Mortalidade entre Idosos no Estado do Paraná e no município de Foz do Iguaçu

Trabalho de Conclusão da Residência apresentado ao Programa de Residência Multiprofissional em Saúde da Família da Universidade Federal da Integração Latino- Americana, como requisito parcial para obtenção do título de Especialista em Saúde da Família na modalidade de residência. Orientador: Walfrido Svoboda. (Prof. Dr. do Curso de Saúde Coletiva - UNILA) e Coorientadora: Carmen Justina Gamarra. (Profa. Dra. do Curso de Saúde Coletiva - UNILA)Objetivo: Analisar a tendência da mortalidade entre idosos residentes no estado do Paraná e no município de Foz do Iguaçu, no período de 2001 a 2012, e mortalidade proporcional por capítulos CID-10. Método: Trata-se de um estudo descritivo, ecológico de série temporal. Os dados dos óbitos e da população idosa de 60 anos ou mais foram obtidos por meio do Sistema de Informação de mortalidade SIM/DATASUS. Foram calculadas as taxas anuais de mortalidade bruta e padronizadas por sexo e faixa etária. Para os dados de mortalidade proporcional por capítulos CID-10 foram calculados os percentuais para os anos selecionados de 2001; 2006; 2011; 2016. As informações foram tabuladas em planilhas do Excel, sendo construídas tabelas e gráficos e analisados por meio de regressão linear simples. Resultados: Observou-se tendência declinante da mortalidade dos idosos no estado do Paraná e no município de Foz do Iguaçu. Ao longo do estudo verificou-se que as doenças do aparelho circulatório constituem-se como a primeira e principal causa de óbito, seguido das neoplasias e doenças do aparelho respiratório. Conclusão: No período analisado, a tendência da mortalidade padronizadas dos idosos obteve decréscimo tanto no Estado como no município, sendo observados maiores coeficientes de mortalidade entre os homens quando comparado às mulheres.Objective: To analyze the mortality trend among elderly people living in the state of Para- ná and in the municipality of Foz do Iguaçu, from 2001 to 2012, and proportional mortality by ICD-10 chapters. Method: This is a descriptive, ecological time series study. Data on deaths and the elderly population aged 60 years and over were obtained using the SIM / Datasus Mortality Infor- mation System. Gross annual mortality rates were standardized and standardized by gen- der and age group. The information was tabulated in Excel spreadsheets, and tables and graphs were constructed and analyzed using simple linear regression. Results: In general terms, a declining trend in mortality among the elderly was observed in the state of Paraná and in the city of Foz do Iguaçu. Throughout the study it was verified that diseases of the circulatory system constitute the first and main cause of death, fol- lowed by neoplasias and diseases of the respiratory system. Conclusion: In the period analyzed, the general trend of standardized mortality among the elderly decreased both in the state and in the municipality, with higher mortality rates among men when compared to womenObjetivo: Analizar la tendencia de la mortalidad entre ancianos residentes en el estado de Paraná y en el municipio de Foz do Iguaçu, en el período de 2001 a 2012, y mortali- dad proporcional por capítulos CID-10. Método: Se trata de un estudio descriptivo, eco- lógico de serie temporal. Los datos de mortalidad y de la población de la tercera edad (mayor de 60años) fueron obtenidos por medio del sistema de información de mortalidad SIM/DATASUS. Fueron calculadas las tasas anuales de mortalidad bruta y estandariza- das por sexo y edad. Las informaciones fueron tabuladas en planillas de cálculo Micro- soft Excel, siendo construidas tablas, gráficos e analizados por medio de regresión linear simple. Resultados: En términos generales fue observada la tendencia declinante de la mortali- dad en personas de la tercera edad en el Estado de Paraná y en el Municipio de Foz de Iguazú. A lo largo de este estudio, se verifico que las enfermedades del aparato circula- torio se consideran como la primera causa de muerte, seguido por Cáncer e enfermeda- des del Aparato Respiratorio. Conclusión: En el periodo analizado, la tendencia de la mortalidad estandarizada en personas de la tercera edad obtuvo decrecimos tanto en el Estado de Paraná como en el Municipio, siendo observados mayores coeficientes de mortalidad en hombres compara- do con mujere

