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  1. Kawasaki Disease

    MedlinePlus

    ... page from the NHLBI on Twitter. What Is Kawasaki Disease? Kawasaki (KAH-wah-SAH-ke) disease is a ... condition involves inflammation of the blood vessels. In Kawasaki disease, the walls of the blood vessels throughout the ...

  2. Kawasaki disease

    MedlinePlus

    ... this page: //medlineplus.gov/ency/article/000989.htm Kawasaki disease To use the sharing features on this page, please enable JavaScript. Kawasaki disease is a rare condition that involves inflammation of ...

  3. Kawasaki disease

    PubMed Central

    Kawasaki, Tomisaku

    2006-01-01

    Short history of Kawasaki disease, clinical features (principal symptoms and other significant symptoms or findings), diagnosis, cardiovascular involvement, epidemiology. Pathological features (lesion of vessels and lesion of organs exclusive of vessels), comparison between infantile periarteritis nodosa (IPN)/Kawasaki disease and classic periarteritis nodosa (CPN), etiology, treatment and management of Kawasaki disease are described. PMID:25792773

  4. Kawasaki disease.

    PubMed

    Kawasaki, Tomisaku

    2006-04-01

    Short history of Kawasaki disease, clinical features (principal symptoms and other significant symptoms or findings), diagnosis, cardiovascular involvement, epidemiology. Pathological features (lesion of vessels and lesion of organs exclusive of vessels), comparison between infantile periarteritis nodosa (IPN)/Kawasaki disease and classic periarteritis nodosa (CPN), etiology, treatment and management of Kawasaki disease are described.

  5. Kawasaki Disease

    MedlinePlus

    ... measles, mumps, rubella) and the Varicella (chicken pox) vaccines . Children over 6 months of age should receive the inactivated influenza (flu) vaccine injection. Long-term follow-up: Children treated for Kawasaki Disease who do not develop ...

  6. How Is Kawasaki Disease Diagnosed?

    MedlinePlus

    ... page from the NHLBI on Twitter. How Is Kawasaki Disease Diagnosed? Kawasaki disease is diagnosed based on your child's signs and ... are the first to suspect a child has Kawasaki disease. Pediatricians are doctors who specialize in treating children. ...

  7. Kawasaki Syndrome

    PubMed Central

    Rowley, Anne H.; Shulman, Stanford T.

    1998-01-01

    Kawasaki syndrome (KS) is an acute, sometimes fatal vasculitis of young children. KS has replaced acute rheumatic fever as the most common cause of acquired heart disease in children in the United States. The illness is manifested by prolonged fever, conjunctival injection, enanthem, exanthem, erythema and swelling of the hands and feet, and cervical adenopathy. These acute features of illness are self-limiting, but coronary artery abnormalities occur in 20% of untreated patients. The etiology of the illness is unknown, but its clinical and epidemiologic features are most consistent with an infectious cause. Common cardiovascular manifestations of the illness include myocarditis, pericardial effusion, and coronary artery aneurysm formation. Treatment with intravenous gamma globulin (IVGG) and aspirin within the first 10 days of illness reduces the prevalence of coronary artery abnormalities from 20% in those treated with aspirin alone to 4%. Patients who develop coronary artery aneurysms, particularly those who develop giant coronary artery aneurysms, may suffer myocardial infarction secondary to thrombosis or stenosis in the abnormal vessel. Additional research to determine the cause of KS is urgently needed to allow for improved diagnosis, more specific therapy, and prevention of the disorder. PMID:9665974

  8. History of Kawasaki disease.

    PubMed

    Kawasaki, Tomisaku; Naoe, Shiro

    2014-04-01

    We describe a short history of Kawasaki disease. In 1967, we published a paper entitled 'Infantile acute febrile mucocutaneous lymph node syndrome with specific desquamation of the fingers and toes. Clinical observation of 50 cases'; this was the first report on what is now called Kawasaki disease. Since then, many reports on cardiology, treatment, epidemiology, pathology and etiology of Kawasaki disease have been published. Furthermore, a recent Chapel Hill Consensus Statement on Kawasaki disease in the classification of vasculitis is given, along with a figure on the relationship and classification of childhood vasculitis by autopsy material.

  9. Living with Kawasaki Disease

    MedlinePlus

    ... can help lower their risk of future heart disease. (Following a healthy lifestyle is advised for all children, not just those who have Kawasaki disease). Children treated with immune globulin should wait 11 ...

  10. Kawasaki Disease: MedlinePlus Health Topic

    MedlinePlus

    ... symptoms. Further problems are rare. NIH: National Heart, Lung, and Blood Institute Start Here Kawasaki Disease (American Academy of ... American Academy of Pediatrics) Kawasaki Disease (National Heart, Lung, and Blood Institute) What Is Kawasaki Disease? (American Heart Association) - ...

  11. What Is Kawasaki Disease?

    MedlinePlus

    ... Do you have questions for the doctor or nurse? Take a few minutes to write your questions for the next time you see your healthcare provider. For example: What can I do to help my child deal with Kawasaki disease? My Questions: We have many other fact sheets ...

  12. How Is Kawasaki Disease Treated?

    MedlinePlus

    ... can help lower the risk of future heart disease. (Following a healthy lifestyle is advised for all children, not just those who have Kawasaki disease.) Children who have had immune globulin should wait ...

  13. Conceptos Basicos Sobre el Propano

    SciTech Connect

    2016-08-01

    El propano provee energia a mas de 143.000 vehiculos en los Estados Unidos y 23 millones en todo el mundo. Flotas de todos los Estados Unidos han implementado con exito el uso de vehiculos que funcionan con gas propano, y en la actualidad varios funcionan gracias a este gas, incluyendo autobuses escolares, lanzaderas y autobuses publicos, asi como tambien furgonetas, taxis, vehiculos utilizados por las fuerzas del orden, barredoras de calles y camiones para uso profesional. El propano tambien se utiliza con frecuencia en aplicaciones fuera de la carretera, tales como montacargas, podadoras y equipos de uso profesional y otros equipos agricolas. Las ventajas del propano incluyen la disponibilidad interna, su rendimiento y el hecho de que genera menos emisiones de gases contaminantes que otras alternativas energeticas.

  14. Vaccines and Kawasaki disease.

    PubMed

    Esposito, Susanna; Bianchini, Sonia; Dellepiane, Rosa Maria; Principi, Nicola

    2016-01-01

    The distinctive immune system characteristics of children with Kawasaki disease (KD) could suggest that they respond in a particular way to all antigenic stimulations, including those due to vaccines. Moreover, treatment of KD is mainly based on immunomodulatory therapy. These factors suggest that vaccines and KD may interact in several ways. These interactions could be of clinical relevance because KD is a disease of younger children who receive most of the vaccines recommended for infectious disease prevention. This paper shows that available evidence does not support an association between KD development and vaccine administration. Moreover, it highlights that administration of routine vaccines is mandatory even in children with KD and all efforts must be made to ensure the highest degree of protection against vaccine-preventable diseases for these patients. However, studies are needed to clarify currently unsolved issues, especially issues related to immunologic interference induced by intravenous immunoglobulin and biological drugs.

  15. Kawasaki disease. The mystery continues.

    PubMed Central

    Bradley, D J; Glodé, M P

    1998-01-01

    Kawasaki disease is an acute systemic vasculitis of unknown cause first described in Japan in 1967. It affects children younger than 10 years, predominantly those younger than 3 years. Children of Asian ancestry are more commonly affected than white children. The diagnosis is made when 4 of the following 5 signs or symptoms are present with fever for at least 5 days: polymorphous rash; conjunctival injection; oral mucosal changes; cervical lymphadenitis; and erythema, swelling, or desquamation of the hands and feet. Various symptoms may be seen also, among them pronounced irritability, arthralgia, and abdominal pain. No diagnostic test exists, and clinicians must carefully exclude diseases that mimic Kawasaki disease. In addition to the above clinical findings, Kawasaki disease causes aneurysm formation in medium-sized arteries, particularly the coronary arteries. Found in about a fourth of patients, these lesions may persist, scar with stenosis, or resolve angiographically. The treatment consists of administering high-dose aspiring and intravenous immune globulin, with the goal of relieving acute illness and minimizing sequelae. Although most respond rapidly, almost 10% of children do not improve clinically with treatment. Complications of Kawasaki disease include myocardial infarction, which may occur during acute illness or later, as a result of coronary abnormalities. Images Figure 1. Figure 2. PMID:9448484

  16. Management of Kawasaki disease

    PubMed Central

    Eleftheriou, D; Levin, M; Shingadia, D; Tulloh, R; Klein, NJ; Brogan, PA

    2014-01-01

    Kawasaki disease (KD) is an acute self-limiting inflammatory disorder, associated with vasculitis, affecting predominantly medium-sized arteries, particularly the coronary arteries. In developed countries KD is the commonest cause of acquired heart disease in childhood. The aetiology of KD remains unknown, and it is currently believed that one or more as yet unidentified infectious agents induce an intense inflammatory host response in genetically susceptible individuals. Genetic studies have identified several susceptibility genes for KD and its sequelae in different ethnic populations, including FCGR2A, CD40, ITPKC, FAM167A-BLK and CASP3, as well as genes influencing response to intravenous immunoglobulin (IVIG) and aneurysm formation such as FCGR3B, and transforming growth factor (TGF) β pathway genes. IVIG and aspirin are effective therapeutically, but recent clinical trials and meta-analyses have demonstrated that the addition of corticosteroids to IVIG is beneficial for the prevention of coronary artery aneurysms (CAA) in severe cases with highest risk of IVIG resistance. Outside of Japan, however, clinical scores to predict IVIG resistance perform suboptimally. Furthermore, the evidence base does not provide clear guidance on which corticosteroid regimen is most effective. Other therapies, including anti-TNFα, could also have a role for IVIG-resistant KD. Irrespective of these caveats, it is clear that therapy that reduces inflammation in acute KD, improves outcome. This paper summarises recent advances in the understanding of KD pathogenesis and therapeutics, and provides an approach for managing KD patients in the UK in the light of these advances. PMID:24162006

  17. Kawasaki disease for dermatologists

    PubMed Central

    Gupta, Aman; Singh, Surjit

    2016-01-01

    Kawasaki disease (KD) is a systemic vasculitis that mostly affects children below the age of 5. The vasculitis involves arteries of medium size, especially the coronaries. Various etiologies have been proposed including association with micro-organisms, bacterial superantigens, and genetic factors, however, the exact cause remains unknown. There is no specific laboratory test for KD. Diagnosis is clinical and depends upon the presence of fever for ≥5 days and 4 or more of five principal features, viz. polymorphous exanthem, extremity changes, mucosal changes involving the lips and oral cavity, bilateral bulbar conjunctival injection, and unilateral cervical lymphadenopathy. The term “incomplete KD” refers to the presence of fever and less than four principal clinical features. Recognition of this group of patients is important because it is usually seen in infants and risk of coronary abnormalities is increased probably because of delays in diagnosis. However, what appears to be “incomplete” at a given point of time may not actually be so because some of the features may have already subsided and others may evolve over time. Hence, a detailed dermatological examination is warranted in all cases, especially in incomplete KD, to ensure timely diagnosis. Although KD is a self-limiting disease in most patients, coronary artery abnormalities (CAAs) including coronary dilatations and aneurysms may develop in up to 25% of untreated patients. CAAs are the most common cause of morbidity and mortality in patients with KD. Treatment is aimed at reducing inflammation and consists of intravenous immunoglobulin (IVIG) along with aspirin. Despite treatment, some patients may still develop CAAs, and hence, long-term follow up is of utmost importance. PMID:27990380

  18. [Cardiac and extracardiac complications in Kawasaki disease].

    PubMed

    Kamada, Masahiro

    2014-09-01

    In terms of frequency and prognosis, discussions of the complications of Kawasaki disease have focused on coronary artery aneurysms and stenosis. However, as revealed by autopsy findings, medium and small muscular arteries in various organs could be injured in patients with Kawasaki disease, leading to the development of a variety of complications. Accurate diagnosis of Kawasaki disease can be especially difficult when incomplete Kawasaki disease is accompanied by rare complications involving the central nervous system, digestive system, and other systems in the body, which leads to delay in treatment and subsequent development of coronary artery aneurysms and delayed improvement of the existing complications. Doctors who treat Kawasaki disease should be familiar with the rare but important complications of Kawasaki disease.

  19. Serum adipokine profiles in Kawasaki disease.

    PubMed

    Kemmotsu, Yasushi; Saji, Tsutomu; Kusunoki, Natsuko; Tanaka, Nahoko; Nishimura, Chiaki; Ishiguro, Akira; Kawai, Shinichi

    2012-02-01

    Adipokines are cytokines derived from adipose tissue. Recently it has been established that adipokines are closely linked to the pathophysiology of not only metabolic diseases, such as diabetes mellitus, obesity, and atherosclerosis, but also to inflammation and immune diseases. In this study we measured serum levels of adipokines in patients with acute Kawasaki disease to investigate the role of adipokines in the pathophysiology of Kawasaki disease. Serum resistin, high-molecular-weight (HMW) adiponectin, leptin, and visfatin levels were measured by enzyme-linked immunosorbent assay in a total of 117 subjects: 56 patients with acute Kawasaki disease, 30 healthy children, and 31 patients with acute infectious diseases. Serum resistin levels in patients with Kawasaki disease were significantly higher than those of healthy children and patients with acute infectious diseases. In contrast, mean serum HMW adiponectin, leptin, and visfatin levels in patients with Kawasaki disease exhibited no statistically significant differences compared with those in healthy children and patients with infectious diseases. Serum resistin levels decreased significantly after administration of intravenous immune globulin. Serum resistin levels on admission were significantly higher in nonresponders compared with responders to intravenous immune globulin therapy. A multivariate model revealed that C-reactive protein was a factor that was significantly related to elevated serum resistin level in patients with Kawasaki disease. In patients with Kawasaki disease, serum resistin levels were elevated, but decreased to nearly normal after intravenous administration of immune globulin. In contrast, serum HMW adiponectin, leptin, and visfatin levels showed no statistically significant changes. These findings suggest that resistin plays an important role, while other adipokines do not play a major role, in the pathogenesis of Kawasaki disease.

  20. What Are the Signs and Symptoms of Kawasaki Disease?

    MedlinePlus

    ... Twitter. What Are the Signs and Symptoms of Kawasaki Disease? Major Signs and Symptoms One of the main symptoms during the early part of Kawasaki disease, called the acute phase, is fever. The fever ...

  1. Kawasaki disease: A brief history.

    PubMed

    Burns, J C; Kushner, H I; Bastian, J F; Shike, H; Shimizu, C; Matsubara, T; Turner, C L

    2000-08-01

    Tomisaku Kawasaki published the first English-language report of 50 patients with Kawasaki disease (KD) in 1974. Since that time, KD has become the leading cause of acquired heart disease among children in North America and Japan. Although an infectious agent is suspected, the cause remains unknown. However, significant progress has been made toward understanding the natural history of the disease and therapeutic interventions have been developed that halt the immune-mediated destruction of the arterial wall. We present a brief history of KD, review progress in research on the disease, and suggest avenues for future study. Kawasaki saw his first case of KD in January 1961 and published his first report in Japanese in 1967. Whether cases existed in Japan before that time is currently under study. The most significant controversy in the 1960s in Japan was whether the rash and fever sign/symptom complex described by Kawasaki was connected to subsequent cardiac complications in a number of cases. Pathologist Noboru Tanaka and pediatrician Takajiro Yamamoto disputed the early assertion of Kawasaki that KD was a self-limited illness with no sequelae. This controversy was resolved in 1970 when the first Japanese nationwide survey of KD documented 10 autopsy cases of sudden cardiac death after KD. By the time of the first English-language publication by Kawasaki in 1974, the link between KD and coronary artery vasculitis was well-established. KD was independently recognized as a new and distinct condition in the early 1970s by pediatricians Marian Melish and Raquel Hicks at the University of Hawaii. In 1973, at the same Hawaiian hospital, pathologist Eunice Larson, in consultation with Benjamin Landing at Los Angeles Children's Hospital, retrospectively diagnosed a 1971 autopsy case as KD. The similarity between KD and infantile periarteritis nodosa (IPN) was apparent to these pathologists, as it had been to Tanaka earlier. What remains unknown is the reason for the

  2. Kawasaki disease - an Indian perspective.

    PubMed

    Singh, Surjit; Kawasaki, Tomisaku

    2009-07-01

    Kawasaki disease (KD) was first reported from Japan in 1967 by a young pediatrician, Tomisaku Kawasaki, while working at the Red Cross Hospital in Tokyo. Soon therafter, Marian Melish independently reported children with a similar clinical profile from Hawaii in the United States. KD has now been reported from all parts of the world, including several centers in India. Based on the epidemiology and clinical features, an infectious etiology has been suspected for long but no definitive causative agent has been implicated so far. Like many other vasculitides, the diagnosis of this condition is based on the recognition of a temporal sequence of clinical features, none of which is pathognomonic in isolation. KD is believed to be the commonest vasculitic disorder of children. Incidence rates as high as 60-150 per 100,000 children below 5 years of age have been reported from several countries. In India (as also perhaps in many other developing countries), however, majority of children with KD continue to remain undiagnosed probably because of the lack of awareness amongst pediatricians. The clinical features of KD can be confused with other common conditions like scarlet fever and the Stevens Johnson syndrome, if the clinician is not careful. Development of coronary artery abnormalities (CAA) is the hallmark of KD and accounts for most of the morbidity and mortality associated with the disease. Prompt recognition of the disease and early initiation of treatment with intravenous immunoglobulin (IVIG) results in significant reduction in the occurrence of CAA. It is, therefore, imperative for the pediatrician to diagnose and treat KD expeditiously. KD should be considered in the differential diagnosis of all febrile illnesses in young children where the fever persists for more than 5-7 days.

  3. Sensorineural hearing loss in Kawasaki disease.

    PubMed

    Aggarwal, Varun; Etinger, Veronica; Orjuela, Andres F

    2016-01-01

    Kawasaki disease is a common nonspecific vasculitis seen in childhood. The most significant long-term sequela is coronary artery aneurysm. However, the spectrum of complications involves not only the heart, but also other organs such as the eyes, skin, kidneys, gallbladder, liver, and central nervous system. Sensorineural hearing loss (SNHL) is a relatively unrecognized complication of the disease. Although most of the complications (except coronary artery aneurysm) are self-limiting, SNHL can be persistent. It is, especially important in infants and young children who might not be able to report the hearing deficits and are most likely to have cognitive and speech delays if this hearing loss is not addressed in a timely manner. We report a child with Kawasaki disease who had SNHL during the 2(nd) week of the illness. The aim of this article is to briefly review the pathophysiology behind this hearing loss and strongly emphasize the importance of universal hearing evaluation in all children diagnosed with Kawasaki disease. This screening in children with Kawasaki disease may provide some timely intervention if needed. Since most Kawasaki disease patients will be seen by cardiologists, we hope to create more awareness about this complication to the cardiology community as well.

  4. Diagnosis and management of kawasaki disease.

    PubMed

    Saguil, Aaron; Fargo, Matthew; Grogan, Scott

    2015-03-15

    Kawasaki disease is an acute, systemic vasculitis that predominantly affects patients younger than five years. It represents the most prominent cause of acquired coronary artery disease in childhood. In the United States, 19 per 100,000 children younger than five years are hospitalized with Kawasaki disease annually. According to U.S. and Japanese guidelines, Kawasaki disease is a clinical diagnosis. Classic (typical) Kawasaki disease is diagnosed based on the presence of a fever lasting five or more days, accompanied by four out of five findings: bilateral conjunctival injection, oral changes such as cracked and erythematous lips and strawberry tongue, cervical lymphadenopathy, extremity changes such as erythema or palm and sole desquamation, and polymorphous rash. Incomplete (atypical) Kawasaki disease occurs in persons with fever lasting five or more days and with two or three of these findings. Transthoracic echocardiography is the diagnostic imaging modality of choice to screen for coronary aneurysms, although other techniques are being evaluated for diagnosis and management. Treatment for acute disease is intravenous immunoglobulin and aspirin. If there is no response to treatment, patients are given a second dose of intravenous immunoglobulin with or without corticosteroids or other adjunctive treatments. The presence and severity of coronary aneurysms and obstruction at diagnosis determine treatment options and the need, periodicity, and intensity of long-term cardiovascular monitoring for potential atherosclerosis.

  5. Estudio de la estructura logica utilizada en la ensenanza y el aprendizaje de los conceptos sobre el comportamiento de gases en el curso introductorio de quimica a nivel universitario

    NASA Astrophysics Data System (ADS)

    Costa Diaz, Agnes

    El estudio que se presenta es de caracter cualitativo, un estudio multicasos donde se estudia la estructura logica utilizada por cuatro (4) profesores universitarios que ensenan el curso introductorio de quimica, en la planificacion, presentacion y evaluacion del tema sobre el comportamiento de los gases. Se utilizaron varias fuentes de informacion como: cuestionarios de profesores y estudiantes, entrevistas, grabaciones videomagnetofonicas, materiales didacticos y una prueba conceptual, entre otros. La informacion recopilada fue analizada de acuerdo al orden logico del contenido presentado, el estilo de ensenanza del profesor, las tecnicas y estrategias utilizadas para el desarrollo de destrezas de pensamiento, el ambiente fisico en el salon de clase y los instrumentos de evaluacion y avaluo. El estudio demuestra que lo que los profesores piensan y planifican para hacer sus presentaciones no necesariamente es lo que ocurre en el salon de clases. El desarrollo de destrezas de pensamiento, que constituye una prioridad de los profesores, no se elaboran efectivamente. El uso de las estrategias de resolucion de problemas numericos predomino. La participacion del estudiante en el salon de clases fue limitada y no se logro demostrar el desarrollo de las destrezas de pensamiento deseadas. Aunque los profesores tienen su propio estilo de ensenanza, el orden logico del contenido presentado en clase fue el mismo o siguio muy de cerca el orden establecido por el libro de texto. Los profesores utilizaron preferentemente la tiza y la pizarra para sus presentaciones y la dinamica en el salon de clases fue esencialmente tradicional. Los profesores hicieron su presentacion y los estudiantes copiaron pasivamente la informacion. Las evaluaciones de los estudiantes fueron esencialmente, pruebas escritas de seleccion multiple de acuerdo con el estilo en que se les enseno. El avaluo fue casi inexistente. La prueba conceptual administrada revela un aprendizaje pobre en los conceptos mas

  6. Kawasaki disease shock syndrome: a rare and severe complication of Kawasaki disease.

    PubMed

    Çakan, Mustafa; Gemici, Hakan; Aktay-Ayaz, Nuray; Keskindemirci, Gonca; Bornaun, Helen; İkizoğlu, Tarkan; Çeliker, Alpay

    2016-01-01

    Kawasaki disease is an acute systemic vasculitis that occurs most commonly in young children. It affects medium-sized muscular arteries and the coronary arteries are the predominant site of involvement. Morbidity and mortality is generally due to coronary artery aneurysms that develop during the chronic phase. Although it is well known that Kawasaki disease can cause myocarditis, tachycardia and heart failure during acute stage, Kawasaki disease shock syndrome has been recently described. It is characterized by hypotension, signs and symptoms of poor perfusion and a shock-like state. Herein we describe two cases of Kawasaki disease shock syndrome that were treated in the pediatric intensive care unit and followed a course without morbidity or mortality.

  7. Conceptos Basicos Sobre el Gas Natural

    SciTech Connect

    2016-08-01

    El gas natural abastece cerca de 150.000 vehiculos en los Estados Unidos y aproximadamente 22 millones de vehiculos en todo el mundo. Los vehiculos de gas natural (NGV, por sus siglas en ingles) son una buena opcion para las flotas de vehiculos de alto kilometraje, tales como autobuses, taxis, vehiculos de recoleccion de basura, los cuales son alimentados centralmente u operan dentro de un area limitada o a lo largo de una ruta con estaciones de servicio de gas natural. Las ventajas del gas natural como combustible alternativo incluyen su disponibilidad interna, la red de distribucion establecida, un costo relativamente bajo, y los beneficios de las emisiones.

  8. Extremely refractory Kawasaki disease with disseminated intravascular coagulation.

    PubMed

    Koh, Young Kwon; Lee, Jae Hee; Park, Yeong Bong

    2017-03-07

    Disseminated intravascular coagulation is a rare complication of Kawasaki disease and appears in <0.1% of Kawasaki disease patients. We report a case of refractory Kawasaki disease complicated with disseminated intravascular coagulation and giant coronary aneurysm. A 5-month-old boy presented with Kawasaki disease with coagulopathy. Although the coagulopathy improved after fresh-frozen plasma and antithrombin-III administration, the fever persisted despite two rounds of intravenous immunoglobulin, along with intravenous methylprednisolone pulse therapy and infliximab administration. Despite all efforts to treatment, the patient had giant coronary aneurysms and died suddenly.

  9. Recognition and management of Kawasaki disease

    PubMed Central

    Han, R K; Sinclair, B; Newman, A; Silverman, E D; Taylor, G W; Walsh, P; McCrindle, B W

    2000-01-01

    Kawasaki disease is the leading cause of acquired heart disease in children in the developed world, with coronary artery aneurysms occurring in up to 25% of untreated cases. The mean annual incidence of Kawasaki disease across Canada is about 13 per 100,000 children less than 5 years of age, based on hospital discharge data from 1990 to 1995. The cause remains unknown, and the diagnosis is based on the same clinical criteria used to describe the disease over 30 years ago. However, nonspecific clinical features, evolving presentations and atypical or incomplete presentations make early diagnosis and timely treatment difficult. Delays in diagnosis and treatment, which occur more frequently in older children, are associated with an increased risk of coronary artery aneurysms. Hence, high diagnostic suspicion and prompt referral are required to reduce the rate of cardiac complications. PMID:10750471

  10. [Aftermaths of lesions of coronary arteries in Kawasaki disease].

    PubMed

    Vostokova, A A; Grunina, E A; Klemenov, A V

    2016-01-01

    Kawasaki disease, also known as cutaneous-mucous-glandular mucocutaneous glandular syndrome, is acute systemic vasculitis of small-to-medium calibre arteries, frequently involving coronary arteries, affect almost exceptionally children, with reports concerning cases of Kawasaki syndrome in 20-to-30-year-old adults being extremely rare. The most serious manifestation of Kawasaki disease is coronaritis and formation of coronary artery aneurysms. The dynamics of the formed coronary aneurysms and, consequently, the fate of patients may be different. Thrombosis of an aneurysm in the early period of the disease and stenosing of the affected coronary artery later on present possible complications of Kawasaki disease and potential causes of myocardial infection in young adults. Increased risk of coronary artery thromboses in Kawasaki disease is conditioned by a decrease in velocity of blood flow and its turbulent pattern in the aneurysms, endothelial dysfunction due to currently existing or endured coronaritis and thrombocytosis typical of this pathology. Predisposing factors of coronary artery stenosing are unfavourable haemodynamic conditions appearing at the sites of the "entry" and "exit" of the aneurysm. Described herein are two case reports of myocardial infarction, one of which being a complication of an acute case of Kawasaki disease in a 29-year-old patient, with the second one being a consequence of coronary artery stenosing in a 25-year-old patient who had endured Kawasaki disease in his childhood.

  11. Unusual imaging presentation of infantile atypical Kawasaki disease.

    PubMed

    Kumar, Nishith; Mittal, Mahesh Kumar; Sinha, Mukul; Gupta, Arpita; Thukral, Brij Bhushan

    2016-01-01

    Kawasaki disease is a systemic medium vessel vasculitis of unknown etiology affecting children under 5 years of age. There are no specific diagnostic tests, and thus, the diagnosis of the disease is primarily made on the basis of clinical criteria. Unusual presentations of Kawasaki disease have been variably reported from different parts of the world. However, presentation of the disease in the form of peripheral thromboembolism and florid non-coronary aneurysms has rarely been described This report describes the imaging findings in infantile atypical Kawasaki disease with aneurysms of multiple medium-sized arteries, including coronary arteries, emphasizing the detection of clinically silent aneurysms in the disease.

  12. Cardiac magnetic resonance feature tracking in Kawasaki disease convalescence

    PubMed Central

    Bratis, Konstantinos; Hachmann, Pauline; Child, Nicholas; Krasemann, Thomas; Hussain, Tarique; Mavrogeni, Sophie; Botnar, Rene; Razavi, Reza; Greil, Gerald

    2017-01-01

    Objective: The objective of this study was to determine whether left ventricular (LV) myocardial deformation indices can detect subclinical abnormalities in Kawasaki disease convalescence. We hypothesized that subclinical myocardial abnormalities due to inflammation represent an early manifestation of the disease that persists in convalescence. Background: Myocardial inflammation has been described as a global finding in the acute phase of Kawasaki disease. Despite normal systolic function by routine functional measurements, reduced longitudinal strain and strain rate have been detected by echocardiography in the acute phase. Methods and Results: Peak systolic LV myocardial longitudinal, radial, and circumferential strain and strain rate were examined in 29 Kawasaki disease convalescent patients (15 males; mean [standard deviation] age: 11 [6.6] years; median interval from disease onset: 5.8 [5.4] years) and 10 healthy volunteers (5 males; mean age: 14 [3.8] years) with the use of cardiac magnetic resonance (CMR) feature tracking. Routine indices of LV systolic function were normal in both groups. Comparisons were made between normal controls and (i) the entire Kawasaki disease group, (ii) Kawasaki disease subgroup divided by coronary artery involvement. Average longitudinal and circumferential strain at all levels was lower in patients compared to normal controls. In subgroup analysis, both Kawasaki disease patients with and without a history of coronary involvement had similar longitudinal and circumferential strain at all levels and lower when compared to controls. There were lower circumferential and longitudinal values in Kawasaki disease patients with persisting coronary artery lesions when compared to those with regressed ones. Conclusion: In this CMR study in Kawasaki disease convalescent patients with preserved routine functional indices, we detected lower circumferential and longitudinal strain values compared to normal controls, irrespective of the

  13. Preventing Long-Term Cardiac Damage in Pediatric Patients With Kawasaki Disease.

    PubMed

    Williams, Kelly

    Kawasaki disease is currently the leading cause of long-term cardiac damage in pediatric patients in the United States. Kawasaki disease is diagnosed based on symptomatology and by ruling out other etiology. There is a significant need for an improved, standardized treatment protocol for patients diagnosed with Kawasaki disease and a more rapid initiation of treatment for these patients. Decreasing the cardiac damage caused by Kawasaki disease with timely diagnosis and treatment needs be a principal goal.

  14. Four cases with Kawasaki disease and viral infection: aetiology or association.

    PubMed

    Giray, Tuba; Biçer, Suat; Küçük, Öznur; Çöl, Defne; Yalvaç, Zerrin; Gürol, Yeşim; Yilmaz, Gülden; Saç, Ahmet; Mogol, Yigit

    2016-12-01

    The aetiology of Kawasaki disease has not yet been precisely determined. It has been associated with a variety of bacterial and viral agents. Some viruses including human adenovirus, coronavirus, and parainfluenza virus type 3 have been isolated from patients with Kawasaki disease. Clinical presentation of patients with human coronavirus and adenovirus infections mimics Kawasaki disease. In addition, these viruses may also be detected in Kawasaki disease as a coinfection. In this report, we present four Kawasaki disease patients infected with adenovirus, coronavirus OC43/HKU1 and parainfluenza virus type 3.

  15. Tomographic myocardial perfusion scintigraphy in children with Kawasaki disease

    SciTech Connect

    Spielmann, R.P.; Nienaber, C.A.; Hausdorf, G.; Montz, R.

    1987-12-01

    Myocardial infarction and stenotic coronary lesions are serious late complications in children with Kawasaki disease. For the noninvasive assessment of myocardial perfusion, dipyridamole-redistribution /sup 201/Tl emission computed tomography (ECT) was performed in seven children (age 2 8/12-8 7/12 yr) 3-20 mo after the acute stage of the disease. In all patients, coronary aneurysms had been demonstrated by cross-sectional echocardiography. The scintigrams of six children showed no significant regional reduction of myocardial thallium uptake. These children had remained asymptomatic since the acute stage of Kawasaki disease. Persistent and transient thallium defects were present in one child with documented myocardial infarction. For this patient, obstruction of corresponding coronary vessels was confirmed by contrast angiography. It is suggested, that /sup 201/Tl ECT after dipyridamole-induced vasodilation may be used as a safe alternative to invasive coronary angiography for follow-up investigations in patients with Kawasaki disease.

  16. Angioscopic observation of coronary lesions in Kawasaki disease

    NASA Astrophysics Data System (ADS)

    Ishikawa, Hiromi

    1993-05-01

    Kawasaki disease is an acute systematic angiitis, specifically affecting the coronary arteries in young children. Coronary aneurysms develop in 10 to 15% of patients with Kawasaki disease. The coronary aneurysm frequently changes into coronary stenosis and obstruction. Hitherto, we could observe and access the severity of these coronary lesions with the use of two dimensional echocardiography and selective coronary angiography. Angiography is the most sensitive means available for diagnosing significant coronary lesions and their severity. However, it is insensitive for detecting intraluminal minute and pathologic changes such as intimal thickening, regeneration of endothelium and thrombus. Recent advance in fiberscopie technology, enabled us to observe the inside of coronary artery percutaneously. We tried to use this angioscopic technique for the observation of coronary lesions in eight patients with Kawasaki disease at chronic stage.

  17. Pathogenetic determinants in Kawasaki disease: the haematological point of view.

    PubMed

    Del Principe, Domenico; Pietraforte, Donatella; Gambardella, Lucrezia; Marchesi, Alessandra; Tarissi de Jacobis, Isabella; Villani, Alberto; Malorni, Walter; Straface, Elisabetta

    2017-04-01

    Kawasaki disease is a multisystemic vasculitis that can result in coronary artery lesions. It predominantly affects young children and is characterized by prolonged fever, diffuse mucosal inflammation, indurative oedema of the hands and feet, a polymorphous skin rash and non-suppurative lymphadenopathy. Coronary artery involvement is the most important complication of Kawasaki disease and may cause significant coronary stenosis resulting in ischemic heart disease. The introduction of intravenous immunoglobulin decreases the incidence of coronary artery lesions to less than 5%. The etiopathogenesis of this disease remains unclear. Several lines of evidence suggest that an interplay between a microbial infection and a genetic predisposition could take place in the development of the disease. In this review, we summarize the state of the art of pathogenetic mechanisms of Kawasaki disease underscoring the relevance of haematological features as a novel field of investigation.

  18. [Kawasaki disease: interdisciplinary and intersocieties consensus (clinical guidelines). Brief version].

    PubMed

    2016-08-01

    Kawasaki disease is an acute self-limiting systemic vasculitis. It is the most common cause of acquired heart disease, with the risk of developing coronary artery aneurysms, myocardial infarction and sudden death. Diagnosis is based on the presence of fever in addition to other clinical criteria. The quarter of the Kawasaki disease patients have "incomplete" presentation. Treatment with intravenous immunoglobulin within ten days of fever onset improves clinical outcomes and reduces the incidence of coronary artery dilation to less than 5%. Non-responders to standard therapy have shown a successful response with the use of corticosteroids and/or biological agents. The long-term management must be delineated according to the degree of coronary involvement in a multidisciplinary manner. To facilitate the pediatrician's diagnosis, treatment and monitoring of Kawasaki disease, a group of experts from the Argentine Society of Pediatrics and the Argentine Society of Cardiology carried out a consensus to develop practical clinical guidelines.

  19. T-Helper Cytokine Profiles in Patients with Kawasaki Disease

    PubMed Central

    Lee, Sang Bum; Kim, Young Hyun; Hyun, Myung Chul; Kim, Yeo Hyang; Kim, Hee Sun

    2015-01-01

    Background and Objectives Kawasaki disease is an acute systemic vasculitis of which pathogenesis suspected is caused by immune dysregulation. The goal of this study is to evaluate the activation pattern of T helper cell type 1 (Th1) and T helper cell type 2 (Th2) in patients with Kawasaki disease. Subjects and Methods Prospective study of 60 patients (male 36, female 24) with diagnosis of Kawasaki disease were enrolled. One hundred and eighty blood samples from these patients were collected according to the different clinical stages {before initial intravenous immunoglobulin (IVIG), 5 days after initial IVIG, 2 months after initial IVIG}. The plasma level of Th1 cytokines; interferon-gamma (IFN-γ) & interleukin (IL)-2 and Th2 cytokines; IL-4 & IL-10 were measured by enzyme-liked immunosorbent assay. Results In all patients, the plasma level of Th1 cytokines (IFN-γ, IL-2) and Th2 cytokines (IL-4 and IL-10) were markedly elevated during the acute stage of Kawasaki disease. Since then, the plasma level of all these cytokines decreased significantly along with the process of clinical stages. Regardless of the existence of coronary artery lesion or no response to initial IVIG treatment, there were no significant differences between them. Conclusion These data suggest that both Th1 and Th2 cells may be activated simultaneously during the acute stage of Kawasaki disease. Further studies are therefore required to establish the difference of activation pattern of T helper cells between Kawasaki disease and other inflammatory diseases. PMID:26617655

  20. Lie symmetries of the shigesada-Kawasaki-Teramoto system

    NASA Astrophysics Data System (ADS)

    Cherniha, Roman; Davydovych, Vasyl'; Muzyka, Liliia

    2017-04-01

    The Shigesada-Kawasaki-Teramoto system, which consists of two reaction-diffusion equations with variable cross-diffusion and quadratic nonlinearities, is considered. The system is the most important case of the biologically motivated model proposed by Shigesada et al. (J. Theor. Biol.79(1979) 83-99). A complete description of Lie symmetries for this system is derived. It is proved that the Shigesada-Kawasaki-Teramoto system admits a wide range of different Lie symmetries depending on coefficient values. In particular, the Lie symmetry operators with highly unusual structure are unveiled and applied for finding exact solutions of the relevant nonlinear system with cross-diffusion.

  1. Kawasaki disease and juvenile systemic lupus erythematosus.

    PubMed

    Diniz, J C; Almeida, R T; Aikawa, N E; Sallum, A M E; Sakane, P T; Silva, C A

    2012-01-01

    Kawasaki disease (KD) is a common vasculitis in childhood. To the authors' knowledge, only one case of juvenile systemic lupus erythematosus (JSLE)-like onset mimicking KD and another case of KD and JSLE association have previously been described. However, the prevalence of this association of the two diseases was not reported. Therefore, over 27 consecutive years, 5419 patients were followed at the Pediatric Rheumatology Unit and 271 (5%) of them met the ACR classification criteria for JSLE. Two (0.7%) of them were female. These also had KD according to European League against Rheumatism / Paediatric Rheumatology European Society (EULAR/PReS) consensus criteria and are described in this report. One case was a 13-year-old who presented all six KD criteria. Echocardiogram showed pericardial effusion, dilatation and tortuosity of right and left coronary, and her symptoms promptly improved after treatment with intravenous immunoglobulin (IVIG). Lupus diagnosis was established a few days later. Another case was a 4-year-old who had also met all six KD criteria, with improvement after IVIG, and lupus diagnosis was made 1 year later. In conclusion, the frequency of the association between these two autoimmune diseases was rare. The occurrence of a second autoimmune systemic disease in a patient with a history of KD should also be considered. Furthermore, the initial presentation of lupus may mimic KD.

  2. Seasonality of Kawasaki Disease: A Global Perspective

    PubMed Central

    Burns, Jane C.; Herzog, Lauren; Fabri, Olivia; Tremoulet, Adriana H.; Rodó, Xavier; Uehara, Ritei; Burgner, David; Bainto, Emelia; Pierce, David; Tyree, Mary; Cayan, Daniel

    2013-01-01

    Background Understanding global seasonal patterns of Kawasaki disease (KD) may provide insight into the etiology of this vasculitis that is now the most common cause of acquired heart disease in children in developed countries worldwide. Methods Data from 1970-2012 from 25 countries distributed over the globe were analyzed for seasonality. The number of KD cases from each location was normalized to minimize the influence of greater numbers from certain locations. The presence of seasonal variation of KD at the individual locations was evaluated using three different tests: time series modeling, spectral analysis, and a Monte Carlo technique. Results A defined seasonal structure emerged demonstrating broad coherence in fluctuations in KD cases across the Northern Hemisphere extra-tropical latitudes. In the extra-tropical latitudes of the Northern Hemisphere, KD case numbers were highest in January through March and approximately 40% higher than in the months of lowest case numbers from August through October. Datasets were much sparser in the tropics and the Southern Hemisphere extra-tropics and statistical significance of the seasonality tests was weak, but suggested a maximum in May through June, with approximately 30% higher number of cases than in the least active months of February, March and October. The seasonal pattern in the Northern Hemisphere extra-tropics was consistent across the first and second halves of the sample period. Conclusion Using the first global KD time series, analysis of sites located in the Northern Hemisphere extra-tropics revealed statistically significant and consistent seasonal fluctuations in KD case numbers with high numbers in winter and low numbers in late summer and fall. Neither the tropics nor the Southern Hemisphere extra-tropics registered a statistically significant aggregate seasonal cycle. These data suggest a seasonal exposure to a KD agent that operates over large geographic regions and is concentrated during winter

  3. Recent Advances in Kawasaki Disease - Proceedings of the 3rd Kawasaki Disease Summit, Chandigarh, 2014.

    PubMed

    Singh, Surjit; Sharma, Dhrubajyoti; Bhattad, Sagar; Phillip, Saji

    2016-01-01

    Kawasaki disease (KD) is the most common cause of acquired heart disease in children in Japan, North America and Europe. It is now being increasingly recognized from the developing countries as well. If not diagnosed and treated in time, KD can result in coronary artery abnormalities in approximately 15-25% cases. The long-term consequences of these abnormalities may manifest in adults as myocardial ischemia and congestive heart failure. Intravenous immunoglobulin (IVIg) remains the drug of choice for treatment of KD, but several new agents like infliximab, cyclosporine, glucocorticoids and statins are now being increasingly used in these patients. While echocardiography has been the preferred imaging modality hitherto, CT coronary angiography has emerged as an exciting new supplementary option and provides an entirely new dimension to this disease. The incidence of KD has shown a progressive increase in several countries and it is likely that this disease would impact public health programmes in the near future even in the developing countries.

  4. Consortium-Based Genetic Studies of Kawasaki Disease in Korea: Korean Kawasaki Disease Genetics Consortium.

    PubMed

    Lee, Jong-Keuk; Hong, Young Mi; Jang, Gi Young; Yun, Sin Weon; Yu, Jeong Jin; Yoon, Kyung Lim; Lee, Kyung-Yil; Kil, Hong-Rang

    2015-11-01

    In order to perform large-scale genetic studies of Kawasaki disease (KD) in Korea, the Korean Kawasaki Disease Genetics Consortium (KKDGC) was formed in 2008 with 10 hospitals. Since the establishment of KKDGC, there has been a collection of clinical data from a total of 1198 patients, and approximately 5 mL of blood samples per patient (for genomic deoxyribonucleic acid and plasma isolation), using a standard clinical data collection form and a nation-wide networking system for blood sample pick-up. In the clinical risk factor analysis using the collected clinical data of 478 KD patients, it was found that incomplete KD type, intravenous immunoglobulin (IVIG) non-responsiveness, and long febrile days are major risk factors for coronary artery lesions development, whereas low serum albumin concentration is an independent risk factor for IVIG non-responsiveness. In addition, we identified a KD susceptibility locus at 1p31, a coronary artery aneurysm locus (KCNN2 gene), and the causal variant in the C-reactive protein (CRP) promoter region, as determining the increased CRP levels in KD patients, by means of genome-wide association studies. Currently, this consortium is continually collecting more clinical data and genomic samples to identify the clinical and genetic risk factors via a single nucleotide polymorphism chip and exome sequencing, as well as collaborating with several international KD genetics teams. The consortium-based approach for genetic studies of KD in Korea will be a very effective way to understand the unknown etiology and causal mechanism of KD, which may be affected by multiple genes and environmental factors.

  5. Kawasaki Disease in India, Lessons Learnt Over the Last 20 Years.

    PubMed

    Singh, Surjit; Kawasaki, Tomisaku

    2016-02-01

    Over the last 20 years, Kawasaki disease is being increasingly recognized in India and it may soon replace acute rheumatic fever to become the commonest cause of acquired heart disease amongst children. However, the vast majority of children with Kawasaki disease in India are still not being diagnosed. Diagnosis of Kawasaki disease is based on a constellation of clinical findings which have a typical temporal sequence. All pediatricians must we familiar with the nuances involved in arriving at a diagnosis of Kawasaki disease. With early diagnosis and prompt treatment, the risk of coronary artery abnormalities can be significantly reduced.

  6. Myocardial infarction in a 35-day-old infant with incomplete Kawasaki disease and chicken pox.

    PubMed

    Kossiva, Lydia; Papadopoulos, Marios; Lagona, Evangelia; Papadopoulos, George; Athanassaki, Corina

    2010-10-01

    Kawasaki disease is an acute febrile vasculitis of infancy and early childhood. It is uncommon in early infancy, because a significant proportion of these children do not meet the classical diagnostic criteria at this age. Infants younger than 6 months with persistent fever and some of the criteria of Kawasaki disease should always raise suspicion for Kawasaki disease early to avoid delayed diagnosis with severe cardiac complications. We present a 35-day-old infant with incomplete Kawasaki disease complicated with myocardial infarction during chicken pox.

  7. BCG and Kawasaki disease in Mexico and Japan.

    PubMed

    Gamez-Gonzalez, Luisa Berenise; Hamada, Hiromichi; Llamas-Guillen, Beatriz Adriana; Ruiz-Fernandez, Miguel; Yamazaki-Nakashimada, Marco

    2017-03-10

    Dr. Tomisaku Kawasaki was the first to describe BCG reactivation in Kawasaki Disease (KD), and this sign is present in about 30-50% of KD patients. It is a very specific early sign of the disease and although it has been recognized for decades, its pathophysiology continues to be an enigma. Recently, Yamada et al. reported a severe BCG reaction with tuberculid in 2 Japanese KD patients. We present 2 cases with KD and severe BCG reaction, one from Japan and the other from Mexico and review the policies of administration of BCG in both countries. The BCG vaccine has a worldwide coverage of 88%. Differences in BCG strains and methods of administration may influence BCG reactions in KD. The BCG reaction in the inoculation site may represent the most useful sign in KD.

  8. Chronic granulomatous disease associated with atypical Kawasaki disease.

    PubMed

    Yamazaki-Nakashimada, M A; Ramírez-Vargas, N; De Rubens-Figueroa, J

    2008-01-01

    Chronic granulomatous disease (CGD) is an infrequent inherited disorder characterized by recurrent infections and abnormal granuloma formation. Patients with CGD have an exuberant inflammatory response and an increased risk of developing autoimmunity. We present the case of a 1-year-old boy with CGD who developed several of the characteristic clinical features of Kawasaki Disease. His illness responded to intravenous immunoglobulin, aspirin, and corticosteroids.

  9. Oral necrotizing microvasculitis in a patient affected by Kawasaki disease.

    PubMed

    Scardina, Giuseppe Alessandro; Fucà, Gerlandina; Carini, Francesco; Valenza, Vincenzo; Spicola, Michele; Procaccianti, Paolo; Messina, Pietro; Maresi, Emiliano

    2007-12-01

    Kawasaki disease (KD) was first described in 1967 by Kawasaki, who defined it as "mucocutaneous lymph node syndrome". KD is an acute systemic vasculitis, which mainly involves medium calibre arteries; its origin is unknown, and it is observed in children under the age of 5, especially in their third year. The principal presentations of KD include fever, bilateral nonexudative conjunctivitis, erythema of the lips and oral mucosa, changes in the extremities, rash, and cervical lymphadenopathy. Within KD, oral mucositis - represented by diffuse mucous membrane erythema, lip and tongue reddening and lingual papillae hypertrophy with subsequent development of strawberry tongue - can occur both in the acute stage of the disease (0-9 days), and in the convalescence stage (>25 days) as a consequence of the pharmacological treatment. KD vascular lesions are defined as systemic vasculitis instead of systemic arteritis. This study analyzed the anatomical-pathological substrata of oral mucositis in a baby affected by Kawasaki disease and suddenly deceased for cardiac tamponade caused by coronary aneurysm rupture (sudden cardiac death of a mechanical type).

  10. Establishment of Kawasaki disease database based on metadata standard

    PubMed Central

    Park, Yu Rang; Kim, Jae-Jung; Yoon, Young Jo; Yoon, Young-Kwang; Koo, Ha Yeong; Hong, Young Mi; Jang, Gi Young; Shin, Soo-Yong; Lee, Jong-Keuk

    2016-01-01

    Kawasaki disease (KD) is a rare disease that occurs predominantly in infants and young children. To identify KD susceptibility genes and to develop a diagnostic test, a specific therapy, or prevention method, collecting KD patients’ clinical and genomic data is one of the major issues. For this purpose, Kawasaki Disease Database (KDD) was developed based on the efforts of Korean Kawasaki Disease Genetics Consortium (KKDGC). KDD is a collection of 1292 clinical data and genomic samples of 1283 patients from 13 KKDGC-participating hospitals. Each sample contains the relevant clinical data, genomic DNA and plasma samples isolated from patients’ blood, omics data and KD-associated genotype data. Clinical data was collected and saved using the common data elements based on the ISO/IEC 11179 metadata standard. Two genome-wide association study data of total 482 samples and whole exome sequencing data of 12 samples were also collected. In addition, KDD includes the rare cases of KD (16 cases with family history, 46 cases with recurrence, 119 cases with intravenous immunoglobulin non-responsiveness, and 52 cases with coronary artery aneurysm). As the first public database for KD, KDD can significantly facilitate KD studies. All data in KDD can be searchable and downloadable. KDD was implemented in PHP, MySQL and Apache, with all major browsers supported. Database URL: http://www.kawasakidisease.kr PMID:27630202

  11. Establishment of Kawasaki disease database based on metadata standard.

    PubMed

    Park, Yu Rang; Kim, Jae-Jung; Yoon, Young Jo; Yoon, Young-Kwang; Koo, Ha Yeong; Hong, Young Mi; Jang, Gi Young; Shin, Soo-Yong; Lee, Jong-Keuk

    2016-07-01

    Kawasaki disease (KD) is a rare disease that occurs predominantly in infants and young children. To identify KD susceptibility genes and to develop a diagnostic test, a specific therapy, or prevention method, collecting KD patients' clinical and genomic data is one of the major issues. For this purpose, Kawasaki Disease Database (KDD) was developed based on the efforts of Korean Kawasaki Disease Genetics Consortium (KKDGC). KDD is a collection of 1292 clinical data and genomic samples of 1283 patients from 13 KKDGC-participating hospitals. Each sample contains the relevant clinical data, genomic DNA and plasma samples isolated from patients' blood, omics data and KD-associated genotype data. Clinical data was collected and saved using the common data elements based on the ISO/IEC 11179 metadata standard. Two genome-wide association study data of total 482 samples and whole exome sequencing data of 12 samples were also collected. In addition, KDD includes the rare cases of KD (16 cases with family history, 46 cases with recurrence, 119 cases with intravenous immunoglobulin non-responsiveness, and 52 cases with coronary artery aneurysm). As the first public database for KD, KDD can significantly facilitate KD studies. All data in KDD can be searchable and downloadable. KDD was implemented in PHP, MySQL and Apache, with all major browsers supported.Database URL: http://www.kawasakidisease.kr.

  12. Marked eosinophilia in a patient with history of severe atypical Kawasaki disease.

    PubMed

    O'Byrne, Michael L; Cohen, Meryl S

    2013-01-01

    An infant with recent atypical, treatment-refractory Kawasaki disease presented with marked eosinophilia. Workup failed to identify an etiology. The eosinophilia spontaneously resolved. Eosinophilia has been observed in the acute phase of Kawasaki disease, but has not been reported following recovery.

  13. Possible involvement of infection with human coronavirus 229E, but not NL63, in Kawasaki disease.

    PubMed

    Shirato, Kazuya; Imada, Yoshio; Kawase, Miyuki; Nakagaki, Keiko; Matsuyama, Shutoku; Taguchi, Fumihiro

    2014-12-01

    Although human coronavirus (HCoV)-NL63 was once considered a possible causative agent of Kawasaki disease based on RT-PCR analyses, subsequent studies could not confirm the result. In this study, this possibility was explored using serological tests. To evaluate the role of HCoV infection in patients with Kawasaki disease, immunofluorescence assays and virus neutralizing tests were performed. Paired serum samples were obtained from patients with Kawasaki disease who had not been treated with γ-globulin. HCoV-NL63 and two antigenically different isolates of HCoV-229E (ATCC-VR740 and a new isolate, Sendai-H) were examined as controls. Immunofluorescence assays detected no difference in HCoV-NL63 antibody positivity between the patients with Kawasaki disease and controls, whereas the rate of HCoV-229E antibody positivity was higher in the patients with Kawasaki disease than that in controls. The neutralizing tests revealed no difference in seropositivity between the acute and recovery phases of patients with Kawasaki disease for the two HCoV-229Es. However, the Kawasaki disease specimens obtained from patients in recovery phase displayed significantly higher positivity for Sendai-H, but not for ATCC-VR740, as compared to the controls. The serological test supported no involvement of HCoV-NL63 but suggested the possible involvement of HCoV-229E in the development of Kawasaki disease.

  14. Incomplete Kawasaki disease associated with complicated Streptococcus pyogenes pneumonia: A case report.

    PubMed

    Leahy, Timothy Ronan; Cohen, Eyal; Allen, Upton D

    2012-01-01

    A three-year-old boy presented with community-acquired pneumonia complicated by empyema. Streptococcus pyogenes (group A streptococcus) was identified on culture of the pleural fluid. The patient improved with antibiotic therapy and drainage of the empyema. During his convalescence, the patient developed persistent fever, lethargy and anorexia. His inflammatory markers were elevated, and repeat cultures were negative. Although the patient had none of the classical mucocutaneous features of Kawasaki disease, an echocardiogram was performed, which revealed coronary artery dilation. The patient was diagnosed with incomplete Kawasaki disease and treated with intravenous immunoglobulin and high-dose acetylsalicylic acid. The fever subsided within 48 h. To the authors' knowledge, the present report is the first report of Kawasaki disease associated with complicated S pyogenes pneumonia. It emphasizes the importance of considering incomplete Kawasaki disease among children with persistent fever, the role of echocardiography in diagnosis, and the potential link between Kawasaki disease and superantigen-producing organisms such as S pyogenes.

  15. Renormalized dynamics of the Dean-Kawasaki model

    NASA Astrophysics Data System (ADS)

    Bidhoodi, Neeta; Das, Shankar P.

    2015-07-01

    We study the model of a supercooled liquid for which the equation of motion for the coarse-grained density ρ (x ,t ) is the nonlinear diffusion equation originally proposed by Dean and Kawasaki, respectively, for Brownian and Newtonian dynamics of fluid particles. Using a Martin-Siggia-Rose (MSR) field theory we study the renormalization of the dynamics in a self-consistent form in terms of the so-called self-energy matrix Σ . The appropriate model for the renormalized dynamics involves an extended set of field variables {ρ ,θ } , linked through a nonlinear constraint. The latter incorporates, in a nonperturbative manner, the effects of an infinite number of density nonlinearities in the dynamics. We show that the contributing element of Σ which renormalizes the bare diffusion constant D0 to DR is same as that proposed by Kawasaki and Miyazima [Z. Phys. B Condens. Matter 103, 423 (1997), 10.1007/s002570050396]. DR sharply decreases with increasing density. We consider the likelihood of a ergodic-nonergodic (ENE) transition in the model beyond a critical point. The transition is characterized by the long-time limit of the density correlation freezing at a nonzero value. From our analysis we identify an element of Σ which arises from the above-mentioned nonlinear constraint and is key to the viability of the ENE transition. If this self-energy would be zero, then the model supports a sharp ENE transition with DR=0 as predicted by Kawasaki and Miyazima. With the full model having nonzero value for this self-energy, the density autocorrelation function decays to zero in the long-time limit. Hence the ENE transition is not supported in the model.

  16. Renormalized dynamics of the Dean-Kawasaki model.

    PubMed

    Bidhoodi, Neeta; Das, Shankar P

    2015-07-01

    We study the model of a supercooled liquid for which the equation of motion for the coarse-grained density ρ(x,t) is the nonlinear diffusion equation originally proposed by Dean and Kawasaki, respectively, for Brownian and Newtonian dynamics of fluid particles. Using a Martin-Siggia-Rose (MSR) field theory we study the renormalization of the dynamics in a self-consistent form in terms of the so-called self-energy matrix Σ. The appropriate model for the renormalized dynamics involves an extended set of field variables {ρ,θ}, linked through a nonlinear constraint. The latter incorporates, in a nonperturbative manner, the effects of an infinite number of density nonlinearities in the dynamics. We show that the contributing element of Σ which renormalizes the bare diffusion constant D(0) to D(R) is same as that proposed by Kawasaki and Miyazima [Z. Phys. B Condens. Matter 103, 423 (1997)]. D(R) sharply decreases with increasing density. We consider the likelihood of a ergodic-nonergodic (ENE) transition in the model beyond a critical point. The transition is characterized by the long-time limit of the density correlation freezing at a nonzero value. From our analysis we identify an element of Σ which arises from the above-mentioned nonlinear constraint and is key to the viability of the ENE transition. If this self-energy would be zero, then the model supports a sharp ENE transition with D(R)=0 as predicted by Kawasaki and Miyazima. With the full model having nonzero value for this self-energy, the density autocorrelation function decays to zero in the long-time limit. Hence the ENE transition is not supported in the model.

  17. Toxic shock syndrome. Possible confusion with Kawasaki's disease.

    PubMed

    Raimer, S S; Tschen, E H; Walker, M K

    1981-07-01

    Toxic shock syndrome (TSS) is a recently recognized condition associated with toxin-producing strains of Staphylococcus aureus. Patients affected with this syndrome are frequently young and have multisystemic complaints such as fever, headache, edema, myalgia, scarlatiniform rash, conjunctival injection, confusion, diarrhea, oliguria, hypotension and shock, This is followed by desquamation of the skin, especially the palms and soles. The majority of cases reported have been in menstruating women who used vaginal tampons regularly. Because similarities exist between toxic shock syndrome and Kawasaki's disease (mucocutaneous lymph node syndrome), as well as other conditions, proper diagnosis and management are of the utmost importance.

  18. Metastable and scaling regimes of one-dimensional Kawasaki dynamics.

    PubMed

    Albarracín, F A Gómez; Rosales, H D; Grynberg, M D

    2016-04-01

    We investigate the large-time scaling regimes arising from a variety of metastable structures in a chain of Ising spins with both first- and second-neighbor couplings while subject to Kawasaki dynamics. Depending on the ratio and sign of these former, different dynamic exponents are suggested by finite-size scaling analyses of relaxation times. At low but nonzero temperatures these are calculated via exact diagonalizations of the evolution operator in finite chains under several activation barriers. In the absence of metastability the dynamics is always diffusive.

  19. Metastable and scaling regimes of one-dimensional Kawasaki dynamics

    NASA Astrophysics Data System (ADS)

    Albarracín, F. A. Gómez; Rosales, H. D.; Grynberg, M. D.

    2016-04-01

    We investigate the large-time scaling regimes arising from a variety of metastable structures in a chain of Ising spins with both first- and second-neighbor couplings while subject to Kawasaki dynamics. Depending on the ratio and sign of these former, different dynamic exponents are suggested by finite-size scaling analyses of relaxation times. At low but nonzero temperatures these are calculated via exact diagonalizations of the evolution operator in finite chains under several activation barriers. In the absence of metastability the dynamics is always diffusive.

  20. Cellulitis-Like Rash Associated with Kawasaki Disease.

    PubMed

    Itamura, Shinji; Ishiguchi, Yukiko; Kuwabara, Kentaro; Yasui, Kozo; Kamada, Masahiro

    2016-01-01

    We present the case of a 5-year-old-boy who developed a fever and cellulitis-like groin rash 5 days before developing conjunctivitis and 6 to 7 days before other typical signs of Kawasaki disease (KD) appeared. The cellulitis failed to respond to antibiotics and no pathogens were isolated. His fever and clinical signs resolved with intravenous immunoglobulin and high-dose aspirin after discontinuation of antibiotics. Nonbacterial cellulitis is a rare presenting sign of KD, but in the appropriate clinical setting and population, a diagnosis of KD should be considered when cellulitis and fever fail to respond to an appropriate antibiotic regimen and no pathogen can be isolated.

  1. ITPKC functional polymorphism associated with Kawasaki disease susceptibility and formation of coronary artery aneurysms.

    PubMed

    Onouchi, Yoshihiro; Gunji, Tomohiko; Burns, Jane C; Shimizu, Chisato; Newburger, Jane W; Yashiro, Mayumi; Nakamura, Yoshikazu; Yanagawa, Hiroshi; Wakui, Keiko; Fukushima, Yoshimitsu; Kishi, Fumio; Hamamoto, Kunihiro; Terai, Masaru; Sato, Yoshitake; Ouchi, Kazunobu; Saji, Tsutomu; Nariai, Akiyoshi; Kaburagi, Yoichi; Yoshikawa, Tetsushi; Suzuki, Kyoko; Tanaka, Takeo; Nagai, Toshiro; Cho, Hideo; Fujino, Akihiro; Sekine, Akihiro; Nakamichi, Reiichiro; Tsunoda, Tatsuhiko; Kawasaki, Tomisaku; Nakamura, Yusuke; Hata, Akira

    2008-01-01

    Kawasaki disease is a pediatric systemic vasculitis of unknown etiology for which a genetic influence is suspected. We identified a functional SNP (itpkc_3) in the inositol 1,4,5-trisphosphate 3-kinase C (ITPKC) gene on chromosome 19q13.2 that is significantly associated with Kawasaki disease susceptibility and also with an increased risk of coronary artery lesions in both Japanese and US children. Transfection experiments showed that the C allele of itpkc_3 reduces splicing efficiency of the ITPKC mRNA. ITPKC acts as a negative regulator of T-cell activation through the Ca2+/NFAT signaling pathway, and the C allele may contribute to immune hyper-reactivity in Kawasaki disease. This finding provides new insights into the mechanisms of immune activation in Kawasaki disease and emphasizes the importance of activated T cells in the pathogenesis of this vasculitis.

  2. Transient lingual papillitis associated with confirmed herpes simplex virus 1 in a patient with kawasaki disease.

    PubMed

    Krakowski, Andrew C; Kim, Silvia S; Burns, Jane C

    2014-01-01

    We present a case of transient lingual papillitis associated with confirmed herpes simplex virus 1 that developed after a child received intravenous immunoglobulin and infliximab for acute Kawasaki disease.

  3. Kawasaki disease: an evidence based approach to diagnosis, treatment, and proposals for future research

    PubMed Central

    Brogan, P; Bose, A; Burgner, D; Shingadia, D; Tulloh, R; Michie, C; Klein, N; Booy, R; Levin, M; Dillon, M

    2002-01-01

    This article proposes a clinical guideline for the diagnosis and treatment of Kawasaki disease in the UK based on the best available evidence to date, and highlights areas of practice where evidence is anecdotal or based on retrospective data. Future research as proposed by the London Kawasaki Disease Research Group is outlined, and clinicians are invited to prospectively enrol their suspected cases into this collaborative research project. PMID:11919108

  4. [Reactivation of the scar of BCG vaccination in Kawasaki's disease: clinical case and literature review].

    PubMed

    García Pavón, Susana; Staines Boone, Tamara; Hernández Bautista, Víctor; Yamazaki Nakashimada, Marco Antonio

    2006-01-01

    Kawasaki disease is an acute febrile multisystemic vasculitis affecting children that can affect the coronary arteries. Routine BCG vaccination in Mexico leads to a 99% coverage in infants younger than 1 year. We present a case of Kawasaki disease with skin lesions at the site of BCG. Clinicians should be aware of this clinical manifestation that could help diagnose atypical or incomplete cases of the disease.

  5. The serum concentration of soluble interleukin-2 receptor in patients with Kawasaki disease.

    PubMed

    Teraura, Hiroyuki; Kotani, Kazuhiko; Minami, Takaomi; Takeshima, Taro; Shimooki, Osamu; Kajii, Eiji

    2017-03-01

    Kawasaki disease is a febrile disease of childhood that is associated with increased inflammatory cytokines and immunoregulatory abnormalities. While the serum concentrations of soluble IL-2 receptor can change under such pathologies, the relevance of the soluble IL-2 receptor concentration in patients with Kawasaki disease has not been specified. We aimed to summarize the existing studies that reported the soluble IL-2 receptor concentrations in patients with Kawasaki disease. Original articles that were published up to July 2016 were collected using a PubMed/Medline-based search engine. A total of nine articles that reported the serum soluble IL-2 receptor concentrations in acute-phase Kawasaki disease were eligible. All of the articles described a high soluble IL-2 receptor concentration in patients with Kawasaki disease relative to the level of controls or the reference range. Two of five articles on patients with coronary artery aneurysms described a significantly higher soluble IL-2 receptor concentration in patients with coronary artery aneurysms than patients without. Two articles on patients with intravenous immunoglobulin therapy described a significant decrease of the soluble IL-2 receptor concentration after the therapy. Accordingly, the serum soluble IL-2 receptor can be a potent marker of disease activity and therapeutic effects in patients with Kawasaki disease; further studies are thus warranted for its use in the clinical setting.

