Resumen: La prevalencia de la plagiocefalia posicional (PP) ha aumentado desde que la Academia Americana de Pediatría recomendara que los bebés duerman en posición supina para prevenir el síndrome de muerte súbita del lactante. Existen grandes controversias en relación de las posibles consecuencias de la PP y del grado de severidad requerido para que éstas se manifiesten. Por otro lado, no hay consenso sobre la eficacia de las terapias de la PP, en temas como el posicionamiento, kinesiología y órtesis craneal. Esta revisión tiene como objetivo actualizar las causas, características principales y evidencia en torno al tratamiento de las PP. Es importante la intervención desde el periodo de recién nacido, abarcando tanto la prevención y educación en el manejo, como la pesquisa temprana, evaluando la posible presencia de tortícolis muscular congénita, para iniciar un tratamiento precoz. La presencia de PP puede ser un marcador de riesgo en el desarrollo psicomotor.

Abstract: Since the American Academy of Pediatrics recommended the supine sleeping position for infants to prevent SIDS, positional plagiocephaly (PP) prevalence has increased. There are great controversies regarding the possible consequences of PP and the degree of severity required for them to manifest. There is no consensus on the efficacy of PP therapies, such as positioning, kinesiology, and cranial orthoses. This review aims to analyze the existing literature to update the causes, main characteristics, and evidence on the treatment of PP. Intervention from the newborn period is important, encompassing both prevention and management education, as well as early screening, evaluating the possible presence of congenital muscular torticollis, to start early treatment. The presence of PP can be a risk marker for psychomotor development.

Resumen: La prevalencia de la plagiocefalia posicional (PP) ha aumentado desde que la Academia Americana de Pediatría recomendara que los bebés duerman en posición supina para prevenir el síndrome de muerte súbita del lactante. Existen grandes controversias en relación de las posibles consecuencias de la PP y del grado de severidad requerido para que éstas se manifiesten. Por otro lado, no hay consenso sobre la eficacia de las terapias de la PP, en temas como el posicionamiento, kinesiología y órtesis craneal. Esta revisión tiene como objetivo actualizar las causas, características principales y evidencia en torno al tratamiento de las PP. Es importante la intervención desde el periodo de recién nacido, abarcando tanto la prevención y educación en el manejo, como la pesquisa temprana, evaluando la posible presencia de tortícolis muscular congénita, para iniciar un tratamiento precoz. La presencia de PP puede ser un marcador de riesgo en el desarrollo psicomotor.

Abstract: Since the American Academy of Pediatrics recommended the supine sleeping position for infants to prevent SIDS, positional plagiocephaly (PP) prevalence has increased. There are great controversies regarding the possible consequences of PP and the degree of severity required for them to manifest. There is no consensus on the efficacy of PP therapies, such as positioning, kinesiology, and cranial orthoses. This review aims to analyze the existing literature to update the causes, main characteristics, and evidence on the treatment of PP. Intervention from the newborn period is important, encompassing both prevention and management education, as well as early screening, evaluating the possible presence of congenital muscular torticollis, to start early treatment. The presence of PP can be a risk marker for psychomotor development.

Resumen: La información clínica es casi tan antigua como la vida misma, incluso se pueden considerar como prehistorias clínicas, en Mesopotamia llevar el registro de los pacientes se plasmaba en papiro, pero es hasta el siglo XIX que ya se habla de formatos electrónicos. Las Tecnologías de la Información y la Comunicación son herramientas claves para alcanzar avances en el sector salud por medio de Expedientes Clínicos Electrónicos (ECE) que permiten además de registrar, archivar, controlar, integrar entre otras cosas los datos de los pacientes mejorar el rendimiento del personal de salud reduciendo su carga de trabajo administrativa y concentrándose en la atención de calidad al paciente por medio de diagnósticos más asertivos y un continuo control sobre su historial médico, por otra parte, debe facilitar el trabajo entre todas las áreas de un hospital, cuyo fin es obtener ayuda en la toma de decisiones y elevar la calidad de la atención brindada al paciente, todo esto con la ayuda de estándares, normas, protocolos, reglas y reglamentos vigentes. La interoperabilidad, es decir, el intercambio de información sobre los procesos o datos clínicos del paciente en las unidades de salud contribuyen que el servicio de salud pueda brindarse al paciente en cualquier institución médica, ya que su ECE estaría homologado, contando con una integración de estándares, factores y lenguaje en común. El contar con un ECE completo para enfoques de investigación permite ser analizados en la prevención errores médicos, negligencias e intervención sanitarias oportunas en la prevención y control de brote de enfermedades.

Resumo: As informações clínicas são quase tão antigas quanto a própria vida, podem até ser consideradas pré-histórias clínicas, na Mesopotâmia se refletia em papiro o registro dos pacientes, mas só no século 19 é que já se fala em formatos eletrônicos. As Tecnologias da Informação e Comunicação são ferramentas fundamentais para alcançar avanços no setor saúde por meio do Prontuário Médico Eletrônico (ECE) que permite, além de registrar, arquivar, controlar, integrar, entre outras coisas, os dados do paciente, melhorando o desempenho da saúde do paciente. o pessoal reduzindo sua carga de trabalho administrativo e concentrando-se no atendimento de qualidade ao paciente por meio de diagnósticos mais assertivos e controle contínuo de seu histórico médico, por outro lado, deve facilitar o trabalho entre todas as áreas de um hospital, cujo objetivo é obter auxílio na tomada de decisões e elevar a qualidade do atendimento prestado ao paciente, tudo isso com o auxílio das normas, normas, protocolos, normas e regulamentos em vigor. A interoperabilidade, ou seja, a troca de informações sobre os processos ou dados clínicos do paciente nas unidades de saúde contribui para que o serviço de saúde possa ser prestado ao paciente em qualquer instituição médica, desde que sua ECE seja aprovada, contando com a integração de padrões, fatores e linguagem comuns. Ter uma ECE completa para abordagens de pesquisa permite ser analisado na prevenção de erros médicos, negligência e intervenção em saúde oportuna na prevenção e controle de surtos de doenças.