RNA sequencing analysis of human podocytes reveals glucocorticoid regulated gene networks targeting non-immune pathways

Glucocorticoids are steroids that reduce inflammation and are used as immunosuppressive drugs for many diseases. They are also the mainstay for the treatment of minimal change nephropathy (MCN), which is characterised by an absence of inflammation. Their mechanisms of action remain elusive. Evidence suggests that immunomodulatory drugs can directly act on glomerular epithelial cells or ‘podocytes’, the cell type which is the main target of injury in MCN. To understand the nature of glucocorticoid effects on non-immune cell functions, we generated RNA sequencing data from human podocyte cell lines and identified the genes that are significantly regulated in dexamethasone-treated podocytes compared to vehicle-treated cells. The upregulated genes are of functional relevance to cytoskeleton-related processes, whereas the downregulated genes mostly encode pro-inflammatory cytokines and growth factors. We observed a tendency for dexamethasone-upregulated genes to be downregulated in MCN patients. Integrative analysis revealed gene networks composed of critical signaling pathways that are likely targeted by dexamethasone in podocytes

Sistema Solar: Planetas Clássicos

O conhecimento curricular de Astronomia para surdos, não pode ser empobrecido, subtraído, fragmentado, mas sim formulado para corresponder a sua identidade de cognição, sem distanciar-se, porém, do direito inalienável a tudo que devem conhecer. Métodos de ensino não podem ser únicos para todos e, um sistema educacional que não revela estas diferenças está fadado em provocar a exclusão destes educandos por considerá-los inaptos, intelectualmente. Sendo assim, ao organizar o conteúdo que será trabalhado em sala de aula, o professor terá sempre em mente o tema Sistema Solar /Planetas Clássicos. Este tema está diretamente ligado a outros temas, permitindo ao aluno surdo fazer parte desse todo tão complexo que é o Universo em que vivemo

Correction: Exome Sequencing in an Admixed Isolated Population IndicatesNFXL1 Variants Confer a Risk for Specific Language Impairment

Children affected by Specific Language Impairment (SLI) fail to acquire age appropriate language skills despite adequate intelligence and opportunity. SLI is highly heritable, but the understanding of underlying genetic mechanisms has proved challenging. In this study, we use molecular genetic techniques to investigate an admixed isolated founder population from the Robinson Crusoe Island (Chile), who are affected by a high incidence of SLI, increasing the power to discover contributory genetic factors. We utilize exome sequencing in selected individuals from this population to identify eight coding variants that are of putative significance. We then apply association analyses across the wider population to highlight a single rare coding variant (rs144169475, Minor Allele Frequency of 4.1% in admixed South American populations) in the NFXL1 gene that confers a nonsynonymous change (N150K) and is significantly associated with language impairment in the Robinson Crusoe population (p = 2.04 × 10–4, 8 variants tested). Subsequent sequencing of NFXL1 in 117 UK SLI cases identified four individuals with heterozygous variants predicted to be of functional consequence. We conclude that coding variants within NFXL1 confer an increased risk of SLI within a complex genetic model

Decreased CXCR1 and CXCR2 expression on neutrophils in anti-neutrophil cytoplasmic autoantibody-associated vasculitides potentially increases neutrophil adhesion and impairs migration