  6. Role of the Egami Score in Predicting Intravenous Immunoglobulin Resistance in Kawasaki Disease Among Different Ethnicities.

    PubMed

    Loomba, Rohit S; Raskin, Alexander; Gudausky, Todd M; Kirkpatrick, Edward

    Early treatment with intravenous immunoglobulin (IVIG) is necessary to help reduce the risk of coronary artery abnormalities, such as coronary artery aneurysms and to help alleviate symptoms, in Kawasaki disease. Some patients, however, do not respond to an initial dose of IVIG and require additional doses. Prediction of these IVIG nonresponders may be of assistance in altering initial therapy to make it more effective. The Egami score has been validated in the Japanese population to predict IVIG nonresponders but has shown to be ineffective in US populations. This study evaluates the Egami score in a Midwest US population, subdividing patients by race and the diagnosis of typical or atypical type of Kawasaki disease. Patients were included in the study if they met criteria for Kawasaki disease and received IVIG in the inpatient setting. A total of 182 patients were studied, and in all studied groups, the Egami score had poor sensitivity at predicting IVIG nonresponders. Sensitivity of the score differed between races and differed between typical and atypical Kawasaki disease. The Egami score, as well as other systems, have been validated to predict IVIG nonresponders. These, however, lack sensitivity in the US population. Other scores developed in the United States have also lacked sensitivity, likely due to the absence of race or Kawasaki disease classification as variables. The development of a sensitive scoring system to predict IVIG nonresponders in US populations will require the incorporation of race and Kawasaki disease classification, factors that seem to alter IVIG response.

  7. Asymptomatic myocardial infarction in Kawasaki disease: Long-term prognosis

    SciTech Connect

    Shiraishi, I.; Onouchi, Z.; Hayano, T.; Hamaoka, K.; Kiyosawa, N. )

    1991-04-01

    Eight patients with Kawasaki disease who had sustained asymptomatic myocardial infarction 8-15 years ago (mean, 13.1 years) were reexamined by various noninvasive cardiac function tests to assess long-term prognosis. At present, electrocardiograms (ECGs) are normal in six patients. However, all eight patients had a prolonged preejection period (PEP) to left ventricular ejection time (LVET) ratio 30 s after amylnitrate (AN) inhalation. Six patients had perfusion defects by exercise thallium-201 myocardial scintigraphy, and two patients developed ST segment depression in treadmill exercise testing. These patients are symptom-free even though their physical activity has not been restricted. Yet they proved to have serious abnormalities suggesting sequelae of myocardial infarction or existing myocardial ischemia. Judging from the results of noninvasive cardiac function tests and recently performed coronary angiography, five of the eight patients require coronary bypass surgery.

  8. [Brain hemorrhage in a patient with Kawasaki disease].

    PubMed

    Yamazaki-Nakashimada, Marco Antonio; Rivas-Larrauri, Francisco; Alcántara-Salinas, Adriana; Hernández-Bautista, Victor; Rodríguez-Lozano, Ana Luisa

    2013-01-01

    Kawasaki disease is an acute, self-limiting vasculitis of unknown origin, characterized by fever, palms and soles edema, cervical lymphadenopathy, strawberry tongue, and non-exudative conjunctivitis. It is a multisystemic vasculitis that affects predominantly infants and young children. The most feared complication is the development of coronary aneurysms that occurs up to 25% of untreated patients; however there are reports of extra coronary involvement. Herein we present the case of a 2 year-old girl who had a severe symptomatology and persistent fever despite intravenous gammaglobulin. Two years later she presented right hemiparesia and headache, with data from CAT and MRI suggestive of brain mass and deviation of the midline, secondary to left frontoparietal haemorrhage that was treated with a craniotomy. She was discharged on prednisone, ASA and rehabilitation.

  9. Common variants in CASP3 confer susceptibility to Kawasaki disease.

    PubMed

    Onouchi, Yoshihiro; Ozaki, Kouichi; Buns, Jane C; Shimizu, Chisato; Hamada, Hiromichi; Honda, Takafumi; Terai, Masaru; Honda, Akihito; Takeuchi, Takashi; Shibuta, Shoichi; Suenaga, Tomohiro; Suzuki, Hiroyuki; Higashi, Kouji; Yasukawa, Kumi; Suzuki, Yoichi; Sasago, Kumiko; Kemmotsu, Yasushi; Takatsuki, Shinichi; Saji, Tsutomu; Yoshikawa, Tetsushi; Nagai, Toshiro; Hamamoto, Kunihiro; Kishi, Fumio; Ouchi, Kazunobu; Sato, Yoshitake; Newburger, Jane W; Baker, Annette L; Shulman, Stanford T; Rowley, Anne H; Yashiro, Mayumi; Nakamura, Yoshikazu; Wakui, Keiko; Fukushima, Yoshimitsu; Fujino, Akihiro; Tsunoda, Tatsuhiko; Kawasaki, Tomisaku; Hata, Akira; Nakamura, Yusuke; Tanaka, Toshihiro

    2010-07-15

    Kawasaki disease (KD; OMIM 611775) is an acute vasculitis syndrome which predominantly affects small- and medium-sized arteries of infants and children. Epidemiological data suggest that host genetics underlie the disease pathogenesis. Here we report that multiple variants in the caspase-3 gene (CASP3) that are in linkage disequilibrium confer susceptibility to KD in both Japanese and US subjects of European ancestry. We found that a G to A substitution of one commonly associated SNP located in the 5' untranslated region of CASP3 (rs72689236; P = 4.2 x 10(-8) in the Japanese and P = 3.7 x 10(-3) in the European Americans) abolished binding of nuclear factor of activated T cells to the DNA sequence surrounding the SNP. Our findings suggest that altered CASP3 expression in immune effecter cells influences susceptibility to KD.

  10. Development of Kawasaki disease in a patient with PFAPA.

    PubMed

    Ninomiya, Takahito; Takada, Hidetoshi; Nagatomo, Yusaku; Nanishi, Etsuro; Nagata, Hazumu; Yamamura, Kenichiro; Doi, Takehiko; Ikeda, Kazuyuki; Hara, Toshiro

    2013-12-01

    Periodic fever, aphthous stomatitis, pharyngitis and cervical adenitis syndrome (PFAPA) is one of the autoinflammatory diseases of unknown etiology characterized by regularly recurrent fever episodes with attacks lasting 3-6 days every 3-8 weeks associated with at least one of the three cardinal clinical signs: aphthous stomatitis, pharyngitis, and cervical adenitis. Kawasaki disease (KD) is an acute, self-limited systemic vasculitis that occurs predominantly in infants and young children. In most KD patients, i.v. immunoglobulin leads to a rapid amelioration of clinical symptoms and significantly decreases the risk of coronary artery aneurysms. Although the etiology of KD is still unknown, it was reported that innate immunity was activated in the patients. Described herein is a patient with PFAPA who developed KD. This is the first report of KD development in a PFAPA patient. The association between KD and PFAPA may represent a genetic predisposition to dysregulated innate immune response.

  11. Cardiovascular imaging in children and adults following Kawasaki disease.

    PubMed

    Dietz, S M; Tacke, C E; Kuipers, I M; Wiegman, A; de Winter, R J; Burns, J C; Gordon, J B; Groenink, M; Kuijpers, T W

    2015-12-01

    Kawasaki disease (KD) is a paediatric vasculitis with coronary artery aneurysms (CAA) as its main complication. Two guidelines exist regarding the follow-up of patients after KD, by the American Heart Association and the Japanese Circulation Society. After the acute phase, CAA-negative patients are checked for cardiovascular risk assessment or with ECG and echocardiography until 5 years after the disease. In CAA-positive patients, monitoring includes myocardial perfusion imaging, conventional angiography and CT-angiography. However, the invasive nature and high radiation exposure do not reflect technical advances in cardiovascular imaging. Newer techniques, such as cardiac MRI, are mentioned but not directly implemented in the follow-up. Cardiac MRI can be performed to identify CAA, but also evaluate functional abnormalities, ischemia and previous myocardial infarction including adenosine stress-testing. Low-dose CT angiography can be implemented at a young age when MRI without anaesthesia is not feasible. CT calcium scoring with a very low radiation dose can be useful in risk stratification years after the disease. By incorporating newer imaging techniques, detection of CAA will be improved while reducing radiation burden and potential complications of invasive imaging modalities. Based on the current knowledge, a possible pathway to follow-up patients after KD is introduced. Key Points • Kawasaki disease is a paediatric vasculitis with coronary aneurysms as major complication. • Current guidelines include invasive, high-radiation modalities not reflecting new technical advances. • Cardiac MRI can provide information on coronary anatomy as well as cardiac function. • (Low-dose) CT-angiography and CT calcium score can also provide important information. • Current guidelines for follow-up of patients with KD need to be revised.

  12. [Dobutamine stress body surface mapping in Kawasaki disease].

    PubMed

    Seki, T; Zhang, J; Ogawa, S; Hirayama, T

    1994-11-01

    The dobutamine (DOB) stress body surface mapping tests were carried out to detect myocardial ischemia in 23 patients who had Kawasaki disease previously. Eight of 23 patients (group A) had coronary stenosis of 75% or more diameter reduction in major coronary arteries without sufficient collateral flow, as shown by the coronary angiography, but without myocardial infarction. Nine patients (group B) showed no ischemic change exercised 201Tl myocardial scintigram. Six patients (group C) had myocardial infarction due to Kawasaki disease. ST segment potential mapping (0.04 sec after the J point in QRS) and ST-T Isointegral mapping were performed using CVM-3000 system (87 leads), and the following calculations were made: number of leads with horizontal or down-sloping ST depression of 0.10 mV or more, lasting 0.08 sec (nST); row number of the minimum lead in the Isointegral map (Imin); number of positive leads on the seventh row in Isointegral mapping (I-7); number of positive leads on the first row in Isointegral mapping (I-1) and I-7/I-1 ratio. Based on these calculations the criteria for detecting myocardial ischemia (nST < or = 2, Imin < or = 2, I-7/I-1 > or = 1) were created and their usefulness was tested using findings of coronary angiography and exercised 201Tl myocardial scintigram as the golden standard. For the diagnosis of ischemic lesion, the DOB stress body surface mapping test in group A had higher specificity (nST: 100%, Imin: 89%, I-7/I-1: 100% vs. 78%) and higher sensitivity (75%, 50%, 63% vs. 38%), than those by the Treadmill test, while ischemic changes were not detected in group C by this test. From these results it is concluded that it is useful in evaluating ischemic heart disease in children who can not perform Treadmill exercised test adequately.

  13. Pediatric Kawasaki Disease and Adult Human Immunodeficiency Virus Kawasaki-Like Syndrome Are Likely the Same Malady.

    PubMed

    Johnson, Raymond M; Bergmann, Kelly R; Manaloor, John J; Yu, Xiaoqing; Slaven, James E; Kharbanda, Anupam B

    2016-09-01

    Background.  Pediatric Kawasaki disease (KD) and human immunodeficiency virus (HIV)(+) adult Kawasaki-like syndrome (KLS) are dramatic vasculitides with similar physical findings. Both syndromes include unusual arterial histopathology with immunoglobulin (Ig)A(+) plasma cells, and both impressively respond to pooled Ig therapy. Their distinctive presentations, histopathology, and therapeutic response suggest a common etiology. Because blood is in immediate contact with inflamed arteries, we investigated whether KD and KLS share an inflammatory signature in serum. Methods.  A custom multiplex enzyme-linked immunosorbent assay (ELISA) defined the serum cytokine milieu in 2 adults with KLS during acute and convalescent phases, with asymptomatic HIV(+) subjects not taking antiretroviral therapy serving as controls. We then prospectively collected serum and plasma samples from children hospitalized with KD, unrelated febrile illnesses, and noninfectious conditions, analyzing them with a custom multiplex ELISA based on the KLS data. Results.  Patients with KLS and KD subjects shared an inflammatory signature including acute-phase reactants reflecting tumor necrosis factor (TNF)-α biologic activity (soluble TNF receptor I/II) and endothelial/smooth muscle chemokines Ccl1 (Th2), Ccl2 (vascular inflammation), and Cxcl11 (plasma cell recruitment). Ccl1 was specifically elevated in KD versus febrile controls, suggesting a unique relationship between Ccl1 and KD/KLS pathogenesis. Conclusions.  This study defines a KD/KLS inflammatory signature mirroring a dysfunctional response likely to a common etiologic agent. The KD/KLS inflammatory signature based on elevated acute-phase reactants and specific endothelial/smooth muscle chemokines was able to identify KD subjects versus febrile controls, and it may serve as a practicable diagnostic test for KD.

  14. Primary treatment of incomplete Kawasaki disease with infliximab and methylprednisolone in a patient with a contraindication to intravenous immune globulin.

    PubMed

    Shirley, Debbie-Ann; Stephens, Ina

    2010-10-01

    Incomplete Kawasaki disease was diagnosed in a 3-year-old boy. Because intravenous immune globulin infusion was not tolerated, he was treated with infliximab and methylprednisolone. Coronary aneurysms were not visualized on initial or follow-up echocardiograms. To our knowledge, this is the first report to document the use of infliximab and methylprednisolone as first line therapy for Kawasaki disease.

  15. Absence of association of FCGR2A gene polymorphism rs1801274 with Kawasaki disease in Greek patients.

    PubMed

    Chatzikyriakidou, Anthoula; Aidinidou, Louiza; Giannopoulos, Andreas; Papadopoulou-Legbelou, Kyriaki; Kalinderi, Kallirhoe; Fidani, Liana

    2015-04-01

    Kawasaki disease is an acute, febrile syndrome in infancy, characterised by vasculitis of medium-sized arteries, and affects predominantly young children. Family-based studies on Kawasaki disease supports the contribution of genetic factors in disorder manifestation. In a recent genome-wide association study, the polymorphism rs1801274 of FCGR2A [Fc fragment of immunoglobulin G, low-affinity IIa, receptor] gene has been implicated in disease pathogenesis. The aim of the present study was to explore the association of this variant, for the first time, in a group of Kawasaki-diseased patients of Greek origin. A total of 47 Kawasaki-diseased children and 50 control subjects were enrolled in the study. Polymerase chain reaction-restriction fragment length polymorphism assay was performed in rs1801274 genotyping. No association was observed between this polymorphism genotypes' or alleles' distribution between Kawasaki-diseased patients and controls. Furthermore, no association was revealed between this polymorphism and cardiovascular complications in Kawasaki-diseased patients. In the literature, the reported data over this polymorphism association with Kawasaki disease in Caucasian patients are contradictory. In addition, the disease shows low prevalence in the Caucasian populations. Therefore, the independent genetic association studies on rs1801274 with Kawasaki disease in various Caucasian groups increase the amount of genetic data, which could be used in a future meta-analysis, increasing the statistical power of the resultant conclusions.

  16. National survey of pediatric hospitalizations due to Kawasaki disease and coronary artery aneurysms in the USA.

    PubMed

    Okubo, Yusuke; Nochioka, Kotaro; Sakakibara, Hiroshi; Testa, Marcia; Sundel, Robert P

    2017-02-01

    Several studies revealed the epidemiology of Kawasaki disease-related hospitalizations among children in the USA and other countries. However, disparities of developing coronary artery aneurysms by race/ethnicity, patient socioeconomic status, and geographic locations remain unknown in the USA. Hospital discharge record data of patients with Kawasaki disease aged 19 years or younger were obtained from the 2003, 2006, 2009, and 2012 Kid's Inpatient Database. The data were weighted to estimate the annual hospitalization rates with respect to age, gender, and race/ethnicity in the USA. Multivariable logistic regression was conducted to ascertain the factors associated with the development of coronary artery aneurysms. Total annual hospitalization rates of Kawasaki disease showed a decreasing trend, ranging from 6.54 per 100,000 children in 2003 to 6.11 per 100,000 children in 2012 (p < 0.001). The proportions of coronary artery aneurysms among patients with Kawasaki disease ranged from 2.25 to 3.20%. Factor associated with the development of coronary artery aneurysms was hospitals in West (OR 2.15, 95% CI 1.42-3.26). Race/ethnicity, health insurance status, and household income were not associated with the development of coronary artery aneurysms. Total hospitalization rates of Kawasaki disease showed a decreasing trend. Children admitted to hospitals in West region were more likely to develop coronary artery aneurysms.

  17. Antiendothelial cell antibodies detected by a cellular based ELISA in Kawasaki disease.

    PubMed Central

    Tizard, E J; Baguley, E; Hughes, G R; Dillon, M J

    1991-01-01

    Kawasaki disease is an acute vasculitic illness of childhood associated with significant morbidity and mortality. A cellular based enzyme linked immunosorbent assay (ELISA) was used to demonstrate the presence of antiendothelial cell antibodies in sera from children with Kawasaki disease. Twenty one of 32 patients with Kawasaki disease had raised IgM antibody titres and four had raised IgG antiendothelial antibody titres. There was a significant difference in the IgM antiendothelial cell antibody titres when comparing the patients with normals and febrile controls. The antibody titre paralleled the disease activity in patients studied serially. There was no relative increase in binding of antiendothelial cell antibodies after cytokine stimulation. These findings may be of importance in further research into the understanding of mechanisms involved in this and other forms of vasculitis in man. PMID:1900406

  18. Recurrent lip swelling as a late presentation of Kawasaki disease: Case report and review of literature.

    PubMed

    Faden, Asmaa

    2013-01-01

    Kawasaki Disease (KD) is an acute systemic vasculitis of unknown etiology. In many developed countries, KD has replaced rheumatic heart disease as the leading cause of acquired heart disease in children. Among the classical criteria for a diagnosis of KD are oral manifestations such as strawberry tongue, erythematous cracked lip, and oropharyngeal mucositis. We report the case of a 24-year-old Saudi female with a history of Kawasaki disease who presented to our oral medicine clinic with recurrent painless swelling of the upper lip. As lip swelling has not previously been reported as an oral manifestation of KD, this case represents a novel presentation of recurrent Kawasaki disease in an adult female.

  19. Epidemiology of Kawasaki disease in Asia, Europe, and the United States.

    PubMed

    Uehara, Ritei; Belay, Ermias D

    2012-01-01

    Kawasaki disease (KD) is a systemic vasculitis that mainly affects children younger than 5 years. Although Dr. Tomisaku Kawasaki first reported KD over 40 years ago, the cause of the disease remains unknown. Currently, KD has been diagnosed in more than 60 countries, including those in Asia, the Middle East, Latin America, and Africa, as well as in North America and Europe. The purpose of this review is to describe the epidemiologic features of KD--particularly its incidence, seasonality, and the occurrence of coronary artery abnormalities--primarily in Japan and the United States, but also in Europe and other Asian countries.

  20. Kawasaki Shock Syndrome in a 12-Year-Old Girl Mimicking Septic Shock

    PubMed Central

    Suntharesan, Janani; Wijesekara, Dimuthu Saraji

    2016-01-01

    Kawasaki disease is diagnosed when fever lasts for more than 5 days with the presence of four out of five of the following clinical features: bilateral conjunctival congestion, changes in the lips and oral cavity, polymorphous exanthem, changes in peripheral extremities, and acute nonpurulent cervical lymphadenopathy (Nakamura et al., 2012). The average age of onset is 2 years and 90% of patients are below 5 years of age. Boys are more affected than girls (Cox and Sallis, 2009). This case report describes an adolescent female who was initially managed as having septic shock and subsequently found to have Kawasaki shock syndrome. PMID:28101385

  1. Recurrent Kawasaki Disease in a Child With Retropharyngeal Involvement

    PubMed Central

    Aldemir-Kocabaş, Bilge; Kıcalı, Mücahit Murat; Ramoğlu, Mehmet G.; Tutar, Ercan; Fitöz, Suat; Çiftçi, Ergin; İnce, Erdal

    2014-01-01

    Abstract Kawasaki disease (KD) is a multisystemic vasculitic disease. Recurrent KD is rare and generally presents in a similar clinical picture as the first episode, and early diagnosis with prompt treatment is the key point in preventing associated cardiovascular morbidities. A 9-year-old boy, who was diagnosed with KD when he was 1.5 years’ old, was referred to our hospital for surgical drainage of retropharyngeal abscess. He had a 7-day history of high fever, sore throat, left-sided neck swelling, and restricted neck movements. Subsequently, he was diagnosed with recurrent KD and retropharyngeal involvement. He was successfully treated with a single dose of intravenous immunoglobulin (IVIG) and acetyl salicylic acid. Recurrence is rare and occurs most commonly in children. Atypical presentation, incomplete disease, short duration of fever, and reduced response to IVIG treatment were found to be the risk factors for recurrence. KD can occasionally present with clinical and radiographic findings of deep neck bacterial infection. Unusual presentations in KD may cause delay in diagnosis and increase the risk of life-threatening complications. We describe a case of recurrent KD presenting with a clinical picture resembling retropharyngeal infection who fully recovered after 1 dose of IVIG instead of surgical drainage and antibiotic use. PMID:25546657

  2. Vascular health late after Kawasaki disease: implications for accelerated atherosclerosis

    PubMed Central

    2014-01-01

    Kawasaki disease (KD), an acute vasculitis that primarily affects young children, is the most common acquired paediatric cardiovascular disease in developed countries. While sequelae of arterial inflammation in the acute phase of KD are well documented, its late effects on vascular health are increasingly unveiled. Late vascular dysfunction is characterized by structural alterations and functional impairment in term of arterial stiffening and endothelial dysfunction and shown to involve both coronary and systemic arteries. Further evidence suggests that continuous low grade inflammation and ongoing active remodeling of coronary arterial lesions occur late after acute illness and may play a role in structural and functional alterations of the arteries. Potential importance of genetic modulation on vascular health late after KD is implicated by associations between mannose binding lectin and inflammatory gene polymorphisms with severity of peripheral arterial stiffening and carotid intima-media thickening. The changes in cholesterol and lipoproteins levels late after KD further appear similar to those proposed to be atherogenic. While data on adverse vascular health are less controversial in patients with persistent or regressed coronary arterial aneurysms, data appear conflicting in individuals with no coronary arterial involvements or only transient coronary ectasia. Notwithstanding, concerns have been raised with regard to predisposition of KD in childhood to accelerated atherosclerosis in adulthood. Until further evidence-based data are available, however, it remains important to assess and monitor cardiovascular risk factors and to promote cardiovascular health in children with a history of KD in the long term. PMID:25550701

  3. Evidence of Microvascular Changes in the Retina following Kawasaki Disease

    PubMed Central

    Chen, Katherine Y. H.; Burgner, David P.; Wong, Tien Y.; Saw, Seang Mei; Quek, Swee Chye; Pang, Audrey Y. C.; Leo, Seo Wei; Wong, Inez B.; Zannino, Diana; Curtis, Nigel; Cheung, Michael; Cheung, Carol Y.; Lim, Terence C. W.

    2017-01-01

    It is unclear whether all children with Kawasaki disease (KD) have increased later cardiovascular risk. The retinal microvasculature reflects changes in the microcirculation and is associated with traditional cardiovascular risk factors and events. The aim of this study was to investigate retinal microvascular parameters in two populations of patients with previous KD and control participants. We performed case-control studies of 116 (57 patients and 59 control participants) Australian and 156 (78 patients and 78 control participants) Singaporean individuals, at least two years since their acute illness. Standardised retinal photographs were graded by trained technicians using a semi-automated software, which quantifies the retinal microvasculature (calibre, branching angle, fractal dimensions, and tortuosity). Retinal venules of Singaporean KD patients were 9.67 μm (95% CI 4.87 to 14.51, p < 0.001) larger than control participants following correction for traditional cardiovascular risk factors. An incremental increase in the size of retinal venules in those with coronary artery abnormalities was observed. There was limited evidence that retinal venules were larger in Australian KD patients with coronary artery abnormalities compared to control participants (7.34 μm, 95% CI 1.30 to 15.99, p = 0.10). Differences in retinal microvasculature were particularly evident in Singaporean KD patients. Larger retinal venules may reflect chronic inflammation and endothelial dysfunction, and are associated with coronary artery disease in adults. PMID:28094311

  4. Hemodynamic simulations in coronary aneurysms of children with Kawasaki disease

    NASA Astrophysics Data System (ADS)

    Sengupta, Dibyendu; Burns, Jane; Marsden, Alison

    2009-11-01

    Kawasaki disease (KD) is a serious pediatric illness affecting the cardiovascular system. One of the most serious complications of KD, occurring in about 25% of untreated cases, is the formation of large aneurysms in the coronary arteries, which put patients at risk for myocardial infarction. In this project we performed patient specific computational simulations of blood flow in aneurysmal left and right coronary arteries of a KD patient to gain an understanding about their hemodynamics. Models were constructed from CT data using custom software. Typical pulsatile flow waveforms were applied at the model inlets, while resistance and RCR lumped models were applied and compared at the outlets. Simulated pressure waveforms compared well with typical physiologic data. High wall shear stress values are found in the narrow region at the base of the aneurysm and low shear values occur in regions of recirculation. A Lagrangian approach has been adopted to perform particle tracking and compute particle residence time in the recirculation. Our long-term goal will be to develop links between hemodynamics and the risk for thrombus formation in order to assist in clinical decision-making.

  5. Upcoming biomarkers for the diagnosis of Kawasaki disease: A review.

    PubMed

    Parthasarathy, Pavithra; Agarwal, Arnav; Chawla, Karan; Tofighi, Taraneh; Mondal, Tapas K

    2015-11-01

    Kawasaki disease (KD) is a major cause of acquired heart disease among children and increases the risk of myocardial infarction. While the biochemical basis of the disease is unclear, the evidence suggests interplay between a microbial infection and a genetic predisposition in the development of the disease. Diagnosis of KD based on clinical observation is not completely reliable and is problematic due to the time-sensitive nature of the disease. Hence, identification of inflammatory, proteomic, and genetic biomarkers may assist in earlier and more effective diagnosis and treatment. This review of observational studies and clinical trials analyzes biomarkers in recent research that may be used to establish a gold standard test for KD diagnosis. 65 articles in the literature are assessed to investigate these new biomarkers in addition to biomarkers presently in use. ESR≥40mm/h, leukocyte count ≥16∗10(9)/L and increased WBC count are together suggestive of the presence of KD. Among proteomic biomarkers, elevated NT-proBNP and differing levels of several other proteomic biomarkers such as iNOS in monocytes and neutrophils have been observed in KD patients. Genetic polymorphisms of six HLA class I genes have also been linked with the disease, alongside MICA alleles A4 and A5.1. The results suggest that NT-proBNP is currently a very promising biomarker for future investigation; further research is warranted to allow for accurate and early detection of the disease using this biomarker.

  6. Variations in ORAI1 Gene Associated with Kawasaki Disease.

    PubMed

    Onouchi, Yoshihiro; Fukazawa, Ryuji; Yamamura, Kenichiro; Suzuki, Hiroyuki; Kakimoto, Nobuyuki; Suenaga, Tomohiro; Takeuchi, Takashi; Hamada, Hiromichi; Honda, Takafumi; Yasukawa, Kumi; Terai, Masaru; Ebata, Ryota; Higashi, Kouji; Saji, Tsutomu; Kemmotsu, Yasushi; Takatsuki, Shinichi; Ouchi, Kazunobu; Kishi, Fumio; Yoshikawa, Tetsushi; Nagai, Toshiro; Hamamoto, Kunihiro; Sato, Yoshitake; Honda, Akihito; Kobayashi, Hironobu; Sato, Junichi; Shibuta, Shoichi; Miyawaki, Masakazu; Oishi, Ko; Yamaga, Hironobu; Aoyagi, Noriyuki; Yoshiyama, Megumi; Miyashita, Ritsuko; Murata, Yuji; Fujino, Akihiro; Ozaki, Kouichi; Kawasaki, Tomisaku; Abe, Jun; Seki, Mitsuru; Kobayashi, Tohru; Arakawa, Hirokazu; Ogawa, Shunichi; Hara, Toshiro; Hata, Akira; Tanaka, Toshihiro

    2016-01-01

    Kawasaki disease (KD; MIM#61175) is a systemic vasculitis syndrome with unknown etiology which predominantly affects infants and children. Recent findings of susceptibility genes for KD suggest possible involvement of the Ca(2+)/NFAT pathway in the pathogenesis of KD. ORAI1 is a Ca(2+) release activated Ca(2+) (CRAC) channel mediating store-operated Ca(2+) entry (SOCE) on the plasma membrane. The gene for ORAI1 is located in chromosome 12q24 where a positive linkage signal was observed in our previous affected sib-pair study of KD. A common non-synonymous single nucleotide polymorphism located within exon 2 of ORAI1 (rs3741596) was significantly associated with KD (P = 0.028 in the discovery sample set (729 KD cases and 1,315 controls), P = 0.0056 in the replication sample set (1,813 KD cases vs. 1,097 controls) and P = 0.00041 in a meta-analysis by the Mantel-Haenszel method). Interestingly, frequency of the risk allele of rs3741596 is more than 20 times higher in Japanese compared to Europeans. We also found a rare 6 base-pair in-frame insertion variant associated with KD (rs141919534; 2,544 KD cases vs. 2,414 controls, P = 0.012). These data indicate that ORAI1 gene variations are associated with KD and may suggest the potential importance of the Ca(2+)/NFAT pathway in the pathogenesis of this disorder.

  7. Gene Transcript Abundance Profiles Distinguish Kawasaki Disease from Adenovirus Infection

    PubMed Central

    Popper, Stephen J.; Watson, Virginia E.; Shimizu, Chisato; Kanegaye, John T.; Burns, Jane C.; Relman, David A.

    2010-01-01

    Background Acute Kawasaki disease (KD) is difficult to distinguish from other illnesses that involve acute rash or fever, in part because the etiologic agent(s) and pathophysiology remain poorly characterized. As a result, diagnosis and critical therapies may be delayed. Methods We used DNA microarrays to identify possible diagnostic features of KD. We compared gene expression patterns in the blood of 23 children with acute KD and 18 age-matched febrile children with 3 illnesses that resemble KD. Results Genes associated with platelet and neutrophil activation were expressed at higher levels in patients with KD than in patients with acute adenovirus infections or systemic adverse drug reactions, but levels in patients with KD were not higher than those in patients with scarlet fever. Genes associated with B cell activation were also expressed at higher levels in patients with KD than in control subjects. A striking absence of interferon-stimulated gene expression in patients with KD was confirmed in an independent cohort of patients with KD. Using a set of 38 gene transcripts, we successfully predicted the diagnosis for 21 of 23 patients with KD and 7 of 8 patients with adenovirus infection. Conclusions These findings provide insight into the molecular features that distinguish KD from other febrile illnesses and support the feasibility of developing novel diagnostic reagents for KD based on the host response. PMID:19583510

  8. Comprension de los conceptos de los enlaces ionico y covalente en estudiantes universitarios del primer curso de quimica general

    NASA Astrophysics Data System (ADS)

    Ballesteros Benavides, Maria Elvira

    participantes no lograron diferenciar los dos enlaces quimicos. Esto implica que reflexionemos sobre la necesidad de revisar tanto las competencias cognoscitivas como la forma de ensenar quimica en el salon de clase. Recomendamos indagar y dar importancia al conocimiento previo de los estudiantes, enfatizar la ensenanza de los conceptos y propiciar el aprendizaje con significado.

  9. A case of atypical Kawasaki disease with giant coronary artery aneurysm containing thrombus

    PubMed Central

    Attard, Montalto S; Grech, V

    2016-01-01

    Introduction Kawasaki disease (KD) is an acute febrile, systemic vasculitic syndrome of unknown etiology, occurring primarily in children younger than 5 years of age. Administration of IVIG within the first 10 days after onset of fever in combination with high dose aspirin reduces the risk of coronary artery damage in KD. Though rare, giant aneurysms of the coronary arteries may develop in untreated cases and prove extremely challenging to manage. Case Presentation A 9-month-old Caucasian boy presented to our paediatric emergency department with a 4-week history of intermittent pyrexia and irritability. Typical mucocutaneous signs of Kawasaki Disease were absent upon presentation. A trans-thoracic echocardiogram identified a giant aneurysm of the left anterior descending artery with thrombus formation in-situ and the child was managed with intravenous immunoglobulin, steroids, high dose aspirin therapy and later warfarinisation. Discussion Cardiovascular sequelae of Kawasaki disease include giant coronary artery aneurysms with thrombosis. Enlargement of a coronary aneurysm after the acute phase of Kawasaki disease is uncommon and the outcome of interventional approaches poorly studied.

  10. The Clinical Diagnosis and Management of Kawasaki Disease: a Review and Update.

    PubMed

    Zhu, Frank H; Ang, Jocelyn Y

    2016-09-01

    Kawasaki disease is an acute, self-limited vasculitis of childhood and has become the leading cause of acquired pediatric heart disease in the USA. Prompt treatment is essential in reducing cardiac-related morbidity and mortality. The underlying etiology remains unknown. The disease itself may be the characteristic manifestation of a common pathway of immune-mediated vascular inflammation in susceptible hosts. The characteristic clinical features of fever for at least 5 days with bilateral nonpurulent conjunctivitis, rash, changes in lips and oral cavity, changes in peripheral extremities, and cervical lymphadenopathy remain the mainstay of diagnosis. Supplementary laboratory criteria can aid in the diagnosis, particularly in cases of incomplete clinical presentation. Diagnosis of Kawasaki disease can be challenging as the clinical presentation can be mistaken for a variety of other pediatric illnesses. Standard of care consists of intravenous immune globulin and aspirin. Corticosteroids, infliximab, and cyclosporine A have been used as adjunct therapy for Kawasaki disease refractory to initial treatment. There is ongoing research into the use of these agents in the initial therapy of Kawasaki disease.

  11. Matrix metalloproteinase haplotypes associated with coronary artery aneurysm formation in patients with Kawasaki disease

    PubMed Central

    Shimizu, Chisato; Matsubara, Tomoyo; Onouchi, Yoshihiro; Jain, Sonia; Sun, Shelly; Nievergelt, Caroline M.; Shike, Hiroko; Brophy, Victoria H.; Takegawa, Tsuyoshi; Furukawa, Susumu; Akagi, Teiji; Newburger, Jane W.; Baker, Annette L.; Burgner, David; Hibberd, Martin L.; Davila, Sonia; Levin, Michael; Mamtani, Manju; He, Weijing; Ahuja, Sunil K.; Burns, Jane C.

    2010-01-01

    Aneurysms of the vascular wall represent a final common pathway for a number of inflammatory processes including atherosclerosis and idiopathic vasculitis syndromes. Kawasaki disease is an acute, self-limited vasculitis in children and the leading cause of acquired coronary artery aneurysms. We sought to identify shared molecular mechanisms of aneurysm formation by genotyping 8 polymorphisms in MMP-1, 3, 7, 12 and 13 in the gene cluster on Chr.11q22 whose gene products have been implicated in aneurysm formation or are known to have elastase activity. We genotyped 482 US-UK Kawasaki disease patients (aneurysm+: n=111, aneurysm−: n=371) and tested our findings in an independent cohort of 200 Japanese Kawasaki disease patients (aneurysm+: n=58, aneurysm−: n=142). Analysis of the five MMP genes identified modest trends in allele and genotype frequencies for MMP-3 rs3025058 (−/T) and haplotypes containing MMP-3 rs3025058 (−/T) and MMP-12 rs2276109 (A/G) (nominal p= 2-4 × 10−5) that conferred increased risk of aneurysm formation in US-UK subjects. This finding was validated in Japanese subjects and suggests the importance of this locus in aneurysm formation in children with Kawasaki disease. The region encompassing these risk haplotypes is a prime candidate for re-sequencing to look for rare genetic variation that may influence aneurysm formation. PMID:20827277

  12. Kawasaki disease mimicking a parapharyngeal abscess: a case report.

    PubMed

    Cai, Qianyun; Luo, Rong; Gan, Jing; Zhang, Li; Qu, Yi; Mu, Dezhi

    2015-05-01

    Parapharyngeal abscess (PPA)-like lesion is a very rare manifestation of Kawasaki disease (KD). Here we report a Chinese case of KD initially mimicking PPA, which is the first one reported in Asia.A 3-year-old male patient presented with fever, drooling, and bilateral painful cervical lymphadenopathy for 3 days. Chest X-ray and echocardiogram were normal. With substantial elevation of white blood count and C-reactive protein, purulent cervical lymphadenitis was considered. Symptoms did not improve after treatment with vancomycin, and the patient further developed trismus and restricted neck movement. Neck CT revealed a 2 × 1.5 cm hypodense lesion in the right parapharyngeal space with peripheral enhancement. PPA was suspected and on the 3rd day following admission, the patient received surgical incision and drainage. One milliliter of serous fluid was drained without bacterial growth on cultures. Fever persisted after surgery. As the clinical course proceeded, additional major signs of KD gradually evolved, and on the 6th day following admission the patient completely fulfilled the diagnostic criteria for KD. Rapid clinical improvement was observed following treatment with high-dose immunoglobulin and aspirin. Due to the parapharyngeal operation, the patient was fed milk through a nasogastric tube for 15 days. His neck incision became infected but healed gradually following dressing change and antibiotic treatment. Currently he remains asymptomatic during regular follow-up and repeated echocardiograms are normal.Both pediatricians and otolaryngologists can learn from this case that KD may initially manifest as PPA. Careful observation for major signs of KD during the clinical course can help to achieve a prompt and correct diagnosis. Thus, unnecessary surgery and cardiac complications of KD may be avoided.

  13. ECG findings after myocardial infarction in children after Kawasaki disease

    SciTech Connect

    Nakanishi, T.; Takao, A.; Kondoh, C.; Nakazawa, M.; Hiroe, M.; Matsumoto, Y.

    1988-10-01

    Standard 12-lead ECGs were evaluated in 17 children with myocardial infarction and 78 children without myocardial infarction after Kawasaki disease; sensitivity and specificity of the ECG infarction criteria were determined. The presence or absence of myocardial infarction was determined from either clinical examination results (coronary angiography, ventriculography, and thallium-201 myocardial imaging) or autopsy findings. Of seven patients with inferior infarction, abnormally deep Q waves in lead II, III, or aVF were observed in six, but the duration was greater than 0.04 second in only one (14%). The sensitivity and specificity of inferior infarction criteria based on Q wave amplitude were 86% and 97%, respectively. Of eight patients with anterior infarction, seven (88%) had abnormally deep and wide (greater than or equal to 0.04 second) Q waves in anterior chest leads. The sensitivity and specificity of the infarction criteria based on the amplitude and duration of the Q wave were 75% and 99%, respectively. Of seven patients with lateral infarction, Q waves were observed in lead I, aVL, or both in four patients, and in all of these patients Q waves were wider than 0.04 second. In two patients with both inferior and anterior infarction, Q waves were observed only in leads II, III, and aVF; in only one patient were the Q waves wider than 0.04 second. Thus deep Q waves in lead II, III, or aVF that are not wider than 0.04 second may indicate inferior infarction in children. Q waves in lead I, aVL, and chest leads associated with anterolateral infarction are in most instances deep and wide.

  14. Comparation of clinical and paraclinical findings among patient with Kawasaki disease in Bandar abbas Koodakan Hospital in 2011-14

    NASA Astrophysics Data System (ADS)

    Borjali, Davood

    Title: Comparation of clinical and paraclinical findings among patient with Kawasaki disease in Bandar abbas Koodakan Hospital in 2011-14 Kawasaki disease(KD) is a kind of vasculitis diagnosed by clinical manifestation and it caused acquired heart disease in children because of coronary arteries involvement. Method: patient divided to three group of American Japanese and incomplete and also study in two group according to fever days and then clinical features and laboratory data were checked. Result: A total of 150 patients were enrolled during the study period. number of patients with incomplete Kawasaki disease was 128 american group was 28 and Japanese was 4 patients, the most prevalent symptom was scaling of extremities(61 bladder most seen in group with fever more than five days. Keyword: Kawasaki , epidemiology , criteria

  15. An apparent case of undiagnosed donor Kawasaki disease manifesting as coronary artery aneurysm in a pediatric heart transplant recipient.

    PubMed

    Friedland-Little, Joshua; Aiyagari, Ranjit; Gajarski, Robert J; Schumacher, Kurt R

    2013-02-01

    We present a case of coronary ectasia and LAD coronary artery aneurysm with angiographic characteristics of Kawasaki disease in a three-yr-old girl two-yr status post-orthotopic heart transplant. Coronary anomalies were noted during initial screening coronary angiography two yr after transplant. Subsequent review of the donor echocardiogram revealed that the LMCA had been mildly dilated prior to transplant. In the absence of any symptoms consistent with Kawasaki disease in the transplant recipient, this appears to be a case of Kawasaki disease in the organ donor manifesting with coronary anomalies in the transplant recipient. The patient has done well clinically, and repeat coronary angiography has revealed partial regression of coronary anomalies. Given multiple reports in the literature of persistent abnormalities of coronary artery morphology and function after Kawasaki disease, close monitoring is warranted, with consideration of potential coronary protective medical therapies.

  16. Primary percutaneous coronary intervention for acute myocardial infarction in a pediatric patient with giant coronary aneurysm due to Kawasaki disease.

    PubMed

    Mongiovì, Maurizio; Alaimo, Annalisa; Vernuccio, Federica; Pieri, Daniele

    2014-01-01

    We report a case of acute myocardial infarction in an 8-year-old boy with a history of Kawasaki disease and giant coronary aneurysms in the right and left coronary arteries. We performed coronary angiography and percutaneous coronary intervention 4 hours after the onset of symptoms. This case suggests that primary percutaneous coronary intervention might be safe and effective in the long-term treatment of acute myocardial infarction due to coronary sequelae of Kawasaki.

  17. Myocardial performance and perfusion during exercise in patients with coronary artery disease caused by Kawasaki disease

    SciTech Connect

    Paridon, S.M.; Ross, R.D.; Kuhns, L.R.; Pinsky, W.W. )

    1990-01-01

    For a study of the natural history of coronary artery lesions after Kawasaki disease and their effect on myocardial blood flow reserve with exercise, five such patients underwent exercise testing on a bicycle. Oxygen consumption, carbon dioxide production, minute ventilation, and electrocardiograms were monitored continuously. Thallium-201 scintigraphy was performed for all patients. One patient stopped exercise before exhaustion of cardiovascular reserve but had no evidence of myocardial perfusion abnormalities. Four patients terminated exercise because of exhaustion of cardiovascular reserve; one had normal cardiovascular reserve and thallium scintiscans, but the remaining patients had diminished cardiovascular reserve. Thallium scintigrams showed myocardial ischemia in two and infarction in one. No patient had exercise-induced electrocardiographic changes. These results indicate that patients with residual coronary artery lesions after Kawasaki disease frequently have reduced cardiovascular reserve during exercise. The addition of thallium scintigraphy and metabolic measurements to exercise testing improved the detection of exercise-induced abnormalities of myocardial perfusion.

  18. Infliximab as the First Retreatment in Patients with Kawasaki Disease Resistant to Initial Intravenous Immunoglobulin.

    PubMed

    Youn, Youngmin; Kim, Jisoo; Hong, Young Mi; Sohn, Sejung

    2016-04-01

    Forty-three patients with Kawasaki disease who were resistant to initial intravenous immunoglobulin (IVIG) were randomized to receive either a second dose of IVIG (n = 32) or an infliximab (n = 11). With IVIG retreatment 21 patients (65.6%) responded, and with infliximab 10 patients (90.9%) responded. The infliximab group had shorter duration of fever and fewer days of hospitalization. Coronary artery outcomes and adverse events were similar.

  19. Validation of the bifurcation diagram in the 2D Ohta–Kawasaki problem

    NASA Astrophysics Data System (ADS)

    Bouwe van den Berg, Jan; Williams, J. F.

    2017-04-01

    We develop a rigorous numerical method to compare local minimizers of the Ohta–Kawasaki functional in two dimensions. In particular, we validate the phase diagram identifying regions of parameter space where rolls are favorable, where hexagonally packed spots have lowest energy and finally where the constant mixed state does. More generally, we present a method to rigorously determine such features in problems where optimal domain sizes are not known a priori.

  20. [Three Cases of Moyamoya Disease with a History of Kawasaki Disease].

    PubMed

    Kawasaki, Toshinari; Arakawa, Yoshiki; Sugino, Toshiya; Mitsuhara, Takafumi; Funaki, Takeshi; Kikuchi, Takayuki; Koyanagi, Masaomi; Yoshida, Kazumichi; Kunieda, Takeharu; Takahashi, Jun C; Takagi, Yasushi; Miyamoto, Susumu

    2015-11-01

    Here, we report three cases of moyamoya disease with a history of Kawasaki disease. A 33-year-old man was found to have stenotic lesions of the internal carotid arteries(ICAs)on both sides at a nearby hospital where he visited complaining of headache and lisping. He had received immunoglobulin therapy for Kawasaki disease at the ages of 1, 2, and 6 years. MRI showed only a chronic ischemic lesion in the white matter. Angiography showed occlusion at the terminal portion of the ICAs on both sides. He was diagnosed with moyamoya disease, but as he had no symptoms and preserved cerebral blood flow (CBF), he was kept under observation. An 8-year-old boy was diagnosed with moyamoya disease and underwent right encephaloduroarteriosynangiosis at a nearby hospital. He had received immunoglobulin therapy for Kawasaki disease at the age of 1 year. His ischemic symptoms worsened. Although MRI detected no apparent ischemic lesion, angiography revealed severe stenosis at the terminal portions of the ICAs on both sides, and 123I-IMP SPECT showed CBF impairment. Bilateral direct bypass was performed. His father was subsequently also diagnosed with moyamoya disease. A 4-year-old girl with epilepsy was diagnosed with moyamoya disease at a nearby hospital. She had been treated with aspirin for Kawasaki disease at the age of 1 year. MRI detected no remarkable ischemic lesions, but angiography revealed mild stenosis at the terminal portions of the ICAs on both sides. Five months later, her ischemic symptoms were worsening with progressing stenotic lesions, and she underwent bilateral direct bypass.

  1. Kawasaki Disease in Latin American Children: Past, Current, and Future Challenges.

    PubMed

    Ulloa-Gutierrez, Rolando; Salgado, Andrea P; Tremoulet, Adriana H

    2014-12-01

    Kawasaki disease (KD) is the leading cause of acquired cardiac disease in children in developed countries and Asia. However, there is a paucity of data available from Latin America. In response to the gap in knowledge about KD in Latin America, a group of pediatric infectious disease researchers from the Kawasaki Disease Research Center at the University of California San Diego and the Sociedad Latinoamericana de Infectología Pediátrica joined efforts during the last decade to address this problem. The Red de Enfermedad de Kawasaki en América Latina (Latin American Kawasaki Disease Network) was launched in 2013 to study the epidemiology of KD among children from the major pediatric tertiary referral hospitals in Latin America. This multinational multicenter network is primarily composed of pediatric infectious diseases, cardiology, rheumatology, and immunology subspecialists and pediatricians from 20 countries, and it is one of the world's largest networks to study the general epidemiology of KD. The first 2 prospective and retrospective multinational multicenter studies looking at the epidemiology of KD in the region were initiated in 2014. Future plans for the network include establishing collaborative research alliances and projects with other centers around the world. To date [ 1], there have been no published studies describing the overall incidence and prevalence of KD in Latin American children. The most important and recent epidemiological study addressing this issue, related to Chile, was published in 2012 [ 2]. Of these, the most recent relevant study addressed the seasonality of KD in different parts of the globe, including some Latin American and Caribbean countries [ 4]. In this document, we briefly summarize relevant available information from Latin America. Although there have been other publications from individual countries that are outside the scope of this communication, the majority of these reports are single case reports, or case series

  2. Extensive cervical lymphadenitis mimicking bacterial adenitis as the first presentation of Kawasaki disease

    PubMed Central

    Rossi, Felipe de Souza; da Silva, Marco Felipe Castro; Kozu, Kátia Tomie; Camargo, Luís Fernando Aranha; Rossi, Flávia Feijó Panico; Silva, Clovis Artur; Campos, Lúcia Maria de Arruda

    2015-01-01

    Cervical adenitis >1.5cm in diameter is the less frequently observed criteria in patients with Kawasaki disease and it is usually found in association with other symptoms during the acute phase. Moreover, the finding of fever and lymphadenitis with intense local signs of inflammation and phlegmon is rarely seen as the initial manifestation of Kawasaki disease. We report the case of a 7-year-old boy who had cervical lymphadenitis with adjacent cellulitis and phlegmon mimicking bacterial adenitis as the first presentation of Kawasaki disease. The patient had fever, cervical lymphadenitis with adjacent cellulitis, and severe headache. Cefadroxil was prescribed based on the clinical diagnosis of bacterial adenitis. Because he remained febrile and phlogistic signs worsened, after 1 day of hospitalization, antibiotics were administrated intravenously (ceftriaxone and oxacillin). The computed tomography of the neck showed primary infectious/inflammatory process. On the fourth day, the patient had dry and scaly lips, and treatment with oxacillin was replaced by clindamycin because the patient was still febrile. On the ninth day, he presented non-exudative bilateral conjunctival injection. On the tenth day of febrile disease, a rash appeared on his trunk, hands and feet. Patient’s symptoms resolved after intravenous administration of immunoglobulin (2g/kg/dose), and he was discharged 2 days later. On the 14th day, the patient had lamellar desquamation of fingers. Kawasaki disease should be considered as a differential diagnosis in children with febrile cervical lymphadenitis unresponsive to empiric antibiotics even if they have adjacent cellulitis and phlegmon. PMID:26132362

  3. Sets of serum exosomal microRNAs as candidate diagnostic biomarkers for Kawasaki disease

    PubMed Central

    Jia, Hong-Ling; Liu, Chao-Wu; Zhang, Li; Xu, Wei-Jun; Gao, Xue-Juan; Bai, Jun; Xu, Yu-Fen; Xu, Ming-Guo; Zhang, Gong

    2017-01-01

    Although Kawasaki disease is the main cause of acquired heart disease in children, no diagnostic biomarkers are available. We aimed to identify candidate biomarkers for diagnosing Kawasaki disease using serum exosomal microRNAs (miRNAs). Using frozen serum samples from a biobank, high-throughput microarray technologies, two-stage real-time quantitative PCR, and a self-referencing strategy for data normalization, we narrowed down the list of biomarker candidates to a set of 4 miRNAs. We further validated the diagnostic capabilities of the identified miRNAs (namely, CT(miR-1246)-CT(miR-4436b-5p) and CT(miR-197-3p)-CT(miR-671-5p)) in 79 samples from two hospitals. We found that this 4-miRNA set could distinguish KD patients from other febrile patients as well as from healthy individuals in a single pass, with a minimal rate of false positives and negatives. We thus propose, for the first time, that serum exosomal miRNAs represent candidate diagnostic biomarkers for Kawasaki disease. Additionally, we describe an effective strategy of screening for biomarkers of complex diseases even when little mechanistic knowledge is available. PMID:28317854

  4. Genome-wide association study identifies FCGR2A as a susceptibility locus for Kawasaki disease.

    PubMed

    Khor, Chiea Chuen; Davila, Sonia; Breunis, Willemijn B; Lee, Yi-Ching; Shimizu, Chisato; Wright, Victoria J; Yeung, Rae S M; Tan, Dennis E K; Sim, Kar Seng; Wang, Jie Jin; Wong, Tien Yin; Pang, Junxiong; Mitchell, Paul; Cimaz, Rolando; Dahdah, Nagib; Cheung, Yiu-Fai; Huang, Guo-Ying; Yang, Wanling; Park, In-Sook; Lee, Jong-Keuk; Wu, Jer-Yuarn; Levin, Michael; Burns, Jane C; Burgner, David; Kuijpers, Taco W; Hibberd, Martin L

    2011-11-13

    Kawasaki disease is a systemic vasculitis of unknown etiology, with clinical observations suggesting a substantial genetic contribution to disease susceptibility. We conducted a genome-wide association study and replication analysis in 2,173 individuals with Kawasaki disease and 9,383 controls from five independent sample collections. Two loci exceeded the formal threshold for genome-wide significance. The first locus is a functional polymorphism in the IgG receptor gene FCGR2A (encoding an H131R substitution) (rs1801274; P = 7.35 × 10(-11), odds ratio (OR) = 1.32), with the A allele (coding for histadine) conferring elevated disease risk. The second locus is at 19q13, (P = 2.51 × 10(-9), OR = 1.42 for the rs2233152 SNP near MIA and RAB4B; P = 1.68 × 10(-12), OR = 1.52 for rs28493229 in ITPKC), which confirms previous findings(1). The involvement of the FCGR2A locus may have implications for understanding immune activation in Kawasaki disease pathogenesis and the mechanism of response to intravenous immunoglobulin, the only proven therapy for this disease.

  5. Periodic fever in MVK deficiency: a patient initially diagnosed with incomplete Kawasaki disease.

    PubMed

    Thors, Valtyr S; Vastert, Sebastiaan J; Wulffraat, Nico; van Royen, Annet; Frenkel, Joost; de Sain-van der Velden, Monique; de Koning, Tom J

    2014-02-01

    Mevalonate kinase deficiency (MKD) is a rare autosomal recessive disorder causing 1 of 2 phenotypes, hyperimmunoglobulin D syndrome and mevalonic aciduria, presenting with recurrent fever episodes, often starting in infancy, and sometimes evoked by stress or vaccinations. This autoinflammatory disease is caused by mutations encoding the mevalonate kinase (MVK) gene and is classified in the group of periodic fever syndromes. There is often a considerable delay in the diagnosis among pediatric patients with recurrent episodes of fever. We present a case of an 8-week-old girl with fever of unknown origin and a marked systemic inflammatory response. After excluding infections, a tentative diagnosis of incomplete Kawasaki syndrome was made, based on the finding of dilated coronary arteries on cardiac ultrasound and fever, and she was treated accordingly. However, the episodes of fever recurred, and alternative diagnoses were considered, which eventually led to the finding of increased excretion of mevalonic acid in urine. The diagnosis of MKD was confirmed by mutation analysis of the MVK gene. This case shows that the initial presentation of MKD can be indistinguishable from incomplete Kawasaki syndrome. When fever recurs in Kawasaki syndrome, other (auto-)inflammatory diseases must be ruled out to avoid inappropriate diagnostic procedures, ineffective interventions, and treatment delay.

  6. Relationship between carotid intima‐media thickness and arterial stiffness in children after Kawasaki disease

    PubMed Central

    Cheung, Y‐f; Wong, S J; Ho, M H K

    2007-01-01

    Background Evidence of premature atherosclerosis and systemic arterial stiffening in patients after Kawasaki disease is accumulating. Aim To test the hypothesis that carotid intima‐media thickness (IMT), a surrogate marker of atherosclerosis, is associated with systemic arterial stiffness in children after Kawasaki disease. Methods A cohort of 72 patients was studied, comprising 26 patients with Kawasaki disease and coronary aneurysms (group I), 24 patients with Kawasaki disease and normal coronary arteries (group II) and 22 healthy age‐matched children (group III). The carotid IMT, carotid artery stiffness index, brachioradial pulse wave velocity (PWV), fasting total cholesterol, high‐density lipoprotein (HDL) cholesterol and low‐density lipoprotein (LDL) cholesterol were determined and compared among the three groups. Results The carotid IMT was related to indices of arterial stiffness, and significant determinants of carotid IMT were identified by multivariate analysis. The mean (standard deviation (SD)) carotid IMT of both group I (0.41 (0.04) mm) and group II (0.39 (0.04) mm) was significantly greater than that of group III (0.36 (0.04) mm; p<0.001 and p = 0.008, respectively). For the entire cohort, carotid IMT correlated positively with LDL cholesterol (r = 0.31, p = 0.009), carotid artery stiffness index (r = 0.40, p = 0.001) and brachioradial PWV (r = 0.28, p = 0.016), but not with age, body mass index, systemic blood pressure, and HDL and total cholesterol. Multiple linear regression analysis identified carotid artery stiffness index (β = 0.25, p = 0.028) and subject grouping (β = −0.39, p = 0.001; model R2 = 0.29) as significant correlates of carotid IMT. Conclusion The increased carotid IMT in children after Kawasaki disease is associated with systemic arterial stiffening. PMID:16820386

  7. Oxidative stress and Kawasaki disease: how is oxidative stress involved from the acute stage to the chronic stage?

    PubMed

    Yahata, Tomoyo; Hamaoka, Kenji

    2017-01-01

    Inflammation and oxidative stress are closely related. Further, oxidative stress plays an important role in the pathology of inflammation-based Kawasaki disease. An excessive in vivo production of reactive oxygen species increases oxidative stress in the body, which triggers an endless vicious spiral of inflammation reactions and reactive oxygen metabolites. This presumably forms diffuse vasculitis in the acute phase. Acute inflammation and oxidative stress can be rapidly controlled by treatments; however, they may remain for a long time. This has recently been identified as a problem in the chronic phase of Kawasaki disease. Generally, the presence of vascular inflammation and oxidative stress impairs blood vessels, leading to the onset of atherosclerosis, which is a widely recognized risk. The current discussion focuses on whether the same is valid for blood vessels in the chronic phase of Kawasaki disease.

  8. Comparison of early and late intravenous gamma globulin treatment of Kawasaki disease on fever and cardiovascular complications

    PubMed Central

    Mohammadzadeh, Iraj; Noei, Somayyeh; Babazadeh, Kazem; Zamani, Hassan; Barari-Savadkoohi, Rahim; Alizadeh-Navaei, Reza

    2016-01-01

    Background: Cardiac involvement was the major leading cause of death in patients with Kawasaki and IVIG administration reduces cardiac complications. The objective of this study was to determine the frequency of cardiovascular complications and duration of fever with regard to the time of intravenous immunoglobulin (IVIG) administration of patients with Kawasaki disease. Methods: This follow-up study was done on all patients with Kawasaki disease who were hospitalized at Amirkola Children’s Hospital between 2006 and 2011. Diagnosis of Kawasaki was clinical and included fever more than 5 days with 4 of 5 signs containing mucosal changes, scaling and skin rash, bilateral nonexudative conjunctivitis, cervical lymph adenopathy and edema in lower extremities. After diagnosis of Kawasaki, all patients received standard treatment (intravenous immunoglobulins and aspirin) and undergoing cardiac echocardiography in 2 weeks, 2 months and 6 months. Information including age, sex, sign of diseases, laboratory findings, and cardiac complications in echocardiography were recorded. Results: This study was performed on 100 patients (61 boys and 39 girls) with Kawasaki disease. The mean age of children was 2.8±2.6 years. Cardiac complication rate was 47% at the onset of the disease and had reached to 7% at the end of the sixth month (P=0.000). Distribution of cardiovascular complications in the second week, the second month and the sixth month after treatment was not significantly different according to the start of time of treatment (p>0.05). Duration of fever in patients who received treatment before 10th day (1.5±1.3) did not have significant difference (P=0.78) with patients who received after 10th day (1.6±0.9). Conclusion: Result shows that most of patients (99%) responded to the treatment with IVIG and ASA and cardiovascular complication ratio decreased. There was not significant relationship between duration of fever and time of IVIG treatment initiation. PMID:27757208

  9. Meta-analysis of the relationship between single nucleotide polymorphism rs72689236 of caspase-3 and Kawasaki disease.

    PubMed

    Xing, Yanlin; Wang, Hong; Liu, Xiaomei; Yu, Xianyi; Chen, Rui; Wang, Ce; Yu, Xuexin; Sun, Le

    2014-10-01

    Kawasaki disease is a pediatric systemic vasculitis of unknown etiology, for which a genetic influence is suspected. But whether single nucleotide polymorphism (SNP) of caspase-3 rs72689236 is associated with Kawasaki disease is controversial. The aim of our study is to assess the association between the SNP of caspase-3 and risk for Kawasaki disease. We searched PubMed, MEDLINE, EMBASE, Springer, Elsevier Science Direct, Cochrane Library Google scholar, CNKI (China National Knowledge Infrastructure, in Chinese) and Wanfang database (in Chinese) to identify studies investigating the association between rs72689236 polymorphism and Kawasaki disease occurrence. There were five eligible studies, which included 4,241 (case group 1,560; control group 2,681) participants in this meta-analysis. Pooled odds ratios (ORs) and 95 % confidence intervals (95 % CIs) were calculated in a fixed-effects model (the Mantel-Haenszel method) or a random-effects model (the DerSimonian and Laird method) when appropriate. Significant associations were found under the overall ORs for A-allele comparison (A vs. G, pooled OR 1.33, 95 % CI 1.21-1.46), AA versus GG comparison (pooled OR 1.64, 95 % CI 1.35-2.00), GA versus GG comparison (pooled OR 1.42, 95 % CI 1.24-1.63), recessive model (AA vs. GG + GA, pooled OR 1.37, 95 % CI 1.15-1.64) and dominant model (AA + GA vs. GG, pooled OR 1.47, 95 % CI 1.29-1.67). This meta-analysis suggested that SNP rs72689236 of caspase-3 might be associated with susceptibility of Kawasaki disease and the allele A might increase the risk of Kawasaki disease in Asian samples such as Japanese and Chinese. In addition, individual studies with large sample size are needed to further evaluate the associations in various ethnic populations.

  10. N-terminal pro-brain natriuretic peptide can be an adjunctive diagnostic marker of hyper-acute phase of Kawasaki disease.

    PubMed

    Kwon, Hyuksool; Lee, Jin Hee; Jung, Jae Yun; Kwak, Young Ho; Kim, Do Kyun; Jung, Jin Hee; Chang, Ikwan; Kim, Kyuseok

    2016-12-01

    The purpose of this study was to determine whether the serum N-terminal pro-brain natriuretic peptide (NT-proBNP) level could be a useful marker for Kawasaki disease in the pediatric emergency department (PED) and in the presence of fever duration of 4 days or less (hyper-acute phase of Kawasaki disease). Medical records of patients who were 1 month to 15 years old of age and presented at the PED with suspected Kawasaki disease from January 1, 2010, to December 31, 2014, were collected retrospectively. Two hundred thirty-nine patients with a history of fever for 4 days or less were diagnosed with Kawasaki disease, as well as 111 patients with other febrile diseases, and were enrolled. The NT-proBNP level was significantly higher in patients with Kawasaki disease (Kawasaki disease vs. other febrile disease group, 444.8 (189.7-951.5) vs. 153.4 (68.9-287.6) pg/mL; p < 0.001), and a cutoff value of 244.7 pg/mL yielded a sensitivity and specificity of 68.6 and 70.3 %, respectively. The area under the curve of the NT-proBNP for predicting Kawasaki disease was 0.763 (95 % CI 0.712-0.814).

  11. Conocimiento de Energía: Principios Esenciales y Conceptos Fundamentales para la Educación de Energía

    SciTech Connect

    2014-06-01

    This is the Spanish version of our Energy Literacy guidebook. Esta guía presenta conceptos de energía que, cuando se entienden y se aplican, ayudan a individuos y a comunidades a tomar decisiones sobre la energía con conocimiento de causa. No es un currículo sino que ofrece un marco sobre el cual puede basarse un plan de estudios. La guía se dirige a cualquier persona que participe en la educación de energía.

  12. Two Cases of Super-Giant Coronary Aneurysms after Kawasaki Disease

    PubMed Central

    Lee, Joowon; Kwon, Bo Sang; Bae, Eun Jung; Noh, Chung Il

    2014-01-01

    Acute giant coronary aneurysm after Kawasaki disease (KD) is a catastrophic complication that can be fatal and very difficult to manage. However, no fixed consensus has been reached for the management of super-giant coronary aneurysms in the acute setting. Here, we report the successful management of young children with super-giant coronary aneurysms after KD. Based on our experience, hemodynamic stabilization to prevent further coronary dilation or rupture and strict anticoagulation to avoid thrombus formation are mandatory in the management of this condition. PMID:24497892

  13. Biphasic thallium 201 SPECT-imaging for the noninvasive diagnosis of myocardial perfusion abnormalities in a child with Kawasaki disease--a case report

    SciTech Connect

    Hausdorf, G.; Nienaber, C.A.; Spielman, R.P.

    1988-02-01

    The mucocutaneous lymph node syndrome (Kawasaki disease) is of increasing importance for the pediatric cardiologist, for coronary aneurysms with the potential of thrombosis and subsequent stenosis can develop in the course of the disease. The authors report a 2 1/2-year-old female child in whom, fourteen months after the acute phase of Kawasaki disease, myocardial infarction occurred. Biphasic thallium 201 SPECT-imaging using dipyridamole depicted anterior wall ischemia and inferolateral infarction. This case demonstrates that noninvasive vasodilation-redistribution thallium 201 SPECT-imaging has the potential to predict reversible myocardial perfusion defects and myocardial necrosis, even in small infants with Kawasaki disease.

