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- ItemAcesso aberto (Open Access)Acidentes vasculares encefálicos em pediatria(Sociedade Brasileira de Pediatria, 2009-12-01) Mekitarian Filho, Eduardo [UNIFESP]; Carvalho, Werther Brunow de [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Hospital Santa Catarina Unidade de Terapia Intensiva Pediátrica; Hospital Pronto-Socorro Infantil Sabará Unidade de Terapia Intensiva Pediátrica; Universidade de São Paulo (USP)OBJECTIVES: To summarize 1) the definitions and epidemiological features of stroke in children; 2) the main risk factors that can lead to stroke in pediatrics and neonatology; 3) the main pathophysiological features involved in the genesis of brain injury in stroke; 4) the clinical manifestations and imaging diagnosis; and 5) the latest recommendations concerning the support measures, treatment, and prophylaxis of stroke in children. SOURCES: A review of the literature published in PubMed, EMBASE, and SciELO databases using the search terms stroke, pediatrics, and neonatology was performed, including relevant references from the chosen texts. SUMMARY OF THE FINDINGS: Stroke in children are rare conditions, with incidence rates among two and eight per 100,000 children up to 14 years, and most cases show an underlying disease such as heart diseases, prothrombotic conditions, sickle-cell disease, and vascular malformations. There are no specific guidelines currently in place for the treatment of stroke in children, although central elements include support treatment, monitoring, and anticoagulation as secondary prevention in certain cases. Prognosis depends on the extent of brain damage and the underlying disease but recurrence rates are high in most cases. CONCLUSIONS: Early diagnosis of stroke in children is very important and pediatricians should be aware of the lack of specificity of the symptoms to avoid late sequelae and improve life quality.
- ItemSomente MetadadadosHigh-resolution structure of a Kazal-type serine protease inhibitor from the dengue vector Aedes aegypti(Int Union Crystallography, 2017) Torquato, Ricardo J. S. [UNIFESP]; Lu, Stephen [UNIFESP]; Martins, Nadia Helena; Tanaka, Aparecida S. [UNIFESP]; Barbosa Pereira, Pedro JoseBlood-feeding exoparasites are rich sources of protease inhibitors, and the mosquito Aedes aegypti, which is a vector of Dengue virus, Yellow fever virus, Chikungunya virus and Zika virus, is no exception. AaTI is a single-domain, noncanonical Kazal-type serine proteinase inhibitor from A. aegypti that recognizes both digestive trypsin-like serine proteinases and the central protease in blood clotting, thrombin, albeit with an affinity that is three orders of magnitude lower. Here, the 1.4 angstrom resolution crystal structure of AaTI is reported from extremely tightly packed crystals (similar to 22% solvent content), revealing the structural determinants for the observed inhibitory profile of this molecule.