Introduction: In anti-neutrophil cytoplasmic autoantibody (ANCA)-associated vasculitides (AAV), persistent inflammation within the vessel wall suggests perturbed neutrophil trafficking leading to accumulation of activated neutrophils in the microvascular compartment. CXCR1 and CXCR2, being major chemokine receptors on neutrophils, are largely responsible for neutrophil recruitment. We speculate that down-regulated expression of CXCR1/2 retains neutrophils within the vessel wall and, consequently, leads to vessel damage.Methods: Membrane expression of CXCR1/2 on neutrophils was assessed by flow cytometry. Serum levels of interleukin-8 (IL-8), tumor necrosis factor alpha (TNF-α), angiopoietin 1 and angiopoietin 2 from quiescent and active AAV patients and healthy controls (HC) were quantified by ELISA. Adhesion and transendothelial migration of isolated neutrophils were analyzed using adhesion assays and Transwell systems, respectively.Results: Expression of CXCR1 and CXCR2 on neutrophils was significantly decreased in AAV patients compared to HC. Levels of IL-8, which, as TNFα, dose-dependently down-regulated CXCR1 and CXCR2 expression on neutrophils in vitro, were significantly increased in the serum of patients with active AAV and correlated negatively with CXCR1/CXCR2 expression on neutrophils, even in quiescent patients. Blocking CXCR1 and CXCR2 with repertaxin increased neutrophil adhesion and inhibited migration through a glomerular endothelial cell layer.Conclusions: Expression of CXCR1 and CXCR2 is decreased in AAV, potentially induced by circulating proinflammatory cytokines such as IL-8. Down-regulation of these chemokine receptors could increase neutrophil adhesion and impair its migration through the glomerular endothelium, contributing to neutrophil accumulation and, in concert with ANCA, persistent inflammation within the vessel wall. © 2012 Hu et al.; licensee BioMed Central Ltd.link_to_subscribed_fulltex

Genomic insights into the origin of farming in the ancient Near East

We report genome-wide ancient DNA from 44 ancient Near Easterners ranging in time between ~12,000 and 1,400 BC, from Natufian hunter–gatherers to Bronze Age farmers. We show that the earliest populations of the Near East derived around half their ancestry from a ‘Basal Eurasian’ lineage that had little if any Neanderthal admixture and that separated from other non-African lineages before their separation from each other. The first farmers of the southern Levant (Israel and Jordan) and Zagros Mountains (Iran) were strongly genetically differentiated, and each descended from local hunter–gatherers. By the time of the Bronze Age, these two populations and Anatolian-related farmers had mixed with each other and with the hunter–gatherers of Europe to greatly reduce genetic differentiation. The impact of the Near Eastern farmers extended beyond the Near East: farmers related to those of Anatolia spread westward into Europe; farmers related to those of the Levant spread southward into East Africa; farmers related to those of Iran spread northward into the Eurasian steppe; and people related to both the early farmers of Iran and to the pastoralists of the Eurasian steppe spread eastward into South Asia

Quantification of Serial Cerebral Blood Flow in Acute Stroke Using Arterial Spin Labeling

Background and Purpose— Perfusion-weighted imaging is used to select patients with acute ischemic stroke for intervention, but knowledge of cerebral perfusion can also inform the understanding of ischemic injury. Arterial spin labeling allows repeated measurement of absolute cerebral blood flow (CBF) without the need for exogenous contrast. The aim of this study was to explore the relationship between dynamic CBF and tissue outcome in the month after stroke onset. Methods— Patients with nonlacunar ischemic stroke underwent ≤5 repeated magnetic resonance imaging scans at presentation, 2 hours, 1 day, 1 week, and 1 month. Imaging included vessel-encoded pseudocontinuous arterial spin labeling using multiple postlabeling delays to quantify CBF in gray matter regions of interest. Receiver–operator characteristic curves were used to predict tissue outcome using CBF. Repeatability was assessed in 6 healthy volunteers and compared with contralateral regions of patients. Diffusion-weighted and T2-weighted fluid attenuated inversion recovery imaging were used to define tissue outcome. Results— Forty patients were included. In contralateral regions of patients, there was significant variation of CBF between individuals, but not between scan times (mean±SD: 53±42 mL/100 g/min). Within ischemic regions, mean CBF was lowest in ischemic core (17±23 mL/100 g/min), followed by regions of early (21±26 mL/100 g/min) and late infarct growth (25±35 mL/100 g/min; ANOVA P &lt;0.0001). Between patients, there was marked overlap in presenting and serial CBF values. Conclusions— Knowledge of perfusion dynamics partially explained tissue fate. Factors such as metabolism and tissue susceptibility are also likely to influence tissue outcome. </jats:sec