  14. The first case of Kawasaki disease in a 20-month old baby following immunization with rotavirus vaccine and hepatitis A vaccine in China: A case report.

    PubMed

    Yin, Shi; Liubao, Peng; Chongqing, Tan; Xiaomin, Wan

    2015-01-01

    Kawasaki disease (KD) after rotavirus and hepatitis A vaccination has not previously been reported in a baby in China. Herein, we describe a 20-month-old child who developed Kawasaki disease after receiving her second dose of Lanzhou lamb rotavirus vaccine (LLR) and her first dose of freeze-dried live attenuated hepatitis A vaccine. The case report was conducted by collecting and analyzing the hospital in-patient medical records and reviewing both the domestic and foreign pertinent literature. These findings will be important to note this possible side effect and to further investigate the association between the above 2 vaccines and Kawasaki disease.

  15. Percutaneous coronary intervention for acute myocardial infarction in a pediatric patient with coronary aneurysm and stenosis due to Kawasaki disease.

    PubMed

    Drossner, David M; Chappell, Clay; Rab, Tanveer; Kim, Dennis

    2012-06-01

    We report the case of an acutely ill 3-year-old female, with a previous medical history of Kawasaki disease, who presented to care with an acute myocardial infarction. We describe the coordinated therapies employed by pediatric and adult cardiologists aimed to establish coronary revascularization.

  16. Intravenous immunoglobulin treatment responsiveness depends on the degree of CD8+ T cell activation in Kawasaki disease.

    PubMed

    Ye, Qing; Gong, Fang-Qi; Shang, Shi-Qiang; Hu, Jian

    2016-10-01

    Kawasaki disease (KD) has become the most common cause of acquired heart disease in children and is also a risk factor for ischemic heart disease in adults. However, Kawasaki disease lacks specific laboratory diagnostic indices. Thus, this study analyzed the T cell activation profiles of Kawasaki disease and assessed their value in the diagnosis of Kawasaki disease and the prediction of intravenous immunoglobulin (IVIG) sensitivity. We analyzed human leukocyte antigen-DR (HLA-DR), CD69 and CD25 expression on peripheral blood CD4+ and CD8+ T cells during the acute phase of KD. We compared the percentages of HLA-DR+/CD69+/CD25+ T cells in the CD4+ and CD8+ T cell populations of IVIG-effective and IVIG-resistant groups. Receiver operating characteristic curves were used to assess the diagnostic value of the above parameters. The median percentage of CD8+HLA-DR+ T cells and the median ratio of CD8+HLA-DR+ T cells/CD8+CD25+ T cells were significantly elevated in the patient group compared with those in the control group during the acute phase of KD. Regarding the diagnosis of Kawasaki disease, the area under the ROC curve was 0.939 for the percentage of CD8+HLA-DR+ T cells. There was a significant difference in the ratio of CD8+HLA-DR+ T cells/CD8+CD69+ T cells between IVIG-resistant patients and IVIG-sensitive patients. Regarding IVIG sensitivity, the area under the ROC curve was 0.795 for it. Excessive CD8+ T cell activation, as well as an imbalance between CD8+ T cell activation and inhibition, underlies the pathogenesis of Kawasaki disease. The percentage of CD8+ HLA-DR+ T cells may be used as an index to diagnose Kawasaki disease. IVIG inhibits CD8+ T cell activation, but excessive CD8+ T cell activation may cause IVIG resistance. The ratio of CD8+HLA-DR+ T cells/CD8+CD69+ T cells may be used as a predictor of IVIG sensitivity.

  17. Dipyridamole-thallium-201 tomography documenting improved myocardial perfusion with therapy in Kawasaki disease

    SciTech Connect

    Nienaber, C.A.; Spielmann, R.P.; Hausdorf, G.

    1988-12-01

    Thallium-201 tomographic perfusion studies after pharmacologic vasodilation were performed in seven children (aged 2 years 8 months to 8 years 7 months), 3 to 20 months after the acute stage of the disease. In all patients coronary aneurysms were seen on cross-sectional echocardiograms. The scintigrams of six children showed no significant regional reduction of myocardial thallium-201 uptake. These children had remained asymptomatic in the follow-up period after the acute inflammatory stage of Kawasaki disease. Persistent and transient thallium defects were present in one child with acute posterolateral myocardial infarction; obstruction of two coronary vessels supplying the defect zones was confirmed by contrast angiography. After 8 months of treatment a follow-up nuclear scan showed marked reduction in the size of the defect and almost complete abolishment of the ischemic reaction. Thus tomographic thallium-201 perfusion scintigraphy in conjunction with vasodilation stress is useful to assess myocardial perfusion in children with Kawasaki disease and demonstrates marked improvement in regional perfusion after adequate medical therapy.

  18. Acute Myocardial Ischemia in Adults Secondary to Missed Kawasaki Disease in Childhood

    PubMed Central

    Rizk, Sherif RY; El Said, Galal; Daniels, Lori B; Burns, Jane C; El Said, Howaida; Sorour, Khaled A; Gharib, Soliman; Gordon, John B

    2015-01-01

    Coronary artery aneurysms that occur in 25% of untreated Kawasaki disease (KD) patients may remain clinically silent for decades and then thrombose resulting in myocardial infarction. Although KD is now the most common cause of acquired heart disease in children in Asia, the United States, and Western Europe, the incidence of KD in Egypt is unknown. We tested the hypothesis that young adults in Egypt presenting with acute myocardial ischemia may have coronary artery lesions due Kawasaki disease (KD) in childhood. We reviewed a total of 580 angiograms of patients ≤ 40 years of age presenting with symptoms of myocardial ischemia. Coronary artery aneurysms were noted in 46 patients (7.9 %) of whom nine presented with myocardial infarction. The likelihood of antecedent KD as the cause of the aneurysms was classified as definite (n=10), probable (n=29), or equivocal (n=7). Compared to the definite and probable groups, the equivocal group had more traditional cardiovascular risk factors, smaller sized aneurysms, and fewer coronary arteries affected. In conclusion, in a major metropolitan center in Egypt, 6.7% of adults age 40 years or younger undergoing angiography for evaluation of possible myocardial ischemia had lesions consistent with antecedent KD. Because of the unique therapeutic challenges associated with these lesions, adult cardiologists should be aware that coronary artery aneurysms in young adults may be due to missed KD in childhood. PMID:25555655

  19. Evaluation of myocardial deformation in patients with Kawasaki disease using speckle-tracking echocardiography during mid-term follow-up.

    PubMed

    Dedeoglu, Reyhan; Barut, Kenan; Oztunc, Funda; Atik, Sezen; Adrovic, Amra; Sahin, Sezgin; Cengiz, Dicle; Kasapcopur, Ozgur

    2017-04-05

    Speckle-tracking echocardiography is a recently developed technique for the evaluation of myocardial deformation or strain. Our objective was to examine strain through a mid-term follow-up of patients with Kawasaki disease.

  20. Downregulation of Th17 cells and the related cytokines with treatment in Kawasaki disease.

    PubMed

    Rasouli, Manoochehr; Heidari, Behzad; Kalani, Mehdi

    2014-11-01

    Given the inflammatory nature of Kawasaki disease (KD) and the pro-inflammatory properties of Th17, this study aimed to determine the frequency of Th17 cells and the levels of corresponding cytokines in acute phase of KD and to evaluate their alterations one and eight weeks after treatment. Th17 and the related cytokine levels were measured in 21 KD patients and 42 positive and negative controls, using flow cytometry and ELISA, respectively. Th17, IL-17, IL-22 and IL-23 were significantly higher (P<0.05) in patients compared with negative controls, but no significant differences (P>0.05) with the positive controls. Furthermore, Th17, IL-17, IL-22 and IL-23 were significantly higher in patients before treatment than those one and eight weeks after. Considering the downregulation of Th17 and its related cytokines with aspirin and intravenous immunoglobulin therapy implies the probable role of Th17 in KD pathogenesis.

  1. Strict management of a pregnant patient with giant coronary artery aneurysm due to Kawasaki disease.

    PubMed

    Taniguchi, Kosuke; Ono, Hiroshi; Sato, Anna; Kinomoto, Satoko; Tagawa, Naomi; Umehara, Nagayoshi; Kato, Hitoshi; Sago, Haruhiko

    2015-10-01

    Coronary artery aneurysms (CAA) may occur in Kawasaki disease (KD). Patients with giant CAA (diameter >8 mm), in particular, have higher risk of myocardial infarction. Previous reports have demonstrated the necessity of anticoagulation therapy in such cases. The management of patients with KD complicated by giant CAA later in life, however, remains controversial. Here, we describe the strict management in the case of a 28-year-old pregnant Japanese woman with KD with giant CAA (diameter, 11 mm). Instead of warfarin, the patient was given low-dose aspirin and i.v. unfractionated heparin during pregnancy to prevent thrombosis in the giant CAA. At 38 weeks of gestation, she had spontaneous delivery of a healthy baby. No thrombotic or bleeding complications were observed. The strict anticoagulation therapy resulted in successful pregnancy and delivery without any adverse events.

  2. Hemodynamic simulations in coronary aneurysms of a patient with Kawasaki Disease

    NASA Astrophysics Data System (ADS)

    Sengupta, Dibyendu; Marsden, Alison; Burns, Jane

    2010-11-01

    Kawasaki Disease is the leading cause of acquired pediatric heart disease, and can cause large coronary artery aneurysms in untreated cases. A simulation case study has been performed for a 10-year-old male patient with coronary aneurysms. Specialized coronary boundary conditions along with a lumped parameter heart model mimic the interactions between the ventricles and the coronary arteries, achieving physiologic pressure and flow waveforms. Results show persistent low shear stress in the aneurismal regions, and abnormally high shear at the aneurysm neck. Correlation functions have been derived to compare wall shear stress and wall shear stress gradients with recirculation time with the idea of localizing zones of calcification and thrombosis. Results are compared with those of an artificially created normal coronary geometry for the same patient. The long-term goal of this work is to develop links between hemodynamics and thrombotic risk to assist in clinical decision-making.

  3. [Use of the urinary trypsin inhibitor ulinastatin for acute Kawasaki disease].

    PubMed

    Kawamura, Yoichi; Kanai, Takashi; Takeshita, Seiichiro; Nonoyama, Shigeaki

    2014-09-01

    Intravenous immunoglobulin (IVIG) therapy is widely recognized as standard treatment for Kawasaki disease(KD). However, about 20 % of KD patients are resistant to IVIG and are considered to be a high risk group for coronary artery lesions (CAL). Ulinastatin(UTI) is one of the neutrophil elastase inhibitors used for patients with pancreatitis or circulatory shock, and several studies have shown its efficacy for KD. Recently, we demonstrated that initial UTI treatment combined with IVIG decreased the number of patients requiring addi- tional rescue treatment and the occurrence of CAL. In this study, no severe adverse events occurred. Further research and a prospective trial are needed to prove the clinical efficacy and demonstrate the limits of UTI in patients with KD.

  4. Kawasaki disease and the emerging coronary artery disease epidemic in India: is there a correlation?

    PubMed

    Singh, Surjit; Aulakh, Roosy; Kawasaki, Tomisaku

    2014-04-01

    Although Kawasaki disease (KD) is now being increasingly reported from India, the vast majority of children with KD are still not being diagnosed and treated. A recent study from Chandigarh has shown that the incidence of KD is at least 4.54/100,000 children below 15 y of age. Extrapolations of this figure suggest that a minimum of 17,417 new cases of KD would be occurring every year in our country. A significant proportion of these children may develop coronary artery abnormalities. These children would then be at risk of developing myocardial ischemia as young adults. It is authors' contention that (undiagnosed) KD in childhood may be contributing to the growing pool of coronary artery disease (CAD) in India. Similarly, a missed diagnosis of KD in childhood should be considered as a possibility while evaluating adults with CAD, especially when there are no overt risk factors and no family history of the disease.

  5. Blinded case-control study of the relationship between human coronavirus NL63 and Kawasaki syndrome.

    PubMed

    Dominguez, Samuel R; Anderson, Marsha S; Glodé, Mary P; Robinson, Christine C; Holmes, Kathryn V

    2006-12-15

    We conducted a blinded, case-control, retrospective study in pediatric patients hospitalized at The Children's Hospital, Denver, Colorado, to determine whether human coronavirus (HCoV)-NL63 infection is associated with Kawasaki syndrome (KS). Over the course of a 7-month period, nasopharyngeal-wash samples from 2 (7.7%) of 26 consecutive children with KS and 4 (7.7%) of 52 matched control subjects tested positive for HCoV-NL63 by reverse transcription-polymerase chain reaction. These data suggest that, although HCoV-NL63 was circulating in children in our community during the time of the study, the prevalence of infection with HCoV-NL63 was not greater in patients with KS than in control subjects.

  6. In Vitro Validation of Patient-Specific Hemodynamic Simulations in Coronary Aneurysms Caused by Kawasaki Disease

    PubMed Central

    Kung, Ethan; Kahn, Andrew M.; Burns, Jane C.; Marsden, Alison

    2014-01-01

    To perform experimental validation of computational fluid dynamics (CFD) applied to patient specific coronary aneurysm anatomy of Kawasaki disease. We quantified hemodynamics in a patient-specific coronary artery aneurysm physical phantom under physiologic rest and exercise flow conditions. Using phase contrast MRI (PCMRI), we acquired 3-component flow velocity at two slice locations in the aneurysms. We then performed numerical simulations with the same geometry and inflow conditions, and performed qualitative and quantitative comparisons of velocities between experimental measurements and simulation results. We observed excellent qualitative agreement in flow pattern features. The quantitative spatially and temporally varying differences in velocity between PCMRI and CFD were proportional to the flow velocity. As a result, the percent discrepancy between simulation and experiment was relatively constant regardless of flow velocity variations. Through 1D and 2D quantitative comparisons, we found a 5–17% difference between measured and simulated velocities. Additional analysis assessed wall shear stress differences between deformable and rigid wall simulations. This study demonstrated that CFD produced good qualitative and quantitative predictions of velocities in a realistic coronary aneurysm anatomy under physiological flow conditions. The results provide insights on factors that may influence the level of agreement, and a set of in vitro experimental data that can be used by others to compare against CFD simulation results. The findings of this study increase confidence in the use of CFD for investigating hemodynamics in the specialized anatomy of coronary aneurysms. This provides a basis for future hemodynamics studies in patient-specific models of Kawasaki disease. PMID:25050140

  7. Urine proteomics for discovery of improved diagnostic markers of Kawasaki disease

    PubMed Central

    Kentsis, Alex; Shulman, Andrew; Ahmed, Saima; Brennan, Eileen; Monuteaux, Michael C; Lee, Young-Ho; Lipsett, Susan; Paulo, Joao A; Dedeoglu, Fatma; Fuhlbrigge, Robert; Bachur, Richard; Bradwin, Gary; Arditi, Moshe; Sundel, Robert P; Newburger, Jane W; Steen, Hanno; Kim, Susan

    2013-01-01

    Kawasaki disease (KD) is a systemic vasculitis of unknown etiology. Absence of definitive diagnostic markers limits the accuracy of clinical evaluations of suspected KD with significant increases in morbidity. In turn, incomplete understanding of its molecular pathogenesis hinders the identification of rational targets needed to improve therapy. We used high-accuracy mass spectrometry proteomics to analyse over 2000 unique proteins in clinical urine specimens of patients with KD. We discovered that urine proteomes of patients with KD, but not those with mimicking conditions, were enriched for markers of cellular injury such as filamin and talin, immune regulators such as complement regulator CSMD3, immune pattern recognition receptor muclin, and immune cytokine protease meprin A. Significant elevations of filamin C and meprin A were detected in both the serum and urine in two independent cohorts of patients with KD, comprised of a total of 236 patients. Meprin A and filamin C exhibited superior diagnostic performance as compared to currently used markers of disease in a blinded case-control study of 107 patients with suspected KD, with receiver operating characteristic areas under the curve of 0.98 (95% confidence intervals [CI] of 0.97–1 and 0.95–1, respectively). Notably, meprin A was enriched in the coronary artery lesions of a mouse model of KD. In all, urine proteome profiles revealed novel candidate molecular markers of KD, including filamin C and meprin A that exhibit excellent diagnostic performance. These disease markers may improve the diagnostic accuracy of clinical evaluations of children with suspected KD, lead to the identification of novel therapeutic targets, and allow the development of a biological classification of Kawasaki disease. PMID:23281308

  8. Predictive value of red blood cell distribution width for coronary artery lesions in patients with Kawasaki disease.

    PubMed

    Xu, Haiyan; Fu, Songling; Wang, Wei; Zhang, Qing; Hu, Jian; Gao, Lichao; Zhu, Weihua; Gong, Fangqi

    2016-08-01

    Recent studies have shown that elevated red blood cell distribution width is associated with poor outcome in cardiovascular diseases. In order to assess the predictive value of red blood cell distribution width, before treatment with intravenous immunoglobulins, for coronary artery lesions in patient with Kawasaki disease, we compared 83 patients with coronary artery lesions and 339 patients without coronary artery lesions before treatment with intravenous immunoglobulin. Clinical, echocardiographic, and biochemical values were evaluated along with red blood cell distribution width. A total of 422 consecutive patients with Kawasaki disease were enrolled into our study. According to receiver operating characteristic curve analysis, the optimal red blood cell distribution width cut-off value for predicting coronary artery lesions was 14.55% (area under the curve was 0.721; p=0.000); eighty-three patients (19.7%) had coronary artery lesions, and 70% of the patients with coronary artery lesions had red blood cell distribution width level >14.55%. Logistic regression analysis revealed that fever duration >14 days (odds ratio was 3.42, 95% confidence interval was 1.27-9.22; p=0.015), intravenous immunoglobulin resistance (odds ratio was 2.33, 95% confidence interval was 1.02-5.29; p=0.04), and red blood cell distribution width >14.55% (odds ratio was 3.49, 95% confidence interval was 2.01-6.05; p=0.000) were independent predictors of coronary artery lesions in patients with Kawasaki disease. In Conclusion, red blood cell distribution width may be helpful for predicting coronary artery lesions in patients with Kawasaki disease.

  9. An adult case of Kawasaki disease with multiplex coronary aneurysms and myocardial infarction: the role of transesophageal echocardiography.

    PubMed

    Habon, T; Toth, K; Keltai, M; Lengyel, M; Palik, I

    1998-07-01

    Kawasaki disease (mucocutaneous lymph node syndrome) is an acute inflammatory disease that primarily affects infants and young children. In spite of proper therapy, coronary aneurysms develop in 10 to 25% of cases. Adult diagnosis of coronary aneurysm, presumably caused by Kawasaki disease, is rare. A 37-year-old male patient with previous inferior wall myocardial infarction (MI) was admitted with an acute anterior wall MI. Coronary angiography, performed 2 weeks after successful thrombolytic therapy, showed right coronary artery occlusion and multiplex (left main, left anterior descending, left circumflex, right coronary artery) giant coronary aneurysms. Transthoracic echocardiography was unable to detect the aneurysms. Transesophageal echocardiography (TEE) visualized a large left main coronary aneurysm with an occlusive thrombus and measured low flow velocity (0.2 m/s) in the proximal left anterior descending artery. At 4 weeks control, TEE showed marked regression of the thrombus, and it was not detectable after 6 months of oral anticoagulation with acenocumarol (International Normalized Ratio: 3-3.5) and standard postinfarction therapy. After 2 years of follow-up, the patient has no symptoms, and myocardial ischemia could not be provoked by stress tests [treadmill, dipyridamole single-photon emission computed tomography (SPECT)]. We conclude that, for diagnosis and follow-up of adult Kawasaki disease, transesophageal echocardiography is indicated. The importance and efficacy of long-term anticoagulant treatment should be emphasized in this disease.

  10. Kawasaki Disease

    MedlinePlus

    ... doctor may give your child high doses of aspirin to lower the fever. Aspirin also helps with the rash and the joint ... might give your child a lower dose of aspirin for several weeks to reduce the chance of ...

  11. Kawasaki Disease With Giant Coronary Aneurysms Requiring a Ventricular Assist Device to Separate From Extracorporeal Membrane Oxygenation: Coronary Issues Can Be a Pediatric Problem Too!

    PubMed

    Adler, Adam C; Kodavatiganti, Ramesh

    2016-08-15

    Kawasaki disease, although common in children, may rarely affect the coronary arteries, leading to aneurysm formation and potential for coronary thrombus formation. Extremely rarely, coronary aneurysms from Kawasaki disease can thrombose, resulting in ischemic myocardium. We present a case of a 31-month-old patient requiring a left ventricular assist device after thrombosis of giant coronary aneurysms led to ischemic cardiomyopathy. At the termination of the surgical procedure, we encountered 2 periods of ventricular assist device dropout requiring intervention. With the increase in the number of pediatric patients with assist devices, we review the basic care for a patient requiring emergent surgery.

  12. Effect and Safety of TNF Inhibitors in Immunoglobulin-Resistant Kawasaki Disease: a Meta-analysis.

    PubMed

    Xue, Li-Jun; Wu, Rong; Du, Gui-Lian; Xu, Yan; Yuan, Kang-Yan; Feng, Zhi-Chun; Pan, Yu-Lin; Hu, Guang-Yu

    2016-08-23

    Previous studies showed that tumor necrosis factor (TNF) inhibitors might decrease the rate of coronary artery abnormalities in pediatrics with intravenous immunoglobulin (IVIG)-resistant Kawasaki disease (KD). Therefore, we aimed to evaluate the effect and safety of TNF inhibitors in IVIG-resistant KD. We undertook a meta-analysis of clinical trials identified in systematic searches of PubMed, EMBASE, Cochrane Database, and Google scholar through May 2016. Five studies were included. Overall, rate of coronary artery aneurysm was comparable between groups (relative risk (RR), 1.05; 95 % confidence interval (95 % CI), 0.60 to 1.81; P = 0.87). No significant differences were recorded between groups in coronary artery Z scores (standardized mean difference (SMD), 0.27; 95 % CI, -0.30 to 0.85; P = 0.35). Meanwhile, TNF inhibitors were not associated with a significant decreased risk of treatment resistance compared with IVIG treatment (RR, 0.65; 95 % CI, 0.37 to 0.15; P = 0.14). However, days of fever was significantly reduced in the TNF inhibitor group (SMD, -0.66; 95 % CI, -0.90 to -0.41; P < 0.001). Additionally, risk of serious adverse events was similar between groups. Therefore, TNF inhibitors could shorten the duration of fever in IVIG-resistant KD. However, TNF inhibitors appear to have no cardioprotective effect in patients with IVIG-resistant KD.

  13. High dose anakinra for treatment of severe neonatal Kawasaki disease: a case report

    PubMed Central

    2014-01-01

    We report an 11-week-old female who presented with Kawasaki disease (KD) complicated by macrophage activation syndrome (MAS). The infant presented to the hospital with persistent fever, cough, diarrhea, and emesis, among other symptoms. Her condition quickly began to decompensate, and she developed classic features (conjunctivitis, rash, cracked lips, distal extremity edema) prompting a diagnosis of acute KD. The patient was treated with standard therapy for KD including three doses of intravenous immunoglobulin (IVIG), aspirin, and high dose glucocorticoids with no change in her condition. Due to a high suspicion for MAS, high dose anakinra therapy was initiated resulting in dramatic clinical improvements. She also received one dose of infliximab for concern for coronary artery changes, and over the course of several months, anakinra and high dose glucocorticoids were tapered. Nearly complete reversal of echocardiogram changes were observed after 8 months, and the infant is now off all immunosuppressive therapy. In this case report, we briefly review the importance of early recognition of MAS in pediatric patient populations with rheumatic diseases, and we suggest early initiation of anakinra therapy as a rapid and effective treatment option. PMID:25045337

  14. Identification of candidate diagnostic serum biomarkers for Kawasaki disease using proteomic analysis

    PubMed Central

    Kimura, Yayoi; Yanagimachi, Masakatsu; Ino, Yoko; Aketagawa, Mao; Matsuo, Michie; Okayama, Akiko; Shimizu, Hiroyuki; Oba, Kunihiro; Morioka, Ichiro; Imagawa, Tomoyuki; Kaneko, Tetsuji; Yokota, Shumpei; Hirano, Hisashi; Mori, Masaaki

    2017-01-01

    Kawasaki disease (KD) is a systemic vasculitis and childhood febrile disease that can lead to cardiovascular complications. The diagnosis of KD depends on its clinical features, and thus it is sometimes difficult to make a definitive diagnosis. In order to identify diagnostic serum biomarkers for KD, we explored serum KD-related proteins, which differentially expressed during the acute and recovery phases of two patients by mass spectrometry (MS). We identified a total of 1,879 proteins by MS-based proteomic analysis. The levels of three of these proteins, namely lipopolysaccharide-binding protein (LBP), leucine-rich alpha-2-glycoprotein (LRG1), and angiotensinogen (AGT), were higher in acute phase patients. In contrast, the level of retinol-binding protein 4 (RBP4) was decreased. To confirm the usefulness of these proteins as biomarkers, we analyzed a total of 270 samples, including those collected from 55 patients with acute phase KD, by using western blot analysis and microarray enzyme-linked immunosorbent assays (ELISAs). Over the course of this experiment, we determined that the expression level of these proteins changes specifically in the acute phase of KD, rather than the recovery phase of KD or other febrile illness. Thus, LRG1 could be used as biomarkers to facilitate KD diagnosis based on clinical features. PMID:28262744

  15. Acute myocardial ischemia in adults secondary to missed Kawasaki disease in childhood.

    PubMed

    Rizk, Sherif R Y; El Said, Galal; Daniels, Lori B; Burns, Jane C; El Said, Howaida; Sorour, Khaled A; Gharib, Soliman; Gordon, John B

    2015-02-15

    Coronary artery aneurysms that occur in 25% of untreated Kawasaki disease (KD) patients may remain clinically silent for decades and then thrombose resulting in myocardial infarction. Although KD is now the most common cause of acquired heart disease in children in Asia, the United States, and Western Europe, the incidence of KD in Egypt is unknown. We tested the hypothesis that young adults in Egypt presenting with acute myocardial ischemia may have coronary artery lesions because of KD in childhood. We reviewed a total of 580 angiograms of patients ≤40 years presenting with symptoms of myocardial ischemia. Coronary artery aneurysms were noted in 46 patients (7.9%), of whom 9 presented with myocardial infarction. The likelihood of antecedent KD as the cause of the aneurysms was classified as definite (n = 10), probable (n = 29), or equivocal (n = 7). Compared with the definite and probable groups, the equivocal group had more traditional cardiovascular risk factors, smaller sized aneurysms, and fewer coronary arteries affected. In conclusion, in a major metropolitan center in Egypt, 6.7% of adults aged ≤40 years who underwent angiography for evaluation of possible myocardial ischemia had lesions consistent with antecedent KD. Because of the unique therapeutic challenges associated with these lesions, adult cardiologists should be aware that coronary artery aneurysms in young adults may be because of missed KD in childhood.

  16. Characterization of the gut microbiota of Kawasaki disease patients by metagenomic analysis

    PubMed Central

    Kinumaki, Akiko; Sekizuka, Tsuyoshi; Hamada, Hiromichi; Kato, Kengo; Yamashita, Akifumi; Kuroda, Makoto

    2015-01-01

    Kawasaki disease (KD) is an acute febrile illness of early childhood. Previous reports have suggested that genetic disease susceptibility factors, together with a triggering infectious agent, could be involved in KD pathogenesis; however, the precise etiology of this disease remains unknown. Additionally, previous culture-based studies have suggested a possible role of intestinal microbiota in KD pathogenesis. In this study, we performed metagenomic analysis to comprehensively assess the longitudinal variation in the intestinal microbiota of 28 KD patients. Several notable bacterial genera were commonly extracted during the acute phase, whereas a relative increase in the number of Ruminococcus bacteria was observed during the non-acute phase of KD. The metagenomic analysis results based on bacterial species classification suggested that the number of sequencing reads with similarity to five Streptococcus spp. (S. pneumonia, pseudopneumoniae, oralis, gordonii, and sanguinis), in addition to patient-derived Streptococcus isolates, markedly increased during the acute phase in most patients. Streptococci include a variety of pathogenic bacteria and probiotic bacteria that promote human health; therefore, this further species discrimination could comprehensively illuminate the KD-associated microbiota. The findings of this study suggest that KD-related Streptococci might be involved in the pathogenesis of this disease. PMID:26322033

  17. CFD research and systems in Kawasaki Heavy Industries and its future prospects

    NASA Astrophysics Data System (ADS)

    Hiraoka, Koichi

    1990-09-01

    KHI Computational Fluid Dynamics (CFD) system is composed of VP100 computer and 2-D and 3-D Euler and/or Navier-Stokes (NS) analysis softwares. For KHI, this system has become a very powerful aerodynamic tool together with the Kawasaki 1 m Transonic Wind Tunnel. The 2-D Euler/NS software, developed in-house, is fully automated, requires no special skill, and was successfully applied to the design of YXX high lift devices and SST supersonic inlet, etc. The 3-D Euler/NS software, developed under joint research with NAL, has an interactively operated Multi-Block type grid generator and can effectively generate grids around complex airplane shapes. Due to the main memory size limitation, 3-D analysis of relatively simple shape, such as SST wing-body, was computed in-house on VP100, otherwise, such as detailed 3-D analyses of ASUKA and HOPE, were computed on NAL VP400, which is 10 times more powerful than VP100, under KHI-NAL joint research. These analysis results have very good correlation with experimental results. However, the present CFD system is less productive than wind tunnel and has applicability limitations.

  18. CFD-based Thrombotic Risk Assessment in Kawasaki Disease Patients with Coronary Artery Aneurysms

    NASA Astrophysics Data System (ADS)

    Sengupta, Dibyendu; Kung, Ethan; Kahn, Andrew; Burns, Jane; Marsden, Alison

    2012-11-01

    Coronary aneurysms occur in 25% of untreated Kawasaki Disease (KD) patients and put patients at increased risk for myocardial infarction and sudden death. Clinical guidelines recommend using aneurysm diameter >8 mm as the arbitrary criterion for treating with anti-coagulation therapy. This study uses patient-specific modeling to non-invasively determine hemodynamic parameters and quantify thrombotic risk. Anatomic models were constructed from CT angiographic image data from 5 KD aneurysm patients and one normal control. CFD simulations were performed to obtain hemodynamic data including WSS and particle residence times (PRT). Thrombosis was clinically observed in 4/9 aneurysmal coronaries. Thrombosed vessels required twice as many cardiac cycles (mean 8.2 vs. 4.2) for particles to exit, and had lower mean WSS (1.3 compared to 2.8 dynes/cm2) compared to vessels with non-thrombosed aneurysms of similar max diameter. 1 KD patient in the cohort with acute thrombosis had diameter < 8 mm. Regions of low WSS and high PRT predicted by simulations correlated with regions of subsequent thrombus formation. Thrombotic risk stratification for KD aneurysms may be improved by incorporating both hemodynamic and geometric quantities. Current clinical guidelines to assess patient risk based only on aneurysm diameter may be misleading. Further prospective study is warranted to evaluate the utility of patient-specific modeling in risk stratifying KD patients with coronary aneurysms. NIH R21.

  19. Assessment Of Coronary Artery Aneurysms Using Transluminal Attenuation Gradient And Computational Modeling In Kawasaki Disease Patients

    NASA Astrophysics Data System (ADS)

    Grande Gutierrez, Noelia; Kahn, Andrew; Shirinsky, Olga; Gagarina, Nina; Lyskina, Galina; Fukazawa, Ryuji; Owaga, Shunichi; Burns, Jane; Marsden, Alison

    2015-11-01

    Kawasaki Disease (KD) can result in coronary artery aneurysms (CAA) in up to 25% of patients, putting them at risk of thrombus formation, myocardial infarction and sudden death. Clinical guidelines recommend CAA diameter >8 mm as the arbitrary criterion for initiating systemic anticoagulation. KD patient specific modeling and flow simulations suggest that hemodynamic data can predict regions at increased risk of thrombosis. Transluminal Attenuation Gradient (TAG) is determined from the change in radiological attenuation per vessel length and has been proposed as a non-invasive method for characterizing coronary stenosis from CT Angiography. We hypothesized that CAA abnormal flow could be quantified using TAG. We computed hemodynamics for patient specific coronary models using a stabilized finite element method, coupled numerically to a lumped parameter network to model the heart and vascular boundary conditions. TAG was quantified in the major coronary arteries. We compared TAG for aneurysmal and normal arteries and we analyzed TAG correlation with hemodynamic and geometrical parameters. Our results suggest that TAG may provide hemodynamic data not available from anatomy alone. TAG represents a possible extension to standard CTA that could help to better evaluate the risk of thrombus formation in KD.

  20. Classification of coronary artery tissues using optical coherence tomography imaging in Kawasaki disease

    NASA Astrophysics Data System (ADS)

    Abdolmanafi, Atefeh; Prasad, Arpan Suravi; Duong, Luc; Dahdah, Nagib

    2016-03-01

    Intravascular imaging modalities, such as Optical Coherence Tomography (OCT) allow nowadays improving diagnosis, treatment, follow-up, and even prevention of coronary artery disease in the adult. OCT has been recently used in children following Kawasaki disease (KD), the most prevalent acquired coronary artery disease during childhood with devastating complications. The assessment of coronary artery layers with OCT and early detection of coronary sequelae secondary to KD is a promising tool for preventing myocardial infarction in this population. More importantly, OCT is promising for tissue quantification of the inner vessel wall, including neo intima luminal myofibroblast proliferation, calcification, and fibrous scar deposits. The goal of this study is to classify the coronary artery layers of OCT imaging obtained from a series of KD patients. Our approach is focused on developing a robust Random Forest classifier built on the idea of randomly selecting a subset of features at each node and based on second- and higher-order statistical texture analysis which estimates the gray-level spatial distribution of images by specifying the local features of each pixel and extracting the statistics from their distribution. The average classification accuracy for intima and media are 76.36% and 73.72% respectively. Random forest classifier with texture analysis promises for classification of coronary artery tissue.

  1. Transluminal Attenuation Gradient for Thrombotic Risk Assessment in Kawasaki Disease Patients with Coronary Artery Aneurysms

    NASA Astrophysics Data System (ADS)

    Grande Gutierrez, Noelia; Kahn, Andrew; Burns, Jane; Marsden, Alison

    2014-11-01

    Kawasaki Disease (KD) can result in coronary aneurysms in up to 25% of patients if not treated early putting patients at risk of thrombus formation, myocardial infarction and sudden death. Clinical guidelines for administering anti-coagulation therapy currently rely on anatomy alone. Previous studies including patient specific modeling and computer simulations in KD patients have suggested that hemodynamic data can predict regions susceptible to thrombus formation. In particular, high Particle Residence Time gradient (PRTg) regions have shown to correlate with regions of thrombus formation. Transluminal Attenuation Gradient (TAG) is determined from the change in radiological attenuation per vessel length. TAG has been used for characterizing coronary artery stenoses, however this approach has not yet been used in aneurysmal vessels. The aim of this study is to analyze the correlation between TAG and PRTg in KD patients with aneurysms and evaluate the use of TAG as an index to quantify thrombotic risk. Patient specific anatomic models for fluids simulations were constructed from CT angiographic image data from 3 KD aneurysm patients and one normal control. TAG values for the aneurysm patients were markedly lower than for the non-aneurysmal patient (mean -18.38 vs. -2). In addition, TAG values were compared to PRTg obtained for each patient. Thrombotic risk stratification for KD aneurysms may be improved by incorporating TAG and should be evaluated in future prospective studies.

  2. Severe Kawasaki disease in a 3-month-old patient: a case report

    PubMed Central

    2013-01-01

    Background Kawasaki disease is a multi-system vasculitis which usually occurs in children under 5 years of age. In infants under three months of age, it is very rare and usually associated with a high incidence of incomplete or atypical forms, often unresponsive to treatment. This condition increases the risk of cardiovascular complications such as coronary artery aneurysms. Case presentation We describe a 3-month-old infant who developed early and severe aneurysms in three coronary arteries despite a timely administration of intravenous immunoglobulins, followed by three days of intravenous methylprednisolone. Conclusion This case report underlines that the development of coronary artery aneurysm correlates with a delayed diagnosis and treatment, incomplete or atypical forms of the disease, and additionally the severity of clinical presentation, especially in cases of very young infants below 3 months of age. Our case is notable because of the very young age of the patient, the severity of clinical presentation with an early development of coronary artery aneurysms and the unresponsiveness to the therapy. PMID:24294914

  3. Ethnic Kawasaki Disease Risk Associated with Blood Mercury and Cadmium in U.S. Children

    PubMed Central

    Yeter, Deniz; Portman, Michael A.; Aschner, Michael; Farina, Marcelo; Chan, Wen-Ching; Hsieh, Kai-Sheng; Kuo, Ho-Chang

    2016-01-01

    Kawasaki disease (KD) primarily affects children <5 years of age (75%–80%) and is currently the leading cause of acquired heart disease in developed nations. Even when residing in the West, East Asian children are 10 to 20 times more likely to develop KD. We hypothesized cultural variations influencing pediatric mercury (Hg) exposure from seafood consumption may mediate ethnic KD risk among children in the United States. Hospitalization rates of KD in US children aged 0–4 years (n = 10,880) and blood Hg levels in US children aged 1–5 years (n = 713) were determined using separate US federal datasets. Our cohort primarily presented with blood Hg levels <0.1 micrograms (µg) per kg bodyweight (96.5%) that are considered normal and subtoxic. Increased ethnic KD risk was significantly associated with both increasing levels and detection rates of blood Hg or cadmium (Cd) in a linear dose-responsive manner between ethnic African, Asian, Caucasian, and Hispanic children in the US (p ≤ 0.05). Increasing low-dose exposure to Hg or Cd may induce KD or contribute to its later development in susceptible children. However, our preliminary results require further replication in other ethnic populations, in addition to more in-depth examination of metal exposure and toxicokinetics. PMID:26742052

  4. Sudden death as a late sequel of Kawasaki disease: postmortem CT demonstration of coronary artery aneurysm.

    PubMed

    Okura, Naoki; Okuda, Takahisa; Shiotani, Seiji; Kohno, Mototsugu; Hayakawa, Hideyuki; Suzuki, Atsuko; Kawasaki, Tomisaku

    2013-02-10

    Kawasaki disease (KD) is an acute, self-limited vasculitis of unknown etiology that primarily affects the coronary artery (CA) and presents during childhood. The characteristic coronary arterial lesion of KD is an aneurysm. Ischemic heart disease derived from a CA aneurysm is experienced approximately two decades after the onset of acute KD. In recent years, the primary issue of concern has been asymptomatic adults with a CA aneurysm caused by undiagnosed KD. We present a case of sudden death as a late KD sequel in a young adult. A postmortem CT scan revealed a coarse calcification of a left anterior descending CA aneurysm, which was confirmed at the time of autopsy. A postmortem CT scan is useful in cases of sudden death where the detection of a calcified CA aneurysm would suggest to the forensic pathologist that the deceased suffered from a late sequel of KD. The use of screening postmortem CT scans for young people may detect cases of unsuspected CA aneurysms, raising the possibility of untreated KD.

  5. Significance of serum 25-hydroxyvitamin D3 and interleukin-6 levels in immunoglobulin treatment of Kawasaki disease in children.

    PubMed

    An, Xinjiang; Fu, Mingyu; Tian, Jing; Xue, Ying; Xu, Hui

    2016-09-01

    The aim of the study was to investigate the significance of the level of serum 25-hydroxyvitamin D3 [25-(OH)D3] and interleukin (IL)-6 in serum prior to and after immunoglobulin treatment in children suffering from Kawasaki disease in order to provide a reference for the successful treatment of Kawasaki disease in children. From February, 2013 to February, 2015, 45 patients with Kawasaki disease were enrolled in the observation group. The normal control group comprised 43 healthy volunteers and the feverish control group 46 patients with respiratory infection and fever. Venous blood was collected from each case before and after immunoglobulin treatment and the level of 25-(OH)D3 and IL-6 in the serum were measured using fluorescent quantitative PCR, enzyme-linked immunosorbent assay and western blotting. Before treatment, the level of 25-(OH)D3 in the feverish control group was significantly lower than that of the normal control group, while the level of 25-(OH)D3 in the observation group was significantly higher than that of the normal control group. The level of 25-(OH)D3 in the feverish control group was lower than the IL-6 level in the normal children, but the difference was not statistically significant (P>0.05). The level 25-(OH)D3 in the observation group was significantly higher than the IL-6 level in the normal control group. The serum content of 25-(OH)D3 was significantly higher after the treatment compared to before treatment levels and after treatment IL-6 level was only slightly lower. It was observed that the 25-(OH)D3 level in the observation group was significantly increased after immunoglobulin treatment and this was positively correlated with the effects of the treatment. The IL-6 level had no significant changes after treatment and had little correlation with the treatment effect. The results suggested that 25-(OH)D3 may be involved in the occurrence of Kawasaki disease in children and in the aggravation of the disease to some extent.

  6. A child with Epstein-Barr Virus-associated hemophagocytic lymphohistiocytosis complicated by coronary artery lesion mimicking Kawasaki disease.

    PubMed

    Kato, Shogo; Yoshimura, Ken; Tanabe, Yuko; Kimata, Takahisa; Noda, Yukihiro; Kawasaki, Hirohide; Kaneko, Kazunari

    2013-10-01

    There is considerable overlap between hemophagocytic lymphohistiocytosis (HLH) and Kawasaki disease (KD) in terms of aberrant immune response though the etiology of KD remains unknown. We present a case fulfilling the criteria of both HLH and KD complicated by coronary artery dilatation: HLH was confirmed to be triggered by Epstein-Barr virus. This case alarms us the possibility that even patients with HLH may be complicated by coronary artery lesion, which is one of the hallmarks of KD. We would like to draw attention that if features of KD become apparent in patients with HLH, echocardiographic examinations should be performed not to miss coronary artery lesion.

  7. Bull's eye dermatoscopy pattern at bacillus Calmette-Guérin inoculation site correlates with systemic involvements in patients with Kawasaki disease.

    PubMed

    Tseng, Han-Chi; Ho, Ji-Chen; Guo, Mindy Ming-Huey; Lo, Mao-Hung; Hsieh, Kai-Sheng; Tsai, Wen-Chien; Kuo, Ho-Chang; Lee, Chih-Hung

    2016-09-01

    For the past decades, although the rash at the bacillus Calmette-Guérin (BCG) inoculation site has been recognized as a diagnostic clue in Kawasaki disease, the present study is the first known one attempting to characterize BCG inoculation by dermatoscopy in Kawasaki disease and correlate the grade of BCG reaction with systemic involvement. Thirty-four patients diagnosed with Kawasaki disease by pediatric specialists were enrolled. We performed detailed history taking, laboratory examination, physical examination and dermatoscopy examinations. Based on the BCG reaction pattern by dermatoscopy, we were able to characterize three patterns: (A) Bull's eye pattern in 18 patients; (B) faint homogenous erythema in nine; and (C) central white patch in seven. Patients from group A exhibited the highest elevation of blood aspartate aminotransferase levels (P < 0.05). Notably, three patients from group A had a significantly dilated coronary artery despite i.v. immunoglobulin injection. We concluded that the bull's eye dermatoscopy sign is not only a useful diagnostic clue but also a severity biomarker in patients with Kawasaki disease.

  8. Hepcidin-Induced Iron Deficiency Is Related to Transient Anemia and Hypoferremia in Kawasaki Disease Patients

    PubMed Central

    Huang, Ying-Hsien; Kuo, Ho-Chang; Huang, Fu-Chen; Yu, Hong-Ren; Hsieh, Kai-Sheng; Yang, Ya-Ling; Sheen, Jiunn-Ming; Li, Sung-Chou; Kuo, Hsing-Chun

    2016-01-01

    Kawasaki disease (KD) is a type of systemic vasculitis that primarily affects children under the age of five years old. For sufferers of KD, intravenous immunoglobulin (IVIG) has been found to successfully diminish the occurrence of coronary artery lesions. Anemia is commonly found in KD patients, and we have shown that in appropriately elevated hepcidin levels are related to decreased hemoglobin levels in these patients. In this study, we investigated the time period of anemia and iron metabolism during different stages of KD. A total of 100 patients with KD and 20 control subjects were enrolled in this study for red blood cell and hemoglobin analysis. Furthermore, plasma, urine hepcidin, and plasma IL-6 levels were evaluated using enzyme-linked immunosorbent assay in 20 KD patients and controls. Changes in hemoglobin, plasma iron levels, and total iron binding capacity (TIBC) were also measured in patients with KD. Hemoglobin, iron levels, and TIBC were lower (p < 0.001, p = 0.009, and p < 0.001, respectively) while plasma IL-6 and hepcidin levels (both p < 0.001) were higher in patients with KD than in the controls prior to IVIG administration. Moreover, plasma hepcidin levels were positively and significantly correlated with urine hepcidin levels (p < 0.001) prior to IVIG administration. After IVIG treatment, plasma hepcidin and hemoglobin levels significantly decreased (both p < 0.001). Of particular note was a subsequent gradual increase in hemoglobin levels during the three weeks after IVIG treatment; nevertheless, the hemoglobin levels stayed lower in KD patients than in the controls (p = 0.045). These findings provide a longitudinal study of hemoglobin changes and among the first evidence that hepcidin induces transient anemia and hypoferremia during KD’s acute inflammatory phase. PMID:27187366

  9. An evaluation of children with Kawasaki disease in Istanbul: a retrospective follow‐up study

    PubMed Central

    Kayiran, Sinan Mahir; Dindar, Aygün; Gurakan, Berkan

    2010-01-01

    BACKGROUND: Kawasaki disease (KD) is an acute, self‐limiting vasculitis of unknown etiology. The incidence of KD is increasing world wide. However, the epidemiological data for KD in Turkey has not been well described. OBJECTIVE: To describe the demographic, clinical, and laboratory features of children with KD who were diagnosed and managed in the American Hospital, Istanbul, Turkey. METHOD: Patients with KD were retrospectively identified from the hospital discharge records between 2002 and 2010. Atypical cases of KD were excluded. A standardized form was used to collect demographic data, clinical information, echocardiography and laboratory results. RESULTS: Thirty‐five patients with KD, with a mean age of 2.5±1.9 years, were identified. Eighty‐five point seven per cent of patients were under 5 years of age. A seasonal pattern favouring the winter months was noticed. In addition to fever and bilateral conjunctival injection, changes in the oral cavity and lips were the most commonly detected clinical signs in our cases. Coronary artery abnormalities were detected in nine patients. The majority of our patients had started treatment with intravenous immunoglobulin in the first 10 days of the onset of fever, and only one patient required systemic steroids for intravenous immunoglobulin‐resistant KD. The coronary artery abnormalities resolved in all nine patients within 8 months. CONCLUSION: This study is the most comprehensive series of children from Turkey with KD included in Medline. As adult‐onset ischemic heart disease may be due to KD in childhood, further prospective clinical investigations are needed to understand the epidemiology, management and long‐term follow‐up of the disease. PMID:21340213

  10. Transthoracic echo-Doppler assessment of coronary microvascular function late after Kawasaki disease.

    PubMed

    Cicala, S; Galderisi, M; Grieco, M; Lamberti, A; Cosimi, R; Pellegrini, F; de Leva, F

    2008-03-01

    The goal of this study was to demonstrate that Doppler transthoracic echocardiography (TTE) may represent a valuable tool for the noninvasive demonstration of coronary microvascular dysfunction in children with previous Kawasaki disease (KD) by the measurement of coronary flow reserve (CFR) during cold pressor test (CPT). Twenty-five children with previous KD (mean follow-up, 4.6 +/- 2.6 years) were included in the study-16 with no evidence of coronary artery lesions (CALs(-)) by TTE and 9 with coronary aneurysms (CALs(+)). Seventeen age-matched healthy subjects were also recruited. Diastolic peak velocity was measured by pulsed Doppler both at rest (DPV(Rest)) and during CPT (DPV(CPT)) in the anterior descending artery. CFR was calculated as DPV(CPT)/DPV(Rest). KD patients demonstrated significantly higher values of DPV(Rest) (0.21 +/- 0.05 vs 0.13 +/- 0.01 cm/sec, p < 0.0001) and DPV(CPT) (0.33 +/- 0.07 vs 0.27 +/- 0.03 cm/sec, p < 0.005). CFR was reduced in KD compared to control subjects (1.5 +/- 0.4 vs 2.1 +/- 0.2, p < 0.0001). CFR was decreased in a similar manner in both CALs(+) patients (1.4 +/- 0.4, p = 0.002 vs controls) and CALs(-) patients (1.6 +/- 0.4, p < 0.0001 vs controls). Doppler TTE at rest and during CPT may represent a valuable modality for CFR evaluation in children with a history of KD. CFR is significantly reduced in KD patients independently of the presence of CALs.

  11. Decreased levels of inflammatory cytokines in immunoglobulin-resistant Kawasaki disease after plasma exchange.

    PubMed

    Fujimaru, Takuya; Ito, Shuichi; Masuda, Hiroshi; Oana, Shinji; Kamei, Koichi; Ishiguro, Akira; Kato, Hitoshi; Abe, Jun

    2014-12-01

    The pathogenesis of coronary artery aneurysm (CAA) formation in Kawasaki disease (KD) remains unknown. However, inflammatory cytokines are thought to play an important role in KD. Patients with intravenous immunoglobulin (IVIG)-resistant KD are more likely to develop CAA. For such refractory patients, steroids and emerging infliximab (IFX) are used; however, further verification is required for their efficacy and safety. Plasma exchange (PE), which removes various inflammatory cytokines, has been used in Japan for over 15 years to prevent CAA in IVIG-resistant KD patients. The sequential change in inflammatory cytokines during the time course of PE has yet to be investigated. In this study, we measured plasma levels of 13 cytokines in nine children with IVIG-resistant KD before the start of PE (day 0: D0), as well as at 1 or 2 days (D1/2), and 4 or 5 days (D4/5) after starting PE. The median age of onset was 8 months (range: 3-53 months). Before PE, patients were treated with IVIG (median dose: 4 g/kg, range: 3-4 g/kg). The median starting period of PE was 8 days after the onset of fever (range: 6-21 days), while its duration was 3 days (range: 2-5 days). Among the 13 cytokines, interleukin-6, tumor necrosis factor-α, tumor necrosis factor receptor I (TNFR1), TNFR2, granulocyte colony-stimulating factor, and IL-17 were significantly lower at D4/5 compared with D0 and/or D1/2, reflecting the potential central efficacy of PE. While three patients developed moderate CAA, their condition regressed within 1 year. The removal of inflammatory cytokines could be the central efficacy of PE against refractory KD.

  12. Usefulness of Calcium Scoring as a Screening Examination in Patients With a History of Kawasaki Disease.

    PubMed

    Kahn, Andrew M; Budoff, Matthew J; Daniels, Lori B; Oyamada, Jun; Gordon, John B; Burns, Jane C

    2017-04-01

    Subsets of patients with a remote history of Kawasaki disease (KD) have coronary artery aneurysms with associated risks of late morbidity. In a pilot study, we previously showed that computed tomography (CT) coronary artery calcium (CAC) scoring detects late CAC in patients with aneurysms and a remote history of KD. We performed CT calcium volume scoring in 166 subjects (median age 19.5 years) with a remote history of KD (median interval from KD to CT 15.1 years). Coronary arteries were classified as normal (n = 100), transiently dilated (n = 23), persistently dilated (n = 10), remodeled aneurysm (n = 9), or aneurysm (n = 24) based on echocardiography. All subjects with coronary arteries classified as normal, persistently dilated, or remodeled aneurysm had zero CAC. Of the 24 subjects with coronary aneurysms, all but 5 had CAC (median volume 542 mm(3); range 17 to 8,218 mm(3)). For subjects imaged ≥9 years after their acute KD (n = 144), the presence of CAC had a sensitivity of 95% and a specificity of 100% for detecting coronary artery abnormalities (defined as coronary artery aneurysm and/or stenosis). In conclusion, coronary calcification was not observed in subjects with a history of KD who had normal coronary arteries by echocardiography during the acute phase. Coronary calcification, which may be severe, occurs late in patients with coronary aneurysms. Therefore, CAC scanning may be a useful tool to screen patients with a remote history of KD or suspected KD and unknown coronary artery status.

  13. Kawasaki Disease: Laboratory Findings and an Immunopathogenesis on the Premise of a "Protein Homeostasis System"

    PubMed Central

    Rhim, Jung-Woo; Kang, Jin-Han

    2012-01-01

    Kawasaki disease (KD) is a self-limited systemic inflammatory illness, and coronary artery lesions (CALs) are a major complication determining the prognosis of the disease. Epidemiologic studies in Asian children suggest that the etiologic agent(s) of KD may be associated with environmental changes. Laboratory findings are useful for the diagnosis of incomplete KD, and they can guide the next-step in treatment of initial intravenous immunoglobulin non-responders. CALs seem to develop in the early stages of the disease before a peak in inflammation. Therefore early treatment, before the peak in inflammation, is mandatory to reduce the risk of CAL progression and severity of CALs. The immunopathogenesis of KD is more likely that of acute rheumatic fever than scarlet fever. A hypothetical pathogenesis of KD is proposed under the premise of a "protein homeostasis system"; where innate and adaptive immune cells control pathogenic proteins that are toxic to host cells at a molecular level. After an infection of unknown KD pathogen(s), the pathogenic proteins produced from an unknown focus, spread and bind to endothelial cells of coronary arteries as main target cells. To control the action of pathogenic proteins and/or substances from the injured cells, immune cells are activated. Initially, non-specific T cells and non-specific antibodies are involved in this reaction, while hyperactivated immune cells produce various cytokines, leading to a cytokine imbalance associated with further endothelial cell injury. After the emergence of specific T cells and specific antibodies against the pathogenic proteins, tissue injury ceases and a repair reaction begins with the immune cells. PMID:22318812

  14. Clinical outcome of patients with refractory Kawasaki disease based on treatment modalities

    PubMed Central

    Kim, Hyun Jung; Lee, Hyo Eun; Yu, Jae Won

    2016-01-01

    Purpose Although a significant number of reports on new therapeutic options for refractory Kawasaki disease (KD) such as steroid, infliximab, or repeated intravenous immunoglobulin (IVIG) are available, their effectiveness in reducing the prevalence of coronary artery lesions (CAL) remains controversial. This study aimed to define the clinical characteristics of patients with refractory KD and to assess the effects of adjuvant therapy on patient outcomes. Methods We performed a retrospective study of 38 refractory KD patients from January 2012 to March 2015. We divided these patients into 2 groups: group 1 received more than 3 IVIG administration+ steroid therapy, (n=7, 18.4%), and group 2 patients were unresponsive to initial IVIG and required steroid therapy or second IVIG (n=31, 81.6%). We compared the clinical manifestations, laboratory results, and echocardiographic findings between the groups and examined the clinical utility of additional therapies in both groups. Results A significant difference was found in the total duration of fever between the groups (13.0±4.04 days in group 1 vs. 8.87±2.30 days in group 2; P=0.035). At the end of the follow-up, all cases in group 1 showed suppressed CAL. In group 2, coronary artery aneurysm occurred in 2 patients (6.4 %). All the patients treated with intravenous corticosteroids without additional IVIG developed CALs including coronary artery aneurysms. Conclusion No statistical difference was found in the development of CAL between the groups. Prospective, randomized, clinical studies are needed to elucidate the effects of adjunctive therapy in refractory KD patients. PMID:27610181

  15. Kawasaki Disease with Fever and Cervical Lymphadenopathy as the Sole Initial Presentation

    PubMed Central

    Jun, Woo Young; Ann, Yu Kyung; Kim, Ja Yeong; Kim, Soo-Jin; Yang, Hyun Suk; Bae, Sun Hwan; Chung, Sochung; Kim, Kyo Sun

    2017-01-01

    Background and Objectives Some patients with Kawasaki disease (KD) present with fever and cervical lymphadenopathy alone. The purpose of this study was to characterize the clinical features of these unusual KD patients and determine whether this is a severe form of KD associated with increased risks of intravenous immunoglobulin (IVIG) resistance and coronary artery lesions (CALs). Subjects and Methods A total of 146 children with KD were reviewed retrospectively, and classified into two groups according to initial clinical features. Those presenting with only fever and cervical lymphadenopathy (LKD) were classified as LKD patients. Other-KD patients included all except the LKD patients. Results Among 146 KD patients, 13 (8.9%) were classified as LKD patients. The LKD patients were significantly older and admitted earlier. The duration between fever onset and KD diagnosis was significantly longer in the LKD patients (5.9 days vs. 4.9 days, p=0.023). The frequency of IVIG resistance was not different between the two groups., In the LKD patients, the incidence of CALs was significantly higher in the acute phase, and without significant difference in the convalescent phase. The percentage of neutrophils and C-reactive protein, albumin, and total bilirubin levels were significantly higher in LKD patients. Conclusion Even though LKD patients were older, admitted earlier, and had higher inflammatory marker levels, they did not have a greater risk of CALs or IVIG resistance. However, echocardiography may be helpful in the acute stage if patients have only fever and cervical lymphadenopathy and are unresponsive to empirical antibiotics. PMID:28154598

  16. Predictive factors of resistance to intravenous immunoglobulin and coronary artery lesions in Kawasaki disease

    PubMed Central

    Lee, Hye Young

    2016-01-01

    Purpose We conducted a study to determine which factors may be useful as predictive markers in identifying Kawasaki disease (KD) patients with a high risk of resistance to intravenous immunoglobulin (IVIG) and developing coronary artery lesions (CAL). Methods We enrolled 287 patients in acute phase of KD at a single center. The demographic, clinical and laboratory data were collected retrospectively. Results There were 34 patients in the IVIG resistant group. The IVIG resistant group had significantly higher serum N-terminal-pro-brain natriuretic protein (NT-proBNP) levels (P<0.01) and polymorphonuclear neutrophil (PMN) percentage (P<0.01) in comparison to the IVIG responders. The results yielded sensitivity (78.8%, 60.6%), specificity (58.2%, 90%) and cutoff value (628.6 pg/mL, 80.3%) of NT-proBNP and PMN respectively, in predicting IVIG resistance. Despite IVIG administration, 13 of the 287 patients developed CAL. The patients in the CAL group had higher NT-proBNP levels (P<0.01) and higher PMN percentage (P<0.01). In these patients, the results yielded sensitivity (73.3%, 56.7%), specificity (67.9%, 88.9%) and cutoff value (853.4 pg/mL, 80.3%) of NT-proBNP and PMN respectively, for predicting CAL. The area under the curve (AUC) for predicting resistance to IVIG was NT-proBNP 0.712, PMN 0.802. The AUC for predicting CAL was NT-proBNP 0.739, and PMN 0.773. Conclusion Serum NT-proBNP levels and PMN percentage were significantly elevated in patients with KD with IVIG resistance and CAL. Thus, they may be useful predicting markers for IVIG resistance and development of CAL in KD patients. PMID:28194213

  17. Image-based modeling of hemodynamics in coronary artery aneurysms caused by Kawasaki disease.

    PubMed

    Sengupta, Dibyendu; Kahn, Andrew M; Burns, Jane C; Sankaran, Sethuraman; Shadden, Shawn C; Marsden, Alison L

    2012-07-01

    Kawasaki Disease (KD) is the leading cause of acquired pediatric heart disease. A subset of KD patients develops aneurysms in the coronary arteries, leading to increased risk of thrombosis and myocardial infarction. Currently, there are limited clinical data to guide the management of these patients, and the hemodynamic effects of these aneurysms are unknown. We applied patient-specific modeling to systematically quantify hemodynamics and wall shear stress in coronary arteries with aneurysms caused by KD. We modeled the hemodynamics in the aneurysms using anatomic data obtained by multi-detector computed tomography (CT) in a 10-year-old male subject who suffered KD at age 3 years. The altered hemodynamics were compared to that of a reconstructed normal coronary anatomy using our subject as the model. Computer simulations using a robust finite element framework were used to quantify time-varying shear stresses and particle trajectories in the coronary arteries. We accounted for the cardiac contractility and the microcirculation using physiologic downstream boundary conditions. The presence of aneurysms in the proximal coronary artery leads to flow recirculation, reduced wall shear stress within the aneurysm, and high wall shear stress gradients at the neck of the aneurysm. The wall shear stress in the KD subject (2.95-3.81 dynes/sq cm) was an order of magnitude lower than the normal control model (17.10-27.15 dynes/sq cm). Particle residence times were significantly higher, taking 5 cardiac cycles to fully clear from the aneurysmal regions in the KD subject compared to only 1.3 cardiac cycles from the corresponding regions of the normal model. In this novel quantitative study of hemodynamics in coronary aneurysms caused by KD, we documented markedly abnormal flow patterns that are associated with increased risk of thrombosis. This methodology has the potential to provide further insights into the effects of aneurysms in KD and to help risk stratify patients for

  18. Pulmonary Artery Dilation and Right Ventricular Function in Acute Kawasaki Disease.

    PubMed

    Numano, Fujito; Shimizu, Chisato; Tremoulet, Adriana H; Dyar, Dan; Burns, Jane C; Printz, Beth F

    2016-03-01

    Coronary artery inflammation and aneurysm formation are the most common complications of Kawasaki disease (KD). Valvulitis and myocarditis are also well described and may lead to valvar regurgitation and left ventricular dysfunction. However, functional changes in the right heart have rarely been reported. We noted several acute KD patients with dilated pulmonary arteries (PA) and thus sought to systematically characterize PA size and right-heart function in an unselected cohort of KD patients cared for at a single clinical center. Clinical, laboratory, and echocardiographic data from 143 acute KD subjects were analyzed. PA dilation was documented in 23 subjects (16.1 %); these subjects had higher median right ventricle myocardial performance index (RV MPI), higher ratio of early tricuspid inflow velocity to tricuspid annular early diastolic velocity (TV E/e'), and lower median TV e' velocity compared to the non-PA dilation group (0.50 vs 0.38 p < 0.01, 4.2 vs 3.6 p < 0.05, and 13.5 vs 15.2 cm/s p < 0.01, respectively). Almost all subjects with PA dilation had improved PA Z-score, RV MPI, and TV E/e' in the subacute phase (p < 0.01). There were no significant differences in indices of left ventricle function between PA dilation group and non-PA dilation group. In summary, PA dilation was documented in 16 % of acute KD subjects. These subjects were more likely to have echocardiographic indices consistent with isolated RV dysfunction that improved in the subacute phase. The long-term consequence of these findings will require longitudinal studies of this patient population.

  19. IL-1 Inhibition May Have an Important Role in Treating Refractory Kawasaki Disease

    PubMed Central

    Dusser, Perrine; Koné-Paut, Isabelle

    2017-01-01

    Kawasaki disease (KD) is an acute inflammatory vasculitis occurring in young children before 5 years and representing at this age, the main cause of acquired heart disease. A single infusion of 2 g/kg of intravenous immunoglobulins along with aspirin has reduced the frequency of coronary artery aneurysms from 25 to 5%. However, 10–20% of patients do not respond to standard treatment and have an increased risk of cardiac complications and death. The development of more potent therapeutic approaches of KD is an urgent need. Phenotypical and immunological similarities between KD and systemic juvenile idiopathic arthritis led to the hypothesis that KD could be considered as an autoinflammatory disease. New insights regarding KD’s pathogenesis have merged from the combination of genetic and transcriptomic data revealing the key role of interleukin-1 (IL-1) signaling in the pathogenesis of the vasculitis. Once activated, IL-1α and IL-1β trigger a local proinflammatory environment-inducing vasodilatation and attracting monocytes and neutrophils to sites causing tissue damage and stress. Both IL-1α and IL-1β have been shown to induce myocarditis and aneurysm formation in Lactobacillus casei cell-wall extract mouse model of KD; both being successfully improved with IL-1 blockade treatment such as anakinra. Treatment failure in patients with the high-risk inositol-triphosphate 3-kinase C genotype was associated with highest basal and stimulated intracellular calcium levels, increased cellular production of IL-1β, and IL-18, and higher circulating levels of both cytokines. Three clinical trials of IL-1 blockade enrolling KD patients are currently being conducted in Western Europe and in USA, they could change KD outcome.