Summary: Clinical information is almost as old as life itself, they can even be considered as clinical prehistories, in Mesopotamia keeping the record of patients was reflected on papyrus, but it is not until the 19th century that electronic formats are already spoken of. Information and Communication Technologies are key tools to achieve advances in the health sector through Electronic Medical Records (ECE) that allow, in addition to registering, filing, controlling, integrating, among other things, patient data, improving the performance of the patient. health personnel reducing their administrative workload and concentrating on quality patient care through more assertive diagnoses and continuous control over their medical history should facilitate work between all areas of a hospital. The purpose is to obtain help in decision-making and raise the quality of care provided to the patient, all this with the help of standards, norms, protocols, rules and regulations in force. Interoperability, that is, the exchange of information on the processes or clinical data of the patient in the health units contributes to the health services can be provided to the patient in any medical institution, since its ECE would be approved, counting on an integration of common standards, factors and language. Having a complete ECE for a research approach allows it to be analyzed in the prevention of medical errors, negligence and timely health intervention in the prevention and control of disease outbreaks.

BACKGROUND: During the last few years it has been shown in several laboratories that Celecoxib (Cx), a non-steroidal anti-inflammatory agent (NSAID) normally used for pain and arthritis, mediates antitumor and antiangiogenic effects. However, the effects of this drug on a tumor cell line resistant to chemotherapeutical drugs used in cancer have not been described. Herein we evaluate the angiogenic and antitumor effects of Cx in the development of a drug-resistant mammary adenocarcinoma tumor (TA3-MTXR). RESULTS: Cx reduces angiogenesis in the chick embryonic chorioallantoic membrane assay (CAM), inhibits the growth and microvascular density of the murine TA3-MTXR tumor, reduces microvascular density of tumor metastases, promotes apoptosis and reduces vascular endothelial growth factor (VEGF) production and cell proliferation in the tumor. CONCLUSION: The antiangiogenic and antitumor Cx effects correlate with its activity on other tumor cell lines, suggesting that Prostaglandins (PGs) and VEGF production are involved. These results open the possibility of using Celecoxib combined with other experimental therapies, ideally aiming to get synergic effects.

Angiogenesis is a complex multi-step process of neovascularization arising from preexisting blood vessels whose generation is regulated by pro- and anti-angiogenic factors. Both Trypanosoma cruzi calreticulin (TcCRT) and its human counterpart (HuCRT) are antiangiogenic. This is the first report where the TcCRT and HuCRT anti-angiogenic properties are compared in vivo. In the chick embryonic chorioallantoid membrane assay (CAM) and at equimolar concentrations, TcCRT displayed significantly higher antiangiogenic activities than its human counterpart. LPS had marginal effects at the concentrations present in the recombinant protein preparations and the TcCRT antiangiogenic effects were largely inhibited by specific polyclonal antibodies, thus, reinforcing the fact that the observed TcCRT effects can be attributed to the parasite-derived molecule and not to the endotoxin. The antiangiogenic TcCRT effects correlate with its anti-tumor in vivo effects, as recently shown in our laboratory.

Tumor resistance to traditional cancer treatments poses an important challenge to modern science. Thus, angiogenesis inhibition is an important emerging cancer treatment. Many drugs are tested and corticosteroids have shown interesting results. Herein we investigate the effect on microvessel density, survival time and tumoral volume of mice with TA3-MTX-R tumors. Twenty six mice were inoculated with lxlO6 tumor cells, 4-5 days after injection, six mice were injected with PBS (group A) and twenty mice were treated with p-met (group B). All animals from Group A died on day 22. Group B was divided into Bl (treated discontinued) and B2 (treated daily) and observed until day 88. All mice were processed for histo-immunohistochemical analysis and the blood vessels were counted. A decrease in microvessel density and tumoral volume and longer survival times were observed in the treated group. We propose that the antiangiogenic p-met effect explains, at least partially, its tumor inhibitory properties. As an important perspective, we will experimentally combine these strategies with those recently described by us with regard to the important antiangiogenic-antitumor effects of Trypanosoma cruzi calreticulin. Since the molecular targets of these strategies are most likely different, additive or synergic effects are envisaged.

Trypanosoma cruzi calreticulin (TcCRT), described in our laboratory, retains several important functional features from its vertebrate homologues. We have shown that recombinant TcCRT inhibits the human complement system when it binds to the collagenous portion of C1q. The generation of classical pathway convertases and membrane attack complexes is thus strongly inhibited. In most T. cruzi-infected individuals, TcCRT is immunogenic and mediates the generation of specific antibodies. By reverting the C1q / TcCRT interaction, a parasite immune evasion strategy, these antibodies contribute to the host / parasite equilibrium. In an in vitro correlate of this situation, we show that the C1q / TcCRT interaction is inhibited by F(ab')2 polyclonal anti-TcCRT IgG fragments. It is therefore feasible that in infected humans anti-TcCRT antibodies participate in reverting an important parasite strategy aimed at inhibiting the classical complement pathway. Thus, membrane-bound TcCRT interacts with the collagenous portion C1q, and this C1q is recognized by the CD91-bound host cell CRT, thus facilitating parasite internalization. Based on our in vitro results, it could be proposed that the in vivo interaction between TcCRT and vertebrate C1q could be inhibited by F(ab')2 fragments anti-rTcCRT or against its S functional domain, thus interfering with the internalization process