VEGFC reduces glomerular albumin permeability and protects against alterations in VEGF receptor expression in diabetic nephropathy

Elevated levels of vascular endothelial growth factor (VEGF) A are thought to cause glomerular endothelial cell (GEnC) dysfunction and albuminuria in diabetic nephropathy. We hypothesized that VEGFC could counteract these effects of VEGFA to protect the glomerular filtration barrier and reduce albuminuria. Isolated glomeruli were stimulated ex vivo with VEGFC, which reduced VEGFA- and type 2 diabetes–induced glomerular albumin solute permeability (Ps’alb). VEGFC had no detrimental effect on glomerular function in vivo when overexpression was induced locally in podocytes (podVEGFC) in otherwise healthy mice. Further, these mice had reduced glomerular VEGFA mRNA expression, yet increased glomerular VEGF receptor heterodimerization, indicating differential signaling by VEGFC. In a model of type 1 diabetes, the induction of podVEGFC overexpression reduced the development of hypertrophy, albuminuria, loss of GEnC fenestrations and protected against altered VEGF receptor expression. In addition, VEGFC protected against raised Ps’alb by endothelial glycocalyx disruption in glomeruli. In summary, VEGFC reduced the development of diabetic nephropathy, prevented VEGF receptor alterations in the diabetic glomerulus, and promoted both glomerular protection and endothelial barrier function. These important findings highlight a novel pathway for future investigation in the treatment of diabetic nephropathy

Effects of p38 mitogen-activated protein kinase inhibition on anti-neutrophil cytoplasmic autoantibody pathogenicity in vitro and in vivo

Objective: To determine whether inhibition of p38 mitogen-activated protein kinase (p38MAPK) reduces the pathogenicity of anti-neutrophil cytoplasmic autoantibodies (ANCAs) in vitro and in vivo. Methods: The effects of the p38MAPK-specific inhibitor AR-447 were studied in vitro using neutrophil respiratory burst and degranulation assays, and in lipopolysaccharide (LPS)-stimulated human glomerular endothelial cells. In vivo, p38MAPK inhibition was investigated in a mouse anti-myeloperoxidase (MPO) IgG/LPS glomerulonephritis model. Mice were treated orally with AR-447 daily, starting before (pretreatment group) or 24 h after disease onset (treatment group), and killed after 1 or 7 day(s). Results: In vitro, AR-447 diminished neutrophil respiratory burst and degranulation induced by patient-derived MPO-ANCA and proteinase 3 (Pr3)-ANCA. In glomerular endothelial cells, AR-447 reduced LPS-induced secretion of IL-6 and IL-8, but not of MCP-1. In mice, pretreatment with AR-447 reduced albuminuria 1 day after induction of glomerulonephritis. After 7 days, no effects on urinary abnormalities were observed upon AR-447 pretreatment or treatment. Also, glomerular neutrophil accumulation was not diminished. In contrast, glomerular macrophage accumulation and the formation of glomerular crescents was significantly reduced by AR-447 pretreatment (vehicle: 12.5 ± 5.6% crescentic glomeruli; AR-447: 7.7 ± 2.7%) and treatment (vehicle 14.6 ± 1.8%; AR-447 6.0 ± 3.4%) at 7 days. Conclusion: This study shows that p38MAPK inhibition markedly reduces ANCA-induced neutrophil activation in vitro. In vivo, p38MAPK inhibition partly reduced crescent formation when the drug was administered prior to disease induction and after disease onset, suggesting that besides p38MAPK activity other signalling pathways contribute to the disease activity