  20. Hepcidin-Induced Iron Deficiency Is Related to Transient Anemia and Hypoferremia in Kawasaki Disease Patients.

    PubMed

    Huang, Ying-Hsien; Kuo, Ho-Chang; Huang, Fu-Chen; Yu, Hong-Ren; Hsieh, Kai-Sheng; Yang, Ya-Ling; Sheen, Jiunn-Ming; Li, Sung-Chou; Kuo, Hsing-Chun

    2016-05-12

    Kawasaki disease (KD) is a type of systemic vasculitis that primarily affects children under the age of five years old. For sufferers of KD, intravenous immunoglobulin (IVIG) has been found to successfully diminish the occurrence of coronary artery lesions. Anemia is commonly found in KD patients, and we have shown that in appropriately elevated hepcidin levels are related to decreased hemoglobin levels in these patients. In this study, we investigated the time period of anemia and iron metabolism during different stages of KD. A total of 100 patients with KD and 20 control subjects were enrolled in this study for red blood cell and hemoglobin analysis. Furthermore, plasma, urine hepcidin, and plasma IL-6 levels were evaluated using enzyme-linked immunosorbent assay in 20 KD patients and controls. Changes in hemoglobin, plasma iron levels, and total iron binding capacity (TIBC) were also measured in patients with KD. Hemoglobin, iron levels, and TIBC were lower (p < 0.001, p = 0.009, and p < 0.001, respectively) while plasma IL-6 and hepcidin levels (both p < 0.001) were higher in patients with KD than in the controls prior to IVIG administration. Moreover, plasma hepcidin levels were positively and significantly correlated with urine hepcidin levels (p < 0.001) prior to IVIG administration. After IVIG treatment, plasma hepcidin and hemoglobin levels significantly decreased (both p < 0.001). Of particular note was a subsequent gradual increase in hemoglobin levels during the three weeks after IVIG treatment; nevertheless, the hemoglobin levels stayed lower in KD patients than in the controls (p = 0.045). These findings provide a longitudinal study of hemoglobin changes and among the first evidence that hepcidin induces transient anemia and hypoferremia during KD's acute inflammatory phase.

  1. Relationship between serum sodium level and coronary artery abnormality in Kawasaki disease

    PubMed Central

    Park, Sora; Kim, Ji Hong

    2017-01-01

    Purpose Kawasaki disease (KD) is an immune-related multisystemic vasculitis that occurs in children, especially ensuing from a coronary artery abnormality. Sodium level is known to be related to vascular injury, which could affect the progress of KD. The purpose of this study was to determine the serum sodium levels that could predict the occurrence of cardiac and coronary artery events in KD. Methods We conducted a retrospective review of medical records for 104 patients with KD from January 2015 to December 2015. Patients with serum Na levels of <135 mEq/L at the time of initial diagnosis were assigned to the hyponatremia group. Laboratory findings and echocardiographic data were analyzed for various aspects. Results Among the 104 patients with KD, 91 were included in the study, of whom 48 (52.7%) had hyponatremia. The degree of fever, white blood cell count, percentage of neutrophils, percentage of lymphocytes, total bilirubin level, brain natriuretic peptide level, erythrocyte sedimentation rate, and C-reactive protein level were higher in the patients with hyponatremia. They also demonstrated a trend of larger coronary artery diameters based on Z scores. Conclusion The severity of vascular inflammation in acute KD with hyponatremia might worsen the prognosis of coronary vasculature. Although no statistically significant correlation was found between the initial serum sodium levels and coronary arteriopathy in the patients with KD in this study, a long-term follow-up study with a larger number of enrolled patients should be designed in the future to elucidate the relationship between serum sodium level and coronary arteriopathy in patients with KD. PMID:28289432

  2. Urinary Colorimetric Sensor Array and Algorithm to Distinguish Kawasaki Disease from Other Febrile Illnesses

    PubMed Central

    Jin, Bo; Deng, Xiaohong; Hu, Guang; Liu, Xiaodan; Zhang, Jie; Jin, Hua; Huang, Min; Kanegaye, John T.; Tremoulet, Adriana H.; Burns, Jane C.; Wu, Jianmin; Cohen, Harvey J.; Ling, Xuefeng B.

    2016-01-01

    Objectives Kawasaki disease (KD) is an acute pediatric vasculitis of infants and young children with unknown etiology and no specific laboratory-based test to identify. A specific molecular diagnostic test is urgently needed to support the clinical decision of proper medical intervention, preventing subsequent complications of coronary artery aneurysms. We used a simple and low-cost colorimetric sensor array to address the lack of a specific diagnostic test to differentiate KD from febrile control (FC) patients with similar rash/fever illnesses. Study Design Demographic and clinical data were prospectively collected for subjects with KD and FCs under standard protocol. After screening using a genetic algorithm, eleven compounds including metalloporphyrins, pH indicators, redox indicators and solvatochromic dye categories, were selected from our chromatic compound library (n = 190) to construct a colorimetric sensor array for diagnosing KD. Quantitative color difference analysis led to a decision-tree-based KD diagnostic algorithm. Results This KD sensing array allowed the identification of 94% of KD subjects (receiver operating characteristic [ROC] area under the curve [AUC] 0.981) in the training set (33 KD, 33 FC) and 94% of KD subjects (ROC AUC: 0.873) in the testing set (16 KD, 17 FC). Color difference maps reconstructed from the digital images of the sensing compounds demonstrated distinctive patterns differentiating KD from FC patients. Conclusions The colorimetric sensor array, composed of common used chemical compounds, is an easily accessible, low-cost method to realize the discrimination of subjects with KD from other febrile illness. PMID:26859297

  3. Urinary Lactate Dehydrogenase Activity and Its Isozyme Patterns in Kawasaki Disease

    PubMed Central

    Kawamura, Yoichi; Kanai, Takashi; Takizawa, Mari; Yoshida, Yusuke; Tsujita, Yuki; Nonoyama, Shigeaki

    2017-01-01

    Abnormal urinary findings, such as sterile pyuria, proteinuria, and microscopic hematuria, are often seen in the acute phase of Kawasaki disease (KD). We investigated the potential significance of urinary lactate dehydrogenase (U-LDH) activity and its isozyme patterns in KD. Total U-LDH activity and its isozymes (U-LDH1-5) levels were compared among 120 patients with KD, 18 patients with viral infection (VI), and 43 patients with upper urinary tract infection (UTI) and additionally compared between intravenous immunoglobulin (IVIG) responders (n = 89) and nonresponders (n = 31) with KD. Total U-LDH activity was higher in KD (35.4 ± 4.8 IU/L, P < 0.05) and UTI patients (66.0 ± 8.0 IU/L, P < 0.01) than in VI patients (17.0 ± 6.2 IU/L). In the isozyme pattern analysis, KD patients had high levels of U-LDH1 and U-LDH2, while UTI patients had high levels of U-LDH3, U-LDH4, and U-LDH5. Furthermore, IVIG nonresponders of KD had significantly higher levels of total U-LDH activity (45.1 ± 4.7 IU/L, P < 0.05), especially U-LDH1 and U-LDH2 (P < 0.05), than IVIG responders (32.0 ± 2.8 IU/L). KD patients have increased levels of total U-LDH activity, especially U-LDH-1 and U-LDH2, indicating a unique pattern of U-LDH isozymes different from that in UTI patients. PMID:28348604

  4. Involvement of innate and adaptive immunity in a murine model of coronary arteritis mimicking Kawasaki disease.

    PubMed

    Schulte, Danica J; Yilmaz, Atilla; Shimada, Kenichi; Fishbein, Michael C; Lowe, Emily L; Chen, Shuang; Wong, Michelle; Doherty, Terence M; Lehman, Thomas; Crother, Timothy R; Sorrentino, Rosalinda; Arditi, Moshe

    2009-10-15

    Kawasaki disease (KD) is the most common cause of acquired cardiac disease and acute vasculitis in children in the developed world. Injection of a cell wall extract isolated from Lactobacillus casei (LCCWE) into mice causes a focal coronary arteritis that histopathologically mimics the coronary lesions observed in KD patients. In this study we used this model to investigate the participation of T cells, B cells, and dendritic cells (DC) in the development of coronary arteritis. RAG1(-/-), B cell(null), and wild-type (WT) mice were injected with a single dose of LCCWE (500 microg/mouse i.p.). None of the RAG1(-/-) mice developed coronary arteritis, whereas 70% of WT and 100% of B cell(null) mice developed coronary lesions, indicating that T cells were required for lesion formation. When splenocytes isolated from LCCWE-treated mice were restimulated with LCCWE, we observed significant IFN-gamma secretion in WT but not in RAG1(-/-) mice. Immunohistochemical staining showed F4/80(+) macrophages, activated MIDC-8(+) myeloid DCs (mDC), plasmacytoid DCs, and colocalization of CD3(+) T cells with mDCs in coronary artery lesions, suggesting an Ag-driven process. T cells but not B cells are required for LCCWE-induced coronary arteritis. Similar to human lesions, the coronary lesions contain macrophages, activated mDCs, and plaslmacytoid DCs all in close proximity to T cells, further strengthening the relevance of this mouse model to the immunopathology of coronary disease in KD. These studies are consistent with the interpretation that macrophages and DCs may collaborate with T cells in the pathological mechanisms of coronary arteritis.

  5. Transforming Growth Factor-β Signaling Pathway in Patients with Kawasaki Disease

    PubMed Central

    Shimizu, Chisato; Jain, Sonia; Lin, Kevin O.; Molkara, Delaram; Frazer, Jeffrey R.; Sun, Shelly; Baker, Annette L.; Newburger, Jane W.; Rowley, Anne H.; Shulman, Stanford T.; Davila, Sonia; Hibberd, Martin L.; Burgner, David; Breunis, Willemijn B.; Kuijpers, Taco W.; Wright, Victoria J.; Levin, Michael; Eleftherohorinou, Hariklia; Coin, Lachlan; Popper, Stephen J.; Relman, David A.; Fury, Wen; Lin, Calvin; Mellis, Scott; Tremoulet, Adriana H.; Burns, Jane C.

    2011-01-01

    Background Transforming growth factor (TGF)-β is a multifunctional peptide that is important in T-cell activation and cardiovascular remodeling, both of which are important features of Kawasaki disease (KD). We postulated that variation in TGF-β signaling might be important in KD susceptibility and disease outcome. Methods and Results We investigated genetic variation in 15 genes belonging to the TGF-β pathway in a total 771 KD subjects of mainly European descendent from the US, UK, Australia and the Netherlands. We analyzed transcript abundance patterns using microarray and RT-PCR for these same genes and measured TGF-β2 protein levels in plasma. Genetic variants in TGFB2, TGFBR2 and SMAD3 and their haplotypes were consistently and reproducibly associated with KD susceptibility, coronary artery aneurysm formation, aortic root dilatation, and intravenous immunoglobulin treatment response in different cohorts. A SMAD3 haplotype associated with KD susceptibility replicated in two independent cohorts and an intronic SNP in a separate haplotype block was also strongly associated (A/G, rs4776338) (p=0.000022, OR 1.50, 95% CI 1.25-1.81). Pathway analysis using all 15 genes further confirmed the importance of the TGF-β pathway in KD pathogenesis. Whole blood transcript abundance for these genes and TGF-β2 plasma protein levels changed dynamically over the course of the illness. Conclusions These studies suggest that genetic variation in the TGF-β pathway influences KD susceptibility, disease outcome, and response to therapy and that aortic root and coronary artery Z scores can be used for phenotype/genotype analyses. Analysis of transcript abundance and protein levels further support the importance of this pathway in KD pathogenesis. PMID:21127203

  6. Tissue Doppler Imaging as a Predictor of Immunoglobulin Resistance in Kawasaki Disease.

    PubMed

    Phadke, Daniel; Patel, Sonali S; Dominguez, Samuel R; Heizer, Heather; Anderson, Marsha S; Glode, Mary P; Jone, Pei-Ni

    2015-12-01

    Kawasaki disease (KD) is characterized by myocarditis and left ventricular dysfunction during the acute phase of the illness. Despite treatment with intravenous immunoglobulin (IVIG), a significant number of patients are IVIG resistant. We evaluated KD patients in the acute phase of illness using tissue Doppler imaging (TDI) to assess whether myocardial dysfunction may predict IVIG resistance. All patients with acute KD presenting to Children's Hospital Colorado from February 2007 through March 2014 were included in this study and underwent echocardiograms with TDI evaluation at diagnosis. Patients were divided into two groups: IVIG resistant and IVIG responder. Group differences were assessed using Wilcoxon-Mann-Whitney and Chi-square testing. Receiver operating characteristic (ROC) curve analysis was utilized to determine threshold values of TDI measurements associated with IVIG resistance. Fifty-one age-matched IVIG resistant patients were compared to 51 IVIG responder patients [median age, IQR 44.57 (20.13-77.07) vs. 33.49 (17.30-62.89) months, p < 0.44]. There were significant differences in the septal and mitral early diastolic velocities (E') (p < 0.001 and p < 0.01), respectively. ROC analysis demonstrated that tricuspid E' <0.15 cm/s, septal E' <0.12 cm/s, and mitral E' <0.16 cm/s were good predictors of IVIG unresponsiveness (AUC = 0.66, 0.66, and 0.70, respectively). There were no differences between the systolic velocities and late diastolic velocities (A'). IVIG resistant KD patients present with significantly greater diastolic dysfunction compared to responders in patients with KD. TDI may be a useful tool to differentiate KD patients at higher risk of IVIG resistance.

  7. Detection of coronary artery stenosis in children with Kawasaki disease. Usefulness of pharmacologic stress sup 201 Tl myocardial tomography

    SciTech Connect

    Kondo, C.; Hiroe, M.; Nakanishi, T.; Takao, A. )

    1989-09-01

    This study determined the feasibility and accuracy of quantitative 201Tl myocardial single-photon emission computed tomography (SPECT) after dipyridamole infusion to detect coronary obstructive lesions in children with Kawasaki disease. 201Tl distribution after dipyridamole infusion was measured in 23 normal children, and with these normal values, quantitative analysis of SPECT was performed in 49 patients. Thirty-four patients had coronary stenosis 90% or greater on angiograms. Side effects resulting from systemic vasodilation were observed in about 70%. Angina pectoris and ischemic ST changes were observed only in patients with coronary stenosis. These symptoms disappeared after aminophylline infusion. Results of visual and quantitative analysis of SPECT were compared. SPECT data were shown on two-dimensional polar maps, and the extent and severity scores were calculated. The sensitivity of SPECT for detection of overall coronary stenosis was 91% (visual analysis) and 88% (quantitative analysis). The specificity of SPECT was 60% visually and 93% quantitatively. The sensitivity of quantitative analysis to detect individual coronary stenosis was similar to that of visual analysis. However, the specificity of visual analysis to detect individual coronary artery stenosis was significantly less than that of quantitative analysis. From these data, we conclude that quantitative analysis of myocardial SPECT after dipyridamole infusion is a safe and accurate diagnostic method for identifying coronary stenosis in children with Kawasaki disease.

  8. Detection of Norovirus GII.17 Kawasaki 2014 in Shellfish, Marine Water and Underwater Sewage Discharges in Italy.

    PubMed

    La Rosa, G; Della Libera, S; Iaconelli, M; Proroga, Y T R; De Medici, D; Martella, V; Suffredini, E

    2017-03-03

    Norovirus (NoV) is a major cause of non-bacterial acute gastroenteritis worldwide, and the variants of genotype GII.4 are currently the predominant human strains. Recently, a novel variant of NoV GII.17 (GII.P17_GII.17 NoV), termed Kawasaki 2014, has been reported as the cause of gastroenteritis outbreaks in Asia, replacing the pandemic strain GII.4 Sydney 2012. The GII.17 Kawasaki 2014 variant has also been reported sporadically in patients with gastroenteritis outside of Asia, including Italy. In this study, 384 shellfish samples were subjected to screening for human NoVs using real-time PCR and 259 (67.4%) tested positive for Genogroup II (GII) NoV. Of these, 52 samples, selected as representative of different areas and sampling dates, were further amplified by conventional PCR targeting the capsid gene, using broad-range primers. Forty shellfish samples were characterized by amplicon sequencing as GII.4 (n = 29), GII.2 (n = 4), GII.6 (n = 2), GII.12 (n = 2), and GII.17 (n = 3). Sixty-eight water samples (39 seawater samples from the corresponding shellfish production areas and 29 water samples from nearby underwater sewage discharge points) were also tested using the above broad-range assay: eight NoV-positive samples were characterized as GII.1 (n = 3), GII.2 (n = 1), GII.4 (n = 2), and GII.6 (n = 2). Based on full genome sequences available in public databases, a novel RT-PCR nested assay specific for GII.17 NoVs was designed and used to re-test the characterized shellfish (40) and water (8) samples. In this second screening, the RNA of GII.17 NoV was identified in 17 additional shellfish samples and in one water sample. Upon phylogenetic analysis, these GII.17 NoV isolates were closely related to the novel GII.17 Kawasaki 2014. Interestingly, our findings chronologically matched the emergence of the Kawasaki 2014 variant in the Italian population (early 2015), as reported by hospital-based NoV surveillance. These results, showing GII.17 No

  9. Cardiopulmonary Function, Exercise Capacity, and Echocardiography Finding of Pediatric Patients With Kawasaki Disease: An Observational Study.

    PubMed

    Tuan, Sheng-Hui; Li, Min-Hui; Hsu, Miao-Ju; Tsai, Yun-Jeng; Chen, Yin-Han; Liao, Tin-Yun; Lin, Ko-Long

    2016-01-01

    Coronary artery (CA) abnormalities influence exercise capacity (EC) of patients with Kawasaki disease (KD), and Z-score of CA is a well established method for detecting CA aneurysm. We studied the influence of KD on cardiopulmonary function and EC; meanwhile we analyzed echocardiographic findings of KD patients. We also assessed the correlation between CA Z-score and EC of KD patients to see if CA Z-score of KD patients could reflect EC during exercise.Sixty-three KD patients were recruited as KD group 1 from children (aged 5-18 y) who received transthoracic echocardiographic examinations and symptom-limited treadmill exercise test for regular follow-up of KD from January 2010 to October 2014 in 1 medical center. We then divided KD group 1 into KD group 2 (<5 y, n = 12) and KD group 3 (≥5 y, n = 51) according to time interval between KD onset to when patients received test. Control groups were matched by age, sex, and body mass index. Max-Z of CA was defined as the maximal Z-score of the proximal LCA or RCA by Dalliarre equation or Fuse calculator.All routine parameters measured during standard exercise test were similar between KD and control groups, except that peak rate pressure products (PRPPs) in KD group 1 to 3 were all lower than corresponding control groups significantly (P = 0.010, 0.020, and 0.049, respectively). PRPPs correlated with Max-Z of CA by both equations modest inversely (by Dallaire, P = 0.017, Spearman rho = -0.301; by Fuse, P = 0.014, Spearman rho = -0.309).Our study recruited larger number of KD patients and provided a newer data of EC of KD patients. Our finding suggests that after acute stage of KD, patients could maintain normal cardiorespiratory fitness. Therefore, we believe that it is important to promote cardiovascular health to KD patients and KD patients should exercise as normal peers. However, since KD patients might still have compromised coronary perfusion during exercise, it remains crucial to

  10. Three Linked Vasculopathic Processes Characterize Kawasaki Disease: A Light and Transmission Electron Microscopic Study

    PubMed Central

    Orenstein, Jan Marc; Shulman, Stanford T.; Fox, Linda M.; Baker, Susan C.; Takahashi, Masato; Bhatti, Tricia R.; Russo, Pierre A.; Mierau, Gary W.; de Chadarévian, Jean Pierre; Perlman, Elizabeth J.; Trevenen, Cynthia; Rotta, Alexandre T.; Kalelkar, Mitra B.; Rowley, Anne H.

    2012-01-01

    Background Kawasaki disease is recognized as the most common cause of acquired heart disease in children in the developed world. Clinical, epidemiologic, and pathologic evidence supports an infectious agent, likely entering through the lung. Pathologic studies proposing an acute coronary arteritis followed by healing fail to account for the complex vasculopathy and clinical course. Methodology/Principal Findings Specimens from 32 autopsies, 8 cardiac transplants, and an excised coronary aneurysm were studied by light (n=41) and transmission electron microscopy (n=7). Three characteristic vasculopathic processes were identified in coronary (CA) and non-coronary arteries: acute self-limited necrotizing arteritis (NA), subacute/chronic (SA/C) vasculitis, and luminal myofibroblastic proliferation (LMP). NA is a synchronous neutrophilic process of the endothelium, beginning and ending within the first two weeks of fever onset, and progressively destroying the wall into the adventitia causing saccular aneurysms, which can thrombose or rupture. SA/C vasculitis is an asynchronous process that can commence within the first two weeks onward, starting in the adventitia/perivascular tissue and variably inflaming/damaging the wall during progression to the lumen. Besides fusiform and saccular aneurysms that can thrombose, SA/C vasculitis likely causes the transition of medial and adventitial smooth muscle cells (SMC) into classic myofibroblasts, which combined with their matrix products and inflammation create progressive stenosing luminal lesions (SA/C-LMP). Remote LMP apparently results from circulating factors. Veins, pulmonary arteries, and aorta can develop subclinical SA/C vasculitis and SA/C-LMP, but not NA. The earliest death (day 10) had both CA SA/C vasculitis and SA/C-LMP, and an “eosinophilic-type” myocarditis. Conclusions/Significance NA is the only self-limiting process of the three, is responsible for the earliest morbidity/mortality, and is consistent with

  11. Epidemiology, Clinical Presentation, and Outcomes of Kawasaki Disease Among Hospitalized Children in an Inner City Hospital Before and After Publication of the American Academy of Pediatrics/American Heart Association Guidelines for Treatment of Kawasaki Disease: An 11-Year Period.

    PubMed

    Sehgal, Swati; Chen, Xinguang; Ang, Jocelyn Y

    2015-11-01

    The effect of 2004 Kawasaki disease (KD) guidelines on diagnosis and outcome of KD is lacking. We studied the epidemiology of KD in our region and compared the incidence, presentation, and outcome of KD before and after publication of the guidelines. A retrospective chart review was conducted for patients admitted with a diagnosis of KD. Demographics, laboratory data, and clinical data were collected. Comparison was made between 2 groups: prepublication (2000-2004) and postpublication (2005-2009) of guidelines. A total of 312 children were included; 64% were African American, 23% White, and 2% Asian; 61% were boys; 79% were complete KD, and 66% were in winter/spring. There was a significant increase in KD cases over the 11 years. There was no significant difference in clinical findings and outcome between the 2 groups. KD admissions in our region significantly increased during the postpublication period. There was no difference in clinical presentation, laboratory findings, or outcome between the 2 groups.

  12. Human coronavirus NL63 is not detected in the respiratory tracts of children with acute Kawasaki disease.

    PubMed

    Shimizu, Chisato; Shike, Hiroko; Baker, Susan C; Garcia, Francesca; van der Hoek, Lia; Kuijpers, Taco W; Reed, Sharon L; Rowley, Anne H; Shulman, Stanford T; Talbot, Helen K B; Williams, John V; Burns, Jane C

    2005-11-15

    Kawasaki disease (KD) is a self-limited, systemic vasculitis of children for which an infectious trigger is suspected. Recently, an association between KD and human coronavirus (HCoV)-New Haven (NH) was reported, on the basis of polymerase chain reaction (PCR) with primers that also amplified HCoV-NL63. We investigated the possible association between these HCoVs in the respiratory tract and KD by reverse-transcriptase (RT) PCR and viral culture in a geographically and ethnically diverse population. Only 1 (2%) of 48 patients with acute KD was positive by RT-PCR for HCoV-NL63/NH in a nasopharyngeal swab. These data do not support an association between these HCoVs and KD.

  13. A 2-month-old boy with hemolytic anemia and reticulocytopenia following intravenous immunoglobulin therapy for Kawasaki disease: a case report and literature review

    PubMed Central

    Kim, Na Yeon; Kim, Joon Hwan; Park, Jin Suk; Kim, Soo Hyun; Cho, Yeon Kyung; Cha, Dong Hyun; Kim, Ki Eun; Kang, Myung Suh; Lim, Kyung Ah

    2016-01-01

    Herein, we report a rare case of hemolytic anemia with reticulocytopenia following intravenous immunoglobulin therapy in a young infant treated for Kawasaki disease. A 2-month-old boy presented with fever lasting 3 days, conjunctival injection, strawberry tongue, erythematous edema of the hands, and macular rash, symptoms and signs suggestive of incomplete Kawasaki disease. His fever resolved 8 days after treatment with aspirin and high dose infusion of intravenous immunoglobulin. The hemoglobin and hematocrit decreased from 9.7 g/dL and 27.1% to 7.4 g/dL and 21.3%, respectively. The patient had normocytic hypochromic anemia with anisocytosis, poikilocytosis, immature neutrophils, and nucleated red blood cells. The direct antiglobulin test result was positive, and the reticulocyte count was 1.39%. The patient had an uneventful recovery. However, reticulocytopenia persisted 1 month after discharge. PMID:28018448

  14. Percepcion de los profesores universitarios acerca del concepto cultura cientifica y de sus implicaciones en el nuevo bachillerato del Recinto de Rio Piedras de la Universidad de Puerto Rico

    NASA Astrophysics Data System (ADS)

    Ramos Pastrana, Nilsa

    El Senado Academico del Recinto de Rio Piedras de la Universidad de Puerto Rico aprobo en el ano academico 2005-2006 la Certificacion 46, que contiene los lineamientos de un nuevo bachillerato. Este nuevo bachillerato introdujo cambios significativos en el curriculo tradicional. Entre ellos se encuentra la reduccion del componente de educacion general y el de Ciencias Biologicas en particular. La reduccion de creditos en el componente de Ciencias Biologicas ha obligado a reevaluar el concepto de cultura cientifica que desarrollan esos cursos. El proposito del estudio consistio en auscultar las percepciones de los profesores de las Facultades de Administracion de Empresas, Humanidades, Ciencias Sociales, Ciencias Naturales, Educacion y Estudios Generales del Recinto de Rio Piedras de la Universidad de Puerto Rico en torno al concepto de cultura cientifica, los contenidos disciplinares del curso de Ciencias Biologicas y la reduccion de creditos en el nuevo bachillerato. Las preguntas que guiaron la investigacion fueron: ¿cuales son las percepciones que tienen los profesores de las Facultades de Administracion de Empresas, Ciencias Sociales, Estudios Generales, Ciencias Naturales, Humanidades y Educacion, en torno al concepto de cultura cientifica y los contenidos disciplinares del curso de Ciencias Biologicas? ¿cuales son las percepciones que tienen los profesores de Ciencias Biologicas en torno al concepto cultura cientifica y los contenidos disciplinares del curso de Ciencias Biologicas? ¿existen diferencias significativas por facultad, genero, experiencia, rango y nombramiento en las percepciones que tienen los profesores del Recinto de Rio Piedras de la Universidad de Puerto Rico sobre los elementos que caracterizan la cultura cientifica y los contenidos biologicos que deben tener los egresados del Recinto? ¿que implicaciones curriculares tienen estos testimonios en el desarrollo del concepto de cultura cientifica en el nuevo bachillerato? Para realizar la

  15. Disruption of Endothelial Cell Homeostasis Plays a Key Role in the Early Pathogenesis of Coronary Artery Abnormalities in Kawasaki Disease

    PubMed Central

    Ueno, Kentaro; Ninomiya, Yumiko; Hazeki, Daisuke; Masuda, Kiminori; Nomura, Yuichi; Kawano, Yoshifumi

    2017-01-01

    Disruption of endothelial cell homeostasis may be associated with the pathogenesis of coronary artery abnormalities (CAA) in Kawasaki disease (KD). We sought to clarify the poorly understood pathogenic role of endothelial cell survival and death in KD vasculitis. Human umbilical vein endothelial cells (HUVECs) stimulated with sera from KD patients, compared with sera from patients with bacterial infections, exhibited significant increases in cytotoxicity, high mobility group box protein 1 (HMGB-1), and caspase-3/7 and a decrease in phosphorylated Akt/Akt (pAkt/Akt) ratios. HUVECs stimulated with sera from KD patients treated with immunoglobulin (IG) showed significantly decreased cytotoxicity, HMGB-1, and caspase-3/7 levels and increased pAkt/Akt ratios, as compared with results for untreated HUVECs (P < 0.001, P = 0.008, P = 0.040, and P < 0.001, respectively). In HUVECs stimulated with sera from KD patients, the increased cytotoxicity levels and the suppression of increased pAkt/Akt ratios after subsequent IG treatment were closely related to the development of CAA (P = 0.002 and P = 0.035). Our data reveal that shifting the balance toward cell death rather than survival appears to perturb endothelial cell homeostasis and is closely related to the development of CAA. The cytoprotective effects of IG treatment appear to ameliorate endothelial cell homeostasis. PMID:28255175

  16. Predicting the characteristics of the aetiological agent for Kawasaki disease from other paediatric infectious diseases in Japan.

    PubMed

    Nagao, Y; Urabe, C; Nakamura, H; Hatano, N

    2016-02-01

    Although Kawasaki disease (KD), which was first reported in the 1960s, is assumed to be infectious, its aetiological agent(s) remains unknown. We compared the geographical distribution of the force of infection and the super-annual periodicity of KD and seven other paediatric infectious diseases in Japan. The geographical distribution of the force of infection, which was estimated as the inverse of the mean patient age, was similar in KD and other paediatric viral infections. This similarity was due to the fact that the force of infection was determined largely by the total fertility rate. This finding suggests that KD shares a transmission route, i.e. sibling-to-sibling infection, with other paediatric infections. The super-annual periodicity, which is positively associated with the sum of an infectious disease's incubation period and infectious period, was much longer for KD and exanthema subitum than other paediatric infectious diseases. The virus for exanthema subitum is known to persist across the host's lifespan, which suggests that the aetiological agent for KD may also be capable of persistent infection. Taken together, these findings suggest that the aetiological agent for KD is transmitted through close contact and persists asymptomatically in most hosts.

  17. Marked Acceleration of Atherosclerosis following Lactobacillus casei induced Coronary Arteritis in a Mouse Model of Kawasaki Disease

    PubMed Central

    Chen, Shuang; Lee, Young Ho; Crother, Timothy R.; Fishbein, Michael; Zhang, Wenxuan; Yilmaz, Atilla; Shimada, Kenichi; Schulte, Danica J; Lehman, Thomas J.A.; Shah, Prediman K.; Arditi, Moshe

    2012-01-01

    Objective To investigate if Lactobacillus casei cell wall extract (LCWE)-induced Kawasaki Disease (KD) accelerates atherosclerosis in hypercholesterolemic mice. Method and Resuslts Apoe−/− or Ldlr−/− mice were injected with LCWE (KD mice) or PBS, fed high fat diet for 8 weeks, and atherosclerotic lesions in aortic sinuses (AS), arch (AC) and whole aorta were assessed. KD mice had larger, more complex aortic lesions with abundant collagen, and both extracellular and intracellular lipid and foam cells, compared to lesions in control mice despite similar cholesterol levels. Both Apoe−/− KD and Ldlr−/− KD mice showed dramatic acceleration in atherosclerosis vs. controls, with increases in en face aortic atherosclerosis and plaque size in both the AS and AC plaques. Accelerated atherosclerosis was associated with increased circulating IL-12p40, IFN-γ, TNF-α, and increased macrophage, DC, and T cell recruitment in lesions. Furthermore, daily injections of the IL-1Ra, which inhibits LCWE induced KD vasculitis, prevented the acceleration of atherosclerosis. Conclusions Our results suggest an important pathophysiologic link between coronary arteritis/vasculitis in the KD mouse model and subsequent atherosclerotic acceleration, supporting the concept that a similar relation may also be present in KD patients. These results also suggest that KD in childhood may predispose to accelerated and early atherosclerosis as adults. PMID:22628430

  18. Assessment of the ability of myocardial contrast echocardiography with harmonic power Doppler imaging to identify perfusion abnormalities in patients with Kawasaki disease at rest and during dipyridamole stress.

    PubMed

    Ishii, M; Himeno, W; Sawa, M; Iemura, M; Furui, J; Muta, H; Sugahara, Y; Egami, K; Akagi, T; Ishibashi, M; Kato, H

    2002-01-01

    The aim of our study was to assess the ability of myocardial contrast echocardiography (MCE) with harmonic power Doppler imaging (HPDI) to identify perfusion abnormalities in patients with Kawasaki disease at rest and during pharmacological stress imaging with dipyridamole. Results were compared with those of 99mTc-tetrofosmin single-photon emission computed tomography (SPECT) imaging as the clinical reference standard. MCE with HPDI was performed on 20 patients with a history of Kawasaki disease. Images were obtained at baseline and during dipyridamole infusion (0.56 mg x kg(-1)) in the apical two- and four-chamber views. Myocardial opacification suitable for the analysis was obtained in all patients. Nine patients with stenotic lesions had a reversible defect after dipyridamole infusion detected by both MCE with HPDI and SPECT, and 3 patients with a history of myocardial infarction had a partially or completely irreversible defect detected by both methods. Three patients with coronary aneurysm without stenotic lesion, 4 patients with regressed coronary aneurysm, and 2 patients with normal coronary artery in acute phase also had normal perfusion at rest and after pharmacological stress by both methods. A 96% concordance (kappa = 0.87) was obtained when comparing the respective segmental perfusion scores using the two methods at baseline, and an 86% concordance (kappa = 0.81) was obtained at postdipyridamole infusion. After combining baseline and postdipyridamole images, each segment was labeled as having normal perfusion, irreversible defects, or reversible defects. Using these classifications, concordance for the two methods was 92% (kappa = 0.87). MCE with HPDI is a safe and feasible method by which to detect asymptomatic ischemia due to severe stenotic lesion, and it may be an important addition to the modalities used to identify patients at risk for myocardial infarction as a complication of Kawasaki disease.

  19. Role of the Egami score to predict immunoglobulin resistance in Kawasaki disease among a Western Mediterranean population.

    PubMed

    Sánchez-Manubens, Judith; Antón, Jordi; Bou, Rosa; Iglesias, Estíbaliz; Calzada-Hernandez, Joan; Borlan, Sergi; Gimenez-Roca, Clara; Rivera, Josefa

    2016-07-01

    Kawasaki disease is an acute self-limited systemic vasculitis common in childhood. Intravenous immunoglobulin (IVIG) is an effective treatment, and it reduces the incidence of cardiac complications. Egami score has been validated to identify IVIG non-responder patients in Japanese population, and it has shown high sensitivity and specificity to identify these non-responder patients. Although its effectiveness in Japan, Egami score has shown to be ineffective in non-Japanese populations. The aim of this study was to apply the Egami score in a Western Mediterranean population in Catalonia (Spain). Observational population-based study that includes patients from all Pediatric Units in 33 Catalan hospitals, both public and private management, between January 2004 and March 2014. Sensitivity and specificity for the Egami score was calculated, and a logistic regression analysis of predictors of overall response to IVIG was also developed. Predicting IVIG resistance with a cutoff for Egami score ≥3 obtained 26 % sensitivity and 82 % specificity. Negative predictive value was 85 % and positive predictive value 22 %. This low sensitivity implies that three out of four non-responders will not be identified by the Egami score. Besides, logistic regression models did not found significance for the use of the Egami score to predict IVIG resistance in Catalan population although having an area under the ROC curve of 0.618 (IC 95 % 0.538-0.698, p < 0.001). Although regression models found an area under the ROC curve >0.5 to predict IVIG resistance, the low sensitivity excludes the Egami score as a useful tool to predict IVIG resistance in Catalan population.

  20. Tropospheric winds from northeastern China carry the etiologic agent of Kawasaki disease from its source to Japan.

    PubMed

    Rodó, Xavier; Curcoll, Roger; Robinson, Marguerite; Ballester, Joan; Burns, Jane C; Cayan, Daniel R; Lipkin, W Ian; Williams, Brent L; Couto-Rodriguez, Mara; Nakamura, Yosikazu; Uehara, Ritei; Tanimoto, Hiroshi; Morguí, Josep-Anton

    2014-06-03

    Evidence indicates that the densely cultivated region of northeastern China acts as a source for the wind-borne agent of Kawasaki disease (KD). KD is an acute, coronary artery vasculitis of young children, and still a medical mystery after more than 40 y. We used residence times from simulations with the flexible particle dispersion model to pinpoint the source region for KD. Simulations were generated from locations spanning Japan from days with either high or low KD incidence. The postepidemic interval (1987-2010) and the extreme epidemics (1979, 1982, and 1986) pointed to the same source region. Results suggest a very short incubation period (<24 h) from exposure, thus making an infectious agent unlikely. Sampling campaigns over Japan during the KD season detected major differences in the microbiota of the tropospheric aerosols compared with ground aerosols, with the unexpected finding of the Candida species as the dominant fungus from aloft samples (54% of all fungal strains). These results, consistent with the Candida animal model for KD, provide support for the concept and feasibility of a windborne pathogen. A fungal toxin could be pursued as a possible etiologic agent of KD, consistent with an agricultural source, a short incubation time and synchronized outbreaks. Our study suggests that the causative agent of KD is a preformed toxin or environmental agent rather than an organism requiring replication. We propose a new paradigm whereby an idiosyncratic immune response, influenced by host genetics triggered by an environmental exposure carried on winds, results in the clinical syndrome known as acute KD.

  1. Factors Associated With Resource Utilization and Coronary Artery Dilation in Refractory Kawasaki Disease (from the Pediatric Health Information System Database).

    PubMed

    Lo, Jennifer Y; Minich, L LuAnn; Tani, Lloyd Y; Wilkes, Jacob; Ding, Qian; Menon, Shaji C

    2016-12-01

    Management guidelines for refractory Kawasaki disease (KD) are vague. We sought to assess practice variation and identify factors associated with large/complex coronary artery aneurysms (LCAA) and resource utilization in refractory KD. This retrospective cohort study identified patients aged ≤18 years with KD (2004 to 2014) using the Pediatric Health Information System. Refractory KD was defined as receiving >1 dose of intravenous immunoglobulin. Demographics, medications, concomitant infections, length of stay (LOS), and charges were collected. Antithrombotic therapy was a surrogate for LCAA. LOS and hospital charges assessed resource utilization. Multivariate regression identified factors associated with LOS, charges, and LCAA. Of 14,194 patients with KD, 2,974 (21%) had refractory KD and 203 of those 2,974 (7%) had LCAA. Additional intravenous immunoglobulin was the sole medication in 77%. Other medications added were steroids (18%), infliximab (2%), and both (3%). Warfarin, low-molecular-weight heparin, tissue plasminogen activator, and clopidogrel were prescribed with equal frequency (2%). Male gender (adjusted relative risk 1.52, 95% confidence interval [CI] 1.08 to 2.16, p <0.01), admission to an intensive care unit (4.79, 95% CI 3.40 to 6.74, p <0.001), arrhythmia (3.00, 95% CI 1.94 to 4.65, p <0.001), and concomitant viral infection (2.29, 95% CI 1.49 to 3.52, p <0.001) were associated with LCAA. Severe illness, race, region, and payer were independently associated with increased charges (p <0.05 for all). In conclusion, treatment for refractory KD varies widely. Concomitant viral infection was associated with a greater risk of LCAA in refractory KD. Better understanding of optimal management may improve outcomes and decrease both variability in management and resource utilization for refractory KD.

  2. Critical Overview of the Risk Scoring Systems to Predict Non-Responsiveness to Intravenous Immunoglobulin in Kawasaki Syndrome.

    PubMed

    Rigante, Donato; Andreozzi, Laura; Fastiggi, Michele; Bracci, Benedetta; Natale, Marco Francesco; Esposito, Susanna

    2016-02-24

    Kawasaki syndrome (KS) is the most relevant cause of heart disease in children living in developed countries. Intravenous immunoglobulin (IVIG) has a preventive function in the formation of coronary artery abnormalities and a poor strictly-curative action in established coronary damage. More than two decades ago, the Harada score was set to assess which children with KS should be subject to administration of IVIG, evaluating retrospectively a large cohort of patients with regard to age, sex and laboratory data. Nowadays, high dose IVIG is administered to all children with a confirmed diagnosis of KS, but a tool for predicting non-responsiveness to the initial infusion of IVIG has not been found. The prediction of IVIG resistance is a crucial issue, as recognising these high-risk patients should consent the administration of an intensified initial treatment in combination with IVIG in order to prevent coronary injuries. Few reports have focused on factors, referring to both clinical parameters and laboratory data at the onset of KS, in order to predict which patients might be IVIG non-responsive. We have analysed three different risk scores which were formulated to predict IVIG resistance in Japanese children with typical KS, but their application in non-Japanese patients or in those with incomplete and atypical patterns of the disease has been studied in a fragmentary way. Overall, our analysis showed that early and definite ascertainment of likely IVIG non-responders who require additional therapies reducing the development of coronary artery involvement in children with KS is still a challenge.

  3. Elevated D-dimer level is a risk factor for coronary artery lesions accompanying intravenous immunoglobulin-unresponsive Kawasaki disease.

    PubMed

    Masuzawa, Yuko; Mori, Masaaki; Hara, Takuma; Inaba, Aya; Oba, Mari S; Yokota, Shumpei

    2015-04-01

    Although there are many reports on the resistance of Kawasaki disease (KD) to initial intravenous immunoglobulin (IVIg) therapy, risk factors for coronary artery lesions in such cases remain to be established. The objective of this study was to explore when additional therapies should be administered and to identify factors helpful for selecting a therapeutic option. Based on their written clinical records, we performed a retrospective review of KD patients who did not respond to initial IVIg therapy and who therefore then underwent plasma exchange (PE) therapy. This was a case-control study to compare the presence or absence of acute coronary lesions in patients treated by PE for IVIg-unresponsive KD at Yokohama City University Hospital or at Yokohama City University Medical Center. Fifteen of 44 patients had acute coronary artery lesions (CAL) correlating with high levels of white blood cells (WBC) (P = 0.045), D-dimer (P = 0.008), and fibrin/fibrinogen degradation products (P = 0.009) and lower levels of fibrinogen (P = 0.013) prior to PE therapy. There was a strong correlation between pre-PE levels of albumin and D-dimer (Pearson's correlation coefficient of 0.610). Multivariate analyses revealed that the odds ratio for CAL when D-dimer was ≥ 4.5 μg/mL was 25.06 (95% CI, 2.56-244.91, P = 0.006). D-dimer elevation and albumin decline in IVIg-unresponsive KD patients could be risk factors for acute CAL, suggesting the possibility that angitis has spread throughout the arterial system, as far as the coronary artery.

  4. Whole genome sequencing of an African American family highlights toll like receptor 6 variants in Kawasaki disease susceptibility

    PubMed Central

    Veeraraghavan, Narayanan; Levy, Eric; Ribeiro dos Santos, Andre M.; Yang, Hai; Hibberd, Martin L.; Tremoulet, Adriana H.; Harismendy, Olivier; Ohno-Machado, Lucila; Burns, Jane C.

    2017-01-01

    Kawasaki disease (KD) is the most common acquired pediatric heart disease. We analyzed Whole Genome Sequences (WGS) from a 6-member African American family in which KD affected two of four children. We sought rare, potentially causative genotypes by sequentially applying the following WGS filters: sequence quality scores, inheritance model (recessive homozygous and compound heterozygous), predicted deleteriousness, allele frequency, genes in KD-associated pathways or with significant associations in published KD genome-wide association studies (GWAS), and with differential expression in KD blood transcriptomes. Biologically plausible genotypes were identified in twelve variants in six genes in the two affected children. The affected siblings were compound heterozygous for the rare variants p.Leu194Pro and p.Arg247Lys in Toll-like receptor 6 (TLR6), which affect TLR6 signaling. The affected children were also homozygous for three common, linked (r2 = 1) intronic single nucleotide variants (SNVs) in TLR6 (rs56245262, rs56083757 and rs7669329), that have previously shown association with KD in cohorts of European descent. Using transcriptome data from pre-treatment whole blood of KD subjects (n = 146), expression quantitative trait loci (eQTL) analyses were performed. Subjects homozygous for the intronic risk allele (A allele of TLR6 rs56245262) had differential expression of Interleukin-6 (IL-6) as a function of genotype (p = 0.0007) and a higher erythrocyte sedimentation rate at diagnosis. TLR6 plays an important role in pathogen-associated molecular pattern recognition, and sequence variations may affect binding affinities that in turn influence KD susceptibility. This integrative genomic approach illustrates how the analysis of WGS in multiplex families with a complex genetic disease allows examination of both the common disease–common variant and common disease–rare variant hypotheses. PMID:28151979

  5. Common variants in the CRP promoter are associated with a high C-reactive protein level in Kawasaki disease.

    PubMed

    Kim, Jae-Jung; Yun, Sin Weon; Yu, Jeong Jin; Yoon, Kyung Lim; Lee, Kyung-Yil; Kil, Hong-Ryang; Kim, Gi Beom; Han, Myung Ki; Song, Min Seob; Lee, Hyoung Doo; Byeon, Jung Hye; Sohn, Saejung; Hong, Young Mi; Jang, Gi Young; Lee, Jong-Keuk

    2015-02-01

    Kawasaki disease (KD) is an acute self-limiting form of vasculitis that afflicts infants and children and manifests as fever and signs of mucocutaneous inflammation. Children with KD show various laboratory inflammatory abnormalities, such as elevations in their white blood cell (WBC) count, C-reactive protein (CRP) level, and erythrocyte sedimentation rate (ESR). We here performed a genome-wide association study (GWAS) of 178 KD patients to identify the genetic loci that influence 10 important KD laboratory markers: WBC count, neutrophil count, platelet count, CRP, ESR, hemoglobin, aspartate aminotransferase (AST), alanine aminotransferase (ALT), albumin, and total protein. A total of 165 loci passed our arbitrary stage 1 threshold for replication (p < 1 × 10(-5)). Of these, only 2 SNPs (rs12068753 and rs4786091) demonstrated a significant association with the CRP level in replication study of 473 KD patients (p < 0.05). The SNP located at the CRP locus (rs12068753) demonstrated the most significant association with CRP in KD patients (beta = 4.73 and p = 1.20 × 10(-6) according to the stage 1 GWAS; beta = 3.65 and p = 1.35 × 10(-8) according to the replication study; beta = 3.97 and p = 1.11 × 10(-13) according to combined analysis) and explained 8.1% of the phenotypic variation observed. However, this SNP did not demonstrate any significant association with CRP in the general population (beta = 0.37 and p = 0.1732) and only explained 0.1% of the phenotypic variation in this instance. Furthermore, rs12068753 did not affect the development of coronary artery lesions or intravenous immunoglobulin resistance in KD patients. These results indicate that common variants in the CRP promoter can play an important role in the CRP levels in KD.

  6. Unique Molecular Patterns Uncovered in Kawasaki Disease Patients with Elevated Serum Gamma Glutamyl Transferase Levels: Implications for Intravenous Immunoglobulin Responsiveness

    PubMed Central

    Hao, Shiying; Deng, Xiaohong; Huang, Min; Ren, Miao; Jiang, Xiyuan; Kanegaye, John T.; Ha, Kee-Soo; Lee, JungHwa; Li, Xiaofeng; Jiang, Xuejun; Yu, Yunxian; Tremoulet, Adriana H.; Burns, Jane C.; Whitin, John C.; Shin, Andrew Y.; Sylvester, Karl G.; McElhinney, Doff B.; Cohen, Harvey J.; Ling, Xuefeng B.

    2016-01-01

    Background Resistance to intravenous immunoglobulin (IVIG) occurs in 10–20% of patients with Kawasaki disease (KD). The risk of resistance is about two-fold higher in patients with elevated gamma glutamyl transferase (GGT) levels. We sought to understand the biological mechanisms underlying IVIG resistance in patients with elevated GGT levels. Method We explored the association between elevated GGT levels and IVIG-resistance with a cohort of 686 KD patients (Cohort I). Gene expression data from 130 children with acute KD (Cohort II) were analyzed using the R square statistic and false discovery analysis to identify genes that were differentially represented in patients with elevated GGT levels with regard to IVIG responsiveness. Two additional KD cohorts (Cohort III and IV) were used to test the hypothesis that sialylation and GGT may be involved in IVIG resistance through neutrophil apoptosis. Results Thirty-six genes were identified that significantly explained the variations of both GGT levels and IVIG responsiveness in KD patients. After Bonferroni correction, significant associations with IVIG resistance persisted for 12 out of 36 genes among patients with elevated GGT levels and none among patients with normal GGT levels. With the discovery of ST6GALNAC3, a sialyltransferase, as the most differentially expressed gene, we hypothesized that sialylation and GGT are involved in IVIG resistance through neutrophil apoptosis. We then confirmed that in Cohort III and IV there was significantly less reduction in neutrophil count in IVIG non-responders. Conclusions Gene expression analyses combining molecular and clinical datasets support the hypotheses that: (1) neutrophil apoptosis induced by IVIG may be a mechanism of action of IVIG in KD; (2) changes in sialylation and GGT level in KD patients may contribute synergistically to IVIG resistance through blocking IVIG-induced neutrophil apoptosis. These findings have implications for understanding the mechanism of

  7. The outcome of short-term low-dose aspirin treatment in Kawasaki disease based on inflammatory markers

    PubMed Central

    Yoo, Jae Won; Kim, Ji Mok

    2017-01-01

    Purpose Previously, Kawasaki disease (KD) treatment with low-dose aspirin was administered for 6–8 weeks after the acute phase. However, inflammatory marker levels normalize before 6–8 weeks. In this study, we aimed to investigate the clinical outcome of short-term low-dose aspirin treatment based on inflammatory and thrombotic marker levels. Methods We performed a retrospective review of the medical records of patients with KD who were hospitalized at Chungnam National University Hospital between September 2012 and May 2014. When fever subsided, low-dose aspirin treatment was started. Inflammatory (white blood cell count, erythrocyte sedimentation rate, and C-reactive protein) and thrombotic markers (D-dimer) were monitored at follow-ups conducted in 1- to 2-week intervals. The low-dose aspirin administration was terminated when both markers were normalized and no cardiovascular complications were observed. Results Eighty-four patients with KD (complete KD, n=49; incomplete KD, n=35) were enrolled. The inflammatory and thrombotic marker levels were normalized within 3–4 weeks on average. At the beginning the low-dose aspirin treatment, 9 patients had coronary artery lesions but 75 did not. When the low-dose aspirin administration was terminated at the time the inflammatory marker levels were normalized, no new CALs developed during the follow-up at 6–8 weeks. Conclusion Most of the inflammatory marker levels were normalized within 3–4 weeks after the acute phase of KD. New cardiovascular complications did not develop during the course of the short-term aspirin treatment based on the inflammatory marker levels, clinical findings, and echocardiography. PMID:28203257

  8. Cardiovascular Response to Exercise Testing in Children and Adolescents Late After Kawasaki Disease According to Coronary Condition Upon Onset.

    PubMed

    Gravel, Hugo; Curnier, Daniel; Dallaire, Frédéric; Fournier, Anne; Portman, Michael; Dahdah, Nagib

    2015-10-01

    Multiple cardiovascular sequelae have been reported late after Kawasaki disease (KD), especially in patients with coronary artery lesions. In this perspective, we hypothesized that exercise response was altered after KD in patients with coronary aneurysms (CAA-KD) compared to those without history of coronary aneurysms (NS-KD). This study is a post hoc analysis of exercise data from an international multicenter trial. A group of 133 CAA-KD subjects was compared to a group of 117 NS-KD subjects. Subjects underwent a Bruce treadmill test followed to maximal exertion. Heart rate (HR), systolic blood pressure (SBP), and diastolic blood pressure (DBP) were assessed at each stage of the test including recovery. Myocardial perfusion was evaluated by stress and rest Tc-99m sestamibi SPECT imaging. Endurance time was similar between NS-KD and CAA-KD (11.3 ± 2.6 vs. 11.0 ± 2.6 min; p = 0.343). HR, SBP, and DBP responses to exercise were similar between groups (p = 0.075-0.942). Myocardial perfusion defects were present in 16.5 % CAA-KD versus 22.2 % NS-KD (p = 0.255). Analysis based on myocardial perfusion status identified a lower heart rate at 1 min into recovery as well as lower DBP at 1 and 5 min into recovery in patients with abnormal SPECT imaging (p = 0.017-0.042). Compared to patients without CA involvement, the presence of coronary aneurysms at the subacute phase of KD does not induce a differential effect on exercise parameters. In contrast, exercise-induced myocardial perfusion defect late after the onset of KD correlates with abnormal recovery parameters.

  9. Association of Kawasaki disease with tropospheric winds in Central Chile: is wind-borne desert dust a risk factor?

    PubMed

    Jorquera, Héctor; Borzutzky, Arturo; Hoyos-Bachiloglu, Rodrigo; García, Alvaro

    2015-05-01

    It has been found that Kawasaki disease (KD) cases diagnosed in Japan, Hawaii and San Diego, USA increase when tropospheric wind patterns arrive from central Asia, suggesting a common, wind-borne causal agent. We analyzed KD cases hospitalized in Santiago, Chile to look for associations with local, regional and large scale meteorological variables. We compiled monthly data of KD incidence rates, local meteorological variables, large scale wind patterns and several El Niño Southern Oscillation (ENSO) indices for 2001-2010; we considered standardized anomalies in all analyses and used linear time series models to account for data autocorrelation. We found that meteorological variables explain 38% of variance in KD rates. A unit increase in northerly wind at 3 lagged months, temperature at 1 and 3 lagged months and monthly change of ENSO 4 index are associated with changes in KD rates of 0.203 (95% CI 0.049-0.358), 0.181 (95% CI 0.014-0.347), 0.192 (95% CI 0.030-0.353) and -0.307 (95% CI -0.458-0.156), respectively. These results are robust when northerly wind level is changed or when a shorter period (2005-2010) is used to estimate model parameters. We found a statistical association of KD at Santiago, Chile with tropospheric, northerly wind patterns suggesting that dust transported from the Atacama Desert could include a causative agent. A novel result is that ENSO dynamics also explain part of KD variability with a decrease in KD when La Niña is dissipating or El Niño is on the rise; hence climate scale dynamics might be taken into account in future studies worldwide - at least as a potential explanatory variable that may confound KD seasonality on a global scale.

  10. IL-1β is Crucial for Induction of Coronary Artery Inflammation in a Mouse Model of Kawasaki Disease

    PubMed Central

    Lee, Young Ho; Schulte, Danica J.; Shimada, Kenichi; Chen, Shuang; Crother, Timothy R.; Chiba, Norika; Fishbein, Michael C.; Lehman, Thomas J.A.; Arditi, Moshe

    2012-01-01

    Background Kawasaki disease (KD) is the most common cause of acute vasculitis and acquired cardiac disease in US children. Untreated, children may develop coronary artery aneurysms, myocardial infarction and sudden death as a result of the illness. Up to a third of KD patients fail to respond to intravenous gammaglobulin (IVIG), the standard therapy, and alternative treatments are being investigated. Genetic studies have indicated a possible role for IL-1β in KD. We therefore explored the role of IL-1β in a murine model of KD. Methods and Results Using an established mouse model of KD that involves injection of Lactobacillus casei cell wall extract (LCWE), we investigated the role of IL- 1β and caspase-1 (activated by the inflammasome and required for IL-1β maturation) in coronary arteritis, and evaluated the efficacy of IL-1 receptor antagonist (IL-1Ra) as a potential treatment. LCWE-induced IL-1β maturation and secretion was dependent on the NLRP3 inflammasome in macrophages. Both caspase1-deficient and IL-1R-deficient mice were protected from LCWE-induced coronary lesions. Injection of recombinant IL-1β to caspase-1-deficient mice restored the ability of LCWE to cause coronary lesions in response to LCWE. Furthermore, daily injections of the IL-1Ra prevented LCWE-mediated coronary lesions, up to three days after LCWE injection. Conclusions Our results strongly suggest that caspase-1 and IL-1β play critical roles in the development of coronary lesions in this KD mouse model, blocked by IL-1Ra. Therefore, anti-IL-1β treatment strategies may constitute an effective, more targeted treatment of KD to prevent coronary lesions. PMID:22361326

  11. Association between the FCGR2A gene H131R polymorphism and risk of Kawasaki disease: a meta-analysis.

    PubMed

    Lin, L; Wang, S Y; Yang, S B; Xiao, F C

    2015-06-11

    Several previous studies have investigated whether the FCGR2A gene H131R polymorphism confers an increased risk of Kawasaki disease (KD), but conflicting results have been reported. To further explore the association of this polymorphism with KD susceptibility, we performed an extensive search of relevant studies and conducted a meta-analysis to obtain a more precise estimate of risk. Systematic searches of the electronic databases Embase, PubMed, and Google Scholar were performed to identify relevant studies. Odds ratios (ORs) and their 95% confidence intervals (CIs) were used for statistical analysis. Six studies were included in the meta-analysis, involving 1709 patients with KD and 3207 controls. Significant association was found between the FCGR2A gene H131R polymorphism and KD risk in analysis of the total population (HH vs RR: OR = 1.97, 95%CI = 1.55-2.50; HH vs HR: OR = 1.38, 95%CI = 1.21-1.57; the dominant model: OR = 0.69, 95%CI = 0.60-0.78; and the recessive model: OR = 1.65, 95%CI = 1.32-2.07). In subgroup analysis by ethnicity, significant association was found between the H131R polymorphism and KD risk in Asians, but not in Caucasians. In addition, we found no significant association between the FCGR2A gene H131R polymorphism and risk of KD-associated coronary artery lesions. In conclusion, this meta-analysis suggested that the H131R polymorphism in the FCGR2A gene might be associated with susceptibility to KD in Asians.

  12. Incidence Rate and Epidemiological and Clinical Aspects of Kawasaki Disease in Children of Maghrebi Origin in the Province of Quebec, Canada, Compared to the Country of Origin

    PubMed Central

    Gorrab, Arbia Abir; Fournier, Anne; Bouaziz, Asma Abed; Spigelblatt, Linda; Scuccimarri, Rosie; Mrabet, Ali; Dahdah, Nagib

    2016-01-01

    The incidence of Kawasaki disease in Maghreb countries is apparently low, unlike those living in the province of Quebec, Canada. This retrospective study compared Maghrebi children living in Quebec to the countries of origin, Morocco, Algeria, and Tunisia. The annualized incidence rate in Quebec (18.49/year/100 000 children under 5 years of age) was 4 to 12 times higher than in Tunisia, Morocco, and Algeria (0.95, 4.52, and 3.15, respectively). The prevalence of incomplete diagnostic criteria was higher in Quebec at 39%, Morocco 43%, and Tunisia 39% compared to Algeria at 8%, with minimal delayed diagnosis (7%) only in Quebec compared to 30%, 35%, and 62%, respectively (P < .001). The rate of coronary aneurysms was comparable however (11% in Quebec vs 4%, 10%, and 25%, in Tunisia, Morocco, and Algeria, respectively; P = .31). The higher incidence of Kawasaki disease in the Maghreb community in Quebec versus the countries of origin seems due to underdiagnosis, which represents a public health concern in those countries. PMID:27336001

  13. Incidence Rate and Epidemiological and Clinical Aspects of Kawasaki Disease in Children of Maghrebi Origin in the Province of Quebec, Canada, Compared to the Country of Origin.

    PubMed

    Gorrab, Arbia Abir; Fournier, Anne; Bouaziz, Asma Abed; Spigelblatt, Linda; Scuccimarri, Rosie; Mrabet, Ali; Dahdah, Nagib

    2016-01-01

    The incidence of Kawasaki disease in Maghreb countries is apparently low, unlike those living in the province of Quebec, Canada. This retrospective study compared Maghrebi children living in Quebec to the countries of origin, Morocco, Algeria, and Tunisia. The annualized incidence rate in Quebec (18.49/year/100 000 children under 5 years of age) was 4 to 12 times higher than in Tunisia, Morocco, and Algeria (0.95, 4.52, and 3.15, respectively). The prevalence of incomplete diagnostic criteria was higher in Quebec at 39%, Morocco 43%, and Tunisia 39% compared to Algeria at 8%, with minimal delayed diagnosis (7%) only in Quebec compared to 30%, 35%, and 62%, respectively (P < .001). The rate of coronary aneurysms was comparable however (11% in Quebec vs 4%, 10%, and 25%, in Tunisia, Morocco, and Algeria, respectively; P = .31). The higher incidence of Kawasaki disease in the Maghreb community in Quebec versus the countries of origin seems due to underdiagnosis, which represents a public health concern in those countries.

  14. Kawasaki Disease-Specific Molecules in the Sera Are Linked to Microbe-Associated Molecular Patterns in the Biofilms

    PubMed Central

    Murata, Kenji; Kanno, Shunsuke; Nishio, Hisanori; Saito, Mitsumasa; Tanaka, Tamami; Yamamura, Kenichiro; Sakai, Yasunari; Takada, Hidetoshi; Miyamoto, Tomofumi; Mizuno, Yumi; Ouchi, Kazunobu; Waki, Kenji; Hara, Toshiro

    2014-01-01

    Background Kawasaki disease (KD) is a systemic vasculitis of unknown etiology. The innate immune system is involved in its pathophysiology at the acute phase. We have recently established a novel murine model of KD coronary arteritis by oral administration of a synthetic microbe-associated molecular pattern (MAMP). On the hypothesis that specific MAMPs exist in KD sera, we have searched them to identify KD-specific molecules and to assess the pathogenesis. Methods We performed liquid chromatography-mass spectrometry (LC-MS) analysis of fractionated serum samples from 117 patients with KD and 106 controls. Microbiological and LC-MS evaluation of biofilm samples were also performed. Results KD samples elicited proinflammatory cytokine responses from human coronary artery endothelial cells (HCAECs). By LC-MS analysis of KD serum samples collected at 3 different periods, we detected a variety of KD-specific molecules in the lipophilic fractions that showed distinct m/z and MS/MS fragmentation patterns in each cluster. Serum KD-specific molecules showed m/z and MS/MS fragmentation patterns almost identical to those of MAMPs obtained from the biofilms formed in vitro (common MAMPs from Bacillus cereus, Yersinia pseudotuberculosis and Staphylococcus aureus) at the 1st study period, and from the biofilms formed in vivo (common MAMPs from Bacillus cereus, Bacillus subtilis/Bacillus cereus/Yersinia pseudotuberculosis and Staphylococcus aureus) at the 2nd and 3rd periods. The biofilm extracts from Bacillus cereus, Bacillus subtilis, Yersinia pseudotuberculosis and Staphylococcus aureus also induced proinflammatory cytokines by HCAECs. By the experiments with IgG affinity chromatography, some of these serum KD-specific molecules bound to IgG. Conclusions We herein conclude that serum KD-specific molecules were mostly derived from biofilms and possessed molecular structures common to MAMPs from Bacillus cereus, Bacillus subtilis, Yersinia pseudotuberculosis and Staphylococcus

  15. A Simple Method for Assessment of Human Anti-Neu5Gc Antibodies Applied to Kawasaki Disease

    PubMed Central

    Padler-Karavani, Vered; Tremoulet, Adriana H.; Yu, Hai; Chen, Xi; Burns, Jane C.; Varki, Ajit

    2013-01-01

    N-Glycolylneuraminic acid (Neu5Gc) is an immunogenic sugar of dietary origin that metabolically incorporates into diverse native glycoconjugates in humans. Anti-Neu5Gc antibodies are detected in all human sera, though with variable levels and epitope-recognition profiles. These antibodies likely play a role in several inflammation-mediated pathologies including cardiovascular diseases and cancer. In cancer, they have dualistic and opposing roles, either stimulating or repressing disease, as a function of their dose, and some of these antibodies serve as carcinoma biomarkers. Thus, anti-Neu5Gc antibodies may signify risk of inflammation-mediated diseases, and changes in their levels could potentially be used to monitor disease progression and/or response to therapy. Currently, it is difficult to determine levels of anti-Neu5Gc antibodies in individual human samples because these antibodies recognize multiple Neu5Gc-epitopes. Here we describe a simple and specific method for detection and overall estimation of human anti-Neu5Gc antibodies. We exploit the difference between two mouse models that differ only by Neu5Gc-presence (wild-type) or Neu5Gc-absence (Cmah−/− knockout). We characterize mouse serum from both strains by HPLC, lectin and mass-spectrometry analysis and show the target Neu5Gc-epitopes. We then use Cmah−/− knockout sera to inhibit all non-Neu5Gc-reactivity followed by binding to wild-type sera to detect overall anti-Neu5Gc response in a single assay. We applied this methodology to characterize and quantify anti-Neu5Gc IgG and IgA in sera of patients with Kawasaki disease (KD) at various stages compared to controls. KD is an acute childhood febrile disease characterized by inflammation of coronary arteries that untreated may lead to coronary artery aneurysms with risk of thrombosis and myocardial infarction. This estimated response is comparable to the average of detailed anti-Neu5Gc IgG profile analyzed by a sialoglycan microarray. Both assays

  16. Use of Lagrangian transport models and Sterilized High Volume Sampling to pinpoint the source region of Kawasaki disease and determine the etiologic agent

    NASA Astrophysics Data System (ADS)

    Curcoll Masanes, Roger; Rodó, Xavier; Anton, Jordi; Ballester, Joan; Jornet, Albert; Nofuentes, Manel; Sanchez-Manubens, Judith; Morguí, Josep-Anton

    2015-04-01

    Kawasaki disease (KD) is an acute, coronary artery vasculitis of young children, and still a medical mystery after more than 40 years. A former study [Rodó et al. 2011] demonstrated that certain patterns of winds in the troposphere above the earth's surface flowing from Asia were associated with the times of the annual peak in KD cases and with days having anomalously high numbers of KD patients. In a later study [Rodó et al. 2014], we used residence times from an Air Transport Model to pinpoint the source region for KD. Simulations were generated from locations spanning Japan from days with either high or low KD incidence. In order to cope with stationarity of synoptic situations, only trajectories for the winter months, when there is the maximum in KD cases, were considered. Trajectories traced back in time 10 days for each dataset and location were generated using the flexible particle Lagrangian dispersion model (FLEXPART Version 8.23 [Stohl et al. 2005]) run in backward mode. The particles modeled were air tracers, with 10,000 particles used on each model run. The model output used was residence time, with an output grid of 0.5° latitude × longitude and a time resolution of 3 h. The data input used for the FLEXPART model was gridded atmospheric wind velocity from the European Center for Medium-Range Weather Forecasts Re-Analysis (ERA-Interim at 1°). Aggregates of winter period back-trajectories were calculated for three different regions of Japan. A common source of wind air masses was located for periods with High Kawasaki disease. Knowing the trajectories of winds from the air transport models, a sampling methodology was developed in order to capture the possible etiological agent or other tracers that could have been released together. This methodology is based on the sterilized filtering of high volumes of the transported air at medium tropospheric levels by aircraft sampling and a later analyze these filters with adequate techniques. High purity

  17. High regression rate of coronary aneurysms developed in patients with immune globulin-resistant Kawasaki disease treated with steroid pulse therapy.

