found that members of the family vary mainly in their U3 region of the long terminal repeats (LTRs). Recovery of a full length genomic copy of Retrosol was performed through a PCR-based approach from wild potato, Solanum oplocense. Further characterization focusing on both LTR sequences of the amplified copy allowed estimating an approximate insertion time at 2 million years ago thus supporting the occurrence of transposition cycles after genus divergence. Copy number of Tnt1-like elements in Solanum species were determined through genomic quantitative PCR whereby results sustain that Retrosol in Solanum species is a low copy number retrotransposon (1-4 copies) while Retrolyc1 has an intermediate copy number (38 copies) in S. peruvianum. Comparative analysis of retrotransposon content revealed no correlation between genome size or ploidy level and Retrosol copy number. The tetraploid cultivated potato with a cellular genome size of 1,715 Mbp harbours similar copy number per monoploid genome than other diploid Solanum species (613-884 Mbp). Conversely, S. peruvianum genome (1,125 Mbp) has a higher copy number. These results point towards a lineage specific dynamic flux regarding the history of amplification/activity of Tnt1-like elements in the genome of Solanum species.

Estudo da perfusão pulmonar em crianças hospitalizadas com bronquite viral aguda por meio da cintilografia pulmonar perfusional quantitativa com 99mTC-MMA

Introdução: O conhecimento da distribuição da perfusão pulmonar pela cintilografia na bronquiolite viral aguda, pode auxiliar no entendimento das alterações no equilíbrio da ventilação - perfusão, peculiares a essa doença do lactente jovem. Objetivo: Avaliar o padrão de distribuição da perfusão pulmonar em pacientes hospitalizados com bronquiolite viral aguda por meio de cintilografia pulmonar perfusional quantitativa com macroagregado de albumina com tecnécio (99mTc-MAA), estabelecendo associação com as avaliações clínica e radiológica, bem como determinando o seu padrão evolutivo até a condição de normalidade. Tipo de estudo: Dois estudos prospectivos com enfoque diagnóstico: um transversal, comparativo, e um longitudinal, evolutivo, controlado. Pacientes e métodos: A amostra da pesquisa foi constituída por pacientes hospitalizados no Hospital de Clínicas de Porto Alegre com diagnóstico de bronquiolite viral aguda, no período de abril de 1998 a setembro de 2000, baseada em critérios clínicos de inclusão: idade entre 01 e 24 meses, com quadro respiratório obstrutivo de vias aéreas inferiores (primeiro episódio de sibilância expiratória de início súbito, com sinais de coriza, tosse irritativa, hipertermia, taquipnéia, tiragem, batimentos de asa de nariz, esforço expiratório), com gravidade suficiente para determinar a hospitalização e cujos pais aceitaram participar do estudo. Todos os pacientes da pesquisa foram submetidos à avaliação clínica, radiológica e da perfusão pulmonar com o radiofármaco. A cintilografia foi realizada na condição de crise (primeiras 24 horas da admissão) e na convalescência (depois de 7 dias da alta hospitalar). A quantificação do fluxo sangüíneo pulmonar, representada em valores percentuais, foi realizada em três áreas de interesse, nas projeções anterior e posterior, de ambos os pulmões. As comparações foram feitas entre ambos os pulmões e entre as condições de crise e controle, considerando as áreas de interesse e os gradientes entre elas e entre as projeções anterior e posterior das mesmas. Para análise comparativa das médias foi utilizado o teste t de Student para amostras pareadas, considerando o nível de significância de 0,05. Resultados: Iniciaram o estudo transversal 38 pacientes e permaneceram no estudo longitudinal 19 pacientes; da amostra total, 22 eram do sexo masculino. A idade variou de 1 a 8 meses (média 2,8 meses). A distribuição do fluxo sangüíneo pulmonar regional foi maior na região superior do pulmão esquerdo (PE) em relação ao pulmão direito (PD), na crise (P < 0,001), e maior na região média do PD, no controle. Os gradientes de distribuição do fluxo sangüíneo pulmonar entre as regiões superior e média e superior e inferior foi maior no PE, na crise e no controle (P < 0,05). O gradiente de distribuição do fluxo sangüíneo pulmonar entre as regiões média e inferior foi maior no PD, na crise e no controle. O gradiente de distribuição do fluxo sangüíneo pulmonar no eixo ântero-posterior na região superior foi > 1,0 em ambos os pulmões, na crise, e apenas no PE, no controle; na região média, foi > 1,0 em ambos os pulmões, na crise e no controle; na região inferior, foi > 1,0 apenas no PD, na crise e no controle (P < 0,05). A distribuição do fluxo sangüíneo pulmonar, comparada entre crise e controle, não mostrou diferença em quaisquer das regiões ou dos gradientes avaliados. Não houve associação entre o padrão de distribuição do fluxo sangüíneo pulmonar regional na crise com a avaliação clínica ou com a avaliação radiológica dos pacientes. Conclusão: não se evidenciou uma distribuição do fluxo sangüíneo pulmonar com caraterística de expressar o padrão da relação ventilação-perfusão em lactentes jovens hospitalizados com bronquiolite viral aguda. Ocorreu apenas uma tendência de redirecionamento da distribuição do fluxo sangüíneo pulmonar para as regiões superiores.