    PubMed

    Adachi, Shinya; Sakaguchi, Heima; Kuwahara, Takashi; Uchida, Yasushi; Fukao, Toshiyuki; Kondo, Naomi

    2010-04-01

    Kawasaki disease is an acute vasculitis syndrome of unknown etiology that mainly affects small and medium-size arteries, particularly the coronary artery. Coronary artery lesions may develop into aneurismal formation and thrombotic occlusion, and progress to ischemic heart disease. The aim of the present study was to investigate the effect of steroid pulse therapy following intravenous immune globulin (IVIG) treatment on the regression rate of aneurysms in Kawasaki disease. Among 93 sequential patients referred to us, because of coronary artery lesions in the acute phase, we found 23 aneurysms in 12 patients during the period from January 1997 to January 2008. We divided them into two groups: a non-steroid group, 7 patients (13 aneurysms) treated with single or multiple IVIG but no steroid pulse therapy; and a steroid group, 5 patients (10 aneurysms) treated with multiple IVIG followed by steroid pulse therapy. We compared the regression rate of the aneurysms between the two groups, retrospectively. The regression rates of the aneurysms in the steroid group were significantly higher than those in the non-steroid group when we analyzed 1) all aneurysms (p = 0.007), 2) giant aneurysms (aneurismal diameter was 4 or more x normal, or > 8 mm) (p = 0.018), and 3) aneurysms in IVIG-resistant patients who were resistant to initial IVIG therapy (p = 0.035). All aneurysms, including the giant aneurysms in the steroid group, regressed, and the regression rate of the aneurysms in the non-steroid group was about 46%(6/13). Steroid pulse therapy may be beneficial for IVIG-resistant patients. Our data suggest that steroid pulse therapy may lead to regression of aneurysms.

  18. Kawasaki Disease (For Parents)

    MedlinePlus

    ... dry, cracked lips swollen tongue with a white coating and big red bumps (called "strawberry tongue") sore, ... take you to a site outside of KidsHealth's control. About KidsHealth Nemours.org Reading BrightStart! Contact Us ...

  19. Kawasaki Disease (For Parents)

    MedlinePlus

    ... Development Infections Diseases & Conditions Pregnancy & Baby Nutrition & Fitness Emotions & Behavior School & Family Life First Aid & Safety Doctors & ... soles of the feet with a purple-red color swollen lymph nodes During the second phase, which ...

  20. Borrowing Basics. FDIC Money Smart Financial Education Curriculum = Conceptos Basicos sobre Prestamos. FDIC Money Smart Plan de Educacion para Capacitacion en Finanzas.

    ERIC Educational Resources Information Center

    Federal Deposit Insurance Corp., Washington, DC.

    This module, an introduction to credit, is one of ten in the Money Smart curriculum, and includes an instructor guide and a take-home guide. It was developed to help adults outside the financial mainstream enhance their money skills and create positive banking relationships. It is designed to enable participants to decide when and how to use…

  1. Check It Out. FDIC Money Smart Financial Education Curriculum = Conceptos Basicos sobre Cuentas Corientes. FDIC Money Smart Plan de Educacion para Capacitacion en Finanzas.

    ERIC Educational Resources Information Center

    Federal Deposit Insurance Corp., Washington, DC.

    This module on how to choose and keep a checking account is one of ten in the Money Smart curriculum, and includes an instructor guide and a take-home guide. It was developed to help adults outside the financial mainstream enhance their money skills and create positive banking relationships. It is designed to enable participants to open and keep a…

  2. Comprehensive pathogen detection associated with four recurrent episodes of Kawasaki disease in a patient during a single year using next-generation sequencing

    PubMed Central

    Sekizuka, Tsuyoshi; Oba, Kunihiro; Katano, Harutaka; Kinumaki, Akiko; Terai, Masaru; Mizutani, Tetsuya; Kuroda, Makoto

    2016-01-01

    Introduction: Kawasaki disease (KD) is the most common multisystem vasculitis in childhood. Pathogens can be associated with the onset of KD. However, a lack of consistency prevails among reports about this disease. Case presentation: For this case of a 1-year-old boy with four recurrent episodes of KD within a year, we analysed profiles of pathogen reads in his serum and pharynx specimens using next-generation sequencing. Comparative analysis of the identified bacterial reads from serum samples found significant correlation of bacteria such as Streptococcus and Haemophilus spp. with the first and fourth episodes (R2 = 0.9506) before treatment. In the first convalescent phase, the number of Streptococcus spp. was reduced remarkably (P < 0.0001). From sequencing of the pharynx specimen from the fourth episode, a similar correlation was found with serum from the fourth episode (R2 = 0.6633). Conclusion: In this case, Streptococcus spp. may have been associated with onset of KD. Further studies must be undertaken to evaluate the putative association of micro-organism infection with KD pathogenesis. PMID:28348750

  3. Genetic variations in the receptor-ligand pair CCR5 and CCL3L1 are important determinants of susceptibility to Kawasaki disease.

    PubMed

    Burns, Jane C; Shimizu, Chisato; Gonzalez, Enrique; Kulkarni, Hemant; Patel, Sukeshi; Shike, Hiroko; Sundel, Robert S; Newburger, Jane W; Ahuja, Sunil K

    2005-07-15

    Kawasaki disease (KD) is an enigmatic, self-limited vasculitis of childhood that is complicated by development of coronary-artery aneurysms. The high incidence of KD in Asian versus European populations prompted a search for genetic polymorphisms that are differentially distributed among these populations and that influence KD susceptibility. Here, we demonstrate a striking, inverse relationship between the worldwide distribution of CCR5- Delta 32 allele and the incidence of KD. In 164 KD patient-parent trios, 4 CCR5 haplotypes including the CCR5- Delta 32 allele were differentially transmitted from heterozygous parents to affected children. However, the magnitude of the reduced risk of KD associated with the CCR5- Delta 32 allele and certain CCR5 haplotypes was significantly greater in individuals who also possessed a high copy number of the gene encoding CCL3L1, the most potent CCR5 ligand. These findings, derived from the largest genetic study of any systemic vasculitis, suggest a central role of CCR5-CCL3L1 gene-gene interactions in KD susceptibility and the importance of gene modifiers in infectious diseases.

  4. Genetic variants in PLCB4/PLCB1 as susceptibility loci for coronary artery aneurysm formation in Kawasaki disease in Han Chinese in Taiwan

    PubMed Central

    Lin, Ying-Ju; Chang, Jeng-Sheng; Liu, Xiang; Tsang, Hsinyi; Chien, Wen-Kuei; Chen, Jin-Hua; Hsieh, Hsin-Yang; Hsueh, Kai-Chung; Shiao, Yi-Tzone; Li, Ju-Pi; Lin, Cheng-Wen; Lai, Chih-Ho; Wu, Jer-Yuarn; Chen, Chien-Hsiun; Lin, Jaung-Geng; Lin, Ting-Hsu; Liao, Chiu-Chu; Huang, Shao-Mei; Lan, Yu-Ching; Ho, Tsung-Jung; Liang, Wen-Miin; Yeh, Yi-Chun; Lin, Jung-Chun; Tsai, Fuu-Jen

    2015-01-01

    Kawasaki disease (KD) is an acute, inflammatory, and self-limited vasculitis affecting infants and young children. Coronary artery aneurysm (CAA) formation is the major complication of KD and the leading cause of acquired cardiovascular disease among children. To identify susceptible loci that might predispose patients with KD to CAA formation, a genome-wide association screen was performed in a Taiwanese KD cohort. Patients with both KD and CAA had longer fever duration and delayed intravenous immunoglobulin treatment time. After adjusting for these factors, 100 susceptibility loci were identified. Four genes were identified from a single cluster of 35 using the Ingenuity Pathway Analysis (IPA) Knowledge Base. Silencing KCNQ5, PLCB1, PLCB4, and PLCL1 inhibited the effect of lipopolysaccharide-induced endothelial cell inflammation with varying degrees of proinflammatory cytokine expression. PLCB1 showed the most significant inhibition. Endothelial cell inflammation was also inhibited by using a phospholipase C (PLC) inhibitor. The single nucleotide polymorphism rs6140791 was identified between PLCB4 and PLCB1. Plasma PLC levels were higher in patients with KD and CC+CG rs6140791genotypes, and these genotypes were more prevalent in patients with KD who also had CAA. Our results suggest that polymorphism of the PLCB4/B1 genes might be involved in the CAA pathogenesis of KD. PMID:26434682

  5. Elevated Inducible Nitric Oxide Levels and Decreased Hydrogen Sulfide Levels Can Predict the Risk of Coronary Artery Ectasia in Kawasaki Disease.

    PubMed

    Song, Ruixia; Liu, Guiying; Li, Xiaohui; Xu, Wenya; Liu, Jia; Jin, Hongfang

    2016-02-01

    Kawasaki disease (KD) is a vasculitis disease in children that is associated with coronary artery ectasia (CAE). We investigated whether inducible nitric oxide synthase (i-NOS) and hydrogen sulfide (H2S) could be used to predict CAE secondary to KD. We enrolled 65 children with KD (35 cases with CAE and 30 cases without CAE), 33 healthy children, and 32 children with fever but without vasculitis disease (febrile group). We measured plasma nitric oxide (NO), total nitric oxide synthase (Total-NOS), i-NOS, constructive nitric oxide synthase (c-NOS) levels, and H2S content in all patients. Plasma NO, Total-NOS, i-NOS, and H2S were higher in KD children than in healthy and febrile children (P < 0.05). The i-NOS level was higher in KD children with CAE compared to those without CAE, while the H2S was lower (both P < 0.05). Using a combination of i-NOS (higher than 10 U/mL) and H2S (lower than 3.31 μmol/L) to predict CAE had 80 % sensitivity and 81 % specificity (P < 0.05). Elevated plasma i-NOS and decreased plasma H2S levels in the acute phase of KD have good predictive value for CAE and may be used to guide appropriate clinical treatment and prevent future cardiovascular complications.

  6. Genetic variants in PLCB4/PLCB1 as susceptibility loci for coronary artery aneurysm formation in Kawasaki disease in Han Chinese in Taiwan.

    PubMed

    Lin, Ying-Ju; Chang, Jeng-Sheng; Liu, Xiang; Tsang, Hsinyi; Chien, Wen-Kuei; Chen, Jin-Hua; Hsieh, Hsin-Yang; Hsueh, Kai-Chung; Shiao, Yi-Tzone; Li, Ju-Pi; Lin, Cheng-Wen; Lai, Chih-Ho; Wu, Jer-Yuarn; Chen, Chien-Hsiun; Lin, Jaung-Geng; Lin, Ting-Hsu; Liao, Chiu-Chu; Huang, Shao-Mei; Lan, Yu-Ching; Ho, Tsung-Jung; Liang, Wen-Miin; Yeh, Yi-Chun; Lin, Jung-Chun; Tsai, Fuu-Jen

    2015-10-05

    Kawasaki disease (KD) is an acute, inflammatory, and self-limited vasculitis affecting infants and young children. Coronary artery aneurysm (CAA) formation is the major complication of KD and the leading cause of acquired cardiovascular disease among children. To identify susceptible loci that might predispose patients with KD to CAA formation, a genome-wide association screen was performed in a Taiwanese KD cohort. Patients with both KD and CAA had longer fever duration and delayed intravenous immunoglobulin treatment time. After adjusting for these factors, 100 susceptibility loci were identified. Four genes were identified from a single cluster of 35 using the Ingenuity Pathway Analysis (IPA) Knowledge Base. Silencing KCNQ5, PLCB1, PLCB4, and PLCL1 inhibited the effect of lipopolysaccharide-induced endothelial cell inflammation with varying degrees of proinflammatory cytokine expression. PLCB1 showed the most significant inhibition. Endothelial cell inflammation was also inhibited by using a phospholipase C (PLC) inhibitor. The single nucleotide polymorphism rs6140791 was identified between PLCB4 and PLCB1. Plasma PLC levels were higher in patients with KD and CC+CG rs6140791genotypes, and these genotypes were more prevalent in patients with KD who also had CAA. Our results suggest that polymorphism of the PLCB4/B1 genes might be involved in the CAA pathogenesis of KD.

  7. Identification of KCNN2 as a susceptibility locus for coronary artery aneurysms in Kawasaki disease using genome-wide association analysis.

    PubMed

    Kim, Jae-Jung; Park, Young-Mi; Yoon, Dankyu; Lee, Kyung-Yil; Seob Song, Min; Doo Lee, Hyoung; Kim, Kwi-Joo; Park, In-Sook; Nam, Hyo-Kyoung; Weon Yun, Sin; Ki Han, Myung; Mi Hong, Young; Young Jang, Gi; Lee, Jong-Keuk

    2013-08-01

    Kawasaki disease (KD) is often complicated by coronary artery lesions (CALs), including aneurysms. Because of the complications associated with KD, this disorder is the leading cause of acquired heart disease in children from developed countries. To identify genetic loci that confer a higher risk of developing CALs, we performed a case-control association study using previous genome-wide association study data for samples from KD cases only (n=186) by grouping KD patients without CALs (control: n=123) vs KD patients with extremely large aneurysms (diameter>5 mm) (case: n=17). Twelve loci with one or more sequence variants were found to be significantly associated with CALs (P<1 × 10(-5)). Of these, an SNP (rs17136627) in the potassium intermediate/small conductance calcium-activated channel, subfamily N, member 2 (KCNN2) at 5q22.3 was validated in 32 KD patients with large aneurysms (diameter>5 mm) and 191 KD patients without CALs (odds ratio (OR)=12.6, P(combined)=1.96 × 10(-8)). This result indicates that the KCNN2 gene can have an important role in the development of coronary artery aneurysms in KD.

  8. Study on the relationship between mean platelet volume and platelet distribution width with coronary artery lesion in children with Kawasaki disease.

    PubMed

    Liu, Ruixi; Gao, Fang; Huo, Junming; Yi, Qijian

    2012-01-01

    Mean platelet volume (MPV) and platelet distribution width (PDW) are correlated with platelet function and may be a more sensitive index than platelet number as a marker of clinical interest in various disorders. Therefore, this study was designed to answer the following questions: do MPV and PDW levels change in Kawasaki disease (KD), is there any relation between CAL in children with MPV and PDW and whether MPV and PDW might support a diagnosis of incomplete KD. A total of 309 KD patients and 160 sex-age matched healthy subjects were enrolled into the study. For all subjects following tests were performed: MPV, PDW, platelet count, white blood cells counts (WBC), C reactive protein (CRP) and erythrocyte sedimentation rate (ESR). Patients with CALs were assigned to three groups depending on the extent of CALs which were visualized by echocardiography: dilatation and/or ectasia, aneurysm and giant aneurysms. We compared patients with fever and four or five of the principal criteria (complete KD, cKD) to the other patients (iKD). Compared with healthy controls a significant decrease in MPV and PDW (p < 0.001 and p < 0.05, respectively) and increase in WBC, platelet count, CRP and ESR (p all < 0.001) was noted in children with KD. There were no statistically differences in MPV and PDW between KD with CALs and KD without CALs (p > 0.05). However, MPV and PDW were significantly lower in patients with iKD than in group with cKD (p = 0.003, p = 0.014, respectively). It was first shown that patients with KD have lower MPV and PDW than control subjects. The diagnosis of iKD is challenging but can be supported by the presence of lower MPV and PDW.

  9. Increased frequency of immunoglobulin (Ig)A-secreting cells following Toll-like receptor (TLR)-9 engagement in patients with Kawasaki disease

    PubMed Central

    Giordani, L; Quaranta, M G; Marchesi, A; Straface, E; Pietraforte, D; Villani, A; Malorni, W; Del Principe, D; Viora, M

    2011-01-01

    Kawasaki disease (KD) is an acute vasculitis affecting mainly infants and children. Human B cells express Toll-like receptor (TLR)-9, whose natural ligands are unmethylated cytosine–guanine dinucleotide (CpG) motifs characteristic of bacterial DNA. The aim of this study was to clarify the pathogenesis of KD analysing the activation status of peripheral blood mononuclear cells (PBMC), focusing on B lymphocyte activation and functions. Ten patients and 10 age-matched healthy donors were recruited from the Bambino Gesù Hospital of Rome, Italy and enrolled into this study. We determined phenotype profile and immunoglobulin (Ig) production of PBMC from KD patients and age-matched controls. We found that the frequency of CD19+ B lymphocytes and CD19+/CD86+ activated B lymphocytes from KD patients during the acute phase before therapy was increased significantly. Moreover, B lymphocytes of acute-phase KD patients were more prone to CpG oligodeoxynucleotide (ODN) activation compared with the age-matched controls, as assessed by a significant increase of the number of IgA-secreting cells (SC). In the same patients we found a marked increase of IgM, IgG, interleukin (IL)-6 and tumour necrosis factor (TNF)-α production compared with the control group. In addition, in two convalescent KD patients, conventional treatment with intravenous immunoglobulin (IVIG) restored the normal frequency of CD19+ B cells, the number of IgA-, IgM- and IgG-SC and the production of IL-6 and TNF-α. Our findings indicate that the percentages of peripheral B lymphocytes of acute-phase KD patients are increased and are prone to bacterial activation in terms of increased numbers of IgA-SC and increased production of IL-6 and TNF-α inflammatory cytokines. Thus, our data support the hypothesis of an infectious triggering in KD. PMID:21175593

  10. Increased frequency of immunoglobulin (Ig)A-secreting cells following Toll-like receptor (TLR)-9 engagement in patients with Kawasaki disease.

    PubMed

    Giordani, L; Quaranta, M G; Marchesi, A; Straface, E; Pietraforte, D; Villani, A; Malorni, W; Del Principe, D; Viora, M

    2011-03-01

    Kawasaki disease (KD) is an acute vasculitis affecting mainly infants and children. Human B cells express Toll-like receptor (TLR)-9, whose natural ligands are unmethylated cytosine-guanine dinucleotide (CpG) motifs characteristic of bacterial DNA. The aim of this study was to clarify the pathogenesis of KD analysing the activation status of peripheral blood mononuclear cells (PBMC), focusing on B lymphocyte activation and functions. Ten patients and 10 age-matched healthy donors were recruited from the Bambino Gesù Hospital of Rome, Italy and enrolled into this study. We determined phenotype profile and immunoglobulin (Ig) production of PBMC from KD patients and age-matched controls. We found that the frequency of CD19(+) B lymphocytes and CD19(+) /CD86(+) activated B lymphocytes from KD patients during the acute phase before therapy was increased significantly. Moreover, B lymphocytes of acute-phase KD patients were more prone to CpG oligodeoxynucleotide (ODN) activation compared with the age-matched controls, as assessed by a significant increase of the number of IgA-secreting cells (SC). In the same patients we found a marked increase of IgM, IgG, interleukin (IL)-6 and tumour necrosis factor (TNF)-α production compared with the control group. In addition, in two convalescent KD patients, conventional treatment with intravenous immunoglobulin (IVIG) restored the normal frequency of CD19(+) B cells, the number of IgA-, IgM- and IgG-SC and the production of IL-6 and TNF-α. Our findings indicate that the percentages of peripheral B lymphocytes of acute-phase KD patients are increased and are prone to bacterial activation in terms of increased numbers of IgA-SC and increased production of IL-6 and TNF-α inflammatory cytokines. Thus, our data support the hypothesis of an infectious triggering in KD.

  11. Multicenter, Single-Arm, Phase IV Study of Combined Aspirin and High-Dose “IVIG-SN” Therapy for Pediatric Patients with Kawasaki Disease

    PubMed Central

    Yoon, Kyung Lim; Lee, Hae Yong; Yu, Jeong Jin; Lee, Jae Young; Han, Mi Young; Kim, Ki Yong

    2017-01-01

    Background and Objectives Intravenous immunoglobulin-SN (IVIG-SN) is a new human immunoglobulin product. Its safety is ensured by pathogen-elimination steps comprising solvent/detergent treatment and a nanofiltration process. This multicenter clinical study was designed to evaluate the efficacy and safety of combined aspirin and high-dose IVIG-SN therapy in pediatric patients with Kawasaki disease (KD). Subjects and Methods We evaluated coronary artery lesions (CALs) at 2 and 7 weeks after administering IVIG-SN; total fever duration; and variations in erythrocyte sedimentation rate, N-terminal pro B-type natriuretic peptide or B-type natriuretic peptide, and creatine kinase-myocardial band level before and after treatment with IVIG-SN (2 g/kg). Adverse events were monitored. Results Forty-five patients were enrolled, three of whom were excluded according to the exclusion criteria; the other 42 completed the study. The male:female ratio was 0.91:1, and the mean age was 29.11±17.23 months. The mean fever duration before IVIG-SN treatment was 6.45±1.30 days. Although most patients had complete KD (40 patients, 90.91%), four had atypical KD (9.09%). After IVIG-SN treatment, one patient (2.38%) had CALs, which was significantly lower than the incidence reported previously (15%) (p=0.022), but not significantly different from recent data (5%). There were no serious adverse events, though 28 patients (63.64%) had mild adverse events. Three adverse drug reactions occurred in 2 patients (eczema, anemia, and increased eosinophil count), all of which were transient. Conclusion IVIG-SN treatment in patients with KD was safe and effective. PMID:28382076

  12. Peripheral Endothelial (Dys)Function, Arterial Stiffness and Carotid Intima-Media Thickness in Patients after Kawasaki Disease: A Systematic Review and Meta-Analyses

    PubMed Central

    Dietz, Sanne M.; Tacke, Carline E. A.; Hutten, Barbara A.; Kuijpers, Taco W.

    2015-01-01

    Background Kawasaki disease (KD) is a systemic pediatric vasculitis. Its main complication is the development of coronary arterial aneurysms (CAA), causing an increased risk for ischemia and myocardial infarction. It is unclear whether KD patients, apart from the presence of CAA, have an increased cardiovascular disease (CVD) risk due to the previous systemic vasculitis. The aim of this study was to systematically review and meta-analyse the literature regarding surrogate markers for CVD risk in KD patients. Methods Medline and Embase were searched for articles comparing endothelial dysfunction (flow-mediated dilation, nitroglycerin-mediated dilation and peripheral arterial tonometry), vascular stiffness (stiffness index, pulse wave velocity) and carotid intima-media thickness (cIMT) between patients and controls. Two investigators assessed the articles for eligibility and evaluated quality. Results Thirty studies were included. For all outcomes, moderate to high heterogeneity between studies was found. Most studies reported a decreased flow-mediated dilation in the whole KD- and CAA-positive group compared to controls, while data on CAA-negative patients were conflicting. The stiffness index was increased in the majority of studies evaluating the whole KD- and CAA-positive group, but not in most studies on CAA-negative patients. Mean cIMT was neither significantly increased in the whole KD-group nor in the CAA-positive group nor in most studies studying CAA-negative patients. Studies measuring maximum cIMT were conflicting. Conclusion Literature suggests that surrogate markers for CVD risk in KD patients are increased in CAA-positive but not in CAA-negative patients. This may indicate that CAA-positive patients should be monitored for CVD in later life. The results of this review have to be interpreted with care due to substantial heterogeneity between studies and methodological limitations, as well as the lack of long-term follow-up studies. PMID:26161871

  13. Mycoplasma Infection as a cause of Persistent Fever after Intravenous Immunoglobulin Treatment of Patients with Kawasaki Disease: Frequency and Clinical Impact

    PubMed Central

    Yoon, Kyung Lim; Cha, Sung-Ho; Moon, Sung Kyoung; Jung, Hae Woon

    2017-01-01

    Background Mycoplasma is a common cause of respiratory infections and may require differential diagnosis from Kawasaki disease (KD). In this study, we investigated the frequency and clinical manifestations of mycoplasma infection in patients with KD. Materials and Methods Medical records of 375 in-patients admitted for treatment during the acute stage of KD, were collected, and reviewed retrospectively. Of these patients, 152 (40.5%) were also tested for recent mycoplasma infection. Patients with positive results (anti-mycoplasma IgM Ab >1:640 or cold agglutinin >1:64) were designated as the case group (n = 37, 24.3%) whereas those with negative results were designated as the control group (n = 115, 75.7%). Clinical findings of the two groups were compared. Results Patients in the case group were older than those in the control group (mean age, 48.2 ± 32.1 months, vs. 31.7 ± 21.7 months; P = 0.001). There were significant differences between the case and control groups in the changes in the extremities (78.3% vs. 57.4%, respectively; P = 0.031), and in fever duration (6.5 ± 2.5 days vs. 5.4 ± 1.5 days; P = 0.047). Of the 37 patients with positive mycoplasma testing, 7 (18.9%) had persistent fever even after the symptoms and signs of systemic inflammation (acute phase of KD) had been resolved. These patients were positive for mycoplasma infection during further evaluation of persistent fever, and all of them responded to macrolide antibiotics. Conclusions We found that mycoplasma infection is somewhat related to KD. When fever persists after resolution of the acute stage of KD, mycoplasma infection may be considered as a possible cause of fever in preschool-aged children. PMID:28271651

  14. Replication and meta-analysis of GWAS identified susceptibility loci in Kawasaki disease confirm the importance of B lymphoid tyrosine kinase (BLK) in disease susceptibility.

    PubMed

    Chang, Chia-Jung; Kuo, Ho-Chang; Chang, Jeng-Sheng; Lee, Jong-Keuk; Tsai, Fuu-Jen; Khor, Chiea Chuen; Chang, Li-Ching; Chen, Shih-Ping; Ko, Tai-Ming; Liu, Yi-Min; Chen, Ying-Ju; Hong, Young Mi; Jang, Gi Young; Hibberd, Martin L; Kuijpers, Taco; Burgner, David; Levin, Michael; Burns, Jane C; Davila, Sonia; Chen, Yuan-Tsong; Chen, Chien-Hsiun; Wu, Jer-Yuarn; Lee, Yi-Ching

    2013-01-01

    The BLK and CD40 loci have been associated with Kawasaki disease (KD) in two genome-wide association studies (GWAS) conducted in a Taiwanese population of Han Chinese ancestry (Taiwanese) and in Japanese cohorts. Here we build on these findings with replication studies of the BLK and CD40 loci in populations of Korean and European descent. The BLK region was significantly associated with KD susceptibility in both populations. Within the BLK gene the rs2736340-located linkage disequilibrium (LD ) comprising the promoter and first intron was strongly associated with KD, with the combined results of Asian studies including Taiwanese, Japanese, and Korean populations (2,539 KD patients and 7,021 controls) providing very compelling evidence of association (rs2736340, OR = 1.498, 1.354-1.657; P = 4.74×10(-31)). We determined the percentage of B cells present in the peripheral blood mononuclear cell (PBMC) population and the expression of BLK in the peripheral blood leukocytes (leukocytes) of KD patients during the acute and convalescent stages. The percentage of B cells in the PBMC population and the expression of BLK in leukocytes were induced in patients in the acute stage of KD. In B cell lines derived from KD patients, and in purified B cells from KD patients obtained during the acute stage, those with the risk allele of rs2736340 expressed significantly lower levels of BLK. These results suggest that peripheral B cells play a pathogenic role during the acute stage of KD. Decreased BLK expression in peripheral blood B cells may alter B cell function and predispose individuals to KD. These associative data suggest a role for B cells during acute KD. Understanding the functional implications may facilitate the development of B cell-mediated therapy for KD.

  15. Histo-blood group gene polymorphisms as potential genetic modifiers of the development of coronary artery lesions in patients with Kawasaki disease.

    PubMed

    Yamamura, K; Ihara, K; Ikeda, K; Nagata, H; Mizuno, Y; Hara, T

    2012-04-01

    Abnormal immunological responses to certain microbial agents may play a crucial role in the pathogenesis of Kawasaki disease (KD). The association studies between histo-blood group genes (Lewis and ABO blood types) and various types of infectious diseases or vasculopathy have been carried out based on the fact that glycosylated antigens could directly mediate microbial infections. We attempted to clarify the role of blood type antigens in the development of KD and coronary artery lesions in KD patients. The subjects included 164 KD patients enrolled from 1998 to 2003 (1st group), 232 patients from 2004 to 2009 (2nd group), and 223 healthy children and 118 patients with growth hormone deficiency as controls. The genotyping of the FUT2 and FUT3 genes, and ABO genotypes, was determined with the TaqMan SNP assay and allele-specific polymerase chain reaction. No significant differences were observed in the genotypes and allele frequencies of the FUT2 and FUT3 genes between the groups. The frequency of the BB blood genotype was significantly higher in KD patients with coronary artery lesions in the 1st and 2nd groups than in the controls (17% and 14% vs. 5%, P = 0.0020). This is the first report to investigate the roles of ABO and Lewis blood types in the development of KD, and in the formation of coronary artery lesions in KD patients. These data suggest that the ABO blood type may play a role in the development of coronary artery lesions in KD patients.

  16. Activated myeloid dendritic cells accumulate and co-localize with CD3+ T cells in coronary artery lesions in patients with Kawasaki disease.

    PubMed

    Yilmaz, Atilla; Rowley, Anne; Schulte, Danica J; Doherty, Terence M; Schröder, Nicolas W J; Fishbein, Michael C; Kalelkar, Mitra; Cicha, Iwona; Schubert, Katja; Daniel, Werner G; Garlichs, Christoph D; Arditi, Moshe

    2007-08-01

    Emerging evidence implicating the participation of dendritic cells (DCs) and T cells in various vascular inflammatory diseases such as giant cell arteritis, Takayasu's arteritis, and atherosclerosis led us to hypothesize that they might also participate in the pathogenesis of coronary arteritis in Kawasaki disease (KD). Coronary artery specimens from 4 patients with KD and 6 control patients were obtained. Immunohistochemical and computer-assisted histomorphometric analyses were performed to detect all myeloid DCs (S-100(+), fascin(+)), all plasmacytoid DCs (CD123(+)) as well as specific DC subsets (mature myeloid DCs [CD83(+)], myeloid [BDCA-1(+)] and plasmacytoid DC precursors [BDCA-2(+)]), T cells (CD3(+)), and all antigen-presenting cells (HLA-DR(+)). Co-localization of DCs with T cells was assessed using double immunostaining. Significantly more myeloid DCs at a precursor, immature or mature stage were found in coronary lesions of KD patients than in controls. Myeloid DC precursors were distributed equally in the intima and adventitia. Mature myeloid DCs were particularly abundant in the adventitia. There was a significant correlation between mature DCs and HLA-DR expression. Double immunostaining demonstrated frequent contacts between myeloid DCs and T cells in the outer media and adventitia. Plasmacytoid DC precursors were rarely found in the adventitia. In conclusion, coronary artery lesions of KD patients contain increased numbers of mature myeloid DCs with high HLA-DR expression and frequent T cell contacts detected immunohistochemically. This suggests that mature arterial myeloid DCs might be activating T cells in situ and may be a significant factor in the pathogenesis of coronary arteritis in KD.

  17. IL-1 signaling is critically required in stromal cells in Kawasaki Disease Vasculitis Mouse Model. Role of both IL-1α and IL-1β

    PubMed Central

    Lee, Youngho; Wakita, Daiko; Dagvadorj, Jargalsaikhan; Shimada, Kenichi; Chen, Shuang; Huang, Ganghua; Lehman, Thomas J.A.; Fishbein, Michael C.; Hoffman, Hal M.; Crother, Timothy R.; Arditi, Moshe

    2015-01-01

    Objective Kawasaki disease (KD) is the most common cause of acute vasculitis and acquired cardiac disease among US children. We have previously shown that both TLR2/MyD88 and IL-1β signaling are required for the Lactobacillus casei cell wall extract (LCWE)-induced KD vasculitis mouse model. The objectives of this study were to investigate the cellular origins of IL-1 production, the role of CD11c+ Dendritic Cells (DCs) and macrophages and the relative contribution of hematopoietic and stromal cells for IL-1 responsive cells, as well the MyD88 signaling in LCWE-induced KD mouse model of vasculitis. Approach and Results Using mouse knockout models as well as antibody depletion, we found that both IL-1α and IL-1β were required for LCWE-induced KD. Both DCs and macrophages were necessary and we found that MyD88 signaling was required in both hematopoietic and stromal cells. However, IL-1 response and signaling was critically required in non-endothelial stromal cells, but not hematopoietic cells. Conclusions Our results suggest that IL-1α and IL-1β as well as CD11c+ DCs and macrophages are essential for the development of KD vasculitis and coronary arteritis in this mouse model. Bone marrow chimera experiments suggest that MyD88 signaling is important in both hematopoietic and stromal cells, while IL-1 signaling and response is required only in stromal cells, but not in endothelial cells. Determining the role IL-1α and IL-1β and of specific cell types in the KD vasculitis mouse model may have important implications for the design of more targeted therapies and understanding of the molecular mechanisms of KD immunopathologies. PMID:26515418

  18. Discussions about the Nature of Science in a Course on the History of Astronomy. (Spanish Title: Discusiones sobre la Naturaleza de la Ciencia en un Curso sobre Historia de la Astronomía.) Discussões sobre a Natureza da Ciência em um Curso sobre a História da Astronomia

    NASA Astrophysics Data System (ADS)

    Pires de Andrade, Victória Flório; L'Astorina, Bruno

    2010-07-01

    There are an increasing number of researches in science education that affirm the importance of discussions on the "nature of science" in basic education level as well as in teacher training. The history of science applied to education is a way to contextualize epistemological discussions, allowing both the understanding of scientific content and learning about science concepts. We present some reasonably consensual definitions on the nature of science that have been widely discussed by the academic community. We show also some episodes in the history of astronomy which can lead to discussions involving some aspects of the nature of science, and how they can do it. Hay un número creciente de investigaciones en la enseñanza de las ciencias que afirman la importancia de debates sobre la "naturaleza de la ciencia" en la educación básica y formación del profesorado. La historia de la ciencia aplicada a la educación es una manera de contextualizar los debates de la epistemología, lo que permite tanto la comprensión de los contenidos científicos como el aprendizaje de conceptos científicos. En esto trabajo, presentamos algunas definiciones bastante consensuales sobre la naturaleza de la ciencia que han sido ampliamente discutidas por la comunidad académica y mostramos cómo algunos episodios en la historia de la astronomía pueden llevar a discusiones sobre algunos aspectos de la naturaleza de la ciencia. Há um número crescente de pesquisas na área de ensino de ciências que afirmam a importância de discussões sobre a "natureza da ciência" na educação básica e na formação de professores. A história da ciência aplicada ao ensino é uma maneira de contextualizar discussões epistemológicas, permitindo tanto a compreensão de conteúdos científicos quanto o aprendizado de noções sobre as ciências. Neste trabalho apresentamos algumas definições razoavelmente consensuais sobre a natureza da ciência que foram amplamente discutidas pela

  19. Reverse regulation of soluble receptor for advanced glycation end products and proinflammatory factor resistin and S100A12 in Kawasaki disease

    PubMed Central

    2012-01-01

    Introduction Kawasaki disease (KD), an acute febrile disease, characterized by systemic vasculitis, predominantly affects infants and children under 5 years of age. Coronary artery lesions (CALs) are its most critical complication, and the etiology remains unknown yet. In order to explore the value of resistin, S100A12 and soluble receptor for advanced glycation end products (sRAGE) in the pathophysiology of KD, we studied the serum levels of resistin, S100A12 and sRAGE in different stages of KD. Methods Serum levels of resistin, S100A12 and sRAGE were measured by enzyme-linked immunosorbent assay (ELISA) method in 15 healthy children and 40 KD patients at acute, afebrile and subacute stage. Results The resistin and S100A12 levels, including the ratio of resistin to sRAGE and S100A12 to sRAGE increased significantly in the acute stage, and decreased progressively in the afebrile and subacute stage. However, the sRAGE levels decreased significantly in the acute stage, and increased progressively in the afebrile and subacute stage. In the acute, afebrile and subacute stage, the resistin levels were higher in intravenous immunoglobulin (IVIG) non-responders (0.64 ± 0.30, 0.48 ± 0.35, 0.28 ± 0.19, × 102 ng/ml) than in IVIG responders (0.35 ± 0.24, 0.21 ± 0.19, 0.12 ± 0.05, × 102 ng/ml). In the acute and subacute stage, the S100A12 levels were higher in IVIG non-responders (7.92 ± 2.61, 4.98 ± 4.75, × 102 ng/ml) than in IVIG responders (5.05 ± 3.22, 2.35 ± 2.26, × 102 ng/ml). In the afebrile and subacute stage, the sRAGE levels were lower in IVIG non-responders (3.51 ± 2.64, 3.65 ± 3.27, × 102 pg/ml) than in IVIG responders (6.00 ± 2.78, 7.19 ± 2.88, × 102 pg/ml). The resistin levels were positively correlated with S100A12 levels. The sRAGE levels were negatively related with S100A12 and resistin levels. Conclusions Resistin, S100A12 and sRAGE are involved in the pathophysiology of KD. PMID:23171632

  20. Infliximab is the new kid on the block in Kawasaki disease: a single-centre study over 8 years from North India.

    PubMed

    Singh, Surjit; Sharma, Dhrubajyoti; Suri, Deepti; Gupta, Anju; Rawat, Amit; Rohit, Manoj Kumar

    2016-01-01

    This was a single-centre study to evaluate the usefulness of tumour necrosis factor-α (TNF-α) blocker, infliximab (IFX), for treatment of Kawasaki disease (KD) in children in Northern Indian. The study was carried out in the Paediatric Allergy-Immunology Unit, Advanced Paediatrics Centre, Post Graduate Institute of Medical Education and Research, Chandigarh. The study period was January 2007 to March 2015. Review of records of 23 children with KD who had received IFX was carried out. Median age at presentation was 2 years (range 2 months to 12 years). Indications for using IFX were intravenous immunoglobulin (IVIg) resistance (12/23 patients); severe KD especially when coronary artery abnormalities (CAAs) had developed in spite of IVIg (9/23 patients); retinal vasculitis in association with KD (1 patient) and economic reasons (1 patient). Twenty one (21/23) patients had received IVIg (2 g/kg) as first line therapy. A dose of IFX was 5-7 mg/kg given intravenously. Screening tests for tuberculosis (chest xray, Tuberculin test, QuantiFERON-TB Gold test) were not carried out prior to IFX infusion in any patient. Duration of follow-up was 0-20 months in 13 patients; 21-40 months in 5 patients and >40 months in 6 patients. Mean follow-up was 28.78±25.49 months, range 1-84 months. Eleven of 12 patients (11/12) who had IVIg resistance showed prompt resolution with IFX. Nineteen patients (19/23) in the cohort had CAAs. Of these, 12 showed improvement over mean follow-up of 28.78±25.49 months (range 1-84 months) and 4 showed normalisation. No adverse reactions were noted during infusion of IFX. On follow-up, none of these patients has developed tuberculosis or any other significant infection over a cummulative follow-up of 662 months. IFX can be considered as a useful adjunct in treatment of children with KD.

  1. Concepciones y concepciones alternativas de estudiantes universitarios/as de biologia y futuros maestros/as de Ciencia de escuela secundaria sobre la teoria de evolucion biologica por seleccion natural

    NASA Astrophysics Data System (ADS)

    Morales Ramos, Egda M.

    La teoria de evolucion biologica (TEB) por seleccion natural es uno de los conceptos unificadores mas importantes del curriculo de Biologia. En Puerto Rico se han hecho pocas investigaciones que abunden sobre las concepciones y concepciones alternativas (CA) que tienen los estudiantes universitarios/as de Biologia y los maestros/as de Ciencia del nivel secundario sobre esta teoria. La politica publica educativa actual establece mediante documentos normativos como los Estandares de contenido y Expectativas de grado del Programa de Ciencias [Puerto Rico Core Standards] la ensenanza de esta teoria. Sin embargo, no se encontraron preguntas sobre la seleccion natural en los ejercicios de practica provistos por el Departamento de Educacion para las pruebas estandarizadas lo cual puede influir para que no se ensene adecuadamente. Las preguntas de investigacion fueron 1. ¿Cuales son las concepciones y concepciones alternativas de estudiantes universitarios/as y de los futuros maestros y maestras de Ciencia sobre la TEB? 2. ¿Cuales conceptos que seleccionan los estudiantes universitarios/as y los futuros maestros y maestras de Ciencia sobre la TEB coinciden con lo aceptado como valido por la comunidad cientifica? y 3. ¿Como comparan las respuestas de la prueba original. v. Entendiendo el cambio biologico que mide concepciones y CA sobre la TEB por seleccion natural, con las de la traducida al idioma espanol? Se utilizo el metodo cuantitativo con un diseno de investigacion transversal por encuesta. La tecnica principal para recopilar los datos fue una prueba con doce items, que formo parte de un instrumento para el cual se recopilaron diversas fuentes de evidencia acerca de su validez. Las muestras estuvieron formadas por 69 estudiantes de Ciencias Naturales y por 16 estudiantes futuros maestros y maestras del nivel secundario de la UPR-RP. Se utilizaron estadisticas descriptivas, analisis de Ji cuadrado y se calcularon los coeficientes alfa de Cronbach y de Spearman

  2. Genetics Home Reference: Kawasaki disease

    MedlinePlus

    ... lips, lining of the mouth (oral mucosa), tongue, palms of the hands, and soles of the feet. ... 10 to 20 times more common in East Asia, including Japan, Korea, and Taiwan. Related Information What ...

  3. Superantigen involvement and susceptibility factors in Kawasaki disease: profiles of TCR Vβ2+ T cells and HLA-DRB1, TNF-α and ITPKC genes among Filipino patients.

    PubMed

    Natividad, Magdalena F; Torres-Villanueva, Celia Aurora T; Saloma, Cynthia P

    2013-01-01

    Superantigens and genetic factors may play roles in the etiology and susceptibility to Kawasaki disease (KD). To investigate these roles, percentages of TCR-Vβ2+ T cells were compared by flow cytometry using anti-Vβ2 monoclonal antibodies and genotyping was done on HLA-DRB1 exon 2, the -308 site of the TNF-α promoter region, and ITPKC SNP rs28493229 by polymerase chain reaction followed by direct sequencing. There were higher percentages of Vβ2+ T-cells in KD patients (9.5 ± 2.15%) compared to healthy controls (7.25 ± 1.48%) (P<0.05, Student's t-test, n=6-8/group). However, no polymorphisms were observed in exon 2 of HLA-DRB1 and in the -308 region of the TNF-α promoter. The ITPKC SNP rs28493229 G/C polymorphism was observed in 1 KD patient and 4 healthy controls. This study suggests that KD etiology may be associated with a superantigen and that HLA-DRB1 exon2, TNF-α -308 region and ITPKC SNP rs28493229 may not be associated with KD. This is the first study investigating Vβ2+ T cells and candidate genes involvement among Filipino KD patients.

  4. Superantigen involvement and susceptibility factors in Kawasaki disease: profiles of TCR Vβ2+ T cells and HLA-DRB1, TNF-α and ITPKC genes among Filipino patients

    PubMed Central

    Natividad, Magdalena F; Torres-Villanueva, Celia Aurora T; Saloma, Cynthia P

    2013-01-01

    Superantigens and genetic factors may play roles in the etiology and susceptibility to Kawasaki disease (KD). To investigate these roles, percentages of TCR-Vβ2+ T cells were compared by flow cytometry using anti-Vβ2 monoclonal antibodies and genotyping was done on HLA-DRB1 exon 2, the -308 site of the TNF-α promoter region, and ITPKC SNP rs28493229 by polymerase chain reaction followed by direct sequencing. There were higher percentages of Vβ2+ T-cells in KD patients (9.5 ± 2.15%) compared to healthy controls (7.25 ± 1.48%) (P<0.05, Student’s t-test, n=6-8/group). However, no polymorphisms were observed in exon 2 of HLA-DRB1 and in the -308 region of the TNF-α promoter. The ITPKC SNP rs28493229 G/C polymorphism was observed in 1 KD patient and 4 healthy controls. This study suggests that KD etiology may be associated with a superantigen and that HLA-DRB1 exon2, TNF-α -308 region and ITPKC SNP rs28493229 may not be associated with KD. This is the first study investigating Vβ2+ T cells and candidate genes involvement among Filipino KD patients. PMID:23565324

  5. Repeated stent thrombosis after DES implantation and localized hypersensitivity to a stent implanted in the distal portion of a coronary aneurysm thought to be a sequela of Kawasaki disease: autopsy report.

    PubMed

    Yokouchi, Yuki; Oharaseki, Toshiaki; Ihara, Fumie; Naoe, Shiro; Sugawara, Shigetada; Takahashi, Kei

    2010-02-01

    The patient was a 40-year-old Japanese woman. At 37 years of age she underwent stent implantation in LAD#7 for an acute myocardial infarction. Subsequently, coronary intervention was performed four times because of occlusion of the stent. Sudden death occurred at 40 years of age due to ventricular tachycardia. Clinically, the patient had had no history of collagen disease, anti-phospholipid antibody syndrome or coagulation disorder. The autopsy revealed only very mild atherosclerotic changes in the aorta and various other organs, but concentric thickening of the intima was observed in all three branches of the coronary arteries. Also, aneurysms accompanied by calcification were observed at each of LAD #6, LCx #11 and RCA #4PD. The stent was occluded with a thrombus, and the vascular walls showed infiltration by lymphocytes, plasma cells and numerous eosinophils. The eosinophil infiltration was confined to the site of the stent. It was surmised that the patient had experienced late stent thrombosis due to a hypersensitivity reaction to the DES on the basis of a development of a state of high susceptibility to thrombus formation because of a coronary aneurysm. The aneurysm was suspected of being a post-inflammatory change of Kawasaki disease.

  6. The Understanding of Astronomy Concepts by Students from Basic Education of a Public School. (Spanish Title: El Entendimiento de Conceptos de Aastronmía Por Los Alumnos de Educación Básica en Una Escuela Pública.) O Entendimento de Conceitos de Astronomia Por Alunos da Educação Básica: O Caso de Uma Escola Pública Brasileira

    NASA Astrophysics Data System (ADS)

    Iria Machado, Daniel; dos Santos, Carlos

    2011-07-01

    We present the results obtained in a research on the comprehension of basic astronomical concepts, in which 561 students from fifth grade middle school to third grade high school of a public school of the city of Foz do Iguaçu (Brazil) took part. A test with 20 multiple-choice questions was applied to indentify the most common conceptions expressed by the students. This test was elaborated based on the literature about misconceptions and covered the following topics: the day-night cycle; the time zones; the seasons of the year; the phases of the Moon; the movement of the Moon; the apparent movement of the Sun in the celestial sphere; the eclipses; the dimensions and distances in the Universe; the brightness of the stars and its observation from Earth. Though a small progress was verified in the proportion of scientifically acceptable answers when comparing the eighth grade of middle school to the fifth, and the third grade of high school to the first, there was an overall predominance of alternative conceptions regarding most of the explored subjects, which persisted up to the last year of secondary school. The comparison to data found in this research made in other socio-cultural contexts revealed, in many aspects, similar notions and difficulties revealed by the students. Se presentan los resultados de una investigación sobre la comprensión de conceptos astronómicos básicos, en la cual participaron 561 estudiantes que cursaban entre el quinto grado de la enseñanza primaria y el tercer año de la enseñanza secundaria de una escuela pública de la ciudad de Foz do Iguaçu (Brasil). Se utilizó un test de 20 preguntas de opción múltiple para identificar las concepciones más comunes expresadas por los estudiantes. Este instrumento de recolección de datos se desarrolló en base a la literatura sobre las concepciones alternativas y trató los siguientes temas: el ciclo día-noche, los husos horarios, las estaciones del año, las fases de la Luna, el

  7. Modelo de accesibilidad de conceptos matematicos aplicados en el curso de Astronomia Descriptiva para estudiantes con impedimentos visuales en la UPR

    NASA Astrophysics Data System (ADS)

    Isidro Villamizar, Gloria Maria

    Este estudio utiliza metodologia de investigacion cualitativa, con el proposito de describir, analizar y evaluar los procesos de diseno y desarrollo de un modelo de accesibilidad que consiste en estrategias de ensenanza de las matematicas para estudiantes con impedimentos visuales matriculados en el curso de Astronomia Descriptiva en la UPR. Se utilizaron las siguientes estrategias para recopilar la informacion, 1) reflexiones de la investigadora en el proceso de diseno y desarrollo de las lecciones adaptadas, que se registraron en un diario reflexivo. 2) entrevista semiestructurada luego de haber trabajado las lecciones de aprendizaje adaptadas con los participantes. 3) observaciones y notas de la investigadora del trabajo de los participantes. Para obtener la informacion de los participantes se obtuvo los permisos institucionales necesarios; se seleccionaron los participantes y se validaron los instrumentos; se realizo el desarrollo de las lecciones adaptadas con los participantes; y finalmente, se analizo la informacion obtenida. El diseno de las lecciones de aprendizaje adaptadas se hizo siguiendo las recomendaciones curriculares de los temas de matematicas aplicados en el curso de Astronomia Descriptiva realizado por la investigadora durante su semestre de internado. El testimonio de las voces de los participantes se obtuvo del proceso de desarrollo de las lecciones de aprendizaje adaptadas de temas seleccionados de conceptos matematicos requeridos en el curso de Astronomia Descriptiva y de la entrevista semiestructurada con los participantes, luego de haber trabajado las lecciones de aprendizaje. Para el desarrollo de las lecciones de aprendizaje, se utilizaron materiales tactiles adaptados, materiales tactiles disenados y materiales disponibles comercialmente. Los textos de las lecciones se imprimieron en tinta y en Braille. Se exhorta a disenar y desarrollar estrategias de ensenanza accesibles, considerando como recursos para evaluar su efectividad a

  8. Kawasaki Disease: Complications, Treatment and Prevention

    MedlinePlus

    ... Understand Your Risk for Congenital Heart Defects Symptoms & Diagnosis of Congenital Heart Defects Care & Treatment for Congenital Heart Defects Congenital Heart Defects Tools & Resources Heart Attack About Heart Attacks Warning Signs of a Heart ...

  9. Sobre el estado evolutivo de β Pictoris

    NASA Astrophysics Data System (ADS)

    Brunini, A.; Benvenuto, O. G.

    Desde el descubrimiento de fuertes excesos infrarrojos en β Pictoris, esta estrella ha sido muy estudiada y es considerada candidata a poseer un sistema planetario propio. β Pic está rodeada de un disco asimétrico de polvo que se observa de canto y que esta vacío a distancias <= 40 AU. Esto se considera una fuerte evidencia en favor de la presencia de (al menos) un planeta gigante. Recientemente se han observado líneas de material circunestelar que se han interpretado como consecuencia de la caída de objetos cometarios sobre esta estrella. Recientemente se ha utilizado la existencia del disco de polvo para atribuir una edad corta (pre - secuencia principal) a βPic. Sin embargo, la evaporación de estos cometas provee suficiente polvo como para explicar la presencia del disco observado sin necesidad de edades cortas. En este trabajo mostramos que la comparación entre la tasa de impactos cometarios estimada en el Sistema Solar para diferentes etapas de su evolución y los datos observados en β Pic indica edades avanzadas para β Pic. Esta estimación debe tomarse con cautela ya que depende de la estructura de los sistemas planetarios. Además mostramos que, desde el punto de vista de la evolución estelar y con las incertezas presentes en la luminosidad y la temperatura efectiva, existe un continuo de edades posible para β Pic. Sin embargo, empleando los datos provenientes de los flujos cometarios encontramos que una edad prolongada es consistente con ambos tratamientos.

  10. Evolution of the Astronomy Concepts Along Basic Education Cycle. (Breton Title: Evolução dos Conceitos de Astronomia no Decorrer da Educação Básica.) La Evolución de los Conceptos de Astronomía Durante la Educación Básica

    NASA Astrophysics Data System (ADS)

    Darroz, Luiz Marcelo; da Rosa, Cleci Werner; Becker da Rosa, Álvaro; Samudio Pèrez, Carlos Ariel

    2014-07-01

    a base para futuras discussões relacionadas à atuação dessas instâncias como meio de promover mudanças ativistas na estrutura curricular, proporcionando, mais efetivamente, a educação em astronomia no ensino básico. Si bien la astronomía es considerada una de las ciencias más antiguas de la humanidad y aunque la comprensión de sus conceptos haya traído enormes avances para la ciencia y, consecuentemente, para la sociedad, se observa que una parte significativa de personas se encuentran al margen de estos conocimientos. De acuerdo con los Parámetros Curriculares Nacionales para la Educación Básica, corresponde a la escuela la difusión de los conceptos científicamente correctos, entre ellos los relacionados al área de astronomía. Sobre esta cuestión, se presenta una investigación realizada con 140 estudiantes del noveno año de la enseñanza fundamental y con 120 estudiantes del tercer año de la enseñanza de nivel medio de cuatro escuelas de la región de Passo Fundo/RS. Se pretendía averiguar, por medio de un cuestionario compuesto de preguntas abiertas y de opción múltiple, el conocimiento de este grupo de alumnos sobre términos y fenómenos astronómicos básicos y, también, si el índice de aciertos crece en la medida que los alumnos avanzan a los diferentes y sucesivos años de la enseñanza fundamental y media. De modo general, los resultados demuestran que la enseñanza de astronomía en la educación básica muestra deficiencias. De los 20 asuntos investigados, 17 revelan índices de aciertos semejantes en las respuestas dadas por los estudiantes de nivel básico y medio, mostrando que muchas concepciones equivocadas permanecen a lo largo de la educación básica. Esto hace evidente que estos temas no son - o son poco - abordados durante esos niveles de escolarización. Así, puede concluirse que la discusión de los conceptos relacionados a la astronomía debe recibir un mayor énfasis en cuanto al abordaje de los diferentes

  11. Sobre os sistemas de referência celeste

    NASA Astrophysics Data System (ADS)

    Poppe, P. C. R.; Martin, V. A. F.

    2003-02-01

    Apresentamos neste trabalho, algumas discussões sobre os sistemas de referência utilizados em Astronomia. Claramente, não é possível esgotar todo este assunto num único texto, mas esperamos, contudo, que o presente material possa ser apreciado nos cursos de Introdução à Astronomia, que estão cada vez mais presentes nas atuais propostas curriculares das graduações de Física. As discussões pertinentes às "Bases de Referência Celeste", serão apresentadas em um outro trabalho.

  12. Lecturas sobre educacion de adultos en America latina (Readings on Adult Education in Latin America). Serie: Retablo de Papel 14.

    ERIC Educational Resources Information Center

    Latapi, Pablo, Comp.; Castillo, Alfonso, Comp.

    Twelve essays written in Spanish on the state of adult education in Latin America are presented. The essays are organized into three main sections, including: "Concepto y evolucion historica de la educacion de adultos" (Conception and Historical Evolution of Adult Education); "Aspectos particulares" (Specific Subjects); and…

  13. Avisos de salud sobre el PFOA y PFOS en el agua potable

    EPA Pesticide Factsheets

    La EPA estableció avisos de salud sobre el ácido perfluorooctanoico (PFOA) y el sulfonato de perfluorooctano (PFOS) para proporcionar información a los operadores de sistemas de agua potable y funcionarios estatales, tribales y locales sobre los riesgos de

  14. Basic Concepts of Astronomy: a Methodological Proposal. (Spanish Title: Conceptos Básicos de Astronomía: Una Propuesta Metodológica.) Conceitos Básicos de Astronomia: Uma Proposta Metodológica

    NASA Astrophysics Data System (ADS)

    Darroz, Luiz Marcelo; Heineck, Renato; Samudio Pérez, Carlos Ariel

    2011-12-01

    In this report, the development of a methodological proposal which approaches basic concepts of astronomy-grounded pedagogically on Meaningful Learning is described. The proposal, which consists of four meetings, was developed by teachers and academics of the course of Professor in Physics of the University of Passo Fundo (UPF), through an extension course to a group of highschool students of a public school of the town of Passo Fundo, RS. The work was focused into basic concepts of astronomy. The signs of Meaningful Learning have been obtained by means of research and evaluation tools that were applied at the end of each meeting. The evaluation of the proposal has been conducted by means of a final questionnaire which was answered by the participants at the end ofthe development of activities. By means of the results obtained from the different instruments, and the comments made by the participants during the activities and by means of the high rates of approval obtained in the final questionnaire, we think that the proposal reached the established goals and it may be repeated with the certainty of success. En este relato se describe una propuesta de desarrollo metodológico que aborda conceptos básicos de astronomía fundamentada pedagógicamente en el Aprendizaje Significativo. La propuesta que comprende cuatro encuentros, fue desarrollada por profesores y académicos del curso de Licenciatura en Física de la Universidad de Passo Fundo (UPF), a través de un curso de extensión para un grupo de Liceo del 6º año de una Escuela Pública de la ciudad de Passo Fundo/RS. El trabajo tuvo como eje principal los "conceptos básicos de astronomía". Los indicios de Aprendizaje Significativo fueron obtenidos por instrumentos de pesquisa y evaluación, siempre aplicados después de cada encuentro. La evaluación de la propuesta fue hecha a través de un cuestionario final y contestado por los participantes al finalizar el desarrollo de actividades. Por los resultados

  15. La utilizacion de los mapas conceptuales en la ensenanza de biologia y su efecto sobre el dominio del proceso de fotosintesis en los estudiantes universitarios

    NASA Astrophysics Data System (ADS)

    Gonzalez Rivera, Maria M.

    Se investigo el efecto de los mapas conceptuales sobre el dominio del proceso de fotosintesis en estudiantes universitarios. La investigacion utilizo dos estrategias: mapas conceptuales individuales y mapas conceptuales colaborativos, con el fin de investigar si existen diferencias significativas en el dominio del proceso de fotosintesis. El analisis de los datos incluyo aspectos cualitativos y cuantitativos. Se desprende del estudio que el 80% de los estudiantes describen la utilizacion de los mapas conceptuales como una experiencia beneficiosa. El 70% de los estudiantes expreso que los mapas conceptuales son utiles en el aprendizaje del proceso de fotosintesis y el 61% indico que facilitan la comprension de los conceptos. Los hallazgos mas importantes del analisis cuantitativo indican que los estudiantes que utilizaron los mapas conceptuales mejoraron significativamente su desempeno en la posprueba global. Se utilizo la prueba Mann-Whitney para investigar si existian diferencias significativas en la posprueba y preprueba global, el valor de W = 1945.0, para un valor p de 0.00, lo cual establece diferencias significativas. Para determinar si existian diferencias significativas entre la posprueba y preprueba del grupo individual, se realizo la prueba nuevamente. El valor de W correspondio a 490.5, que es significativo, con un valor p de 0.00. Se concluye que existen diferencias significativas entre la ejecucion de la posprueba y preprueba del grupo individual. Los datos proveen suficiente evidencia para sostener que los estudiantes que utilizaron la estrategia de mapas conceptuales individuales mejoraron el dominio del proceso de fotosintesis significativamente. Se realizo nuevamente la prueba para los resultados de posprueba y preprueba del grupo colaborativo. El valor de W correspondio a 446 con un valor p de 0.00. Se concluyo que existen diferencias significativas entre la ejecucion de la posprueba y preprueba del grupo colaborativo. Finalmente, se efectuo una

  16. Kawasaki disease and ENSO-driven wind circulation

    NASA Astrophysics Data System (ADS)

    Ballester, Joan; Burns, Jane C.; Cayan, Dan; Nakamura, Yosikazu; Uehara, Ritei; Rodó, Xavier

    2013-05-01

    disease (KD) is the most common cause of acquired heart disease in children worldwide. Recently, a climatological study suggested that KD may be triggered by a windborne agent traveling across the north Pacific through the westerly wind flow prevailing at midlatitudes. Here we use KD records to describe the association between enhanced disease activity on opposite sides of the basin and different phases of the El Niño-Southern Oscillation (ENSO) phenomenon, via the linkage to these tropospheric winds. Results show that years with higher-than-normal KD cases in Japan preferentially occur during either El Niño Modoki or La Niña conditions, while in San Diego during the mature phase of El Niño or La Niña events. Given that ENSO offers a degree of predictability at lead times of 6 months, these modulations suggest that seasonal predictions of KD could be used to alert clinicians to periods of increased disease activity.

  17. Obtenga más información sobre la etiqueta Safer Choice

    EPA Pesticide Factsheets

    Entérese más acerca del programa EPA Diseño para el medio ambiente, incluyendo información sobre su historia, proyectos anteriores y otros programas de la EPA que están relacionados con este programa.

  18. Some Research-Based Issues and Recommendations Expressed at the Seminario Internacional Sobre la Educacion Bilingue.

    ERIC Educational Resources Information Center

    Bernal, Ernesto M.

    The first Seminario Internacional Sobre la Educacion Bilingue (International Seminar on Bilingual Education), under the aegis of the National Association for Bilingual Education and the Mexican secretary for public education, brought together professionals from Canada, the United States, and Mexico in Oaxtepec, Mexico in November 1986 to share…

  19. A kinetic concepto of lipid transport in ruminants.

    PubMed

    Palmquist, D L

    1976-03-01

    Summarization of the literature shows a strong correlation between dietary fatty acid intake and total lipid concentration in plasma in lactating cows whereas total milk fat secreted is related to neither of these. In the process of plasma triglyceride removal, chylomicra and very low density lipoproteins are converted to low density lipoproteins. Limited kinetic data indicate that the fractional removal rates for chulomicra and very low density lipoproteins are rapid in lactating cows whereas fractional removal of low density lipoproteins is slower, resulting in accumulation of the latter in plasma. Under such conditions, low density lipoprotein concentrations of plasma would not be expected to reflect quantitatively the transfer of plasma triglyceride fatty acids to milk fat. Quantitative analysis or triglyceride fatty acid turnover in density less than 1.006 lipoproteins should delineate the role of plasma lipid transport in milk fat synthesis. High fat diets protected from rumen biohydrogenation have proven to be a useful approach in studying ruminant fat metabolism and may be used more extensively to elucidate the role of cholesterol in plasma lipid transport and the metabolism of essential fatty acids in ruminants.

  20. Conversation with Lara about the Earth and Land. (Spanish Title: Conversando con Lara sobre la Tierra y la Teirra.) Conversando com Lara sobre a Terra e a Terra

    NASA Astrophysics Data System (ADS)

    da Conceição Barbosa-Lima, Maria

    2010-12-01

    The present article is the analysis of a conversation between the author and Lara, a four-yearold- girl, enrolled in nursery school, while she makes a drawing of the Earth. It took place outside school environment and without any other person around to avoid interference during the interview. According to Ferreira & Silva (2004), a researcher can only comprehend a child's drawing, or form, by listening to him/her while he/she is creating it. Lara presented the traditional flat drawing, picturing the sky parallel to the ground, as reported by Nardi & Carvalho (1996). However, when asked to draw the World - term used by Butterworth et al. (2002), in order to avoid unnecessary confusion - she represented it by a circle, with herself on the surface. Her drawings led to the conclusion that such girl does not know yet the World in which she lives is the Earth, and probably because of that, within her age and consequent maturity, she accurately differentiates the concepts of land and Earth. El presente artículo analiza una entrevista libre, mientras una niña de 4 años y 4 meses, matriculada en el pregrado, dibuja la Tierra. Esta entrevista se realizó fuera del ambiente escolar y sin otra persona alrededor que pudiera interferir. De acuerdo con Ferreira Silva (2004), para quien investiga es posible conocer realmente lo que un niño o una niña pone en el papel a través de grafismos y/o dibujos si se lo escucha durante el proceso de creación de la escritura con imágenes. La niña, en este caso, representa la Tierra con el tradicional dibujo plano y el "cielo" paralelo al suelo, conforme analizaron Nardi & Carvalho (1996). Pero, cuando se Le solicita dibujar el "Mundo" - palabra empleada en un trabajo de Butterworth et al. (2002), con intención de no provocar "confusiones" innecesarias a sus sujetos de investigación- lo representa de forma circular, poniéndose sobre su superficie. Sus dibujos llevan a concluir que esta niña aún no tiene conocimiento que el mundo

  1. A Reappraising of Cosmography: the Interface Between Astronomical and Geographic Studies. (Breton Title: Releitura do Conceito de Cosmografia: a Interface Entre os Estudos Astronômicos e Geográficos.) Una Relectura del Concepto de Cosmografía: la Interfase Entre los Estudios Astronómicos y Geográficos

    NASA Astrophysics Data System (ADS)

    Azevedo Sobreira, Paulo Henrique

    2012-12-01

    The concept of "Cosmography" is in disuse since the 80s of the last century, but the astronomical themes previously discussed in the school subjects of Geography and Cosmography remain in current textbooks. The use of term "Cosmography" was rescued in this research, and the study of its re-signification prompted the appearance of the term Geographic Cosmography. The Geographic Cosmography is a field of studies of the Geography, whose set of knowledge and skills is predominantly scholar. It studies the interface between terrestrial and celestial knowledge, and assigns a geographic significance to them. It examines human and natural relationships with Sidereal Space and its consequences for society and nature. O conceito de "Cosmografia" está em desuso desde os anos 80 do século XX, mas os temas astronômicos anteriormente abordados nas disciplinas escolares de Cosmografia e de Geografia permanecem nos atuais livros didáticos. O uso do termo "Cosmografia" foi resgatado nesta pesquisa e o estudo de sua ressignificação proporcionou o surgimento do termo Cosmografia Geográfica. A Cosmografia Geográfica é um campo de estudos da Geografia, cujo conjunto de conhecimentos e habilidades é predominantemente escolar. Estuda a interface entre os conhecimentos terrestres e os celestes e lhes atribui significância geográfica. Analisa as relações humanas e naturais com o Espaço Sideral e suas consequências para a sociedade e a natureza.

    Aunque el concepto de "Cosmografía" no se usa desde la década de los '80 del siglo pasado, los temas astronómicos que se enseñaban anteriormente en las asignaturas escolares de Cosmografía y de Geografía permanecen en los actuales libros didácticos. El uso del término "Cosmografía" fue rescatado en esta investigación y el estudio de su resignificación proporcionó el surgimiento del término Cosmografía Geográfica. La Cosmografía Geográfica es un campo de estudio de la Geografía, donde

  2. O que bilíngues bimodais têm a nos dizer sobre desenvolvimento bilíngue?

    PubMed Central

    de Quadros, Ronice Müller; Lillo-Martin, Diane; Pichler, Deborah Chen

    2013-01-01

    O objetivo deste trabalho é apresentar o que as pesquisas que estamos desenvolvendo com crianças ouvintes, filhas de pais surdos, adquirindo Língua Brasileira de Sinais (Libras) e Português e Língua de Sinais Americana (ASL) e Inglês (Lillo-Martin et al. 2010) têm a nos dizer sobre desenvolvimento bilíngue. Os dados deste estudo fazem parte de um banco de dados de interações espontâneas coletadas longitudinalmente, alternando contextos de aquisição da Libras e do português como língua alvo, no Brasil e dados coletados longitudinalmente. nos mesmos contextos, de crianças adquirindo ASL e inglês1. Além disso, há também dados do estudo experimental com testes aplicados nos dois pares de línguas que se agregam ao presente estudo. Uma visão geral dos estudos desenvolvidos sobre a aquisição bilíngue bimodal por crianças ouvintes, filhas de pais surdos, será apresentada e, então, serão expostos alguns aspectos linguísticos deste tipo de aquisição, considerando as discussões sobre aquisição bilíngue a partir da pesquisa realizada. PMID:24431480

  3. University Students' Conceptions about the Moon Phases. (Spanish Title: Concepciones de Estudiantes Universitários sobre Las Fases de la Luna.) Concepções de Estudantes Universitários sobre as Fases da Lua

    NASA Astrophysics Data System (ADS)

    de Fátima Oliveira Saraiva, Maria; da Silveira, Fernando Lang; Steffani, Maria Helena

    2011-07-01

    In this article we describe the development of a multiple choice test about lunar phases and analyze the results of its application to ten groups of Physics students at the UFRGS. During the improvement of the test, we noticed that the percentage of right answers about some concepts increased significantly when associated with the reformulation of the question, emphasizing the importance of being careful to avoid incorrect answers generated by unclear questions, and not by ignorance on the matter. We confirm the results of other studies that show that students have great difficulty to relate the Moon's phase with its position in the sky at given time. On the other hand, our results suggest that, in general, students of Physics understand the phenomenon of lunar phases better than the average of university students. En estese artículo se describe la elaboración de una prueba de opción múltiple sobre las fases de la Luna y se analizan los resultados de su aplicación en diez grupos de estudiantes de Física de UFRGS. Durante el mejoramiento de la prueba observamos que el porcentaje de aciertos creció considerablemente cuando considerada una nueva redacción de la pregunta, destacando el cuidado que se debe tomar a fin de evitar respuestas incorrectas generadas por preguntas poco claras y no a causa de la ignorancia de los estudiantes sobre el tema. Confirmamos los resultados de otros estudios que las mayores dificultades de los alumnos sobre el tema fases de la Luna están en relacionar la fase de la Luna con su posición en el cielo en determinado momento. Por otra parte, nuestros resultados sugieren que, en general, los estudiantes de la Física comprenden mejor el fenómeno de las fases lunares que el promedio de los estudiantes universitarios. Neste artigo descrevemos a elaboração de um teste de múltipla escolha sobre as fases da Lua e analisamos os resultados de sua aplicação em dez grupos de estudantes de Física da UFRGS. Durante o aprimoramento do

  4. Tendências de teses e dissertações sobre ensino de astronomia no Brasil

    NASA Astrophysics Data System (ADS)

    Bretones, P. S.; Megid Neto, J.

    2003-08-01

    Neste trabalho são apresentados os resultados de uma pesquisa do tipo estado da arte sobre teses e dissertações defendidas no Brasil e relativas ao ensino de Astronomia. Teve por objetivo identificar essa produção e conhecer as principais tendências da pesquisa nesse campo. O procedimento inicial consistiu de um levantamento bibliográfico junto ao Centro de Documentação em Ensino de Ciências (CEDOC) da Faculdade de Educação da UNICAMP e ao Banco de Teses da CAPES disponível na Internet. Foram localizadas 13 dissertações de mestrado e 3 teses de doutorado, as quais foram estudadas em função dos seguintes aspectos: instituição, ano de defesa, nível escolar abrangido no estudo, foco temático do estudo e gênero de trabalho acadêmico. Deste conjunto de pesquisas, 13 (81,3%) delas foram defendidas a partir da segunda metade dos anos 90, indicando uma preocupação mais recente com temas relativos ao ensino de Astronomia no conjunto da produção acadêmica em programas de pós-graduação no Brasil. Verificou-se que 43,7% dos trabalhos foram produzidas na USP e 18,8% na UNICAMP. Quanto ao nível escolar abrangido nos estudos, predominaram os estudos direcionados ao Ensino Fundamental de 5a a 8a séries (62,5%). No que diz respeito ao foco temático das pesquisas, as principais tendências voltaram-se: 56,3% para Conteúdo e Método; 43,8% para Concepções do Professor; 37,5% para Currículo e Programas; 37,5% para Recursos Didáticos. Quanto ao gênero de trabalho acadêmico, verificou-se que 43,8% são de Pesquisa Experimental e 31,3% de Pesquisa de Análise de Conteúdo. Estudos de revisão bibliográfica como este visam colaborar com a divulgação ampla da produção acadêmica em determinada área, traçando algumas de suas tendências. Ao mesmo tempo possibilita, a partir de investigações decorrentes, apontar as suas contribuições para o ensino e sinalizar com necessidades a serem supridas por futuras pesquisas.

  5. Rigidity of critical points for a nonlocal Ohta–Kawasaki energy

    NASA Astrophysics Data System (ADS)

    Dipierro, Serena; Novaga, Matteo; Valdinoci, Enrico

    2017-04-01

    We investigate the shape of critical points for a free energy consisting of a nonlocal perimeter plus a nonlocal repulsive term. In particular, we prove that a volume-constrained critical point is necessarily a ball if its volume is sufficiently small with respect to its isodiametric ratio, thus extending a result previously known only for global minimizers. We also show that, at least in one-dimension, there exist critical points with arbitrarily small volume and large isodiametric ratio. This example shows that a constraint on the diameter is, in general, necessary to establish the radial symmetry of the critical points.

  6. A resolution designating January 26, 2011, as "National Kawasaki Disease Awareness Day".

    THOMAS, 112th Congress

    Sen. Webb, Jim [D-VA

    2011-01-26

    01/26/2011 Read twice and referred to the Committee on the Judiciary. (text of measure as introduced: CR S291) (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

  7. Giant right coronary artery aneurysm secondary to Kawasaki disease in child: a case report.

    PubMed

    Zhang, Shanshan; Liu, Geli; Yu, Tielian; Zhou, Guiming; Zheng, Rongxiu

    2015-01-01

    Coronary artery aneurysm or ectasia was reported in approximately 15% to 25% of the affected children, particularly in the proximal end of the main blood vessel and the left anterior descending part. Rare patients have been reported with aneurysm in the distal end of the right coronary artery. In this case report, we present a rare case with aneurysm in the distal end of the right coronary artery. Multi-slice computed tomography was performed for the coronary angiography. Aspirin (10 mg/kg body weight per day) and gamma globulin (2 kg/kg body weight) was administrated via intravenous injection. The patient is currently in a healthy status with a 12-month follow up.

  8. A Proposed Activity for a Meaningful Learning about the Moon Phases. (Breton Title: Uma Proposta de Atividade Para a Aprendizagem Significativa sobre as Fases da Lua.) Una Actividad Propuesta Para EL Aprendizaje Significativo Acerca de Las Fases de la Luna

    NASA Astrophysics Data System (ADS)

    Martins, Bruno Andrade; Langhi, Rodolfo

    2012-12-01

    This paper presents one of the concepts of Astronomy and its consequent failure in teaching this topic in high school, even when the official documents point out the necessity of Astronomy teaching at this school level. Among the spontaneous conceptions in Astronomy that high school students carry with them, even after the end of the school, we emphasized in this research the Moon phases. The development of different strategies in relation to traditional methods, aimed to teaching-learning process on this topic was considered in this study. These strategies were devised based on the reference frame of the Meaningful Learning, as elaborated by Ausubel. The proposals presented here include the active participation of students in experimental activities and other didactic activities, for their continuous evaluation during the process. These activities finished with a Comics elaboration about the Moon phases. Therefore, the objective of this paper is to present a proposal for differentiated teaching activity about Moon phases supported by the theoretical principles of Meaningful Learning at Physics classes. Este texto foca um dos conteúdos de Astronomia e a consequente falha no ensino deste tema no ensino médio, apesar de os documentos oficiais apresentarem a necessidade de se trabalhar a Astronomia neste nível de ensino. Dentre as concepções alternativas em Astronomia que os alunos do ensino médio carregam consigo, mesmo após o término dos estudos, destacamos, nesta pesquisa, o fenômeno das fases da Lua. O desenvolvimento de estratégias diferenciadas em relação ao ensino tradicional, visando o processo de ensino-aprendizagem sobre este tema, foi contemplado neste trabalho como um dos resultados obtidos sob a luz dos referenciais da aprendizagem significativa, fundamentados em Ausubel. Segundo a proposta aqui apresentada, a participação ativa dos alunos na execução de uma atividade experimental e outras atividades didáticas, que visam sua cont

  9. Reflexión bioética sobre el uso de organismos genéticamente modificados

    PubMed Central

    Yunta, Eduardo Rodríguez

    2011-01-01

    El presente artículo reflexiona desde los 4 principios de la bioética el uso comercial de organismos genéticamente modificados. Se cuestiona fundamentalmente la falta de transferencia de tecnología entre el mundo desarrollado y en desarrollo y el que el presente sistema de patentamiento de organismos vivos modificados fomenta intereses comerciales y no da debida importancia al desarrollo sostenible de la agricultura y ganadería en los países en desarrollo, donde más se necesita. Se reflexiona sobre la importancia que tiene evaluar los riesgos antes de introducirse en el mercado organismos genéticamente modificados y la necesidad de regulación en los países. PMID:21927675

  10. Human breast milk and adipokines--A potential role for the soluble leptin receptor (sOb-R) in the regulation of infant energy intake and development.

    PubMed

    Zepf, F D; Rao, P; Moore, J; Stewart, R; Ladino, Yuli Martinez; Hartmann, B T

    2016-01-01

    Concentrations of different adipokines in human breast milk are thought to be able to affect energy intake of the infant. Leptin is a hormone synthesized by adipose tissue and the human placenta and favors satiety. The availability of leptin in breast milk is influenced by epithelial cells of the mammary gland that are known to be able to produce leptin, as well as leptin from maternal circulation that is transported to the breast milk, and which can thus in turn reach neonatal blood after absorption. Research so far as mainly focused on leptin concentrations in breast milk. However, evidence suggests that in addition to leptin concentrations levels of the so-called soluble leptin receptor (sOb-R), the main high-affinity binding protein for leptin in humans, are necessary in order to calculate the free leptin index (FLI) and to assess function of the leptin axis. FLI is calculated from the ratio of leptin to the sOb-R, and serves as the main parameter for assessing function of the leptin axis throughout maturation and development. Here we propose that assessing sOb-R levels in addition to leptin concentrations in breast milk could serve as a valuable tool to investigate effects of the leptin axis in breast milk because sOb-R concentrations can impact available leptin levels, and which in turn can have significant implications for infant energy intake and related development.

  11. Educación sobre sexualidad y prevención del VIH: un diagnóstico para América Latina y el Caribe

    PubMed Central

    DeMaria, Lisa M.; Galárraga, Omar; Campero, Lourdes; Walker, Dilys M.

    2016-01-01

    RESUMEN Objetivo Mostrar, a través de un diagnóstico en América Latina y el Caribe, el panorama legislativo y curricular sobre sexualidad y prevención contra el virus de inmunodeficiencia humana (VIH) en el ámbito escolar, contrastándolo con los comportamientos sexuales reportados en encuestas demográficas y de salud. Métodos En mayo de 2008 se realizó, con el apoyo del Fondo de Población de las Naciones Unidas (UNFPA), una encuesta a informantes clave en 34 países de la Región. El cuestionario autoaplicado solicitó información sustantiva de agentes de las diferentes partes interesadas, como ministerios de educación y de salud, sobre los programas de prevención contra el VIH/Sida que se están aplicando en las escuelas. Resultados Respondieron a la encuesta 27 países que representan 95,5% de la población objetivo (6 a 18 años de edad). La mayoría de los países informó tener al menos un libro de texto o un capítulo específico para enseñar los temas de educación sobre sexualidad y prevención del VIH. En la escuela secundaria se cubren la mayor parte de los temas pertinentes relevantes para la educación sobre sexualidad, pero no todos. Por ejemplo, el problema de la discriminación por orientación o preferencia sexual no se incluye en los programas escolares. Conclusiones El material educativo sobre sexualidad debe ser revisado y actualizado periódicamente de modo que refleje los avances en los temas y en la forma de tratar los contenidos. En cada país el currículo debe abordar el tema del respeto a la diversidad sobre orientación, preferencia e identidad sexuales, y en particular el manejo apropiado de la educación para prevenir infecciones de transmisión sexual (ITS) en hombres que tienen sexo con hombres. Los esfuerzos de evaluación de la efectividad de los programas deben contemplar desenlaces tales como marcadores biológicos (incidencia y prevalencia de ITS y embarazo) y no únicamente indicadores de conocimiento y

  12. Tendências De Teses e Dissertações Sobre Educação em Astronomia No Brasil

    NASA Astrophysics Data System (ADS)

    Bretones, Paulo Sergio; Megid Neto, Jorge

    2005-07-01

    Apresentam-se os resultados de uma pesquisa do tipo estado da arte sobre teses e dissertações defendidas no Brasil e relativas ao ensino de Astronomia, com objetivo de identificar essa produção e conhecer as principais tendências da pesquisa nesse campo. Foram localizadas 13 dissertações de mestrado e 3 teses de doutorado, as quais foram estudadas em função dos seguintes aspectos: isntituição, ano de defesa, nível escolar abrangido no estudo, foco temático do estudo e gênero de trabalho acadêmico. Pretende-se assim colaborar com a divulgação ampla da produção acadêmica na área. Ao mesmo tempo o estudo possibilita, a partir de investigações decorrentes, apontar as contribuições dessa produção para o ensino e sinalizar com necessidades a serem supridas por futuras pesquisas.

  13. 76 FR 82039 - Receipt of Petition for Decision That Nonconforming 2000-2003 Kawasaki ZR750 Motorcycles Are...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-12-29

    ...) rear turn signal lamps. Standard No. 111 Rearview Mirrors: Inspection of all vehicles, and installation of U.S.-model mirrors on vehicles that are not already so equipped. Standard No. 120 Tire...

  14. 76 FR 14116 - Notice of Receipt of Petition for Decision That Nonconforming 2002 Kawasaki Ninja ZX-6R...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-03-15

    .... 30141(a)(1)(A), as set forth in 49 CFR part 593. Instead, the petitioner chose to establish import... to be adequate as set forth in 49 U.S.C part 30141(a)(1)(B). The petitioner contends that the 2002... Cars, 122 Motorcycle Brake Systems, and 205 Glazing Materials. The petitioner further contends that...

  15. Un analisis de la influencia de las fricciones de los campos no militares sobre las fricciones del campo militar presentes en la operacion de rescate de rehenes Chavin de Huantar (An Analysis of the Influence that Friction in Non-Military Fields of Action Had Upon Military Friction in the Hostage Rescue Operation Chavin de Huantar)

    DTIC Science & Technology

    2012-05-16

    necesidad inmediata de eliminar la incertidumbre de lo que ocurría al interior de la residencia, por lo que el empleo de micrófonos era vital, a fin...en rarísimas ocasiones se pronuncia sobre hechos políticos y que esta solicitud directa significó una tremenda presión internacional sobre un

  16. Concepto de ingeniería del Laboratorio Científico de Marte

    NASA Video Gallery

    El robot más grande y "más malo", y más nuevo para Marte es el Laboratorio Científico de Marte. Tiene el tamaño de un vehículo utilitario deportivo y está provisto de 10 instrumentos, nunca antes h...

  17. Anesthesia Basics

    MedlinePlus

    ... Loss Surgery? A Week of Healthy Breakfasts Shyness Anesthesia Basics KidsHealth > For Teens > Anesthesia Basics Print A ... español Conceptos básicos sobre la anestesia What Is Anesthesia? No doubt about it, getting an operation can ...

  18. Cambios históricos en el aporte terrígeno de la cuenca del Río de la Plata sobre la plataforma interna Uruguaya

    NASA Astrophysics Data System (ADS)

    Marrero, Analía; Tudurí, Adriana; Pérez, Laura; Cuña, Caroline; Muniz, Pablo; Lopes Figueira, Rubens; Michaelovitch de Mahiques, Michel; Alves de Lima Ferreira, Paulo; Pittauerová, Daniela; Hanebuth, Till; García Rodríguez, Felipe

    2014-12-01

    B 13813-4. También se determinó una mayor acumulación de sedimentos a través del tiempo en el cinturón de barro del Río de la Plata (plataforma continental adyacente), comparado con aquel registrado en la Barra del Indio (límite entre zona intermedia y externa del estuario). Estas diferencias podrían estar relacionadas con la influencia del Río de la Plata, el cual genera un ambiente altamente dinámico sobre la Barra del Indio y un ambiente más estable sobre el cinturón de barro en la plataforma continental.

  19. Desarrollo de la Escala sobre el Estigma Relacionado con el VIH/SIDA para Profesionales de la Salud mediante el uso de métodos mixtos123

    PubMed Central

    Varas-Díaz, Nelson; Neilands, Torsten B.; Guilamo-Ramos, Vincent; Cintrón Bou, Francheska N.

    2009-01-01

    El estigma relacionado con el VIH/SIDA continúa siendo un obstáculo para la prevención primaria y secundaria del VIH. Las consecuencias para las personas que viven con la enfermedad han sido muy documentadas y continúan siendo una gran preocupación para las personas que proveen servicios de salud y para aquellas que investigan el tema. Estas consecuencias son preocupantes cuando el estigma emana de profesionales de la salud porque se puede limitar el acceso a los servicios. Uno de los principales obstáculos para la investigación del estigma relacionado con el VIH en Puerto Rico es la falta de instrumentos cuantitativos para evaluar las manifestaciones del estigma entre profesionales de la salud. El objetivo principal de este estudio fue desarrollar y probar las propiedades psicométricas de una escala sobre el estigma relacionado con el VIH/SIDA culturalmente apropiada para personas que proveen servicios de salud puertorriqueñas y desarrollar una versión corta de la escala que pudiera usarse en escenarios clínicos con tiempo limitado. El instrumento desarrollado estuvo basado en evidencia cualitativa recopilada entre profesionales y estudiantes de profesiones de la salud puertorriqueños/as (n=80) y administrado a una muestra de 421 profesionales de la salud en adiestramiento. La escala contenía 12 dimensiones del estigma relacionado con el VIH/SIDA. El análisis cuantitativo corroboró 11 de ellas, teniendo como resultado un instrumento con validez y confiabilidad satisfactoria. Estas dimensiones, a su vez, fueron subcomponentes de un factor de estigma general superior. PMID:20333258

  20. How Is Vasculitis Treated?

    MedlinePlus

    ... Clinical Trials Links Related Topics Aneurysm Blood Tests Kawasaki Disease Raynaud's Smoking and Your Heart Send a link ... of vasculitis. For example, the standard treatment for Kawasaki disease is high-dose aspirin and immune globulin. Immune ...

  1. Cardiovascular Conditions of Childhood

    MedlinePlus

    ... diagnosed, treated and even cured in younger children. Kawasaki Disease This childhood illness can result in long-term ... complications. Learn the symptoms, diagnosis and treatment for Kawasaki disease. Cholesterol Raised cholesterol levels early in life may ...

  2. Investigaccion-accion en la sala de clases sobre las creencias de la cultura de la ciencia de un grupo de estudiantes universitarios y su relacion reciproca con el aprendizaje de las ciencias biologicas

    NASA Astrophysics Data System (ADS)

    Cordova-Santiago, Lizzette Astrid

    La investigacion---accion que se llevo a cabo en la sala de clases tenia como punto de partida las creencias de la cultura de la ciencia de un grupo de estudiantes universitarios para luego examinar sus implicaciones en el proceso de aprendizaje de las Ciencias Biologicas. ¿Que se supone que hagan las creencias en relacion con el aprendizaje? ¿En que consiste incorporar este aspecto a la practica educativa universitaria? Utilizando el modelo de Kemmis y McTaggart (1987) la investigacion-accion se planteo como un proceso dinamico en cuatro momentos en espiral constituidos por la planificacion, la accion, la observacion y la reflexion. Cada una de las fases tuvo una intencion retrospectiva y prospectiva formando una espiral de autorreflexion del conocimiento y la accion. Se llevaron a cabo audio grabaciones en clases y analisis de documentos. Ademas, la profesora-investigadora hizo un portafolio para reflexionar sobre las creencias de la cultura de la ciencia que tienen los estudiantes y las creencias del aprendizaje que tiene la profesora y sobre como la comprension de estos elementos ayudo a mejorar su practica educativa a traves del tiempo. Los resultados obtenidos apuntan a que las creencias de la cultura de la ciencia que tiene el grupo de estudiantes son diversas. Ellos si creen que la ciencia tiene una cultura la cual describieron como: complicada y desconocida que evoluciona constantemente, que es un conjunto de metodos, que es altamente tecnologica, que resuelve problemas de salud, ayuda a interpretar la realidad del mundo que los rodea y su origen y que existen unas intersecciones entre la ciencia y el poder. Sobre las creencias del proceso de aprendizaje de la profesora-investigadora, estas senalan que el modelaje de actores, la vision de la academia que tiene ella asi como la participacion y negociacion entre todos los involucrados en el proceso educativo, son factores que inciden en el proceso de aprendizaje.

  3. Modelos para la Unificacion de Conceptos, Metodos y Procedimientos Administrativos (Guidelines for Uniform Administrative Concepts, Methods, and Procedures).

    ERIC Educational Resources Information Center

    Serrano, Jorge A., Ed.

    These documents, discussed and approved during the first meeting of the university administrators affiliated with the Federation of Private Universities of Central America and Panama (FUPAC), seek to establish uniform administrative concepts, methods, and procedures, particularly with respect to budgetary matters. The documents define relevant…

  4. Distinción Empírica Entre Engagement y Trabajolismo en Enfermeras Hospitalarias de Japón: Efecto Sobre la Calidad del Sueño y el Desempeño Laboral

    PubMed Central

    Kubota, Kazumi; Shimazu, Akihito; Kawakami, Norito; Takahashi, Masaya; Nakata, Akinori; Schaufeli, Wilmar B.

    2016-01-01

    Objetivo El objetivo de este estudio es demostrar la distinción entre engagement y trabajolismo, estudiando su relación con la calidad del sueño y el desempeño laboral. Método Un total de 447 enfermeras de 3 hospitales de Japón fueron entrevistadas mediante un cuestionario autoadministrado que incluía la escala Utrecht (UWES, Utrecht Work Engagement Scale), la Escala de Adicción al Trabajo Holandesa (DUWAS, Dutch Workaholism Scale), preguntas sobre la calidad del sueño (7 ítems) con respecto a (1) dificultad para conciliar el sueño, (2) dificultad para mantener el sueño, (3) despertar temprano por la mañana, (4) dormirse o tomar siestas durante el día, (5) somnolencia diurna excesiva en el trabajo, (6) dificultad para despertarse por la mañana, y (7) despertar cansado en la mañana, y el Cuestionario sobre Salud y Desempeño (CSD) de la Organización Mundial de la Salud. Resultados Los modelos de ecuaciones estructurales demostraron que el engagement se relaciona positivamente con la calidad del sueño y el rendimiento laboral, mientras que el trabajolismo tiene una relación negativa con la calidad del sueño y el desempeño laboral. Conclusión Los resultados indican que el engagement y el trabajolismo son conceptualmente diferentes. El primero tiene una connotación positiva, mientras que el segundo se asocia de manera negativa al bienestar (buena calidad del sueño y buen rendimiento en el trabajo). PMID:26752805

  5. Coronary artery aneurysm presenting as a large mass encroaching on the right atrium in an adult patient with untreated Kawasaki disease

    PubMed Central

    Wassef, Nancy

    2015-01-01

    A 26-year-old man presented with atypical chest pain and dyspnoea for several days before admission that was not related to exertion. The patient had no medical history other than a long duration of fever and rash as a child, which resolved after a few weeks. The initial blood investigations showed thrombocytopenia and raised inflammatory markers with a negative troponin level. The patient had positive antiplatelet antibodies and was diagnosed with immune thrombocytopenic purpura (ITP). Echocardiography showed a large cystic mass at the right atrium. Coronary multislice CT showed a huge aneurysm at the origin of the right coronary artery (RCA), which was confirmed by coronary angiography. The patient received intravenous immunoglobulin and platelet transfusion before coronary artery bypass surgery and he had a successful resection of the aneurysm with a saphenous vein graft to distal RCA. The patient had a good recovery and was discharged home. PMID:25819826

  6. High School Student's Alternative Conceptions About the Phenomenon of the Formation of the Moon Phases. (Spanish Title: Concepciones Alternativas de Alumnos de Educación Media Sobre el Fenómeno de Formación de las Fases de La Luna.) Concepções Alternativas de Alunos do Ensino Médio Sobre o Fenômeno de Formação das Fases da Lua

    NASA Astrophysics Data System (ADS)

    Iachel, Gustavo; Langhi, Rodolfo; Fernandes Scalvi, Rosa Maria

    2008-07-01

    Forty students, at ages between 14 and 18 years old, from three schools in Bauru city, were questioned about their alternative conceptions concerning the phenomenon of formation of the Moon Phases. It was observed that some of the pupils confound the phenomenon of the formation of the Moon Phases with the phenomenon of the formation of the lunar eclipses, others are unaware of the reason of the phenomenon, they present incoherent alternative conceptions of the reality or incomplete conceptions. The results found here are aimed at the teachers of Elementary Education and can be used as a subsidy for future development of new pedagogical methods. Cuarenta estudiantes, con edad entre 14 y 18 años, pertenecientes a tres escuelas de la ciudad de Bauru, fueron cuestionados sobre sus concepciones alternativas acerca del fenómeno de la formación de las fases de la Luna. Fue observado que algunos alumnos confunden el fenómeno de formación de las fases de la Luna con el fenómeno de formación de los eclipses lunares, otros desconocen el motivo delfenómeno, presentan concepciones alternativas incoherentes con la realidad o bien presentan concepciones incompletas. Los resultados aquí encontrados son destinados a los profesores de la Enseñanza Básica y podrán ser usados como ayuda para el futuro desarrollo de nuevos métodos pedagógicos. Quarenta estudantes, com idades entre 14 e 18 anos, pertencentes a três escolas da cidade de Bauru, foram questionados sobre suas concepções alternativas acerca do fenômeno de formação das fases da Lua. Foi observado que alguns dos alunos confundem o fenômeno da formação das fases da Lua com o fenômeno da formação dos eclipses lunares, outros desconhecem o motivo do fenômeno, apresentam concepções alternativas incoerentes com a realidade ou então concepções incompletas. Os resultados aqui encontrados são destinados aos professores do Ensino Básico e poderão ser usados como subsídio parafuturo desenvolvimento de

  7. [The Spanish AIDS Study Group and Spanish National AIDS Plan (GESIDA/Secretaría del Plan Nacional sobre el Sida) recommendations for the treatment of tuberculosis in HIV-infected individuals (Updated January 2013)].

    PubMed

    Rivero, Antonio; Pulido, Federico; Caylá, Joan; Iribarren, José A; Miró, José M; Moreno, Santiago; Pérez-Camacho, Inés

    2013-12-01

    This consensus document was prepared by an expert panel of the Grupo de Estudio de Sida (GESIDA [Spanish AIDS Study Group]) and the Plan Nacional sobre el Sida (PNS [Spanish National AIDS Plan]). The document updates current guidelines on the treatment of tuberculosis (TB) in HIV-infected individuals contained in the guidelines on the treatment of opportunistic infections published by GESIDA and PNS in 2008. The document aims to facilitate the management and treatment of HIV-infected patients with TB in Spain, and includes specific sections and recommendations on the treatment of drug-sensitive TB, multidrug-resistant TB, and extensively drug-resistant TB, in this population. The consensus guidelines also make recommendations on the treatment of HIV-infected patients with TB in special situations, such as chronic liver disease, pregnancy, kidney failure, and transplantation. Recommendations are made on the timing and initial regimens of antiretroviral therapy in patients with TB, and on immune reconstitution syndrome in HIV-infected patients with TB who are receiving antiretroviral therapy. The document does not cover the diagnosis of TB, diagnosis/treatment of latent TB, or treatment of TB in children. The quality of the evidence was evaluated and the recommendations graded using the approach of the Grading of Recommendations Assessment, Development and Evaluation Working Group.

  8. Efectos combinados de la ampliación de la atención primaria de salud y de las transferencias condicionadas de dinero en efectivo sobre la mortalidad infantil en Brasil, 1998–2010*

    PubMed Central

    Guanais, Frederico C.

    2015-01-01

    Objetivos. Examiné los efectos combinados del acceso a la atención primaria mediante el Programa de Salud Familiar (PSF) y las transferencias condicionadas de dinero en efectivo del Programa Bolsa Familia (PBF) sobre la mortalidad infantil posneonatal (MIPN) en Brasil. Métodos. Empleé un análisis ecológico longitudinal usando datos en panel de 4 583 municipios brasileños de 1998 al 2010, con 54 253 observaciones en total. Estimé modelos de regresión de efectos fijos por mínimos cuadrados ordinarios, con la tasa de MIPN como la variable dependiente y el PSF, el PBF y sus interacciones como las principales variables independientes de interés. Resultados. La asociación de una mayor cobertura del PSF con una menor tasa de MIPN se volvió más fuerte conforme aumentaba la cobertura del PBF. En los promedios de todas las demás variables, cuando la cobertura de PBF era 25%, la MIPN predicha fue 5,24 (intervalo de confianza [IC] de 95% = 4,95, 5,53) para una cobertura del PSF de 0%, y de 3,54 (IC de 95% = 2,77, 4,31) para una cobertura del PSF de 100%. Cuando la cobertura del PBF era de 60%, la MIPN predicha fue 4,65 (IC de 95% = 4,36, 4,94) para una cobertura del PSF de 0%, y de 1,38 (IC de 95% = 0,88, 1,89) para una cobertura del PSF de 100%. Conclusiones. El efecto del PSF depende de la ampliación del PBF. Para las poblaciones empobrecidas y subatendidas, la combinación de intervenciones tanto del lado de la oferta como del lado de la demanda podría ser necesaria para mejorar los resultados en salud.

  9. Essays on Eclipses, Transits and Occultations as Teaching Tools in the Introductory Astronomy College Course. (Spanish Title: Ensayos sobre Eclipses, Tránsitos y Ocultaciones Como Herramientas de Enseñanza en el Curso Universitario Introductorio a la Astronomía.) Ensaios sobre Eclipses, Trânsitos e Ocultações Como Ferramentas de Ensino em um Curso Universitário Introdutório de Astromomia

    NASA Astrophysics Data System (ADS)

    Dcruz, Noella L.

    2014-07-01

    We occasionally include projects in our learner-centered introductory astronomy college course to enable non-science major students explore some astronomical concepts in more detail than otherwise. Such projects also highlight ongoing or upcoming astronomical events. We hope that students will feel more interested in astronomy through projects tied to astronomical events. In Spring 2012, we offered short essays focused on eclipses, transits and occultations to promote the rare transit of Venus that occurred on June 5th, 2012. We asked students to write two short essays from three that were offered. The essays contained descriptive and conceptual parts. They were meant to serve as teaching tools. 62% of 106 essays from 55 students earned A, B or C grades. 21% of 47 feedback survey respondents felt the essays increased their interest in astronomy. 49% of respondents felt that the essays were not educationally beneficial and should not be offered again. The most common written response to our survey indicated that students need more guidance and better preparation in writing successful essays. Since students found the conceptual parts of the essays difficult, in the future we will provide relevant activities prior to essay deadlines to help students create successful essays. Ocasionalmente, incluimos proyectos en nuestro curso de introducción a la astronomía universitario centrado en el alumno para permitir que los estudiantes de carreras no científicas exploren algunos conceptos astronómicos en más detalle que lo habitual. Estos proyectos también ponen en relevancia eventos astronómicos en curso o futuros. Esperamos que los estudiantes se sientan más interesados en la astronomía a través de proyectos vinculados a eventos astronómicos. En el período de primavera de 2012 (EUA), propusimos breves ensayos centrados en los eclipses, tránsitos y ocultaciones para promover el raro tránsito de Venus que se produjo el 5 de junio de 2012. Le pedimos a los

  10. High School Students' Previous Knowledge about the Stars. (Spanish Title: Conocimientos Previos de Estudiantes de Secundaria Acerca de Las Estrellas.) O Conhecimento Prévio de Alunos do Ensino Médio sobre as Estrelas

    NASA Astrophysics Data System (ADS)

    Iachel, Gustavo

    2011-12-01

    Based on the readings of articles related to Astronomy Education published in Brazil, it was noticed a lack of research on previous knowledge of students about the physical characteristics of stars, a fact that motivated us to develop this study. Previous knowledge of 125 students (approximated 15 years old) constituted the study sample; data was collected through written questionnaires (Appendix A) for analysis. From the content analysis of these responses it was possible to achieve some inferences as, for example, many students have some difficult to develop an explanatory model on the functioning of a star; there are few who say that the stars have a certain length of existence; some students have said that stars have tips; few recognize that a star is formed by a mass of gas; some previous knowledge come from purely visual aspects; furthermore, some students do not have the habit of observing nature in detail. We see this research as a reference in which science teachers can recognize the importance of previous knowledge for practice teaching and acquire resources for planning their lessons. De la lectura de artículos relacionados con la Educación en Astronomía publicados en el Brasil, se encuentra una falta de investigaciones acerca del conocimiento previo de los estudiantes sobre las características físicas de las estrellas, hecho que nos motivó a desarrollar este estudio. Los datos analizados se obtuvieron al aplicar un cuestionario a 125 estudiantes de secundaria, para posteriormente realizar un análisis de contenido, tal cuestionario se presenta en el Anexo A. Al realizar el análisis de contenido de las respuestas obtenidas, fue posible hacer algunas inferencias, como por ejemplo; muchos estudiantes tienen dificultades para desarrollar un modelo explicativo acerca del funcionamiento de una estrella; pocos estudiantes dicen que las estrellas tienen un cierto tiempo de vida; algunos estudiantes imaginan que las estrellas tienen puntas; pocos

  11. Investigaciones sobre cascadas electromagnéticas

    NASA Astrophysics Data System (ADS)

    Orellana, M.; Pellizza, L.; Romero, G. E.

    Results from the latest generations of telescopes have revealed a rich sky at high and very high energies with more than a thousand sources at GeV energies and more than a hundred sources at TeV energies. The sources are galactic and extra-galactic natural particle accelerators where emission processes operate efficiently at the gamma-ray domain. The development of pair-photon cascades within the source or along the line of sight may modify the originally emitted spectrum. This effect should be included in our interpretation of the observations in order to progress in the understanding of the physical origin of the emission. Through numerical simulations; we follow the three-dimensional trajectories of such cascades. I here report on the status of our investigations; with focus on the propagation through the background photon fields. FULL TEXT IN SPANISH

  12. Reflecting on Character (Reflexionando Sobre el Caracter).

    ERIC Educational Resources Information Center

    Candelaria, Cordelia

    1980-01-01

    Responding to the "Proyecto Resolana" article in the July/August 1980 issue of this journal, the article notes the heterogeneity of Hispanic Americans, the three main effects of the European conquest on people of the Western Hemisphere, and attempts to further define the character of Hispanic Americans. (SB)

  13. Reflecting on Culture. (Reflexionando Sobre la Cultura.)

    ERIC Educational Resources Information Center

    Irizarry, Estelle

    1980-01-01

    The article comments on two articles, previously published in the same journal, which address the relationship between the "little" cultural tradition of Chicanos, Cubans, and Puerto Ricans and the "great" tradition of Hispanic arts and letters. Notes similarities among these groups and calls for the banding together of…

  14. Reflecting on Language. (Reflexionando Sobre el Idioma.)

    ERIC Educational Resources Information Center

    Mazas, Jose Garcia

    1980-01-01

    Covering a 500-year span, this article traces the changes in and evolution of the Spanish language from its earliest written accounts in the eleventh century to the Spanish that was brought by the Conquistadores to the New World. (DS)

  15. Nota sobre "Neblina" (Notes on "Neblina")

    ERIC Educational Resources Information Center

    De Bruyne, Jacques

    1974-01-01

    Suggests that the Royal Spanish Academy change the definition of "neblina" in the next edition of the "Dictionary of the Spanish Language" to "niebla ligera" or "light fog," and cites literary usage in support. (Text is in Spanish.) (CK)

  16. Sobre | Smokefree Español

    Cancer.gov

    Espanol.smokefree.gov ofrece apoyo y recursos para norteamericanos que hablan español y quieren dejar de fumar. Este sitio en la red fue creada por la División de Investigación para el Control del Tabaco del Instituto Nacional del Cáncer.

  17. Urticarial Vasculitis

    MedlinePlus

    ... IgA Vasculitis (Henoch-Schönlein Purpura) Hypersensitivity Vasculitis (Leukocytoclastic) Kawasaki Disease Microscopic Polyangiitis Polyarteritis Nodosa Polymyalgia Rheumatica Takayasu’s Arteritis ...

  18. Learning about the Sky from the Environment: An Experience Working Along One Year with Students of Elementary Education. (Spanish Title: Aprendiendo sobre EL Cielo Desde el Entorno: Una Experiencia Trabajando Durante un Año Junto a Estudiantes del Primario.) Aprendendo sobre o Céu a Partir do Entorno: Uma Experiência de Trabalho ao Longo de um Ano com Alunos de Ensino Fundamental

    NASA Astrophysics Data System (ADS)

    Longhini, Marcos Daniel; Gomide, Hanny Angeles

    2014-12-01

    Research developed with 95 students of the 6th year of elementary education in a public school of Uberlândia, Minas Gerais. It was a continuous work from February to December 2013, which led the students to participate in activities of observation of the environment, specifically the sky, analyzing the changes occurred. We focused on the study of variations in temperature, rainfall, day length, variations in the size of the shadows and changes in the aspect of the Moon. Our focus of analysis targeted the discussion of the knowledge that these students had about the topics indicated and as they entered the stage during the implementation of the proposal. The results showed a limited perception that students have of their environment, however, lately expanded due to the undertaken activities, especially in relation to the Moon. Working with systematic measure procedures reveals the careful handling of data so that they become understandable to students, and working with the shadows points towards the students first understand how shadows are formed, and then apply this knowledge to Astronomy. Finally, we conclude that the lived process consisted of an initial step of a work that should be encouraged for the subsequent years of training of these students. Proyecto de investigación desarrollado con 95 alumnos del sexto año de primaria en una escuela pública de Uberlândia, Minas Gerais. Fue un trabajo continuo, de febrero a diciembre de 2013, que llevó a los estudiantes a participar en actividades de observación de su entorno, entre ellas, el cielo, analizando los cambios ocurridos. Nos centramos en el estudio de las variaciones en la temperatura, las precipitaciones, la duración del día, las variaciones en el tamaño de las sombras y los cambios en los aspectos de la Luna. Nuestro foco de análisis se centró en discutir el conocimiento que estos estudiantes tenían sobre los temas indicados al inicio y término de la propuesta. Los resultados mostraron una

  19. Estudio de los Esquemas Conceptuales y de los Perfiles de Unos Alumnos de Segundo de Bup en Relacion con el Concepto de Pendiente de Una Recta.

    ERIC Educational Resources Information Center

    Gimenez, Carmen Azcarate

    1992-01-01

    Presents a study to determine students' concept of slope carried out in three classes of the second form before introducing the notion of derivative. Discusses the meaning of conceptual framework and reviews literature on slope. Analyzes student responses to a questionnaire for mathematical content and expression and interprets the results. (MDH)

  20. "Cien Anos de Soledad" y el concepto de la "Caida Afortunada" ("One Hundred Years of Solitude" and the Concept of the "Fortunate Fall")

    ERIC Educational Resources Information Center

    Dario Carrillo, German; Stults, Barry

    1972-01-01

    Shows the influence of R.W.B. Lewis' work about the fall of Adam on the Marquez novel. Marquez' view coincides with Lewis' that Adam's fall should be considered not as a lapse from divine favor, but as an actual rise to the normal human level. (DS)

  1. El uso de las simulaciones educativas en la ensenanza de conceptos de ciencias y su importancia desde la perspectiva de los estudiantes candidatos a maestros

    NASA Astrophysics Data System (ADS)

    Crespo Ramos, Edwin O.

    This research was aimed at establishing the differences, if any, between traditional direct teaching and constructive teaching through the use of computer simulations and their effect on pre-service teachers. It's also intended to gain feedback on the users of these simulations as providers of constructive teaching and learning experiences. The experimental framework used a quantitative method with a descriptive focus. The research was guided by two hypothesis and five inquiries. The data was obtained from a group composed of twenty-nine students from a private Metropolitan University in Puerto Rico and elementary school pre-service teachers. They were divided into two sub-groups: experimental and control. Two means were used to collect data: tests and surveys. Quantitative data was analyzed through test "t" for paired samples and the non-parametric Wilcoxon test. The results of the pre and post tests do not provide enough evidence to conclude that using the simulations as learning tools was more effective than traditional teaching. However, the quantitative results obtained were not enough to reject or dismiss the hypothesis Ho1. On the other hand, an overall positive attitude towards these simulations was obtained from the surveys. The importance of including hands-on activities in daily lesson planning was proven and well recognized among practice teachers. After participating and working with these simulations, the practice teachers expressed being convinced that they would definitely use them as teaching tools in the classroom. Due to these results, hypothesis Ho2 was rejected. Evidence also proved that practice teachers need further professional development to improve their skills in the application of these simulations in the classroom environment. The majority of these practice teachers showed concern about not being instructed on important aspects of the use of simulation as part of their college education curriculum towards becoming teachers.

  2. Experiencias sobre el impacto del Programa de Formación en Ética de la Investigación Biomédica y Psicosocial en el ámbito de la salud mental y la investigación conductual.

    PubMed

    Barrios, Liliana Mondragón

    2012-01-01

    El propósito de este trabajo es presentar el impacto y la integración que los conocimientos adquiridos en el Programa Internacional de Formación en Ética de la Investigación Biomédica y Psicosocial de la Universidad de Chile han tenido en mi experiencia profesional, en el ámbito de la investigación psicosocial en un Instituto de Salud de México. Para este objetivo, expondré tres áreas en las cuales se ha podido evidenciar tal impacto: trabajo en los comités de ética, desarrollo de programas de académicos en bioética e investigación y publicación sobre ética y bioética. El motivo que me llevó a incursionar en el Programa fue que su enseñanza vincula la investigación psicosocial con la ética y la bioética, lo cual me permitió dirigir este tipo de reflexión hacia problemas como violencia, suicidio, adicciones, depresión y salud mental, y a nuevos campos como los estudios comunitarios, con poblaciones en riesgo o vulnerables, en los cuales las diversas implicaciones son difíciles de indagar.

  3. Experiencias sobre el impacto del Programa de Formación en Ética de la Investigación Biomédica y Psicosocial en el ámbito de la salud mental y la investigación conductual

    PubMed Central

    Barrios, Liliana Mondragón

    2012-01-01

    El propósito de este trabajo es presentar el impacto y la integración que los conocimientos adquiridos en el Programa Internacional de Formación en Ética de la Investigación Biomédica y Psicosocial de la Universidad de Chile han tenido en mi experiencia profesional, en el ámbito de la investigación psicosocial en un Instituto de Salud de México. Para este objetivo, expondré tres áreas en las cuales se ha podido evidenciar tal impacto: trabajo en los comités de ética, desarrollo de programas de académicos en bioética e investigación y publicación sobre ética y bioética. El motivo que me llevó a incursionar en el Programa fue que su enseñanza vincula la investigación psicosocial con la ética y la bioética, lo cual me permitió dirigir este tipo de reflexión hacia problemas como violencia, suicidio, adicciones, depresión y salud mental, y a nuevos campos como los estudios comunitarios, con poblaciones en riesgo o vulnerables, en los cuales las diversas implicaciones son difíciles de indagar. PMID:22754085

  4. The Meanings of Astronomical Observation: An Analysis on the Basis of Relationship with Knowledge. (Spanish Title: Los Sentidos de la Observación Astronómica: un Análisis sobre la Base de la Relación con el Saber.) Os Sentidos da Observação Astronômica: Uma Análise com Base na Relação com o Saber

    NASA Astrophysics Data System (ADS)

    Klein, Alberto Eduardo; de Mello Arruda, Sergio; Meneghello Passos, Marinez; Vinicius Domenes Zapparoli, Ferdinando

    2010-12-01

    This article presents results of a research which aimed to understand the meanings that people construct for astronomical observation. The subjects, students and school teachers, initially received some instruction on how to view astronomical objects through the telescope. After the observation was realized, they were interviewed. The data analysis allowed the creation of 12 categories, later interpreted on the basis of relationship with knowledge (relation to the world, with himself and with others), as presented by Bernard Charlot. Este artículo presenta los resultados de una investigación que tuvo como objetivo comprender los sentidos que las personas construyen para la observación astronómica. Los sujetos, los estudiantes y maestros de escuela, recibieron inicialmente algunas instrucciones sobre cómo ver los objetos astronómicos a través del telescopio. Al término de la observación, fueron entrevistados. El análisis de datos permitió la creación de 12 categorías que más tarde fueron interpretadas sobre la base de la relación con el conocimiento (relación con el mundo, consigo mismo y con los demás), tal como presentado por Bernard Charlot. Este artigo apresenta resultados de uma pesquisa que objetivou entender quais os sentidos que as pessoas constroem para a observação astronômica. Os sujeitos da pesquisa, estudantes e professores do ensino médio, receberam inicialmente alguma instrução sobre como visualizar os objetos astronômicos através do telescópio. Após a realização da observação, eles foram entrevistados. A análise dos dados permitiu a elaboração de 12 categorias que foram posteriormente interpretadas com base nas relações com o saber (relação com o mundo, consigo mesmo e com o outro), conforme apresentadas por Bernard Charlot.

  5. Mixed-Methods Study that Examines Nine Science Teachers' Perceptions of Slooh Robotic Telescope for Teaching Astronomy. (Breton Title: Métodos Mistos de Estudo que Examinam a Percepção de Nove Professores de Ciências sobre o Telescópio Robótico Slooh Para Ensino de Astronomia.) Métodos Mixtos de Estudio que Examinan la Percepcion de Nueve Profesores de Ciencias sobre EL Telescopio Robótico Slooh Para la Enseñanza de la Astronomía

    NASA Astrophysics Data System (ADS)

    Gershun, Daniel C.; Slater, Timothy F.; Berryhill, Katie J.

    2014-07-01

    Although previous studies show that robotic telescopes have the potential to enhance student learning, there is comparatively little research that focuses on teacher perceptions of this technology. This study investigates: "what is the academic merit of using SLOOH robotic telescopes to teach astronomy as perceived by science teachers?" Our sample consists of nine science teachers of students aged 13-18 years. Pre- and post-tests, interviews, and surveys were collected during two weeks of a summer online course about robotic telescopes. While pre and post-tests do not reveal a statistically significant gain in astronomy content knowledge, analysis of qualitative data reveals five themes which describe the most important aspects of using SLOOH according to participants: "Images," "Interface," "Classroom Application," "Instructor Impact," and "Logistical Issues." Analysis of these themes suggests that SLOOH can provide an interactive and social learning environment with capabilities to incorporate crossdisciplinary themes. Embora estudos anteriores mostram que os telescópios robóticos têm o potencial de melhorar a aprendizagem dos alunos, há relativamente pouca investigação focada nas percepções de professores a respeito desta tecnologia. Este estudo investiga: "qual é o mérito acadêmico da utilização de telescópios robóticos Slooh para ensinar astronomia, tal como percebido pelos professores de ciências?" Nossa amostra é composta por nove professores de ciências de estudantes com idades entre 13-18 anos pré e pós-testes, entrevistas, e levantamentos foram coletados durante duas semanas de um curso on-line de verão sobre telescópios robóticos. Enquanto os testes pré e pós não revelaram um ganho estatisticamente significativo no conhecimento do conteúdo astronomia, a análise de dados qualitativos revela cinco temas que descrevem os aspectos mais importantes da utilização Slooh de acordo aos participantes: "Imagens", "Interface", "Aplica

  6. Emotional Disturbance. Fact Sheet = Problemas Emocionales. Hojas Informativas Sobre Discapacidades.

    ERIC Educational Resources Information Center

    National Information Center for Children and Youth with Disabilities, Washington, DC.

    This fact sheet, written in both English and Spanish, provides a definition, information on incidence, typical characteristics, and educational implications of emotional disturbance. The definition is from the Individuals with Disabilities Education Act (IDEA) and incidence in 1999-2000 is reported as about 470,000 children and youth. Educational…

  7. Gobierno Federal Contina Investigacin Cientfica Sobre Erupciones en Flint

    EPA Pesticide Factsheets

    Flint, MICH. (24 de marzo, 2016) - Los expertos federales, del estado y del condado de salud y agua entienden que los residentes de Flint están preocupados por la calidad general de su agua-tanto como para beber y para bañarse. En este momento, el an

  8. Epilepsy. Fact Sheet = Epilepsia. Hojas Informativas Sobre Discapacidades.

    ERIC Educational Resources Information Center

    National Information Center for Children and Youth with Disabilities, Washington, DC.

    This fact sheet, written in both English and Spanish, provides a definition, information on incidence, typical characteristics, and educational implications of epilepsy. It notes that epilepsy is classified as "other health impaired" under the Individuals with Disabilities Education Act (IDEA) and that children with epilepsy or seizure disorders…

  9. [Parenting Information: Teenagers. Informacion Para los Padres: Sobre los Jovenes.

    ERIC Educational Resources Information Center

    Moreno, Steve

    These four booklets are devoted specifically to the concerns of parents and their teenage children and are part of a series of 22 booklets designed specifically to help parents understand their children and help them to learn. "Parents--Learn about Your Teenager" (booklet #6) explains the changes which occur during the teen years and the…

  10. Pensamientos Sobre (Thoughts on) Teaching English as a Second Language.

    ERIC Educational Resources Information Center

    Ulibarri, Mari-Luci

    This document presents ideas on various topics in teaching English as a second language. Some of the problems of English orthography and semantics are illustrated. The role of contrastive analysis is mentioned with Spanish-English illustrations. A list of second-language-acquisition principles and techniques is provided, and suggestions for…

  11. Primeros resultados sobre el estudio de oscilaciones no radiales

    NASA Astrophysics Data System (ADS)

    Córsico, A.; Benvenuto, O. G.

    En el Observatorio de La Plata se ha comenzado a elaborar un código de pulsaciones el cual resuelve el problema de las oscilaciones no radiales en el caso adiabático. Dicho código está basado en la técnica de diferencias finitas ampliamente usado en cálculos de estructura y evolución estelar. En este trabajo se presentan los primeros resultados encontrados aplicando el código mencionado al caso de una polítropa de índice n=3. Se presentan los valores de las autofrecuencias y las autofunciones para diferentes modos de pulsación de dicha configuración politrópica. En un futuro próximo, se aplicará este programa al estudio de las pulsaciones no radiales de estrellas enanas blancas.

  12. Sobre prestamos y clasificaciones linguisticas (Regarding Borrowing and Linguistic Classification).

    ERIC Educational Resources Information Center

    Key, Mary Ritchie

    1988-01-01

    This article explores the traditionally accepted etymologies of several lexical borrowings in the indigenous languages of the Americas within the framework of comparative linguistics and linguistic classification. The first section presents a general discussion of the problem of tracing lexical borrowings in this context. The section features a…

  13. Um Olhar sobre "Beleza Americana" (A Look at "American Beauty").

    ERIC Educational Resources Information Center

    Bissoto, Maria Luisa

    2000-01-01

    Discusses the film "American Beauty" in light of a reading of Karl Marx. Finds that the film shows the circularity which marks bourgeois society, even though the rhythm of industry and renovation of the society masks it. States that Marx praises the industry, invention, and innovation of the bourgeoisie. (BT)

  14. Reflexiones Sobre Investigacion Educacional (Reflections on Educational Research).

    ERIC Educational Resources Information Center

    Valle, Victor M.

    Educational research can serve to improve education in both developed and developing countries. It can be oriented toward increasing knowledge about the educational reality, generating theories, or confirming immediate educational political decisions. Educational research should be an interdisciplinary undertaking; this variety helps to unify…

  15. Questions about Brain Development = Preguntas sobre el desarrollo del cerebro.

    ERIC Educational Resources Information Center

    Southeastern Regional Vision for Education (SERVE), Tallahassee, FL.

    Noting that new research shows that a baby's earliest years shape how he or she grows later in life, this brochure, in English- and Spanish-language versions, provides brief answers to some important questions parents may have about their baby's brain. The questions answered are: (1) "Why is brain development a popular subject lately?; (2)…

  16. Posible influencia de exoplanetas sobre la actividad estelar

    NASA Astrophysics Data System (ADS)

    Flores, M.; Saffe, C.; Buccino, A. P.; Jaque Arancibia, M.; Mauas, P.

    2016-08-01

    The aim of this work is to analize the possible difference in the levels of activity showed by stars with and without planets. Several authors have suggested that stars with planets, in particular those with hot-Jupiter-like planets, have activity levels greater than those showed for stars of the same spectral class, but without planets. In this contribution we present the analysis of chromospheric activity indexes for 353 objects. To do so, we used high-resolution spectra () of F-, G-, and K-type stars taken with the High Accuracy Radial velocity Planet Searcher spectrograph, installed at the 3.6 m ESO telescope. We do no find a significant difference in the activity indexes of stars with and without planets.

  17. Estudios sobre Educacion, 2002 (Studies on Education, 2002).

    ERIC Educational Resources Information Center

    Estudios sobre Educacion, 2002

    2002-01-01

    This journal, which provides abstracts of its articles mostly in Spanish and a few in English, contains studies (estudios) and notes (notas) about educational issues, as well as relevant book reviews (recensiones). Studies in this issue (No. 3, 2002) are: "Unprotected Time of Early Adolescence and Intergenerational Relations: A New…

  18. Spina Bifida. Fact Sheet = Espina Bifida. Hojas Informativas Sobre Discapacidades.

    ERIC Educational Resources Information Center

    National Information Center for Children and Youth with Disabilities, Washington, DC.

    This fact sheet offers definitions of the three types of spina bifida (spina bifida occulta, meningocele, and myelomeningocele), outlines their incidence, describes characteristics of individuals with spina bifida, and reviews educational implications. The fact sheet discusses the need for many children with myelomeningocele to learn to manage…

  19. Iniciativa sobre Efectividad: Primeros frutos (Initiative about Effectiveness: First Fruits).

    ERIC Educational Resources Information Center

    Moreno Garcia, Teresa, Ed.

    2001-01-01

    This Spanish- and Portuguese-language bulletin is a follow-up to No. 15 (PS 030 558), which examined some Effectiveness Initiative (EI) projects. This issue presents some beginning efforts to reflect on what has been learned through EI and to draw conclusions. The articles cover the results of EI projects from such angles as their relations with…

  20. Estudios sobre Educacion, 2002 (Studies on Education, 2002).

    ERIC Educational Resources Information Center

    Estudios sobre Educacion, 2002

    2002-01-01

    This scholarly journal deals with the study of education. Articles in this second issue are: "La Vertebracion Academica de la Formacion Inicial del Profesorado" (The Academic Backbone of the Initial Formation of Teachers) (Jose M. Esteve); "Deficiencia Visual en el Nino" (Visual Deficiency in the Young Child) (Feli Peralta;…

  1. Los ojos de la NASA sobre la Tierra

    NASA Video Gallery

    La NASA cuenta con más de una decena de satélites que estudian la Tierra. Conoce la información que recaban los satélites, junto con Gilberto Colón, asistente especial del subdirector del Centro de...

  2. Mitral Valve Prolapse

    MedlinePlus

    ... Kawasaki Disease Long Q-T Syndrome Marfan Syndrome Metabolic Syndrome Mitral Valve Prolapse Myocardial Bridge Myocarditis Obstructive Sleep Apnea Pericarditis Peripheral Vascular Disease Rheumatic Fever Sick Sinus Syndrome Silent Ischemia Stroke Sudden ...

  3. Silent Ischemia

    MedlinePlus

    ... Kawasaki Disease Long Q-T Syndrome Marfan Syndrome Metabolic Syndrome Mitral Valve Prolapse Myocardial Bridge Myocarditis Obstructive Sleep Apnea Pericarditis Peripheral Vascular Disease Rheumatic Fever Sick Sinus Syndrome Stroke Sudden Cardiac Arrest ...

  4. Cardiac Syndrome X

    MedlinePlus

    ... Kawasaki Disease Long Q-T Syndrome Marfan Syndrome Metabolic Syndrome Mitral Valve Prolapse Myocardial Bridge Myocarditis Obstructive Sleep Apnea Pericarditis Peripheral Vascular Disease Rheumatic Fever Sick Sinus Syndrome Silent Ischemia Stroke Sudden ...

  5. Vulnerable Plaque

    MedlinePlus

    ... Kawasaki Disease Long Q-T Syndrome Marfan Syndrome Metabolic Syndrome Mitral Valve Prolapse Myocardial Bridge Myocarditis Obstructive Sleep Apnea Pericarditis Peripheral Vascular Disease Rheumatic Fever Sick Sinus Syndrome Silent Ischemia Stroke Sudden ...

  6. Myocardial Bridge

    MedlinePlus

    ... Kawasaki Disease Long Q-T Syndrome Marfan Syndrome Metabolic Syndrome Mitral Valve Prolapse Myocarditis Obstructive Sleep Apnea Pericarditis Peripheral Vascular Disease Rheumatic Fever Sick Sinus Syndrome Silent Ischemia Stroke Sudden ...

  7. Coronary Artery Anomalies

    MedlinePlus

    ... Kawasaki Disease Long Q-T Syndrome Marfan Syndrome Metabolic Syndrome Mitral Valve Prolapse Myocardial Bridge Myocarditis Obstructive Sleep Apnea Pericarditis Peripheral Vascular Disease Rheumatic Fever Sick Sinus Syndrome Silent Ischemia Stroke Sudden ...

  8. Carotid Artery Disease

    MedlinePlus

    ... Kawasaki Disease Long Q-T Syndrome Marfan Syndrome Metabolic Syndrome Mitral Valve Prolapse Myocardial Bridge Myocarditis Obstructive Sleep Apnea Pericarditis Peripheral Vascular Disease Rheumatic Fever Sick Sinus Syndrome Silent Ischemia Stroke Sudden ...

  9. Double Outlet Right Ventricle

    MedlinePlus

    ... Kawasaki Disease Long Q-T Syndrome Marfan Syndrome Metabolic Syndrome Mitral Valve Prolapse Myocardial Bridge Myocarditis Obstructive Sleep Apnea Pericarditis Peripheral Vascular Disease Rheumatic Fever Sick Sinus Syndrome Silent Ischemia Stroke Sudden ...

  10. Diastolic Dysfunction

    MedlinePlus

    ... Kawasaki Disease Long Q-T Syndrome Marfan Syndrome Metabolic Syndrome Mitral Valve Prolapse Myocardial Bridge Myocarditis Obstructive Sleep Apnea Pericarditis Peripheral Vascular Disease Rheumatic Fever Sick Sinus Syndrome Silent Ischemia Stroke Sudden ...

  11. Pericarditis

    MedlinePlus

    ... Kawasaki Disease Long Q-T Syndrome Marfan Syndrome Metabolic Syndrome Mitral Valve Prolapse Myocardial Bridge Myocarditis Obstructive Sleep Apnea Peripheral Vascular Disease Rheumatic Fever Sick Sinus Syndrome Silent Ischemia Stroke Sudden ...

  12. Pulmonary Atresia

    MedlinePlus

    ... Kawasaki Disease Long Q-T Syndrome Marfan Syndrome Metabolic Syndrome Mitral Valve Prolapse Myocardial Bridge Myocarditis Obstructive Sleep Apnea Pericarditis Peripheral Vascular Disease Rheumatic Fever Sick Sinus Syndrome Silent Ischemia Stroke Sudden ...

  13. Diseases of the Tricuspid Valve

    MedlinePlus

    ... Kawasaki Disease Long Q-T Syndrome Marfan Syndrome Metabolic Syndrome Mitral Valve Prolapse Myocardial Bridge Myocarditis Obstructive Sleep Apnea Pericarditis Peripheral Vascular Disease Rheumatic Fever Sick Sinus Syndrome Silent Ischemia Stroke Sudden ...

  14. Cyanosis

    MedlinePlus

    ... Kawasaki Disease Long Q-T Syndrome Marfan Syndrome Metabolic Syndrome Mitral Valve Prolapse Myocardial Bridge Myocarditis Obstructive Sleep Apnea Pericarditis Peripheral Vascular Disease Rheumatic Fever Sick Sinus Syndrome Silent Ischemia Stroke Sudden ...

  15. Reproductive Health in Men and Women With Vasculitis

    ClinicalTrials.gov

    2014-06-25

    Giant Cell Arteritis; Takayasu's Arteritis; Polyarteritis Nodosa; Wegener's Granulomatosis; Microscopic Polyangiitis; Churg-Strauss Syndrome; Behcet's Disease; Kawasaki Disease; Henoch-schoenlein Purpura; Vasculitis, Central Nervous System; Drug-induced Necrotizing Vasculitis

  16. 78 FR 42976 - Notice Pursuant to the National Cooperative Research and Production Act of 1993-International...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-07-18

    ...--International Electronics Manufacturing Initiative Notice is hereby given that, on June 13, 2013, pursuant to.... (``the Act''), International Electronics Manufacturing Initiative (``iNEMI'') has filed written... TE Connectivity, Kawasaki, Kanagawa, JAPAN. Cookson Electronics, South Plainfield, NJ, has...

  17. Acceptability of an Embodied Conversational Agent-based Computer Application for Hispanic Women

    PubMed Central

    Wells, Kristen J.; Vázquez-Otero, Coralia; Bredice, Marissa; Meade, Cathy D.; Chaet, Alexis; Rivera, Maria I.; Arroyo, Gloria; Proctor, Sara K.; Barnes, Laura E.

    2015-01-01

    There are few Spanish language interactive, technology-driven health education programs. Objectives of this feasibility study were to: 1) learn more about computer and technology usage among Hispanic women living in a rural community; and 2) evaluate acceptability of the concept of using an embodied conversational agent (ECA) computer application among this population. A survey about computer usage history and interest in computers was administered to a convenience sample of 26 women. A sample video prototype of a hospital discharge ECA was administered followed by questions to gauge opinion about the ECA. Data indicate women exhibited both a high level of computer experience and enthusiasm for the ECA. Feedback from community is essential to ensure equity in state of the art dissemination of health information. Hay algunos programas interactivos en español que usan la tecnología para educar sobre la salud. Los objetivos de este estudio fueron: 1) aprender más sobre el uso de computadoras y tecnología entre mujeres Hispanas que viven en comunidades rurales y 2) evaluar la aceptabilidad del concepto de usar un programa de computadora utilizando un agente de conversación encarnado (ECA) en esta población. Se administro una encuesta sobre el historial de uso y del interés de aprender sobre computadoras fue a 26 mujeres por muestreo de conveniencia. Un ejemplo del prototipo ECA en forma de video de un alta hospitalaria fue administrado y fue seguido por preguntas sobre la opinión que tenían del ECA. Los datos indican que las mujeres mostraron un alto nivel de experiencia con las computadoras y un alto nivel de entusiasmo sobre el ECA. La retroalimentación de la comunidad es esencial para asegurar equidad en la diseminación de información sobre la salud con tecnología de punta. PMID:26671558

  18. Memories of Astronomy Education in Brazil: Clippings from the Discourses of Interviewed Researchers on the Subject. (Spanish Title: Memorias de la Educación en Astronomía en Brasil: Recortes de los Discursos de Investigadores Entrevistados Acerca del Tema ) Memórias da Educação em Astronomia no Brasil: Recortes a Partir das Falas de Pesquisadores Entrevistados sobre o Tema

    NASA Astrophysics Data System (ADS)

    Iachel, Gustavo; Nardi, Roberto

    2014-12-01

    This paper presents a historical retrospective concerning data from a research in Astronomy Education in Brazil, after 1973. It was organized on the basis of the speech analysis of national researchers considered references in this field by their peers. Furthermore, it was elaborated on the basis of other studies from the areas of Science Education, Physics and Astronomy. This historical overview was developed in order to facilitate understanding of the contexts in which the interviewed researchers have developed professionally. Moreover, we attempted to recover the memory of the growing field of research in Astronomy Education in the country. We believe that the history presented can help those trying to understand the past in an attempt to resolve current and future demands. Se presenta en este artículo una retrospectiva histórica referente a datos provenientes de la investigación en enseñanza de la astronomía en el Brasil, después de 1973, organizada sobre la base del análisis de los discursos de los investigadores nacionales considerados referencias en este campo, y también en la lectura de las publicaciones en las áreas de Enseñanza de las Ciencias, Física y Astronomía. Este repaso histórico se desarrolló con el fin de facilitar la comprensión de los contextos en los que los investigadores entrevistados se han desarrollado profesionalmente. Por otra parte, se intentó recuperar la memoria del creciente campo de la investigación en Educación en Astronomía en el país. Creemos que el relato presentado puede contribuir a quien trata de comprender el pasado, en un intento de resolver las demandas actuales y futuras. Relata-se neste artigo uma retrospectiva histórica referente a dados provenientes de pesquisa em Educação em Astronomia no país, pós 1973, organizada com base na análise das falas de pesquisadores considerados referências nacionais nesse campo, como também na leitura de publicações das áreas de ensino de Ciências, F

  19. [Functional connectivity and complex networks in focal epilepsy. Pathophysiology and therapeutic implications].

    PubMed

    Pastor, Jesús; Sola, Rafael G; Vega-Zelaya, Lorena; Garnes, Óscar; Ortega, Guillermo J

    2014-05-01

    Introduccion. El modelo tradicional de cirugia de la epilepsia focal consiste en la localizacion y reseccion de la zona epileptogena. Sin embargo, una minoria significativa de pacientes epilepticos sigue teniendo crisis tras la reseccion, lo que muestra el nivel de conocimiento incompleto que actualmente se tiene sobre esta materia. Objetivo. Introducir algunos conceptos de conectividad funcional y redes complejas y su aplicacion al estudio de registros neurofisiologicos de pacientes con epilepsia focal farmacorresistente, principalmente del lobulo temporal. Desarrollo. Con el objeto de entender con plenitud los nuevos desarrollos en el area de redes complejas y sus aplicaciones al estudio de la epilepsia, se revisaran los conceptos fundamentales de la metodologia de redes complejas, sincronizacion y conectividad funcional. Asimismo, se revisaran algunos de los trabajos mas recientes en los que se analizan registros neurofisiologicos y resonancias funcionales de pacientes con epilepsia focal bajo esta nueva perspectiva. Conclusiones. Una vision mas amplia en la perspectiva para el entendimiento de la epilepsia focal, como la tratada en este trabajo, permitira tambien plantear nuevas alternativas al tratamiento quirurgico de la epilepsia focal, tanto con el desarrollo de nuevos metodos no invasivos como con la mejora y optimizacion de algunos de los metodos invasivos ya existentes.

  20. [Cultural domain of the causes of diabetes in three generations of popular stratum in Guadalajara, Mexico].

    PubMed

    García de Alba-García, Javier E; Salcedo-Rocha, Ana L; Hayes Bautista, David; Milke Najar, María Eugenia

    2015-01-01

    Introducción: la creciente prevalencia de diabetes se debe afrontar de diversas maneras. Determinar la transmisión generacional del conocimiento cultural ofrece pautas para la prevención y el control de la enfermedad. Al identificar y comparar las estructuras semánticas del conocimiento compartido, sentamos las bases de una atención culturalmente comprensiva. El objetivo es caracterizar los principales elementos relacionados con el dominio cultural sobre las causas de la diabetes en una población de abuelos, padres e hijos pertenecientes a estratos populares en Guadalajara, México. Métodos: estudio antropológico cognitivo en 104 personas seleccionadas al azar en el sector Libertad de Guadalajara, Jalisco, México. Se aplicaron técnicas de listas libres para obtener el modelo semántico y el promedio de conocimiento cultural sobre las causas del padecimiento por análisis de consenso. Resultados: los grupos estudiados se dividieron por generación de abuelos, padres e hijos. Se evidenció transmisión intergeneracional al presentar el conocimiento cultural una estructura semántica básica y un consenso significativo. Conclusiones: la estructura semántica sobre causas de la diabetes incluye como elementos: a) las emociones, como dimensión tradicional; b) conductas relacionadas al estilo de vida, como dimensión cotidiana; c) algunos conceptos biomédicos, como dimensión emergente.

  1. LA BIOÉTICA COMO QUEHACER FILOSÓFICO

    PubMed Central

    Ferrer, Jorge José

    2009-01-01

    El artículo examina el estatuto epistemológico de la bioética como disciplina académica. El autor sostiene que el estatuto epistemológico de un discurso lo determina la pregunta fundamental que se plantea y la respuesta que se busca, focos integradores del discurso. En el caso de la bioética, la pregunta fundamental es de índole moral. La bioética es pues una disciplina ética que tiene su hogar epistemológico en la filosofía. El autor también defiende el concepto de “éticas aplicadas”. Sugiere finalmente que el método de la bioética, sobre todo la que se hace desde nuestras latitudes, debería adoptar el círculo hermenéutico como metodología para su filosofar. PMID:20463860

  2. [Colors, tastes, numbers?: synesthesia in a Spanish sample].

    PubMed

    Melero, Helena; Peña-Melián, Ángel; Ríos-Lago, Marcos

    2015-02-16

    Introduccion. La sinestesia es un fenomeno neurologico caracterizado por la activacion simultanea de dos sistemas (o atributos) sensoriales, uno de los cuales no ha sido estimulado directamente. Dicha activacion se produce de una forma involuntaria, automatica y consistente a lo largo del tiempo. Objetivo. Estimar la frecuencia relativa de las diferentes modalidades de sinestesia en una muestra española. Sujetos y metodos. Estudio realizado en contextos educativos (55,04%), laborales (20,54%) y digitales (24,4%) mediante el cuestionario de sinestesia de la Fundacion Artecitta. Resultados. El analisis de las respuestas de 803 participantes sugiere que un 13,95% de la muestra estudiada experimenta alguna sinestesia. El analisis de la frecuencia relativa de las diferentes modalidades muestra que la mas frecuente es la que relaciona conceptos temporales con configuraciones espaciales (44,6%). Un 33,9% percibe colores cuando escucha sonidos o musica, un 25,9% asocia colores a los conceptos temporales, un 20,5% asigna genero o personalidad a las letras y numeros, un 10,7% experimenta la modalidad grafema-color, y un 5,4% siente un sabor especifico en su boca al escuchar palabras. Conclusiones. Los datos sugieren que la presencia de sinestesia en la muestra española estudiada es elevada y que la investigacion sobre el fenomeno y sus diferentes modalidades ha de ser abordada basandose en el conocimiento actual sobre su variabilidad fenomenologica y sus bases geneticas y neurofisiologicas. Asimismo, los resultados obtenidos son utiles para ajustar los items del cuestionario y aumentar su capacidad discriminativa.

  3. ¿Origen dinámico del polvo sobre la superficie de Iapetus?

    NASA Astrophysics Data System (ADS)

    Leiva, A. M.; Briozzo, C. B.

    We implement the three-dimensional Circular Restricted Three Body Prob- lem for low energy particles entering the Saturn­Iapetus system from the recently discovered dust ring. The distribution of impacts with the surface of Iapetus so obtained shows features resembling that of the dark regions observed in this satellite. FULL TEXT IN SPANISH

  4. Informe sobre el proyecto contrastivo hispano-hungaro (Report on the Spanish-Hungarian Contrastive Project)

    ERIC Educational Resources Information Center

    Fulei-Szanto, Andres

    1974-01-01

    A description of a contrastive linguistics project in Hungary aiming to augment linguistic theories in the Spanish language and propound theories for scientific and artistic translation. (Text is in Spanish.) (CK)

  5. Consideraciones sobre la Ansiedad en la Primera Infancia (Considerations Concerning Anxiety in Early Infancy).

    ERIC Educational Resources Information Center

    Muller, Elsa

    The results of an experience obtained while working with children in the early stages of infancy are presented. They are basically observations taken of a child's reaction to sudden changes, particularly separation from its mother. Anxiety was observed in these infants in diverse circumstances; in some cases it was at a normal level and in others…

  6. Cultural Diversity Awareness Inventory = Inventario Sobre el Reconocimiento de Diversas Culturas.

    ERIC Educational Resources Information Center

    Henry, Gertrude B.

    This booklet features a checklist designed to help persons who are involved in providing direct services to culturally diverse, young special needs children to assess their attitudes, beliefs, and behavior toward these children. The booklet also contains suggestions and lists of print, film, and filmstrip resources for developing a school program…

  7. Ahorre Energia: Consejos sobre el ahorro de dinero y energia en el hogar (Book)

    SciTech Connect

    Not Available

    2014-09-01

    Learn how to save money with Energy Saver: Tips on Saving Money & Energy at Home, from the U.S. Department of Energy. The Energy Saver guide will help you reduce your monthly energy costs and live more efficiently. This guide takes you through the systems and appliances that consume the most energy in your home, and provides solutions to cut costs for you while saving the environment. The Energy Saver guide also includes transportation tips to help you save money at the pump.

  8. Mental Retardation. Fact Sheet = El Retraso Mental. Hojas Informativas Sobre Discapacidades.

    ERIC Educational Resources Information Center

    National Information Center for Children and Youth with Disabilities, Washington, DC.

    This fact sheet on mental retardation is written in both English and Spanish. It begins with a vignette of a 15-year-old boy with mental retardation. Mental retardation is briefly explained as are some causes of mental retardation. It notes that a diagnosis of mental retardation looks at two things: first, the ability of a person's brain to learn,…

  9. Sobre Algumas Tecnicas de Perturbacao Utilizadas no Problema Ressonante 3/1

    NASA Astrophysics Data System (ADS)

    Balthazar, J. M.; Sagnier, J. L.; Ferraz Mello, S.; Koiller, J.; Yokoyama, T.

    1987-05-01

    ABSTRACT. This work concerns with the study of a particular 3/1 resonant problem for which we have determined formal solutions according to the model belonging to the domain of the Restricted Elliptic Problem of Three Bodies. Key & : ASTEROIDS

  10. Iniciativa sobre Efectividad: Un entorno para el aprendizaje (Initiative about Effectiveness: An Environment for Learning).

    ERIC Educational Resources Information Center

    Moreno Garcia, Teresa, Ed.

    2000-01-01

    This Spanish- and Portuguese-language bulletin presents articles focusing on the Effectiveness Initiative (EI), a project of the Bernard van Leer Foundation for making a qualitative analysis of those elements of the programs of Early Childhood Development (ECD) that benefit the participants and their communities and cultures. The first article…

  11. Modelo analítico del efecto de PRS sobre satélites GPS

    NASA Astrophysics Data System (ADS)

    Meza, A.; Brunini, C.; Usandivaras, J. C.

    El sistema GPS (Global Position System) es, hoy en día, la herramienta de navegación y posicionamiento más potente y lo será sin duda en la próxima década. Gran parte de su valiosa utilidad se debe a la alta precisión que permite lograr y ésta, a su vez, depende, entre otras causas, de la precisión con que se conocen las órbitas de los satélites. La presión de radiación solar (PRS) fija el límite de la precisión con que pueden calcularse en la actualidad las efemérides satelitarias. El objetivo de este trabajo es proponer una mejor resolución de este fenómeno. El modelo analítico aquí presentado, se basa en el análisis del comportamiento de los residuos de un ajuste por mínimos cuadrados en el que se utiliza el modelo de PRS propuesto por Beutler. El mismo consiste en un modelo determinista del fenómeno con dos parámetros libres. Los resultados obtenidos ponen de manifiesto que, aún después de aplicar dichos parámetros, prevalecen en los residuos efectos semidiurnos en las componentes radial,tangencial y normal. Estos resultados obtenidos se comparan con los de un trabajo desarrollado por el Instituto de Berne (Beutler et al., 1994), en el que se utilizaron como pseudo-observaciones las órbitas precisas del IGS (CODE). El intervalo de integración escogido por este centro fueron las semanas 680 y 681. En resumen se tienen arcos de 14 días para todos los satélites, donde las efemérides precisas de los mismos para los 14 días fueron utilizados como pseudo-observaciones. El modelo de fuerza que empleó dicho centro fue básicamente el tradicional en lo que respecta al modelo de las fuerzas gravitacionales, y para la PRS utilizo el modelo standard de Beutler. Los parámetros de este modelo junto con las 6 condiciones iniciales (posición y velocidad) fueron ajustados por el método general de mínimos cuadrados. Los residuos en la componente radial, tangencial y normal, para los satélites con un buen comportamiento, presentan una componente semidiurna. El modelo analítico planteado en este trabajo, predice el comportamiento de los residuos que se observan en las publicaciones más recientes. Esto abre el camino para plantear una estimación distinta de las incógnitas del problema, basado en el método de colocación por mínimos cuadrados. Ello requiere modelar estadísticamente la señal debida a las componentes de la PRS que no son tomadas en cuenta en el modelo determinista.

  12. Consideracoes Historicas sobre o Ensino Profissionalizante no Brasil (Historical Considerations about Professional Education in Brazil).

    ERIC Educational Resources Information Center

    Barros, Marta Silene Ferreira

    2000-01-01

    Analyzes the paths taken in professional education in Brazil from the colonial period until the formation of the republic. Refers to specialists as well as specific laws for each period described in the study. (BT)

  13. Simposio interamericano sobre administracion de la educacion (Inter-American Symposium on Educational Administration).

    ERIC Educational Resources Information Center

    Cespedes, Francisco S., Ed.

    The presidents and foreign ministers in Latin America recognize the importance of applying technology to school administration as the first step in any educational reform. In October 1968, the Organization of American States (OAS) [Organizacion de los Estados Americanos (OEA)], sponsored a symposium in Brasilia, Brazil, in cooperation with the…

  14. Curso Introductorio sobre el Sistema DIALOG (Introductory Course on the DIALOG System).

    ERIC Educational Resources Information Center

    Rodriguez, Ketty

    As an introduction to the use of the DIALOG online retrieval service, this guide presents material that was developed during a fellowship at Carlos III University, School of Library Science and Documentation, Madrid (Spain) and that is based on a course on the same subject taught in English at Texas Women's University. Although the use of DIALOG…

  15. SOBR: A High-Performance Shared Output Buffered Router for Networks-on-Chip

    NASA Astrophysics Data System (ADS)

    Chen, Yancang; Xie, Lunguo

    This paper presents a single-cycle shared output buffered router for Networks-on-Chip. In output ports, each input port always has an output virtual-channel (VC) which can be exchanged by VC swapper. Its critical path is only 24 logic gates, and it reduces 9.4% area overhead compared with the classical router.

  16. Las Preguntas Que Hacen los Padres sobre la Escuela (Questions Parents Ask about School).

    ERIC Educational Resources Information Center

    National Opinion Research Center, Chicago, IL.

    This guide presents questions that parents frequently ask about their children's school along with answers to those questions. The questions and answers were prepared based on the results of studies conducted by the Partnership for Family Involvement in Education, the U.S. Department of Education, the GTE Foundation, and by the National Center for…

  17. Guia para los padres sobre educacion preescolar (A Parents' Guide to Early Childhood Education).

    ERIC Educational Resources Information Center

    Dodge, Diane Trister; Phinney, Joanna

    This handbook, entirely in Spanish, was originally intended for parents whose children attend programs which use "The Creative Curriculum for Early Childhood" (CCEC), but the information is also useful to parents whose children attend early childhood programs using other curriculum models based on child development theories. The purpose…

  18. Recopilacion Bibliografica Sobre Investigacion y Cambio Cultural (Bibliographic Compilation about Cultural Investigation and Exchange).

    ERIC Educational Resources Information Center

    Centro Latinoamericano de Educacion de Adultos, Santiago (Chile).

    The bibliography forms part of a project to define guidelines for a method of cultural investigation in the education of adults. A brief introduction is followed by a list of libraries and the plan for the listing of entries in the bibliography. Entries are arranged alphabetically by author under the following general headings: background on the…

  19. Una Metodologia de Analisis de la Interaccion Alumno-Orgendaor en la Investigacion Sobre Informatica Educativa.

    ERIC Educational Resources Information Center

    Estepa, A.; And Others

    1992-01-01

    The recording of the interaction between pupil and computer is one of the data sources frequently used in research on the use of computers in teaching. Describes the analysis methodology of these recordings to determine the use of computers in statistics and its adaptation to other research work on the use of computers in education. (Author/MDH)

  20. Nueva investigacion sobre kindergarten de dia completo (Recent Research on All-Day Kindergarten). ERIC Digest.

    ERIC Educational Resources Information Center

    Clark, Patricia

    Noting that much of the early research on the effects of all-day kindergarten had serious problems with internal and external validity due to inadequate methodological standards, this Spanish-language digest reviews research conducted in the 1990s. The digest discusses the academic, social, and behavioral effects of all-day kindergarten, as well…

  1. Cerebral Palsy. Fact Sheet = La Paralisis Cerebral. Hojas Informativas Sobre Discapacidades.

    ERIC Educational Resources Information Center

    National Information Center for Children and Youth with Disabilities, Washington, DC.

    This fact sheet on cerebral palsy is written in both English and Spanish. First, it provides a definition of cerebral palsy and considers various causes (e.g., an insufficient amount of oxygen reaching the fetal or newborn brain). The fact sheet then offers incidence figures and explains characteristics of the three main types of cerebral palsy:…

  2. Recursos de Trabajo: Informacion sobre Carreras (Occupational Resources: Career Information). CHOICE (Challenging Options in Career Education).

    ERIC Educational Resources Information Center

    Putnam and Northern Westchester Counties Board of Cooperative Educational Services, Yorktown Heights, NY.

    Part of a two-level career education curriculum initially developed for migrant children, the book is the first of three secondary level texts designed to provide high school students with self-awareness, job and role information, and decision-making/goal attaining information related to career education. The text provides job and role information…

  3. Sobre o uso das séries de Puiseux em mecanica celeste

    NASA Astrophysics Data System (ADS)

    Miloni, O. I.

    2003-08-01

    Neste trabalho é apresentada uma demonstração do uso dos diferentes desenvolvimentos em séries para as equações de perturbação em Mecânica Celeste no marco Hamiltoniano. Em trabalhos clássicos como os de Poincaré (Poincaré, 1893) por exemplo, já esta planteado o uso de potências não inteiras no pequeno parâmetro, o que evidencia a não analiticidade das funções quando uma ressonância ocorre. Nestes trabalhos os desenvolvimentos são na raíz quadrada da massa de Júpiter (o pequeno parâmetro). Mais recentemente (Ferraz-Mello, 1985) outros tipos de desenvolvimentos foram aplicados modificando substancialmente as ordens de grandeza e a velocidade de convergência das séries. Com esta abordagem, os desenvolvimentos foram expressados em termos da raíz cúbica do pequeno parâmetro. Neste trabalho apresentamos um enfoque geral, onde os diferentes tipos de desenvolvimentos em séries de Puiseux (Valiron, 1950) são obtidos a partir da aplicação de Teorema de Preparação de Weierstrass (Goursat, 1916) considerando a equação de Hamilton-Jacobi como uma equação algébrica. Os resultados são aplicados ao problema restrito dos três corpos em ressonância de primeira ordem e, dependendo da grandeza da excentricidade do asteróide em relação à de Júpiter, obtemos os diferentes desenvolvimentos, em raíz quadrada ou raíz cúbica da massa de Júpiter.

  4. Questions Often Asked about Special Education Services = Preguntas sobre los servicios de educacion especial.

    ERIC Educational Resources Information Center

    Kupper, Lisa, Ed.

    This guide, available in both English and Spanish, answers questions often asked by parents about special education services. Questions and answers address the following topics: where to begin if a parent believes a child needs special education services, services available to very young children, the evaluation process, the Individualized…

  5. Profesionalismo: Un estudio fenomenologico sobre experiencias de universitarios en programas de salud

    NASA Astrophysics Data System (ADS)

    Lopez Ortiz, Wilma J.

    Some studies suggest that, upon admission, medicine programs students display eagerness for community service, aspirations to be useful, and to contribute to society's well-being. Those same studies reflect that qualities of idealism, moral nature, and internal motivation, suffer a subsequent diminishing. The researchers inferred that the main reason for this process of change in the mood and disposition of these future physicians lies in the modeling they receive from medical professionals throughout clinical learning activities, by way of behavior and relationships exhibited during daily interaction with peers, patients and the students themselves. This phenomenological study used a cross-sectional sample to explore the experiences of future health workers as they went through didactic and clinical phases of their training curriculum. The study employed semi-structured interviews and reflective journals to explore those experiences and to discover the meanings ascribed by the participants. The analysis revealed that the students defined "professionalism" in terms of scientific knowledge, commitment, respect for human dignity, comradeship, courtesy, empathy, integrity, altruism, motivation. They also described their feelings as they went through the didactic and clinical experiences, and recognized as very important the extracurricular activities of community service, describing them as useful opportunities which contributed to understand their work in terms of a mission dedicated to the achievement of the social benefit. From their individual perspectives, the clinical environment could, in general, be described as congruent with those characteristics of professionalism. During the study we had the opportunity to share, in a little deeper way, the environment... the world... of this small group of young students as we went on trying to decipher their feelings and thoughts. At the end, we realized the richness of their sensibilities, we perceived the intensity of their moral and ethical convictions, we were able to understand their concerns, worries, struggles and efforts. This life event had profound and significant repercussions in our personal and professional life. As a result, and from now on, we will no longer look at our young scholars and apprentices without imagining a noble spirit, with goals which at times could seem unattainable... without completely visualizing or conceiving real hope for a better country.

  6. Perspectiva sobre una Personalidad Senera: Carmen Fischer Ramirez (Perspective on a Singular Personality: Carmen Fischer Ramirez).

    ERIC Educational Resources Information Center

    Quezeda, Dina Alarcon

    1992-01-01

    Traces the career of Carmen Fischer Ramirez, focusing on her work in improving early childhood education in Chile. Reviews her university career, work with the World Organization for Early Childhood Education, and major publications. (AC)

  7. Perspectiva General sobre la Sordo-Ceguera (Overview on Deaf-Blindness). DB-LINK.

    ERIC Educational Resources Information Center

    Miles, Barbara

    This overview provides basic information on the causes of deaf-blindness and the particular challenges faced by individuals who are deaf-blind. Causes of deaf-blindness include various syndromes, multiple congenital anomalies, prematurity, congenital prenatal dysfunction, and various postnatal causes. Differences between people deaf-blind from…

  8. Bibliografia sobre el "bilinguismo" del Paraguay (A Bibliography on Bilingualism in Paraguay)

    ERIC Educational Resources Information Center

    Melia, Bartomeu

    1974-01-01

    This bibliography of ninety-five entries ranging in publication date from 1847 to 1947 brings together information from areas of history, literature, sociology, anthropology, sociolinguistics, descriptive linguistics, folk-lore and language planning, the central criterion being the relationship of these areas specifically to the bilingual…

  9. Speech and Language Disorders. Fact Sheet = Trastornos del Habla y Lenguaje. Hojas Informativas Sobre Discapacidades.

    ERIC Educational Resources Information Center

    National Information Center for Children and Youth with Disabilities, Washington, DC.

    This fact sheet on speech and language disorders is presented in English and Spanish. It provides information on the definition of speech and language disorders and possible causes; the incidence (about one in ten people); and characteristics of delayed communication, speech disorders, and language disorders. It notes educational implications,…

  10. Reflexiones Sobre la Capacitacion de Docentes (Reflections on In-Service Teacher Training).

    ERIC Educational Resources Information Center

    Valle, Victor M.

    Everyone concerned with educational systems performance agrees that the improvement of teaching qualities is a high priority in any educational effort. Teachers are assigned the role of change agents and are presented with new challenges, e.g., to make education global and permanent, flexible enough to serve in any environment (in or out of the…

  11. Homework Tips for Parents = Consejos para los padres sobre la tarea escola.

    ERIC Educational Resources Information Center

    Department of Education, Washington, DC. Office of Intergovernmental and Interagency Affairs.

    Homework has been a part of students' lives since the beginning of formal school in the United States; the push for increased homework has increased, fueled by rising academic standards. Noting that parents involved can have either a positive or a negative influence on the value of homework, this booklet, in both English and Spanish, offers…

  12. Sobre la ensenanza de la literatura hispanoamericana (The Teaching of Hispanoamerican Literature).

    ERIC Educational Resources Information Center

    Ellis, Keith

    There are three main problems in teaching Latin American literature: (1) It is difficult to maintain a regional overview, while, at the same time, including a sense of the literary history of Latin America; (2) It is necessary to teach literature so that the material seems worthwhile in its own right and not only as a complement to other…

  13. Sobre las soluciones acotadas del problema instantáneo de dos cuerpos

    NASA Astrophysics Data System (ADS)

    Altavista, C.

    La demostración se basa en el hecho de que las integrales del problema de los N-cuerpos admiten componentes en el campo complejo según las raíces n-ésimas de la unidad. Definida la matriz unitaria correspondiente, la fórmula de Cayley permite transformar la matriz unitaria en una matriz hermitiana. Utilizando como parámetros los cosenos direccionales de un sistema de coordenadas orbitales referidos a un sistema de referencia fijo, puede construirse, utilizando el operador hermitiano antes definido, una forma cuadrática cuyas raíces mínima y máxima definen las cotas respectivas de los movimientos de los mencionados cosenos direccionales.

  14. 75 FR 44261 - Notice of Agreement Filed

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-07-28

    ... agreement under the Shipping Act of 1984. Interested parties may submit comments on the agreement to the... Agreement. Parties: COSCO Container Lines Company, Limited; Kawasaki Kisen Kaisha, Ltd.; Yangming (UK) Ltd.; and Hanjin Shipping Co., Ltd. Filing Party: Amy Cano; Nixon Peabody LLP; 555 West Fifth Street,...

  15. Los Angeles and Long Beach Harbors, Model Enhancement Program, Effects of Wind on Circulation in Los Angeles-Long Beach Harbors

    DTIC Science & Technology

    1994-04-01

    WES, SPL, and the Ports. Mr. Dan Muslin, followed by Mr. Angel P. Fuertes , Mr. Mike Piszker, and then Ms. Jane Grandon were SPL points of contact. Mr...John Warwar, Mr. Dick Wittkop, and Ms. Lillian Kawasaki, Port of Los Angeles, and Mr. Michael Burke, followed by Mr. Angel Fuertes and Dr. Geraldine

  16. Sufficient Conditions for Global Minimality of Metastable States in a Class of Non-convex Functionals: A Simple Approach Via Quadratic Lower Bounds

    NASA Astrophysics Data System (ADS)

    Shirokoff, David; Choksi, Rustum; Nave, Jean-Christophe

    2015-06-01

    We consider mass-constrained minimizers for a class of non-convex energy functionals involving a double-well potential. Based upon global quadratic lower bounds to the energy, we introduce a simple strategy to find sufficient conditions on a given critical point (metastable state) to be a global minimizer. We show that this strategy works well for the one exact and known metastable state: the constant state. In doing so, we numerically derive an almost optimal lower bound for both the order-disorder transition curve of the Ohta-Kawasaki energy and the liquid-solid interface of the phase-field crystal energy. We discuss how this strategy extends to non-constant computed metastable states, and the resulting symmetry issues that one must overcome. We give a preliminary analysis of these symmetry issues by addressing the global optimality of a computed lamellar structure for the Ohta-Kawasaki energy in one (1D) and two (2D) space dimensions. We also consider global optimality of a non-constant state for a spatially in-homogenous perturbation of the 2D Ohta-Kawasaki energy. Finally we use one of our simple quadratic lower bounds to rigorously prove that for certain values of the Ohta-Kawasaki parameter and aspect ratio of an asymmetric torus, any global minimizer for the 1D problem is automatically a global minimizer for the 2D problem on the asymmetric torus.

  17. Targeting Signal Transducers and Activators of Transcription-3 (STAT3) as a Novel Strategy in Sensitizing Breast Cancer to EGFR-Targeted Therapy

    DTIC Science & Technology

    2009-06-01

    Clin Invest 114 (5):619-622. Qin, H. R., H. J. Kim, J. Y. Kim, E. M. Hurt, G. J. Klarmann, B. T. Kawasaki , M. A. Duhagon Serrat, and W. L. Farrar... nursing , and include postdoctoral training.) INSTITUTION AND LOCATION DEGREE (if applicable) YEAR(s) FIELD OF STUDY Chung-Shan Medical & Dental

  18. Advances in Vessel and Aircraft Technologies

    DTIC Science & Technology

    2010-05-25

    domain (disaster prevention, disaster rescue, disaster prediction, etc.) (4) Medical/welfare ( disease prevention, diagnosis, cure, rehabilitation...requirement. 9 Leading Business Enterprises and Academia in Robotics Robots: Industrial robots: Fanuc, Yasukawa Electric, Kawasaki Heavy...that can help care for the aged and disabled in nursing homes and other facilities were developed, together with portable remote-control devices (Fig

  19. [Autisms that 'cure themselves'].

    PubMed

    Artigas-Pallares, J; Paula-Perez, I

    2016-01-01

    Introduccion. La investigacion sobre el autismo, basada principalmente en el modelo categorico del Manual diagnostico y estadistico de los trastornos mentales, se ha centrado de forma preferente en la epidemiologia, las manifestaciones clinicas, los mecanismos cognitivos y los determinantes biologicos y ambientales; sin embargo, se ha prestado escaso interes a las trayectorias evolutivas, las cuales son decisivas de cara al pronostico a medio y largo plazo. Objetivo. Revisar el curso evolutivo de niños diagnosticados de autismo que, aun conservando a medio o largo plazo rasgos conductuales acordes con el perfil inicial, alcanzan una adaptacion social y laboral satisfactorias, y ademas dejan de cumplir los criterios que dieron lugar al diagnostico inicial. Desarrollo. Se ha revisado la bibliografia sobre el autismo centrada en el analisis de la evolucion de las manifestaciones clinicas y de su repercusion desde las primeras edades hasta la edad adulta. Asimismo, se han tomado en consideracion aspectos conceptuales sobre el autismo que facilitan la comprension y el significado de los patrones evolutivos. Conclusiones. Alrededor del 20% de los niños diagnosticados dejan de cumplir los criterios en los que se baso el diagnostico y, ademas, alcanzan un ajuste social y laboral satisfactorio. Como factores favorecedores se identifica: inteligencia normal, buen nivel de lenguaje y baja incidencia de 'comorbilidades'; por el contrario, en las series notificadas no se señalan como factores determinantes las intervenciones terapeuticas precoces e intensivas. Por ultimo, se menciona el concepto de neurodiversidad, donde la recuperacion se centra en el desarrollo optimo de las capacidades de cada individuo en un entorno facilitador.

  20. Efficacy of social support on metabolic syndrome among low income rural women in Chiapas, México.

    PubMed

    Bezares-Sarmiento, Vidalma del Rosario; Bacardí-Gascón, Montserrat; Márquez-Rosa, Sara; Molinero-González, Olga; Estrada-Grimaldo, Martha; Jiménez-Cruz, Arturo

    2013-01-01

    Introducción: El propósito de este estudio fue valorar una intervención de soporte social entre mujeres rurales de Chiapas, sobre los cambios en el estilo de vida, el autoconcepto, y el síndrome metabólico (MS). Métodos: Se realizó una muestra de conveniencia entre todas la mayores de 16 años de una población rural marginada del centro de Chiapas. Se utilizaron dos cuestionarios. Uno sobre el auto-concepto de salud y el otro sobre el perfil de estilos saludables. Los componentes del MS se valoraron de acuerdo a los criterios de la Federación Internacional de Diabetes. La intervención se realizó durante un período de tres meses y se dividió en 13 sesiones que incluían soporte social (SS) y educación nutricional (EN). Resultados: Cumplieron con los criterios de inclusión, 586 mujeres. Al inicio del estudio 47% tenían MS; obesidad abdominal, 69%; altos niveles de glucosa, 27%; de triglicéridos, 56%; de presión arterial sistólica, 17%; de presión arterial diastólica, 15%; y bajos niveles de colesterol- HDL, 55%. Después de la intervención 38% presentaron MS y se observó una reducción de todos los componentes del MS. Al final del estudio se observaron cambios significativos en AF5, PETS-1 y algunos componentes del SM. Conclusiones: Después de una intervención de SS y EN, se observaron cambios significativos en varias dimensiones del AF5 y del PETS-1, así como en SM y todos los componentes del SM.

  1. Alfabetización en Astronomía de docentes de Educación Primaria y de Educación Secundaria en La Plata

    NASA Astrophysics Data System (ADS)

    De Biasi, M. S.; Orellana, R. B.

    2014-10-01

    La educación de este siglo tiene como uno de sus retos alcanzar la alfabetización cientfica de todos los ciudadanos para que comprendan y tomen decisiones sobre el mundo natural y sus cambios originados por la actividad humana utilizando el conocimiento científico. En esta misión los docentes de los niveles obligatorios de enseñanza juegan un papel clave por su rol de agentes multiplicadores del conocimiento. Se requiere, entonces de una adecuada alfabetización en ciencias de los docentes o, como mínimo, que dominen los temas científicos a enseñar. En el campo de la Astronomía, numerosas investigaciones han señalado que maestros de primaria y estudiantes de profesorados poseen una escasa formación en estos temas (Camino 1995 y 1999, Gangui 2010), que frecuentemente presentan a los alumnos concepciones alternativas o no científicas de los fenómenos astronómicos cotidianos (Kriner 2004, Vega Navarro 2007, Gangui et al 2010); a lo que se suma la presentación confusa o errónea de algunos temas astronómicos en los textos escolares (Kriner 2004). Desde 2011, la Facultad de Ciencias Astronómicas y Geofísicas, UNLP, ofrece un curso de capacitación destinado a fortalecer y actualizar los contenidos académicos y didácticos de los docentes del distrito La Plata utilizando diversas estrategias didácticas. Los contenidos comprenden los temas astronómicos de los diseños curriculares vigentes. La evaluación diagnóstica de los conocimientos previos de los docentes cursantes sobre los contenidos de mayor presencia en los diseños curriculares mostró resultados similares a las investigaciones arriba mencionadas. Referente a los movimientos de la Tierra, en promedio, el 54% poseía conceptos erróneos y el 16% no los sabía; con referencia a la Luna el 56% poseía conceptos erróneos y un 4% no los sabía. Los resultados del curso mostraron que el 95% de los docentes revirtió sus conceptos previos erróneos, que adquirió criterios para la búsqueda de

  2. [Quality of life in children and adolescents with autism spectrum disorder without intellectual disability].

    PubMed

    Cuesta-Gomez, J L; Vidriales-Fernandez, R; Carvajal-Molina, F

    2016-01-01

    Introduccion. El concepto de calidad de vida tiene gran importancia en la intervencion dirigida a las personas con discapacidad. Resulta indiscutible que el alcance de una calidad de vida satisfactoria debe ser el objetivo de las intervenciones clinicas dirigidas al colectivo de personas con trastorno del espectro autista (TEA), y un elemento clave para diseñar los tratamientos necesarios que mejoren el pronostico de desarrollo futuro. A pesar de ello, el conocimiento sobre las condiciones objetivas y subjetivas que predicen una mayor satisfaccion en las personas con TEA es aun muy limitado. Objetivo. Explorar la percepcion de la calidad de vida que experimenta un grupo de niños y adolescentes con TEA sin discapacidad intelectual asociada. Pacientes y metodos. Muestra de 12 niños y 11 adolescentes con TEA sin discapacidad intelectual asociada. Dependiendo de la edad, se les aplico el cuestionario de calidad de vida especifico. Resultados. Ambos grupos informan positivamente sobre su calidad, sin que existan diferencias en las dimensiones basicas. No obstante, en el caso de los adolescentes se obtienen puntuaciones mas bajas en el area de autodeterminacion en comparacion con las demas. Conclusiones. La discusion se centra en la identificacion de las dimensiones mas relevantes para la calidad de vida, las implicaciones para la intervencion y la necesidad de adecuar las metodologias empleadas para la evaluacion subjetiva de estos factores, debido a que las caracteristicas de los TEA pueden alterar las habilidades necesarias para la valoracion de la experiencia personal y requerir la adaptacion de los procedimientos empleados.

  3. [Asomatognosia as a manifestation of migraine with aura. case report and review].

    PubMed

    Scribano Parada, María de la Paz; Buonanotte, Carlos Federico

    2015-01-01

    Introducción: Durante años el estudio de la migraña con aura ha sorprendido por la versatilidad de su forma de presentación. Las auras se manifiestan con el desarrollo gradual de síntomas neurológicos que van desde alteraciones visuales hasta trastornos de la percepción. Estos últimos son formas de presentación poco frecuentes siendo el motivo de este artículo. Caso Clínico: Se presenta el caso de una paciente de sexo femenino de 53 años con diagnóstico de migraña con aura la cual hace un relato autobiográfico de sus crisis, con especial énfasis en una variante de asomatognosia como forma de presentación. A continuación se discute sobre la asomatognosia como un fenómeno perteneciente a las alteraciones del esquema corporal y los diferentes conceptos y formas clínicas relacionados con estas y se hacer un breve repaso sobre las posibles localizaciones anatómicas de estas afecciones. Conclusión: La migraña con aura puede manifestarse con una variada sintomatología previa al dolor. La asomatognosia es una forma infrecuente de presentación. Un campo de interés en la investigación de esta área incluyen un esfuerzo por definir la especificidad y localización de la lesión como un método para la mejor comprensión de cómo las lesiones a áreas muy específicas del cerebro afectan la percepción y la memoria.

  4. [Cognitive reserve in substance addicts in treatment: relation to cognitive performance and activities of daily living].

    PubMed

    Pedrero-Pérez, Eduardo J; Rojo-Mota, Gloria; Ruiz-Sánchez de León, José M; Fernández-Méndez, Laura M; Morales-Alonso, Sara; Prieto-Hidalgo, Ana

    2014-12-01

    Introduccion. El concepto de reserva cognitiva ha ido ganando interes en la medida en que se ha acumulado evidencia sobre su relacion con la resistencia del cerebro a declinar en su funcionamiento ante amenazas o alteraciones neurologicas. Aunque se ha estudiado en un gran numero de alteraciones (degenerativas, traumaticas, psicopatologicas), pocos trabajos relacionan la reserva cognitiva con la adiccion a sustancias, un proceso multidimensional con clara base neurologica. Objetivo. Explorar la reserva cognitiva de pacientes en tratamiento por adiccion a drogas, relacionandolo con su rendimiento cognitivo en pruebas neuropsicologicas y en actividades de la vida diaria. Pacientes y metodos. Muestra de 57 pacientes en tratamiento por adiccion a sustancias en un centro especifico. Se administraron el cuestionario de reserva cognitiva, la evaluacion cognitiva de Montreal y el inventario de sintomas prefrontales, y se recogieron variables relacionadas con la adiccion. Resultados. Se encontro una relacion positiva entre la reserva cognitiva y el tiempo de abstinencia, y negativa con la gravedad de la adiccion. Aparecieron diferencias significativas segun la reserva cognitiva en rendimiento neuropsicologico (especialmente en ciertos dominios cognitivos) y en actividades cotidianas. Conclusiones. La reserva cognitiva aparece como una variable relacionada con la adiccion y los deficits cognitivos que la acompañan; resulta ser una potencial diana de las actividades rehabilitadoras, vinculada al paradigma de enriquecimiento ambiental, como estrategia para potenciar la resistencia frente al deterioro cognitivo que favorece y mantiene la adiccion y para disminuir el potencial reforzador de la conducta de consumo.

  5. A Diagnostic Assessment for the Teaching of Astronomy. (Spanish Title: Una Evaluación Diagnóstica Para la Enseñanza de la Astronomia.) Uma Avaliação Diagnóstica Para o Ensino da Astronomia

    NASA Astrophysics Data System (ADS)

    Pacifico Ribeiro de Assis Silveira, Felipa; Soares Gomes de Sousa, Célia Maria; Moreira, Antonio

    2011-07-01

    This article aims to present the results of a diagnostic evaluation, used as a tool for collecting data on prior knowledge of scientific concepts needed to understand the topic "Earth and Universe", from a group comprised of 47 students of 6th grade. The educational method of diagnosing the student's prior knowledge before teaching them is founded on the Meaningful Learning theory, proposed by David Ausubel. The diagnostic evaluation consisted of 25 questions; the answers were analyzed and categorized, making possible their interpretation, which allows us to understand the meanings assigned by the student to these concepts. It follows from the diagnostic evaluation, that the majority of students surveyed had difficulties in exposing scientific concepts on the topic "Earth and Universe" when starting the 6th grade. However, we identified relevant ideas and representations that contributed to the re-signification of scientific concepts proposed for the teaching of the subject in this grade. The results of diagnostic evaluation served as reference to the organization of the syllabus, making possible the learning process by matching the sequence of teaching to the students" characteristics and context of the classroom. It is expected that other researchers in this topic can also use the instrument presented in this paper. Este artículo tiene como objetivo presentar los resultados de una evaluación diagnóstica, utilizada como una herramienta para recoger datos sobre el conocimiento previo de los conceptos científicos necesarios para comprender el tema "Tierra y Universo", de un grupo compuesto por 47 alumnos de 6º grado de la escuela primaria. La acción pedagógica del diagnóstico de los conocimientos previos del estudiante antes de enseñarles está justificada por la teoría del Aprendizaje Significativo, propuesta por David Ausubel. La evaluación de diagnóstico consistió en 25 preguntas, las respuestas fueron analizadas y clasificadas objetivando-se su

  6. Efecto de la dieta artificial MP sobre la emergencia y relacion de sexos de Phymastichus coffea (Hymenoptera:Eulophidae) mantenido sobre su hueped, Hypothenemus hampei (Coleoptera: Scloytidae)a traves de generaciones contin

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Phymastichus coffea La Salle (Hymenoptera: Eulophidae) is an endoparasitoid that attacks the adult coffee berry borer, Hypothenemus hampei Ferrari (Coleoptera: Scolytidae). The MP diet developed by Portilla and Streett is the only reported diet that allows cultures of P. coffea to develop and repr...

  7. Sobre as inclinações carnais: inflexões do pensamento cristão sobre os desejos e as sensações prazerosas do baixo corporali

    PubMed Central

    RIOS, LUÍS FELIPE; PARKER, RICHARD; TERTO, VERIANO

    2011-01-01

    On carnal inclinations: from early Christianity to the present This study develops a historical review of the meanings of the “flesh” in the West, focusing on its significance in the context of Christianity. Our hope is that a study along these lines can help to illuminate current understandings of questions related to sexuality both within and outside of the religious contexts found in contemporary Brazil. Such questions are of special interest for those who are concerned with both old and new problems found in the field that has come to be known as sexual and reproductive rights, with implications for the field of Public Health. PMID:21980215

  8. Análise sobre o Conhecimento de um Grupo de Alunos do Ensino Médio da Rede Estadual de São Paulo sobre Termos e Fenômenos Astronômicos do Cotidiano

    NASA Astrophysics Data System (ADS)

    de Oliveira, E. F.; Voelzke, M. R.; Amaral, L. H.

    2007-08-01

    Embora os Parâmetros Curriculares Nacionais do Ensino Médio (PCN-EM) e as orientações complementares a esses Parâmetros (PCN+) apontem a importância de uma abordagem significativa de conceitos relacionados à astronomia nas aulas de Física, muitos estudantes terminam o Ensino Médio (EM) sem compreender a razão de certos acontecimentos de origem celeste, ainda que estes façam parte de seu cotidiano. Este trabalho tem por objetivo analisar os conhecimentos básicos em astronomia dos alunos de EM da escola estadual Batista Renzi, bem como investigar os meios através dos quais estes conhecimentos foram adquiridos. Para tanto foi elaborado um questionário de múltipla escolha aplicado a 310 alunos distribuídos entre as três séries do EM dos períodos matutino e noturno. Dessa forma, observou-se que apenas 34,5% relacionaram as estações do ano à inclinação do eixo de rotação da Terra, 21,3% indicaram a influência gravitacional da Lua e do Sol como responsáveis pelo fenômeno das marés, 24,5% indicaram corretamente quais são os objetos celestes mais próximos da Terra, 36,1% identificaram ano-luz como uma medida de distância e 34,2% reconheceram uma estrela cadente como meteoro. Em contrapartida, 67,1% compreendiam a sucessão entre dia e noite, 73,9% identificaram o Sol como estrela e 52,3% relacionaram o Big Bang à origem do Universo. Além disso, foram comparadas as respostas de alunos de diferentes séries e períodos, observando-se, dentre outras coisas, que os estudantes do terceiro ano apresentam um percentual de acertos semelhante ao dos alunos do primeiro, caracterizando que a abordagem de tópicos relacionados à astronomia no EM não tem contribuído para uma maior compreensão dos fenômenos e conceitos.

  9. [Sudden death of a young man as late sequelae complicating a pediatric disease: About a case].

    PubMed

    Pierry, Clémence; Franchet, Camille; Tuchtan-Torrents, Lucile; Macon, Céline; Torrents, Julia; Capuani, Caroline; Piercecchi-Marti, Marie-Dominique

    2017-04-01

    In France, sudden death is responsible every year for 40,000 deaths. The most frequent etiology is cardiac disease. Atheromatous-related pathology is the most common etiology beyond 35, but cardiomyopathies and channelopathies are responsible for a significant number of deaths in young adults. Some acquired disorders can also cause sudden cardiac death. We report the case of a 17-year-old man who died suddenly after sport. Autopsy and pathological study found multiple giant coronary aneurysms. Thrombosis and fibrous scar of myocardial ischemic events were observed. These lesions were in favor of late sequelae of Kawasaki disease. Kawasaki disease is a rare but not exceptional cause of sudden cardiac death in young adults. In the lack of known clinical history, some aspects, even not specific, should evoke this diagnosis. Even in front of apparent good clinical tolerance, these sequelae require appropriate follow-up because of a significant risk of sudden death.

  10. Exanthema and acute anuric renal failure.

    PubMed

    Resch, M; Banas, B; Endemann, D; Mack, M; Riegger, G A J; Gröne, H J; Krämer, B K

    2006-05-01

    A 15-year-old girl with a history of Kawasaki disease was admitted to our nephrological department due to acute renal failure. Despite antibiotic therapy because of fever and the symptoms of a pharyngitis in the last few days, the girl showed persisting fever and developed arthralgias, an exanthema and a rising serum creatinine as well as anuria. A wide variety of differential diagnoses has to be thought of because of the history of the Kawasaki disease (symptoms like fever, pharyngitis, exanthema and arthralgia), i.e. hemolytic-uremic syndrome, vasculitis, ascending infection, postinfection glomerulonephritis. In consideration of etiologically unclear "rapidly progressive renal failure" with anuria and thrombocytopenia an immediate renal biopsy was done and revealed a severe drug induced acute interstitial nephritis. Due to this diagnosis we treated the patient with corticosteroids. Within 4 weeks serum creatinine declined to 1.8 mg/dl but did not normalize.

  11. "O Que Diriam Sobre Os Portugueses?????" [What Would You Say about Portuguese People?]: Intercultural Curiosity in Multilingual Chat-Rooms

    ERIC Educational Resources Information Center

    Araujo e Sa, Maria Helena; de Carlo, Maddalena; Melo-Pfeifer, Silvia

    2010-01-01

    In this study, we intend to discuss questioning as a sign of Intercultural Communicative Competence in plurilingual environments, stressing the relationship between questioning and the process of developing discovery skills in Romance chat-rooms. Focusing specifically on episodes beginning with intercultural questioning, we will analyse: (1)…

  12. Estudio numerico y experimental del proceso de soldeo MIG sobre la aleacion 6063--T5 utilizando el metodo de Taguchi

    NASA Astrophysics Data System (ADS)

    Meseguer Valdenebro, Jose Luis

    Electric arc welding processes represent one of the most used techniques on manufacturing processes of mechanical components in modern industry. The electric arc welding processes have been adapted to current needs, becoming a flexible and versatile way to manufacture. Numerical results in the welding process are validated experimentally. The main numerical methods most commonly used today are three: finite difference method, finite element method and finite volume method. The most widely used numerical method for the modeling of welded joints is the finite element method because it is well adapted to the geometric and boundary conditions in addition to the fact that there is a variety of commercial programs which use the finite element method as a calculation basis. The content of this thesis shows an experimental study of a welded joint conducted by means of the MIG welding process of aluminum alloy 6063-T5. The numerical process is validated experimentally by applying the method of finite element through the calculation program ANSYS. The experimental results in this paper are the cooling curves, the critical cooling time t4/3, the weld bead geometry, the microhardness obtained in the welded joint, and the metal heat affected zone base, process dilution, critical areas intersected between the cooling curves and the curve TTP. The numerical results obtained in this thesis are: the thermal cycle curves, which represent both the heating to maximum temperature and subsequent cooling. The critical cooling time t4/3 and thermal efficiency of the process are calculated and the bead geometry obtained experimentally is represented. The heat affected zone is obtained by differentiating the zones that are found at different temperatures, the critical areas intersected between the cooling curves and the TTP curve. In order to conclude this doctoral thesis, an optimization has been conducted by means of the Taguchi method for welding parameters in order to obtain an improvement on mechanical properties in aluminum metal joint. Los procesos de soldadura por arco electrico representan unas de las tecnicas mas utilizadas en los procesos de fabricacion de componentes mecanicos en la industria moderna. Los procesos de soldeo por arco se han adaptado a las necesidades actuales, haciendose un modo de fabricacion flexible y versatil. Los resultados obtenidos numericamente en el proceso de soldadura son validados experimentalmente. Los principales metodos numericos mas empleados en la actualidad son tres, metodo por diferencias finitas, metodos por elementos finitos y metodo por volumenes finitos. El metodo numerico mas empleado para el modelado de uniones soldadas, es el metodo por elementos finitos, debido a que presenta una buena adaptacion a las condiciones geometricas y de contorno ademas de que existe una diversidad de programas comerciales que utilizan el metodo por elementos finitos como base de calculo. Este trabajo de investigacion presenta un estudio experimental de una union soldada mediante el proceso MIG de la aleacion de aluminio 6063-T5. El metodo numerico se valida experimentalmente aplicando el metodo de los elementos finitos con el programa de calculo ANSYS. Los resultados experimentales obtenidos son: las curvas de enfriamiento, el tiempo critico de enfriamiento t4/3, geometria del cordon, microdurezas obtenidas en la union soldada, zona afectada termicamente y metal base, dilucion del proceso, areas criticas intersecadas entre las curvas de enfriamiento y la curva TTP. Los resultados numericos son: las curvas del ciclo termico, que representan tanto el calentamiento hasta alcanzar la temperatura maxima y un posterior enfriamiento. Se calculan el tiempo critico de enfriamiento t4/3, el rendimiento termico y se representa la geometria del cordon obtenida experimentalmente. La zona afectada termicamente se obtiene diferenciando las zonas que se encuentran a diferentes temperaturas, las areas criticas intersecadas entre las curvas de enfriamiento y la curva TTP. Para finalizar el trabajo de investigacion se ha realizado una optimizacion, con la aplicacion del metodo de Taguchi, de los parametros de soldeo con el objetivo de obtener una mejora sustancial en las propiedades mecanicas de las uniones metalicas de aluminio.

  13. Investigación del USGS sobre el ecosistema de arrecifes de coral en el Atlántico

    USGS Publications Warehouse

    Kuffner, Ilsa B.; Yates, Kimberly K.; Zawada, David G.; Richey, Julie N.; Kellogg, Christina A.; Toth, Lauren T.; Torres-Garcia, Legna M.

    2015-10-23

    Los arrecifes de coral son estructuras sólidas, biomineralizadas que protegen comunidades costeras actuando como barreras protectoras de peligros tales como los huracanes y los tsunamis. Estos proveen arena a las playas a través de procesos naturales de erosión, fomentan la industria del turismo, las actividades recreacionales y proveen hábitats pesqueros esenciales. La conti-nua degradación mundial de ecosistemas de arrecifes de coral está bien documentada. Existe la necesidad de enfoque y organización de la ciencia para entender los procesos complejos físicos y biológicos e interacciones que están afectando el estado de los arrecifes coralinos y su capacidad para responder a un entorno cambiante.

  14. Personal Safety for Children: A Guide for Parents = Una guia para los padres sobre la seguridad personal de los ninos.

    ERIC Educational Resources Information Center

    Department of Justice, Washington, DC.

    Noting that parents and teachers have the responsibility of safeguarding children and teaching them the skills they need to be safe, this pamphlet, in Spanish and English versions, is designed to help parents talk to their children about how to protect themselves against abduction and exploitation. The pamphlet is organized into six sections.…

  15. DISYUNTIVAS EN LAS CONCEPCIONES SOBRE AUTONOMÍA Y BENEFICENCIA QUE AFECTAN LA TERAPÉUTICA DEL INTENTO SUICIDA1

    PubMed Central

    Mondragón, Liliana; Monroy, Zuraya; Ito, Ma. Emily; Medina-Mora, Dra. Ma. Elena

    2010-01-01

    El objetivo del trabajo es conocer las disyuntivas entre los principios de beneficencia y autonomía, que se presentan en la relación médico-paciente, durante la terapéutica del intento de suicidio. La investigación se realizó en dos hospitales psiquiátricos de la Ciudad de México. La muestra incluyó a tres sujetos con intento de suicidio, mayores de 18 años, que eran atendidos en consulta externa a causa de una lesión autoinfligida en el último año, y a tres psiquiatras que trataban a estos pacientes. La información se obtuvo previo consentimiento informado en entrevistas individuales. Se llevó a cabo un análisis de discurso argumentado para encontrar los significados que los participantes otorgaron a los principios bioéticos y las posibles disyuntivas entre éstos. Las discordancias entre la beneficencia y la autonomía estuvieron relacionadas con el beneficio del tratamiento, el respeto por los valores y las creencias de los pacientes, entre otros. Este trabajo presenta consideraciones éticas relevantes en el escenario clínico, al ofrecer al psiquiatra un análisis bioético que le permita actuar de acuerdo con la beneficencia y respetando la autonomía del paciente frente a casos de intento de suicidio y, de esta forma procurar una mejor atención para ellos. PMID:20830214

  16. Mobile Library Guidelines. IFLA Professional Report No. 28 [and] Lineamientos sobre Bibliotecas Moviles. Informes Professionales de IFLA: 30.

    ERIC Educational Resources Information Center

    Pestell, Robert

    This publication provides the latest information available on the equipment and operation of mobile libraries operating out of road vehicles. The guide provides details on the establishment of mobile library services, financing, vehicles, furniture and equipment, staffing, collections, service base, and publicity. Some generalizations with regard…

  17. Validacion de un Inventario Sobre La Percepcion de Los Padres de Superdotados Respecto a Los Servicios Educativos Disponibles Para Estos

    ERIC Educational Resources Information Center

    Medina Munoz, Arlette Zamarie

    2013-01-01

    In Puerto Rico, there isn't a survey that collects the parent's perception of the available services for gifted children. Considering this, in this investigation an instrument was created and scientifically validated to collect the parents' perception of the educational services available. The instrument was validated using internal and external…

  18. El Conocimiento Ocupacional y del Yo para los Grupos Especiales. Monografias sobre el Conocimiento Ocupacional y del Yo.

    ERIC Educational Resources Information Center

    Hoyt, Kenneth B.

    This Spanish translation of ED 132 428 includes the three papers representing Office of Education attempts to face the need for improving delivery of career education to special portions of the population. New additions are brief sections on basic definitions and additional considerations of the significance of work. The first paper, on career…

  19. The ABCs of Special Education: A Handbook for Parents = El ABS Sobre Educacion Especial: Un Folleto para los Padres.

    ERIC Educational Resources Information Center

    Ewing, Preston E., Jr.; Hinton, Valeska S.

    This bilingual handbook is intended to help parents understand their rights under P.L. 94-142, the Education for All Handicapped Children Act. The following topics are addressed: the Act's legislative history, identification of special education, explanation of P.L. 94-142, parents' rights to know, student records, student testing, students'…

  20. [Sobre la (No) Responsabilidad de la Tecnociencia en los Problemas Ambientales y la Búsqueda de Política].

    PubMed

    Martínez Barrera, Jorge

    2016-01-01

    In this paper I propose to reflect upon modern configuration of technique, i.e., technoscience, and our responsibility towards environmental management. I show that the technological products of our world imply a certain attitude of aggression towards nature, contrasting with the attitude of protection from her, which was peculiar of the pre-technological world. Finally I suggest recovering the classical notion of politics as a possible alternative for controlling techno-scientific imperatives.

  1. Una Guia de Consejos Practicos Sobre la Lectura para los Padres (A Guide to Reading Tips for Parents).

    ERIC Educational Resources Information Center

    Department of Education, Washington, DC.

    The No Child Left Behind program changes the federal role in education by asking America's schools to describe their success in terms of what each student accomplishes. The information in this reading guide, presented in Spanish, was developed by the United States Department of Education to assist parents, caregivers, and teachers in understanding…

  2. DISYUNTIVAS EN LAS CONCEPCIONES SOBRE AUTONOMÍA Y BENEFICENCIA QUE AFECTAN LA TERAPÉUTICA DEL INTENTO SUICIDA.

    PubMed

    Mondragón, Liliana; Monroy, Zuraya; Ito, Ma Emily; Medina-Mora, Dra Ma Elena

    2010-06-01

    El objetivo del trabajo es conocer las disyuntivas entre los principios de beneficencia y autonomía, que se presentan en la relación médico-paciente, durante la terapéutica del intento de suicidio.La investigación se realizó en dos hospitales psiquiátricos de la Ciudad de México. La muestra incluyó a tres sujetos con intento de suicidio, mayores de 18 años, que eran atendidos en consulta externa a causa de una lesión autoinfligida en el último año, y a tres psiquiatras que trataban a estos pacientes. La información se obtuvo previo consentimiento informado en entrevistas individuales. Se llevó a cabo un análisis de discurso argumentado para encontrar los significados que los participantes otorgaron a los principios bioéticos y las posibles disyuntivas entre éstos.Las discordancias entre la beneficencia y la autonomía estuvieron relacionadas con el beneficio del tratamiento, el respeto por los valores y las creencias de los pacientes, entre otros. Este trabajo presenta consideraciones éticas relevantes en el escenario clínico, al ofrecer al psiquiatra un análisis bioético que le permita actuar de acuerdo con la beneficencia y respetando la autonomía del paciente frente a casos de intento de suicidio y, de esta forma procurar una mejor atención para ellos.

  3. Liv and Lucky in Liverland. . . Color Us Healthy! A Workbook about Your Liver = Un Cuaderno de trabajo sobre tu higado.

    ERIC Educational Resources Information Center

    1995

    This workbook/coloring book, on the liver and good health is designed for primary school students. The 21 line drawings illustrate different aspects of liver function, maintaining a healthy liver, and preventing liver disease. Each page is captioned in both English and Spanish. (ND)

  4. Impacto de la emisión de axiones sobre las propiedades evolutivas y pulsacionales de enanas blancas DB

    NASA Astrophysics Data System (ADS)

    Battich, T.; Althaus, L. G.; Córsico, A. H.

    2016-08-01

    White dwarfs are found to be good laboratories for studying the properties of fundamental particles such as the hypothetical axions. If these particles exist and interact with electrons, they would be emitted from the dense interior of white dwarfs, abandoning these stars without interact again, becoming an important energy sink. This would have a detectable effect on the evolutionary and pulsational properties of white dwarfs. This effect was already studied for DA white dwarfs (white dwarfs with a surface rich in hydrogen), but not for DB white dwarfs (hydrogen-deficient white dwarfs). We studied the general effect of axion emission on the evolution of DB white dwarfs and on the pulsational properties of DBV white dwarfs (pulsating DBs) with the aim of determining the potential of these stars to study the physics of axions. Moreover, we use an estimation of the rate of change of period of the DBV white dwarf PG 1351489 corresponding to the dominant period to derive a new limit on axion mass.

  5. Ecocardiografía tridimensional. Nuevas perspectivas sobre la caracterización de la válvula mitral

    PubMed Central

    Solis, Jorge; Sitges, Marta; Levine, Robert A.; Hung, Judy

    2010-01-01

    Recent developments in three-dimensional echocardiography have made it possible to obtain images in real time, without the need for off-line reconstruction. These developments have enabled the technique to become an important tool for both research and daily clinical practice. A substantial proportion of the studies carried out using three-dimensional echocardiography have focused on the mitral valve, the pathophysiology of mitral valve disease and, in particular, functional mitral regurgitation. The aims of this article were to review the contribution of three-dimensional echocardiography to understanding of the functional anatomy of the mitral valve and to summarize the resulting clinical applications and therapeutic implications. PMID:19232192

  6. Apuntes sobre la distribución geográfica de Neoleucinodes elegantalis (Lepidoptera: Crambidae) en Colombia

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Neoleucinodes elegantalis is considered the most limiting pest for production and merchandising of solanaceous fruit and vegetables in the Neotropics. The present study updates the geographic distribution of N. elegantalis in areas of major agricultural production of Solanum lycopersicum, S. melong...

  7. The Need to Disentangle Key Concepts from Ecosystem-Approach Jargon

    PubMed Central

    WAYLEN, K A; HASTINGS, E J; BANKS, E A; HOLSTEAD, K L; IRVINE, R J; BLACKSTOCK, K L

    2014-01-01

    Argot Ambiente-Estrategia Resumen La estrategia ambiental – como es promocionada por la Convención Biológica sobre Diversidad en 2000 – es una estrategia para un manejo holístico, sustentable y equitativo de recursos naturales, que habrá de implementarse por vía de los 12 Principios de Malawi. Estos principios describen la necesidad de manejar la naturaleza en términos de ecosistemas dinámicos, mientras se compromete totalmente con las personas locales. Es un concepto ambicioso. Hoy en día, el término es común en la investigación y la literatura de políticas sobre el manejo ambiente. Sin embargo, se han relacionado múltiples significados con el término, lo que resulta en confusión. Revisamos referencias a la estrategia ambiental de 1957 a 2012 e identificamos tres usos principales: como una alternativa para manejo ambiental o basado en ecosistemas; en referencia a una estrategia integrada y equitativa para el manejo de recursos según la CBD; y como un término que indica un enfoque en el entendimiento y la valuación de los servicios ambientales. Aunque los usos de este término y sus variantes pueden traslaparse en su significado, típicamente no reflejan en su totalidad los valores de la estrategia ambiental como fue definida por la CBD. Por ejemplo, actualmente hay un énfasis creciente en los servicios ambientales, pero enfocarse solamente en estos no promueve la descentralización del manejo o el uso de todas las formas de conocimiento, siendo ambas integrales para el concepto de la CBD. Resaltamos que los Principios de Malawi están en riesgo de ser olvidados. Para entender mejor estos principios, se requiere de más esfuerzo para implementarlos. Dichos esfuerzos deben ser evaluados, idóneamente con estrategias comparativas, antes de permitir que el concepto de la CBD de manejo holístico y comprometido socialmente sea abandonado o reemplazado. Es posible que los intentos por implementar los 12 principios juntos enfrentarán muchos obst

  8. ONR (Office of Naval Research) Far East Scientific Bulletin. Volume 9, Number 3, July to September 1984,

    DTIC Science & Technology

    1984-09-01

    C-033-82 (1982). "Development of the Narrow Gap Submerged Arc Welding Process - NSA Process," Hirai, Y. et al., Kawasaki Steel Technical Report, 5, 81...upsurge in the resources committed to research in the neurosciences in general, and to membrane phenomena specifically. Because of this large...reader a review of most of the current research being conducted in Japan in the neuroscience and membrane physiology areas. The presentation of the

  9. Responding to the Threat from Third World Air Defense Systems: A comparison of U.S. Policy Options

    DTIC Science & Technology

    1990-12-01

    quietly sitting on the sidelines nursing its own economic and political problems. The scenario projects a future crisis in which Third World nations with...ambitious and successful economic plan. Japanese economic success is not limited to the civilian sector, Mitsubishi and Kawasaki Heavy Industries derived...consumption and trafficking, terrorism against American interests and people, immigration/population explosions, pollution and disease control, world

  10. Evaluation of Androgen Receptor Function in Prostate Cancer Prognosis and Therapeutic Stratification

    DTIC Science & Technology

    2012-10-01

    at early stages of the disease . Within the first reporting period we hacve designed, tested and completed the quality control of specific proves...we will provide a quantitative incex of AR dysfunction for enhancing disease prognostic characteristics to improve accuracy and to stratify patients...Romics, Banfi et al. 2008), (Qiu, Leuschner et al. 2008),(Wako, Kawasaki et al. 2008), (Szabo, Bartok et al. 2009) (Szabo et al 2009). We reasoned

  11. Complement Activation Alters Platelet Function

    DTIC Science & Technology

    2013-10-01

    ongoing inflammatory responses such as those observed in atherosclerosis, arthritis and inflammatory bowel disease (Danese et al., 2003). Nonetheless...inflammatory response in the microvasculature of inflammatory bowel disease patients. Gastroenterology 124:1249- 1264. Elzey, B.D., J. Tian, R.J...Shiraki, R., N. Inoue, S. Kawasaki , A. Takei, M. Kadotani, Y. Ohnishi, J. Ejiri, S. Kobayashi, K. Hirata, S. Kawashima, and M. Yokoyama. 2004

  12. Evaluation of Androgen Receptor Function in Prostate Cancer Prognosis and Therapeutic Stratification

    DTIC Science & Technology

    2013-10-01

    cancer tissues (surgery or diagnostic biopsy specimens) at early stages of the disease and matched with longitudinal follow up data. Within the first...Leuschner et al. 2008),(Wako, Kawasaki et al. 2008), (Szabo, Bartok et al. 2009) (Szabo et al. 2009). We reasoned that evaluation of AR dysfunction...will be incorporated into nomograms modeling time-to-event data, including prediction of disease progression, combined with established clinical

  13. Harnessing Autopsied DIPG Tumor Tissues for Orthotopic Xenograft Model Development in the Brain Stems of SCID Mice

    DTIC Science & Technology

    2012-09-01

    virtually all children with this disease within 1-2 years of diagnosis1. Because DIPGs are not amenable for surgery due to its location and...10. Hurt EM, Kawasaki BT, Klarmann GJ, Thomas SB, Farrar WL. CD44+ CD24(-) prostate cells are early cancer progenitor/stem cells that provide a model...co-expression of CD117 (c-kit) and osteocalcin in activated bone marrow stem cells in different diseases . Br J Haematol. 2002;118:305-312. 18

  14. Mixed Algorithms in the Ising Model on Directed BARABÁSI-ALBERT Networks

    NASA Astrophysics Data System (ADS)

    Lima, F. W. S.

    On directed Barabási-Albert networks with two and seven neighbours selected by each added site, the Ising model does not seem to show a spontaneous magnetisation. Instead, the decay time for flipping of the magnetisation follows an Arrhenius law for Metropolis and Glauber algorithms, but for Wolff cluster flipping the magnetisation decays exponentially with time. On these networks the magnetisation behaviour of the Ising model, with Glauber, HeatBath, Metropolis, Wolf or Swendsen-Wang algorithm competing against Kawasaki dynamics, is studied by Monte Carlo simulations. We show that the model exhibits the phenomenon of self-organisation (= stationary equilibrium) defined in Ref. 8 when Kawasaki dynamics is not dominant in its competition with Glauber, HeatBath and Swendsen-Wang algorithms. Only for Wolff cluster flipping the magnetisation, this phenomenon occurs after an exponentially decay of magnetisation with time. The Metropolis results are independent of competition. We also study the same process of competition described above but with Kawasaki dynamics at the same temperature as the other algorithms. The obtained results are similar for Wolff cluster flipping, Metropolis and Swendsen-Wang algorithms but different for HeatBath.

  15. [Proposed model of executive functions based on factorial analyses].

    PubMed

    Tirapu-Ustarroz, J; Cordero-Andres, P; Luna-Lario, P; Hernaez-Goni, P

    2017-01-16

    Introduccion. Desde que Lezak acuñara el termino de funciones ejecutivas como las capacidades mentales esenciales para llevar a cabo una conducta eficaz, creativa y aceptada socialmente, estas han adquirido progresivo protagonismo en la investigacion neuropsicologica. Diversos modelos han sido planteados para explicar su naturaleza, pero no existe consenso respecto a si nos encontramos ante un constructo unitario o un sistema de procesamiento multimodal con componentes independientes, pero interconectados. Para conocer la estructura de este constructo se han utilizado estudios de lesion, neuroimagen y, recientemente, el analisis factorial, que se plantea como una metodologia prometedora para ampliar nuestro conocimiento sobre un concepto tan generico como las funciones ejecutivas. Desarrollo. El proposito de este estudio es realizar una revision sistematica de modelos factoriales de atencion y control ejecutivo en adultos, entre los años 1991-2016, utilizando las bases de datos PubMed, OvidSP y PsycINFO. En total, se revisaron 33 articulos. A partir de la bibliografia, se realiza una propuesta integradora de los procesos ejecutivos. Conclusiones. Aunque no disponemos de un unico modelo que pueda explicar la complejidad de las funciones ejecutivas, si parece existir acuerdo respecto a su multidimensionalidad. En analisis factoriales, actualizacion, inhibicion y alternancia gozan de fuerte evidencia, si bien hay trabajos que plantean factores novedosos. Nuestra propuesta integradora trata de combinar los procesos ejecutivos hallados en la bibliografia con sus correspondientes correlatos neuroanatomicos, defendiendo que la metodologia ideal deberia utilizar informacion procedente de estudios de lesion, tecnicas de neuroimagen y modelos psicometricos-computacionales.

  16. [Brain death: attitude and knowledge of medical personnel in a third level hospital].

    PubMed

    Santibáñez-Velázquez, Martín; Olguín-Sánchez, Erika; Ángeles-Vélez, Adrián; García-García, Bertha Angélica

    2016-01-01

    Introducción: la muerte encefálica se define como el cese irreversible de las funciones de las estructuras neurológicas intracraneales, tanto de los hemisferios cerebrales como del troncoencéfalo. El objetivo es conocer la actitud y los conocimientos que tiene ante la muerte encefálica el personal médico relacionado con el trasplante y la donación de órganos y tejidos en un hospital de tercer nivel de la ciudad de México. Métodos: fueron encuestados 67 médicos con el método de pluma, papel y un cuestionario impreso; se distribuyeron en dos grupos: grupo A no quirúrgicos y grupo B quirúrgicos. Se exploraron la actitud y los conocimientos de los criterios establecidos en la Ley General de Salud en México. Contestaron la encuesta 35 hombres y 32 mujeres, con una mediana de edad de 42 años. Resultados: más del 90 % en ambos grupos desearía participar en un curso-taller de muerte encefálica, así como ser potenciales donadores y receptores de órganos. Un alto porcentaje conoce parcialmente la ley sobre muerte encefálica y los conceptos clínicos. El 68 % de la población encuestada no conoce los estudios complementarios establecidos para confirmar el diagnóstico de muerte encefálica. Al comparar ambos grupos no se encontró diferencia significativa (p = 0.170). Conclusión: el médico debe responsabilizarse más en el dominio de la muerte encefálica.

  17. La Enseñanza/Aprendizaje del Modelo Sol-Tierra Análisis de la Situación Actual y Propuesta de Mejora Para la Formación de los Futuros Profesores de Primaria

    NASA Astrophysics Data System (ADS)

    Martínez Sebastià, Bernat

    2004-12-01

    This work is an extened summary of the autor's PhD thesis. It deals with the teaching of astronomy (day/night, seasons) in primary school. At first, students teachers' undestanding of astronomical concepts related to Sun-Earth system have been analysed. Taking into account the results of the previous analysis and using a socio-constructivist approach a teaching sequence has been designed. This sequence has been tested with different groups of students teachers showing an improvement in their undestanding of elementary astronomical concepts. El trabajo que presentamos es un resumen extenso de la tesis doctoral del autor. El enfoque utilizado ha sido tratar de ligar la investigación sobre las ideas, razonamientos y obstáculos de los profesores de primaria con la planificación de la enseñanza del modelo Sol-Tierra que permite explicar el ciclo día/noche y las estaciones. En primer lugar, se ha procedido a realizar un análisis crítico de los resultados que se obtienen en el aprendizaje de los contenidos astronómicos en la enseñanza habitual. En segundo lugar se ha diseñado un curriculum potencialmente superador de esta situación desde una orientación que concibe la enseñanza y el aprendizaje como un proceso de construcción de conocimientos en una estructura problematizada. Finalmente, esta secuencia didáctica ha sido experimentada con diferentes grupos de estudiantes de magisterio, mostrando una mejora relevante en la comprensión de los conceptos astronómicos fundamentales.

  18. Desarrollo curricular, conciencia ambiental y tecnologia para estudiantes de intermedia: Una investigacion en accion

    NASA Astrophysics Data System (ADS)

    Rodriguez Ramos, Teresita

    Se llevó a cabo una investigación en acción con los propósitos de 1) documentar las relaciones de las tecnologías de la información y la comunicación en las clases de ciencias de escuela intermedia como elemento de apoyo cuando se aborda el tema ambiental y sus conceptos pertinentes, a partir de las observaciones de la investigadora, así como las entrevistas y diarios reflexivos de los estudiantes de una escuela intermedia en la zona metropolitana, y luego 2) diseñar una unidad instruccional sobre el tema ambiental que integre actividades tecnologías para el curso de ciencias de la escuela intermedia según el modelo PROCIC y las observaciones que hayan iniciado los estudiantes participantes. Finalmente, se plantearon las implicaciones educativas para el currículo del Programa de Ciencias al instrumentar este modelo de unidad mediante PROCIC, e integrado la tecnología y el tema ambiental. Los hallazgos se analizaron y se categorizaron de acuerdo con las preguntas de investigación. El hallazgo principal de la investigación aborda las cuatro relaciones centrales en las que se articula la utilización de las tecnologías y sus aplicaciones en la clase de ciencias. Estas cuatro relaciones que recogen la posición de los estudiantes son: 1) Perspectiva de los estudiantes hacia la tecnología. 2) Participación de los estudiantes en los aspectos docentes. 3) Aprendizaje estudiantil sobre el ambiente, y 4) Conciencia ambiental en relación con la vida diaria. Estas relaciones ponen de manifiesto,cómo se plantea en las implicaciones, la necesidad de más investigación en acción en la sala de clases, la importancia—como tema transversal—de la conciencia ambiental mediante la tecnología al construir conocimientos significativos dentro y fuera de la escuela, asó como, valorar la investigación y la dialogicidad en la sala de clases como actividades que obligan al reexamen de la práctica didáctica en su formas curriculares de objetivos, recursos

  19. Endothelial function in pre-pubertal children at risk of developing cardiomyopathy: a new frontier

    PubMed Central

    Tavares, Aline Cristina; Bocchi, Edimar Alcides; Guimarães, Guilherme Veiga

    2012-01-01

    Although it is known that obesity, diabetes, and Kawasaki's disease play important roles in systemic inflammation and in the development of both endothelial dysfunction and cardiomyopathy, there is a lack of data regarding the endothelial function of pre-pubertal children suffering from cardiomyopathy. In this study, we performed a systematic review of the literature on pre-pubertal children at risk of developing cardiomyopathy to assess the endothelial function of pre-pubertal children at risk of developing cardiomyopathy. We searched the published literature indexed in PubMed, Bireme and SciELO using the keywords ‘endothelial', ‘children', ‘pediatric' and ‘infant' and then compiled a systematic review. The end points were age, the pubertal stage, sex differences, the method used for the endothelial evaluation and the endothelial values themselves. No studies on children with cardiomyopathy were found. Only 11 papers were selected for our complete analysis, where these included reports on the flow-mediated percentage dilatation, the values of which were 9.80±1.80, 5.90±1.29, 4.50±0.70, and 7.10±1.27 for healthy, obese, diabetic and pre-pubertal children with Kawasaki's disease, respectively. There was no significant difference in the dilatation, independent of the endothelium, either among the groups or between the genders for both of the measurements in children; similar results have been found in adolescents and adults. The endothelial function in cardiomyopathic children remains unclear because of the lack of data; nevertheless, the known dysfunctions in children with obesity, type 1 diabetes and Kawasaki's disease may influence the severity of the cardiovascular symptoms, the prognosis, and the mortality rate. The results of this study encourage future research into the consequences of endothelial dysfunction in pre-pubertal children. PMID:22473410

  20. Endothelial function in pre-pubertal children at risk of developing cardiomyopathy: a new frontier.

    PubMed

    Tavares, Aline Cristina; Bocchi, Edimar Alcides; Guimarães, Guilherme Veiga

    2012-01-01

    Although it is known that obesity, diabetes, and Kawasaki's disease play important roles in systemic inflammation and in the development of both endothelial dysfunction and cardiomyopathy, there is a lack of data regarding the endothelial function of pre-pubertal children suffering from cardiomyopathy. In this study, we performed a systematic review of the literature on pre-pubertal children at risk of developing cardiomyopathy to assess the endothelial function of pre-pubertal children at risk of developing cardiomyopathy. We searched the published literature indexed in PubMed, Bireme and SciELO using the keywords 'endothelial', 'children', 'pediatric' and 'infant' and then compiled a systematic review. The end points were age, the pubertal stage, sex differences, the method used for the endothelial evaluation and the endothelial values themselves. No studies on children with cardiomyopathy were found. Only 11 papers were selected for our complete analysis, where these included reports on the flow-mediated percentage dilatation, the values of which were 9.80±1.80, 5.90±1.29, 4.50±0.70, and 7.10±1.27 for healthy, obese, diabetic and pre-pubertal children with Kawasaki's disease, respectively. There was no significant difference in the dilatation, independent of the endothelium, either among the groups or between the genders for both of the measurements in children; similar results have been found in adolescents and adults. The endothelial function in cardiomyopathic children remains unclear because of the lack of data; nevertheless, the known dysfunctions in children with obesity, type 1 diabetes and Kawasaki's disease may influence the severity of the cardiovascular symptoms, the prognosis, and the mortality rate. The results of this study encourage future research into the consequences of endothelial dysfunction in pre-pubertal children.

  1. Steppin' On Up: A Post-Secondary Guide for Migrant Students = Tomando Accion: Una Guia para los Estudiantes Migrantes Sobre Que Hacer Despues de la Escuela Secundaria.

    ERIC Educational Resources Information Center

    Western Stream Migrant Education Program Coordination Center, Portland, OR.

    This bilingual guide (English and Spanish) provides information for migrant students on postsecondary education. The guide includes information on: (1) career planning, involving self-exploration, occupational exploration, and strategies for reaching career objectives; (2) planning for postsecondary education during high school, including a…

  2. Tips for Parents on Keeping Children Drug Free = Consejos para Los Padres Sobre Como Mantener a Los Hijos Libres de La Droga.

    ERIC Educational Resources Information Center

    Department of Education, Washington, DC. Office of Intergovernmental and Interagency Affairs.

    Research shows that recent trends in youth drug use have stabilized; however, the rates of use remain at high levels. It has been shown that the earlier drug use is initiated, the more likely a person is to develop drug problems later in life. Youth substance abuse may lead to many other problems that affect not only the child, but also the…

  3. Feedback Cheerleader, Mean-Spirited Feedback Estudio Critico Discursivo De Ideologias Sobre El Feedback Escrito En Un Departamento Universitario De Espanol En Estados Unidos

    ERIC Educational Resources Information Center

    Dominguez-Mujica, Maria Eugenia

    2012-01-01

    The aim of this research is to investigate ideologies that monitor and control styles of written feedback as well as discursive resources used in the expression of those ideologies. Using socio-cognitive analysis, a development of critical discourse studies, I have analyzed 44 sessions of chat on the Internet, 78 journal notes, 31 emails and 12…

  4. Informe sobre el avance del proyecto de determinaciones de V sen i para todas las estrellas B más brillantes que 6.5 mag.

    NASA Astrophysics Data System (ADS)

    Abt, H.; Levato, H.

    Se ha finalizado con la determinación de V sen i para todas las estrellas B más brillantes que 6.5 mag y al norte de -30 grados de declinación. Esta muestra involucra casi 1000 estrellas. Las observaciones fueron realizadas desde KPNO. Mientras tanto, se ha completado desde CASLEO la observación de 350 estrellas B más brillantes que 6.5 mag. al sur de -30 grados. Además de la determinación de la rotación axial se determinan, en los casos posibles, los anchos equivalentes de las líneas 4471 Ådel He I y 4481 Ådel Mg II.

  5. The Dyslexia Handbook: Procedures Concerning Dyslexia and Related Disorders = Manual sobre la dislexia: Procedimientos relacionados con la dislexia y otros desordenes.

    ERIC Educational Resources Information Center

    Texas Education Agency, Austin.

    This handbook, available in English and Spanish, contains the Texas State Board of Education's approved procedures concerning dyslexia and related disorders and information regarding the state's dyslexia statutes and their relation to the federal Rehabilitation Act of 1973, Section 504, and the Individuals with Disabilities Education Act. Chapters…

  6. Conversacion sobre "Tres tristes tigres". Una entrevista de Rita Guibert (A Conversation about "Three Sad Tigers". An Interview with Rita Guibert)

    ERIC Educational Resources Information Center

    Cabrera Infante, Guillermo

    1971-01-01

    Interview took place in London, England, on October 5, 1970 between Cuban writer Guillermo Cabrera Infante and journalist Rita Guibert. Special issue dedicated to contemporary Spanish American literature. (DS)

  7. Tax and Record Keeping Information for Family Child Care = Informacion Sobre los Impuestos y la Documentacion para el Cuidado Infantil en el Hogar.

    ERIC Educational Resources Information Center

    Gellert, Sandra

    This pamphlet from the Children's Foundation, in both English- and Spanish-language versions, provides advice to child care providers on record-keeping methods. The pamphlet also gives definitions and guidance on business expenses (100% deductible, shared personal and business, and depreciated capital expenses), time-space formula, self-employment…

  8. Investigación observacional sobre el papel de las estrellas binarias en la ecología de cúmulos estelares

    NASA Astrophysics Data System (ADS)

    González, J. F.; Levato, H.; Grosso, M.

    We present preliminary results of a long-term project devoted to the observational study of the binary star population in open clusters and its connection with the dynamical and evolutionary properties of the clusters. We report the discovery of 17 double-lined spectroscopic binaries, 30 radial velocity variables and about 30 suspected variables. In the 17 clusters of our sample the binary frequency ranges between 20 and 40 %, and reaches typically 60 % if all suspected binaries are included. We study the spatial distribution of the binary stars with respect to the cluster center and we discuss the statistical correlation of the mass-ratio distribution with the cluster age.

  9. Lo Que los Padres y los Maestros Deberian Saber sobre la...Aceleraction (What Parents and Teachers Should Know about Academic Acceleration).

    ERIC Educational Resources Information Center

    Guenther, Alex

    Designed for Spanish-speaking educators and parents, this pamphlet discusses academic acceleration for gifted children. Major types of academic acceleration and their benefits are described. These include: (1) early admission to kindergarten that saves parents of gifted children the expenses of a year of preschool, allows children to be…

  10. Producción masiva automatizada de la broca del café Hypothenemus hampei Ferrari (Coleóptera: Scolytidae) y de sus parasitoides sobre dietas artificiales

    Technology Transfer Automated Retrieval System (TEKTRAN)

    This article reviews the current state of knowledge concerning the mass rearing system of the coffee berry borer, cbb, Hypothenemus hampei (Ferrari) (Coleoptera: Scolytidae), and its African parasitoids: the ectoparasitoids Cephalonomia stephanoderis (Betrem) and Prorops nasuta ((Waterston) (Hymenop...

  11. Manual sobre la Educacion en California para Padres de Idiomas Minoritarios (A Handbook on California Education for Language Minority Parents). Revised Edition. Spanish/English Edition.

    ERIC Educational Resources Information Center

    California State Dept. of Education, Sacramento. Office of Bilingual Bicultural Education.

    The handbook, an update of the 1986 handbook, is designed for Spanish-speaking parents of California public school students, and answers commonly-asked questions about the state public education system and its services, particularly those of interest to this population. Information is presented in both Spanish-and English-language sections, in a…

  12. Sobre la convertibilidad de ciertos adjectivos en adverbios en el idioma espanol (Concerning the Convertibility of Some Spanish Adjectives into Adverbs).

    ERIC Educational Resources Information Center

    Zierer, Ernesto

    1971-01-01

    This paper considers Spanish adjectives and the possibility of converting some adjectives into adverbs, keeping the same general significance of a sentence. The conversion of an adjective into an adverb under these circumstances can be accomplished through a transformation which can be applied to a particular logical-semantic structure. The author…

  13. Manual sobre la Educacion en California para Padres de Idiomas Minoritarios = A Handbook on California Education for Language Minority Parents--Spanish/English Edition.

    ERIC Educational Resources Information Center

    California State Dept. of Education, Sacramento. Bilingual Education Office.

    This bilingual handbook, presented in both Spanish and English, is designed to assist parents of language minority students who are residing in California. The book is part of the technical assistance effort of the State Department of Education to clarify the operations of the California schools to language minority parents so they can better…

  14. Simposio sobre Educacion de Ninas: Evidencias, Temas, Acciones. Actas de sesiones. (Symposium on Girls Education: Evidence, Issues, Actions. Proceedings). (Washington, DC, May 17-18, 2000).

    ERIC Educational Resources Information Center

    Agency for International Development (IDCA), Washington, DC.

    This symposium highlighted core issues of controversy in girls' education and developed implications for policy and practice. Its evidence-based discussion forum encouraged dialogue, debate, and increased interaction and developed partnerships among academic institutions, nongovernmental organizations, multilateral development agencies, and other…

  15. Ahorre Energía: Consejos sobre el ahorro de dinero y energía en el hogar (Spanish Brochure), Energy Savers Guide

    SciTech Connect

    2014-09-01

    La versión en castellano de la guía del Departamento de Energía de los Estados Unidos que ayuda a consumidores a ahorrar energía y dinero en el hogar y en las carreteras. The Spanish-language version of U.S. Department of Energy's consumer guide to saving energy and money at home and on the road.

  16. How To Talk to Your Teens and Children about AIDS = Como hablar con sus adolescentes y sus ninos sobre el SIDA.

    ERIC Educational Resources Information Center

    National PTA, Chicago, IL.

    Two brochures, one in English and one in Spanish, provide parents with basic information that will enable them to educate their children about Acquired Immune Deficiency Syndrome (AIDS). Contents address 11 questions: (1) What is AIDS? (2) How do you get AIDS? (3) How is AIDS not spread? (4) Who can get AIDS? (5) How can you tell if someone has…

  17. Otra perspectiva sobre lo que los ninos deben estar aprendiendo (Another Look at What Young Children Should Be Learning). ERIC Digest.

    ERIC Educational Resources Information Center

    Katz, Lilian G.

    This Spanish-language ERIC Digest addresses the question of what young children should be learning that will best serve their development and learning in the long term. Two major dimensions of development--normative and dynamic--are explored, and four categories of learning goals are discussed: (1) knowledge; (2) skills; (3) dispositions; and (4)…

  18. Catalysts for Change: Three Case Studies of Quality Education Worldwide = Catalizadores del Cambio: Tres Casos de Estudio sobre la Educacion de Calidad en el Mundo

    ERIC Educational Resources Information Center

    Puriefoy, Wendy D.

    2007-01-01

    Public education is the cornerstone of democracy and is absolutely fundamental to a democratic, civil and prosperous society. Beyond the boundaries of the United States, other countries are working to provide quality education to their children through civil society institutions. In particular, there are three extraordinary organizations in Peru,…

  19. Nuevos resultados sobre la cinemática global y nuclear de NGC 253: movimientos no circulares y emisión en Br γ

    NASA Astrophysics Data System (ADS)

    Camperi, J. A.; Gunthardt, G. I.; Díaz, R. J.; Agüuero, M. P.; Gimeno, G.; Pessev, P.

    Continuing with previous research (Camperi et al., BAAA, 54, 377, 2011), new heliocentric radial velocity distributions are presented for the nearby galaxy NGC 253, obtained from the ionized hydrogen recombination line Hα. These distributions have been derived from long-slit spectroscopy for various position angles. It is also shown the heliocentric radial velocity distribution corresponding to part of the infrared data (ionized hydrogen recombination line Brγ) observed with the Phoenix spectrograph of the Gemini South Observatory. Sequential mapping with the long slit using this instrument will enable to study in detail the kinematics of the galaxy's core, which is strongly obscured by dust. FULL TEXT IN SPANISH

  20. Etnografía acelerada para transformar normas sociales sobre género y sexualidad en hombres puertorriqueños heterosexuales1,2

    PubMed Central

    Ortiz-Torres, Blanca; Rivera-Ortiz, Rafael J.; Mendoza, Sigrid

    2014-01-01

    Resumen La construcción de roles de género dominantes contribuyen al riesgo de contraer VIH, y por tal razón se ha urgido a que se integren las normas sociales relativas al género en las intervenciones preventivas del VIH. Este estudio pretende adaptar y desarrollar una intervención que facilite la transformación de normas sociales del género y de prácticas sexuales en hombres puertorriqueños. La intervención propone transformar normas sociales relacionadas al género y sexualidad en barras comunitarias utilizando el modelo de líderes de opinión. Luego de ser elegidos/as, los/as líderes de opinión diseminan mensajes integrando la importancia de relaciones equitativas entre parejas para la prevención del VIH. La primera fase de esta intervención es discutida en este artículo, la cual incluye un proceso de etnografía acelerada para identificar los escenarios comunitarios en los que podemos desarrollar esta intervención y permitirnos entender la cultura de las barras comunitarias. A partir de las observaciones etnográficas, pudimos: desarrollar un protocolo de seguridad para realizar las observaciones, desarrollar un perfil de la cultura de las barras, elegir las barras a participar en las dos condiciones del estudio y adaptar los instrumentos de la intervención para que respondieran a la particularidad de los/as participantes. PMID:25530828

  1. Guia para la Ensenanza Combinada de Ingles y Ciencia. Para Padres/sobre Padres. (A Guide to Teaching English and Science Together. For Parents/about Parents).

    ERIC Educational Resources Information Center

    Schwartz, Wendy

    In the past, students who knew only a little English (called limited English proficient, or LEP), were usually taught only low-level science and mathematics. Now, new science and mathematics teaching methods can help LEP students get a good education in both fields. This guide will help parents know if their children are learning as much as…

  2. Parenting Information for Parents: Books 1-3 (Informacion Para Los Padres Sobre La Crianza De Los Hijos: Libros 1-3).

    ERIC Educational Resources Information Center

    Moreno, Steve

    These 3 booklets provide ideas, guidelines, and activities for establishing effective parenting and are part of a series of 22 booklets specifically designed to help parents understand their children and help them to learn. The first booklet (booklet #20) discusses preparation for parenthood, infant and toddler developmental stages, the importance…

  3. 8 de noviembre de 2006: Mercurio pasea sobre el disco solar (Micro eclipse anular de Sol o el segundo tránsito de Mercurio del siglo XXI)

    NASA Astrophysics Data System (ADS)

    Mallamaci, C. C.

    On Wendsday November 8, 2006, the second transit of Mercury over the Sun of the 21st. Century, took place. In this work we present the principal characteristics of the phenomenon ocurrence, the visibility region and the local circumstances for some locations of Argentina and other countries of the world. Full TEXT IN SPANISH

  4. Politica Nacional sobre Discapacidad: Un Informe del Progreso, Diciembre 2000-Diciembre 2001 (National Disability Policy: A Progress Report, December 2000-December 2001).

    ERIC Educational Resources Information Center

    National Council on Disability, Washington, DC.

    This report (written in Spanish) of the National Council on Disability (NCD) describes the nation's progress in advancing public policies to increase the inclusion, empowerment, and independence of people with disabilities in light of the Americans with Disabilities Act of 1990. The report covers December 2000 through December 2001. It reviews…

  5. Teorí­as de primer y segundo orden sobre el potencial de ciertas figuras de equilibrio de cuerpos celestes

    NASA Astrophysics Data System (ADS)

    Gumbau, Manuel Forner

    2010-11-01

    Uno de los problemas que aborda la Mecánica Celeste es la determinación de las figuras de equilibrio de los cuerpos celestes. Para investigar su solución mediante métodos directos, se precisa evaluar el potencial generado por su autogravitación, el generado por su fuerza centrí­fuga y el generado por la fuerza de atracción entre los cuerpos. Los métodos clásicos de Finlay y Kopal que afrontan estos problemas, para determinar el potencial autogravitatorio en las configuraciones de equilibrio, emplean desarrollos en serie de los potenciales interior y exterior del potencial autogravitatorio. Estos métodos incurren en el error de suponer la convergencia en capas donde resulta cuestionable dicha convergencia para estos desarrollos en serie. En este trabajo se han elaborado unos algoritmos que contemplan toda la casuí&stica y que permiten una manipulación efic iente del producto de polinomios de Legendre, del producto de funciones asociada s de Legendre y del producto de armónicos esféricos como combinacióon lineal de ellos mismos, respectivamente. Se han obtenido, para primer y segundo orden en las amplitudes, los desarrollos correctos para los potencial es interior y exterior del potencial autogravitatorio para configuraciones de equilibrio aisladas, y , en primer orden de amplitudes, los mismos potenciales para los sistemas binarios próximos. Se ha elaborado un método analítico, en primer orden respecto de las amplitudes, para la determinación del potencial de marea en sistemas binarios próximos en el cual se manifiesta la forma de la componente secundaria del sistema

  6. Development and Initial Validation of a Questionnaire to Assess the Reading Beliefs of Undergraduate Students: The "Cuestionario de Creencias Sobre la Lectura"

    ERIC Educational Resources Information Center

    Lordán, Eva; Solé, Isabel; Beltran, Francesc S.

    2017-01-01

    The aim of this research was to develop a new questionnaire for exploring the reading beliefs of undergraduate students, because the only currently available instrument has conceptual and methodological limitations. The paper describes the process of developing the instrument and presents a range of psychometric data obtained from a sample of 558…

  7. Conservación de material histórico sobre papel en el Observatorio Astronómico de la Universidad Nacional de Córdoba

    NASA Astrophysics Data System (ADS)

    Laguzzi, N.; Tonini, A.; Andreoli, G.; Goldes, G.; Paolantonio, S.; Cequeira, F.; Landi, L.; Alba, J.

    At the recently created Astronomical Museum ``Pte. Sarmiento - Dr. Benjamin Gould", the task of preventive conservation of historic documents has been faced. These materials include: 1) letters exchanged between national authorities and the directors of the Observatory, during the first decades (1870-1880-1890); b) original observation logs from these very first times, containing astrometrical and photometrical data; c) a variety of ancient books and papers; d) administrative documents. The state of conservation of this patrimony was varied: since well-conserved books and letters, to highly degraded logs. The observation logs written by B. Gould and the astronomers who followed him had been stocked in a safe with a permanent humidity of about 70 %, without any ventilation and exposed to the attack of insects of the family ``dermestidae." These conditions could not be worse for the conservation of paper. In order to stop the proccess of degradation and create a healthy environment for written-paper conservation, a team was formed with personnel belonging to the Cultural Area of the Municipality. The tasks being performed on the observation logs are: 1) an initial, mechanical cleaning, performed once the material is extracted from the contaminated safe: by these means, adult insects and pupas are removed 2) a stage of about two weeks of duration, in which the logs are mantained in a vacuum chamber, in orden to completely eliminate the adult, pupa and egg stage insects by anoxia 3) the final mechanical cleaning 4) storage in a clean location. In order to perform these tasks, we work in collaboration with the Environmental Observatory of the City, and the group of Material-Science Research of Fa.M.A.F. Regarding the letters, a mechanical cleaning was performed. After that, the letters were digitized by means of a scanner, inventoried, put inside acid-free polipropylene envelops and filed for conservation, protected from intense light and external sources of contamination. Copies of these letters will be included as exhibits.

  8. Consideraciones sobre la investigacion hermeneutica en la educacion en lenguas y culturas extranjeras (Aspects of Applying a Hermeneutic Approach to Foreign Language and Culture Education).

    ERIC Educational Resources Information Center

    Zoreda, Margaret Lee

    Drawing on writings by recent post-modernist thinkers and semioticians, this paper focuses on a combination of hermeneutic and semiotic viewpoints and applies them to defining the nature of interpretation in an educational setting (e.g., text interpretation), the interpreter, and the essence of the act of comprehension and interpretation. The main…

  9. La investigacion sobre la calidad de los programas para ninos de hasta dos anos de edad (Research on Quality in Infant-Toddler Programs). ERIC Digest.

    ERIC Educational Resources Information Center

    Honig, Alice Sterling

    Concern about the quality of infant-toddler care programs has grown recently in response to two factors. The first is the need of employed parents for such care, and the second is research emphasizing the importance of brain development in the early years. This Spanish-language Digest introduces some of the many issues related to the quality of…

  10. Sobre la posible existencia de un bulbo o núcleo de población II en la Nube Mayor de Magallanes

    NASA Astrophysics Data System (ADS)

    Clariá, J. J.; Dutra, D. M.; Bica, E.; Piatti, A. E.

    Based on recent results obtained with the Hubble Space Telescope, we present a census of genuine globular clusters in the Large Magellanic Cloud (LMC) and we examine their spatial distribution. Spectroscopic observations carried out at Complejo Astronómico El Leoncito (CASLEO, Argentina) allow us to add two new clusters (NGC 1928 and NGC 1939) to the list of genuine LMC globular clusters. We present evidence that old clusters projected on the LMC bar region may constitute a population II core, probably reminiscent of an ancient bulge, which together with a central disc could have evolved into the observed LMC bar by SMC and/or Galaxy interactions. A detailed discussion was given in MNRAS 305, 373 (1999).

  11. Guia para Madres y Padres de Familia sobre Educacion Pre-Escolar a Temprana Edad (A Parents' Guide to Early Childhood Education).

    ERIC Educational Resources Information Center

    Dodge, Diane Trister; Phinney, Joanna

    This booklet for parents explains what children learn in preschools that employ the Creative Curriculum for Early Childhood and the ways in which learning can be reinforced at home. The first sections of the booklet explain the goals and philosophy of experience-based preschools. Goals include teaching children to love reading and school and to be…

  12. Desarrollo de un instrumento para medir percepciones sobre el contexto de construccion del conocimiento cientifico de estudiantes universitarios de nuevo ingreso

    NASA Astrophysics Data System (ADS)

    Garcia-Ramirez, Jaime Antonio

    En esta investigacion, se desarrollo un instrumento que permite medir percepciones relacionadas al contexto de constriccion del conocimiento cientifico. Se examinaron instrumentos existentes y se encontro que el VOSTS (Views on science, technology, and society), instrumento desarrollado empiricamente en Canada por Aikenhead, Ryan y Fleming, podia traducirse y validarse en el contexto cultural puertorriqueno. El instrumento es extenso, consta de 113 reactivos, cada uno con una premisa basica relacionada a la tematica ciencia, tecnologia y sociedad y un numero de alternativas relacionadas a la premisa que oscila entre siete y trece. Se delimito su utilizacion a los quince reactivos identificados por los autores como relacionados a la construccion social del conocimiento cientifico. Metodologicamente, se procedio a utilizar el modelo de adaptacion intercultural, que permite que el instrumento desarrollado satisfaga las dimensiones de equivalencia semantica, de contenido, tecnica, de criterio y conceptual, atemperado asi al instrumento original. Se cumplio con este proposito mediante la traduccion de la version original en ingles al espanol y viceversa. Se utilizaron comites para examinar la traduccion y la retro-traduccion del instrumento. Se realizo una prueba piloto con estudiantes universitarios de nuevo ingreso, utilizando el instrumento traducido para asegurar su intelegibilidad. La confiabilidad del instrumento se determino mediante la intervencion de un panel de expertos quienes clasificaron las distintas posiciones dentro de cada reactivo en: realista, con merito e ingenua; se transformaron estas opciones en valores numericos lo que permitio establecer una escala Likert para cada una. Se suministro el instrumento a una muestra de estudiantes universitarios de nuevo ingreso con caracteristicas similares a las de la poblacion puertorriquena en cuanto a ejecucion en las pruebas de aptitud verbal y matematica del College Board. Los resultados de sus contestaciones fueron transformados numericamente para poder obtener el coeficiente de correlacion de Spearman-Brown para el instrumento (0.661, p < 0.01). El analisis de las contestaciones de los estudiantes refleja percepciones diversas y, en algunos casos, contradictorias con respecto al contexto de construccion del conocimiento cientifico.

  13. La influencia del medio interestelar sobre la evolución del remanente de supernova (RSN) G53.6-2.2

    NASA Astrophysics Data System (ADS)

    Giacani, E. B.; Dubner, G.; Cappa, C.; Testori, J. C.

    G53.6-2.2 is a supernova remnant with an unusual morphology: in the radio band the overall shape can be described as two shells that overlap on the NW side of the remnant. The X-ray emission fills the source and peaks in the region where the radio rings overlap; while in the optical range the emission consists of filaments that correlate with portions of radio rings that overlap in the NW. The aim of the present project is to investigate the neutral hydrogen distribution around the remnant in search for signatures that allow to disclose the role of the surrounding gas in conditioning the observed morphology.

  14. Que Sucede? Manual Informativo Sobre Rehabilitacion y Educacion Especial en Costa Rica (What's Happening? Informative Manual on Rehabilitation and Special Education in Costa Rica).

    ERIC Educational Resources Information Center

    de Mezerville, Gaston; And Others

    The manual, in Spanish, provides descriptions of rehabilitation, medical, and special education services; centers and institutions which offer physical and mental rehabilitation services; and lists of professionals and advocacy organizations in Costa Rica. Part 1 includes an overview of rehabilitation and special education, a short history of…

  15. Kathy Finds Out about the Introduction of Solids. Mother-to-Mother Support = Josefa Descubre Conocimientos sobre la Introduccion de Solidos. Apoyo Madre a Madre.

    ERIC Educational Resources Information Center

    Magalhaes, Rebecca; Stone-Jimenez, Maryanne; Allen de Smith, Paulina; Smith, Natalia

    These magazine-sized booklets, one in English, one in Spanish, are in cartoon format and are designed to be used by people with limited literacy in English or Spanish. This booklet explains that exclusive breastfeeding means giving no water, liquids, or food; breast milk contains sufficient water to satisfy the baby's thirst; at about 6 months,…

  16. Perspectivas sobre las escuelas charter: Una resena para padres de familia (Perspectives on Charter Schools: A Review for Parents). ERIC Digest.

    ERIC Educational Resources Information Center

    Donahoo, Saran

    Recently, charter schools have gained popularity with parents, students, and others as alternatives to public schools, but what are charter schools and what effects are they having? This Spanish-language Digest defines charter schools and clarifies some of the administrative and legal details surrounding such schools. The Digest also lays out some…

  17. Estudio Sobre Portadores Cronicos de Salmonellas en Manipuladores de Alimentos de la Ciudad de Iquitos (Study of Chronic Salmonella Carriers in Food Handlers in the City of Iquitos)

    DTIC Science & Technology

    1990-01-01

    manipuladores de alimentos en estudio. 779 (77.90%) fueron del sexo femcnino y 221 (22.10%) del sexo masculino. siendo el mayor porcentaje mujeres (234 - 30.04...papel de ios portadlores cr6- Woos en 460 mujeres dadas de alt. del hospital de Chile, encontrandose 34 porta- dores o sea 7.4 % excediindose las...4 sujetos 3.6 % portadores cr6nicos de Salmoncilas. 1S0 En Argentina 1974, se inves:,16 la frecuencia de Saiimoncilas en 146 manipulado- res de

  18. Uso de los Datos de Biomonitoreo para Informar sobre la Evaluacion Infantil (American translation is: USING BIOMONITORING DATA TO INFORM EXPOSURE ASSESSMENT IN CHILDREN)

    EPA Science Inventory

    Discussing the challenges associated with estimating and interpreting toxicant exposures and health risks from biomonitoring data. This extended abstract was translated in Spanish and published in Acta Toxicologica Argentina.

  19. Sobre la naturaleza de cinco candidatos a cúmulos abiertos ubicados próximos a la dirección del centro galáctico

    NASA Astrophysics Data System (ADS)

    Piatti, A. E.; Clariá, J. J.

    CCD BVI Johnson-Cousins observations obtained for 1759 stars in 4'×4' regions around the unstudied southern stellar aggregates Ruprecht 103, 124, 129, 146 and 166 are presented. The objects are described as open clusters in the catalogues of star clusters and associations of Alter et al. (1970) and LyngÅ (1987), as well as, in the ESO/Uppsala Survey of the ESO (B) Atlas (Lauberts 1982). Our analysis shows that none of these objects are genuine open clusters, except perhaps Ruprecht 166, since no clear main sequences (MSs) or other meaningful features can be seen in the extracted (V,B-V) and (V,V-I) colour-magnitude diagrams (CMDs). The star sequences seen in the distinct CMDs, specially for Ruprecht 124 and 129, are apparently formed by the superimposition of MS field stars affected by varying amounts of interstellar absorption and/or placed at different distances from the Sun. The CMDs of Ruprecht 166 present a pronounced variation in the luminosity function along the apparent MS, a fact from which we can infer the notion of these stars had a different origin. Star counts carried out within and outside the cluster candidate fields not only support the results that the objects do not present a significant number density contrast with respect to the Galactic disk, but also show that they do not appear to be candidate late stages of star cluster dynamical evolution. Several other stellar aggregates included in open cluster catalogues have previously been disproved as genuine physical systems (see, e.g., Carraro & Patat 1995, MNRAS, 276, 563; Carraro 2000, A&A, 357, 145; Piatti & Clariá 2001, A&A, 370, 931). Thus, the present work implies the potential likelihood of other wrongly classified open clusters.

  20. Pick and Choose: A Videotape Series on Nutrition for Migrant Families (Coja y Escoja: Peliculas para Television Sobre la Nutricion para las Familias Migratorias).

    ERIC Educational Resources Information Center

    1979

    One of the major problems faced by migrant workers throughout the United States is a lack of awareness of the relationship between proper diet and an individual's general health and well being. To help solve this problem was the major objective of the series "Pick and Choose." The three 15-minute programs in the series present…

  1. International Work Group for Indigenous Affairs Newsletter, July 1991-December 1992 = Boletin de Grupo Internacional de Trabajo sobre Asuntos Indigenas, Septiembre 1991-Diciembre 1992.

    ERIC Educational Resources Information Center

    IWGIA Newsletter, 1992

    1992-01-01

    This document contains seven consecutive English-language issues of the IWGIA Newsletter, from July 1991 through December 1992, followed by the seven corresponding issues in Spanish. These newsletters provide educators with a resource on the history, current conditions, and struggles for self-determination of indigenous peoples around the world.…

  2. Japanese Resource Dependence.

    DTIC Science & Technology

    1982-03-01

    Ii -+ l lr , .. .. . + .... - Industrializing Countries) in major plant construction (steel mills, copper smelters, petro-chemical complexes) and...International Trade & Industry Minister 1980 7 Mawkh A S$181 million contract for a.Libyan ciment works Is won by K~awasaki Heavy Industries 31 may...I~Q IIRI OMOWBQU ATMQ PANI tar.A W8T=-.w -T- NPOMT WHERE ja 60" Accemim 3. gffapgWER N1,21.ep uuM~M"Ca 𔃾. iTI L (5. i M06 TYPE O F NPO T a OCmee COV

  3. Critical percolation in bidimensional coarsening

    NASA Astrophysics Data System (ADS)

    Cugliandolo, Leticia F.

    2016-11-01

    I discuss a recently unveiled feature in the dynamics of two dimensional coarsening systems on the lattice with Ising symmetry: they first approach a critical percolating state via the growth of a new length scale, and only later enter the usual dynamic scaling regime. The time needed to reach the critical percolating state diverges with the system size. These observations are common to Glauber, Kawasaki, and voter dynamics in pure and weakly disordered systems. An extended version of this account appeared in 2016 C. R. Phys. . I refer to the relevant publications for details.

  4. A review of Solenysa spiders from Japan (Araneae, Linyphiidae), with a comment on the type species S. mellotteei Simon, 1894

    PubMed Central

    Wang, Fang; Ono, Hirotsugu; Tu, Lihong

    2015-01-01

    Abstract The present paper gives a review of Solenysa species from Japan and provides a solution for the species bearing the generotype name Solenysa mellotteei Simon, 1894. A total of six species are recorded, including two new species Solenysa macrodonta sp. n. and Solenysa trunciformis sp. n. The species collected from Kawasaki (NSMT-Ar 11154) and Hachioji should be the generotype Solenysa mellotteei, with Solenysa akihisai Tu, 2011, syn. n. as its junior synonym. To distinguish these congeneric species from each other, their genital characters are provided in detail based on images collected by scanning electron microscopy and light microscopy. PMID:25685031

  5. Sound absorption and concentration fluctuations in water-propanol mixtures

    NASA Astrophysics Data System (ADS)

    Madigosky, W. M.; Warfield, R. W.

    1987-02-01

    The excess ultrasonic sound absorption in 1-propanol water mixtures has been measured from 45 kHz to 474 MHz and is shown to result from a coupling of the sound wave with the long-wavelength spectrum of the composition fluctuations. The results are shown to be in agreement with the fluctuation theories of Fixman, Romanov and Solovyev, and Kawasaki and the more recent theories of Kroll and Ruhland, and Bhattacharjee and Ferrell. It is further suggested that the large absorption observed in alcohol-water mixtures may be due to the presence of large associated groups, or clusters.

  6. Simulating the Rayleigh-Taylor instability with the Ising model

    SciTech Connect

    Ball, Justin R.; Elliott, James B.

    2011-08-26

    The Ising model, implemented with the Metropolis algorithm and Kawasaki dynamics, makes a system with its own physics, distinct from the real world. These physics are sophisticated enough to model behavior similar to the Rayleigh-Taylor instability and by better understanding these physics, we can learn how to modify the system to better re ect reality. For example, we could add a vx and a vy to each spin and modify the exchange rules to incorporate them, possibly using two body scattering laws to construct a more realistic system.

  7. Cancer Risk in Patients With Inflammatory Systemic Autoimmune Rheumatic Diseases

    PubMed Central

    Yu, Kuang-Hui; Kuo, Chang-Fu; Huang, Lu Hsiang; Huang, Wen-Kuan; See, Lai-Chu

    2016-01-01

    Abstract The aim of this study was to determine whether inflammation is related to cancer development, and whether the incidence of cancer is increased and occurs in a site-specific manner in patients with systemic autoimmune rheumatic diseases (SARDs). This study included a nationwide dynamic cohort of patients with various newly diagnosed SARDs from 1997 to 2010 with follow-up until 2012. This study included 75,123 patients with SARDs. During 562,870 person-years of follow-up, 2844 patients developed cancer. Between 1997 and 2010, the highest number of newly diagnosed SARDs cases were rheumatoid arthritis (n = 35,182), followed by systemic lupus erythematosus (SLE, n = 15,623), Sjögren syndrome (n = 11,998), Kawasaki disease (n = 3469), inflammatory bowel disease (n = 2853), scleroderma (n = 1814), Behçet disease (n = 1620), dermatomyositis (n = 1119), polymyositis (n = 811), and vasculitis other than Kawasaki disease (n = 644). A significant standardized incidence ratio (SIR) of overall cancer was observed for patients with SLE (1.41; 95% confidence interval [CI], 1.28–1.56), Sjögren syndrome (1.19; 95% CI, 1.08–1.30), scleroderma (1.27; 95% CI, 1.02–1.59), dermatomyositis (4.79; 95% CI, 4.01–5.73), polymyositis (1.47; 95% CI, 1.05–2.06), vasculitis excluding Kawasaki disease (1.75; 95% CI, 1.20–2.55), and Kawasaki disease (2.88; 95% CI, 1.60–5.20). Overall, patients with most SARDs had a significantly higher risk of inflammation-associated site-specific cancers and hematologic malignancies. This study confirms that autoimmunity is associated with site-specific and hematological malignancies and provides clinical evidence of an association between inflammation and subsequent site-specific cancer development. These findings support the importance of inflammation in site-specific organ system carcinogenesis. PMID:27149461

  8. The Fairness Debate in U.S.-Japan Economic Relations

    DTIC Science & Technology

    1991-01-01

    34r’PrIc AD-A253 101 ’TE •111111111111lurni1 9 1992 The Fairness Debate in U.S.- Japan Economic Relations H Roger Benjamin, Loren Yager, Michael Shires...Mark Peterson D•zitributIon USn1Tito A i ! The research described in this report was conducted in RAND’s Center for U.S.- Japan Relations. The...Center’s research is sup- ported by Boeing Commercial Airplane Group, Citicorp, The Ford Foundation, Hitachi, IBM- Japan , C. Itoh, Kawasaki Heavy Industries

  9. Developing Strategies to Block Beta-Catenin Action in Signaling and Cell Adhesion During Carcinogenesis

    DTIC Science & Technology

    2002-07-01

    interactions of B- 6 catenin and its partners, which might have therapeutic value in cancer or other diseases . With this information in hand, we have...model system for the tumor suppressor APC" Keystone Meeting on "Wnt and B-catenin signaling in Develo and Disease ", Taos NM March 2002. "Cell adhesion...recent data suggest that the picture is shown to associate with the Rho-GEF ASEF ( Kawasaki et more complex: DE-cadherin promotes border cell migration al

  10. Intramuscular Transplantation and Survival of Freshly Isolated Bone Marrow Cells following Skeletal Muscle Ischemia-reperfusion Injury

    DTIC Science & Technology

    2013-01-01

    used to deplete highly differentiated cells. This depletion enriches for stem and progenitor cells and has been applied to a variety of disease and...limb ischemia due to peripheral artery disease . Cell Transplant. 2009;18(3):371Y380. 8. Murphy MP, Lawson JH, Rapp BM, Dalsing MC, Klein J, Wilson MG...ischemia. J Vasc Surg. 2011;53(6):1565Y1574.e1. 9. Zhong W, Sumita Y, Ohba S, Kawasaki T, Nagai K, Ma G, Asahina I. In vivo comparison of the bone

  11. Analysis of muon radiography of the Toshiba nuclear critical assembly reactor

    SciTech Connect

    Morris, C. L.; Bacon, Jeffery; Borozdin, Konstantin; Fabritius, J. M.; Perry, John; Ramsey, John; Ban, Yuichiro; Izumi, Mikio; Sano, Yuji; Yoshida, Noriyuki; Miyadera, Haruo; Mizokami, Shinya; Otsuka, Yasuyuki; Yamada, Daichi; Sugita, Tsukasa; Yoshioka, Kenichi

    2014-01-13

    A 1.2 × 1.2 m{sup 2} muon tracker was moved from Los Alamos to the Toshiba facility at Kawasaki, Japan, where it was used to take ∼4 weeks of data radiographing the Toshiba Critical Assembly Reactor with cosmic ray muons. In this paper, we describe the analysis procedure, show results of this experiment, and compare the results to Monte Carlo predictions. The results validate the concept of using cosmic rays to image the damaged cores of the Fukushima Daiichi reactors.

  12. A parity breaking Ising chain Hamiltonian as a Brownian motor

    NASA Astrophysics Data System (ADS)

    Cornu, F.; Hilhorst, H. J.

    2014-10-01

    We consider the translationally invariant but parity (left-right symmetry) breaking Ising chain Hamiltonian {\\cal H} =-{U_2}\\sumk sksk+1 - {U_3}\\sumk sksk+1sk+3 and let this system evolve by Kawasaki spin exchange dynamics. Monte Carlo simulations show that perturbations forcing this system off equilibrium make it act as a Brownian molecular motor which, in the lattice gas interpretation, transports particles along the chain. We determine the particle current under various different circumstances, in particular as a function of the ratio {U_3}/{U_2} and of the conserved magnetization M=\\sum_ksk . The symmetry of the U3 term in the Hamiltonian is discussed.

  13. Viral Oncolytic Therapeutics for Neoplastic Meningitis

    DTIC Science & Technology

    2012-07-01

    Herpes simplex virus g134.5 expression and oncolysis of diffuse liver metastases by Myb34.5. J Clin...Invest 2002;109:871–82. Kuruppu D, Tanabe KK. Viral oncolysis by herpes simplex virus and other viruses. Cancer Biology & Therapy. 2005; 4(5...524-31 Kuruppu D, Brownell A, Zhu A, Yu M, Wang X, Kulu Y, Fuchs B, Kawasaki H, Tanabe KK. Positron emission tomography of herpes simplex virus 1 oncolysis. Cancer Research. 2007; 67(7): 3295.

  14. Minimization of Wave Drag Due to Thickness with Constraints on Constant Volume and Maximum Thickness Position

    NASA Astrophysics Data System (ADS)

    Ishida, Yoji

    We have developed a numerical method for design of minimum-drag supersonic wing thickness with constraints on total volume and wing maximum thickness position. The method is based on the linearized supersonic theory and is an extension of Kawasaki's method which deals only with total volume constraint. The maximum thickness position of the wing, a new constraint condition, is an important information from both aerodynamic and structural point of view. The addition of the constraint has considerably extended the design possibility and has actually produced many interesting optimum thickness families. Numerical examples are given for delta, gothic and arrow wings which confirm the usefulness of present design method.

  15. Accounting for the Impact of Conservation on Human Well-Being

    PubMed Central

    Milner-Gulland, EJ; Mcgregor, JA; Agarwala, M; Atkinson, G; Bevan, P; Clements, T; Daw, T; Homewood, K; Kumpel, N; Lewis, J; Mourato, S; Palmer Fry, B; Redshaw, M; Rowcliffe, JM; Suon, S; Wallace, G; Washington, H; Wilkie, D

    2014-01-01

    Los conservacionistas cada vez más se comprometen con el concepto del bienestar humano para mejorar el diseño y la evaluación de sus intervenciones. Desde la convención de la influyente Comisión Sarkozy en 2009, los investigadores del desarrollo han estado refinando las conceptualizaciones y los marcos de trabajo para entender y medir el bienestar humano y están comenzando a convergir con un entendimiento común de cuál es la mejor forma de hacer esto. En la conservación el término bienestar humano tiene un uso amplio, pero existe la necesidad de la orientación en su operación para medir los impactos de las intervenciones de la conservación sobre la gente. Presentamos un marco de trabajo para entender el bienestar humano que podría ser útil particularmente en la conservación. El marco de trabajo incluye tres condiciones: cumplir con las necesidades, perseguir objetivos y experimentar una calidad satisfactoria de vida. Resumimos algunas de las complejidades involucradas en la evaluación de los efectos del bienestar de las intervenciones de la conservación con el entendimiento de que el bienestar varía entre la gente, en el tiempo y con las prioridades del evaluador. Los retos clave para la investigación de los impactos del bienestar de las intervenciones de la conservación incluyen la necesidad de crear una colección de estudios de caso para trazar lecciones generalizables: hacer uso del potencial de la tecnología moderna para apoyar la investigación del bienestar; y contextualizar espacial y temporalmente las evaluaciones de los impactos de la conservación sobre el bienestar dentro del marco más amplio del cambio social. Existen caminos que atraviesan la confusión que rodea al término bienestar, y los marcos de trabajo existentes, como el del acercamiento de Bienestar en Países en Desarrollo, pueden ayudar a los conservacionistas a negociar los obstáculos de la operación del concepto. Los conservacionistas tienen la oportunidad de

  16. A protocol for eliciting nonmaterial values through a cultural ecosystem services frame

    PubMed Central

    Gould, Rachelle K; Klain, Sarah C; Ardoin, Nicole M; Satterfield, Terre; Woodside, Ulalia; Hannahs, Neil; Daily, Gretchen C; Chan, Kai M

    2015-01-01

    Servicios Ambientales Culturales Resumen Los deseos, necesidades y valores no materiales de los accionistas influyen frecuentemente sobre el éxito de los proyectos de conservación. Estas consideraciones son difíciles de articular y caracterizar, lo que resulta en entendimiento limitado en el manejo y la política. Concebimos un protocolo de entrevista diseñado para mejorar el entendimiento de los servicios ambientales culturales (SAC). El protocolo inicia con la discusión de actividades relacionadas con ecosistemas (p. ej.: recreación, cacería) y manejo; después señala a los SAC, dando pie a los valores que encierran conceptos identificados en la Evaluación Ambiental del Milenio (2005) y explorado en otras investigaciones sobre SAC. Hicimos pruebas piloto del protocolo en Hawái y Columbia Británica. En cada localidad entrevistamos a 30 individuos de diversos entornos. Analizamos los resultados de las dos localidades para determinar la efectividad del protocolo de entrevista en la obtención de valores no materiales. Los componentes cualitativos y espaciales del protocolo nos ayudaron a caracterizar los valores culturales, sociales y éticos asociados con el ecosistema de múltiples maneras. Los mapas y las preguntas de situación, o de tipo viñeta, ayudaron a los encuestados a articular valores difíciles de discutir. Las preguntas abiertas permitieron a los encuestados expresar una diversidad de valores ambientales y demostraron ser suficientemente flexibles para que los encuestados comunicaran valores que el protocolo no buscaba explícitamente. Finalmente, los resultados sugieren que ciertos valores, aquellos mencionados frecuentemente en la entrevista, son particularmente prominentes para poblaciones particulares. El protocolo puede proporcionar datos eficientes, contextuales y basados en lugar sobre la importancia de atributos ambientales particulares para el bienestar humano. Los datos cualitativos son complementarios para las evaluaciones cuantitativas y

  17. Epigenomic functional characterization of genetic susceptibility variants in systemic vasculitis.

    PubMed

    Sawalha, Amr H; Dozmorov, Mikhail G

    2016-02-01

    Systemic vasculitides are poorly understood inflammatory diseases of the blood vessels that are frequently associated with significant organ damage. Genetic risk variants contribute to the susceptibility of vasculitis, but functional consequences of these genetic variants are largely unknown. Most genetic risk variants in immune-mediated diseases, including systemic vasculitis, are localized to non-coding genetic regions suggesting they might increase disease risk by influencing regulatory elements within the genome. Long range regulatory interactions pose an additional obstacle in localizing functional consequences associated with risk variants to specific genes or cell types. We used cell-type specific enrichment patterns of histone changes that mark poised, primed, and active enhancers, and DNase hypersensitivity to identify specific immune cells mediating genetic risk in vasculitis. Our data suggest that genetic risk variants in ANCA-associated vasculitis are significantly enriched in enhancer elements in Th17 cells, supporting a role for Th17 cells in this disease. Primed and active enhancer elements in B cells can be potentially affected by genetic risk variants associated with Kawasaki disease. Genetic risk in Behçet's disease and Takayasu arteritis might affect enhancer elements in multiple cell types, possibly explained by influencing enhancers in hematopoietic stem cells. Interestingly, our analyses indicate a role for B cells in Kawasaki disease, Behçet's disease, and Takayasu arteritis, and suggest that further work to characterize the involvement of B cells in these diseases is warranted.

  18. Molecular characterization of Orientia tsutsugamushi serotypes causing scrub typhus outbreak in southern region of Andhra Pradesh, India

    PubMed Central

    Usha, K.; Kumar, E.; Kalawat, Usha; Kumar, B. Siddhartha; Chaudhury, A.; Gopal, D. V. R. Sai

    2016-01-01

    Background & objectives: Scrub typhus is a vector-borne zoonotic infection caused by Orientia tsutsugamushi. Local epidemiology of the circulating serotypes of scrub typhus is not available from most parts of India. We conducted this study for the diagnosis of scrub typhus using IgM ELISA and to detect O. tsutsugamushi serotypes circulating in southern Andhra Pradesh, India. Methods: Samples were collected from patients clinically suspected to have scrub typhus and were subjected to IgM ELISA to measure IgM antibodies against O. tsutsugamushi. Nested polymerase chain reaction (PCR) was performed targeting strain-specific regions in ELISA-positive samples. Results: Of a total of 663 samples, 258 (38.91%) were found to be positive by IgM ELISA. Serotypes could be detected in 230 (34.69%) samples only. Only two serotypes, Karp and Kawasaki, were found in the serum samples, with the former being predominant. The dual infection of Karp and Kawasaki serotypes was found in seven patients. Other serotypes such as Gilliam, Kuroki and Kato were not detected in the samples. Interpretation & conclusion: The nested PCR products proved useful in presumptively identifying the endemic O. tsutsugamushi serotypes. The present study could be significant in understanding scrub typhus epidemiology in this region. PMID:28256470

  19. Myocardial scintigraphy with 201thallium in pediatric cardiology: A review of 52 cases

    SciTech Connect

    Bjoerkhem, G.E.; Evander, E.; White, T.; Lundstroem, N.R. )

    1990-01-01

    We report our experience of myocardial scintigraphy with 201thallium (201Tl) in 52 children, aged 4 days to 18 years, in which 80 studies were made primarily to demonstrate or exclude impaired myocardial perfusion. For analysis, the patients were divided into the following eight groups: group I, coronary artery malformations (five patients); group II, Kawasaki's syndrome (six patients); group III, arterial switch operation (seven patients); group IV, dilated cardiomyopathy (18 patients); group V, hypertrophic cardiomyopathy (four patients); group VI, myocardial dysfunction after surgery for congenital heart disease (five patients); group VII, pulmonary atresia (three patients); and group VIII, miscellaneous (four patients). Myocardial scintigraphy was performed with a planar or tomographic technique at rest or after exercise (four patients). Isotope-uptake defects, indicating impaired myocardial perfusion, were present in 14 patients, including small infants. Defects were seen in all groups except those with hypertrophic cardiomyopathy and pulmonary atresia. The absence of such defects in several of the patients with Kawasaki's syndrome was particularly valuable as it made coronary angiography unnecessary. In the other groups of patients myocardial scintigraphy was a valuable adjunct to other investigations.

  20. Simulation of nucleation in almost hard-sphere colloids: the discrepancy between experiment and simulation persists.

    PubMed

    Filion, L; Ni, R; Frenkel, D; Dijkstra, M

    2011-04-07

    In this paper we examine the phase behavior of the Weeks-Chandler-Andersen (WCA) potential with βε = 40. Crystal nucleation in this model system was recently studied by Kawasaki and Tanaka [Proc. Natl. Acad. Sci. U.S.A. 107, 14036 (2010)], who argued that the computed nucleation rates agree well with experiment, a finding that contradicted earlier simulation results. Here we report an extensive numerical study of crystallization in the WCA model, using three totally different techniques (Brownian dynamics, umbrella sampling, and forward flux sampling). We find that all simulations yield essentially the same nucleation rates. However, these rates differ significantly from the values reported by Kawasaki and Tanaka and hence we argue that the huge discrepancy in nucleation rates between simulation and experiment persists. When we map the WCA model onto a hard-sphere system, we find good agreement between the present simulation results and those that had been obtained for hard spheres [L. Filion, M. Hermes, R. Ni, and M. Dijkstra, J. Chem. Phys. 133, 244115 (2010); S. Auer and D. Frenkel, Nature 409, 1020 (2001)].

  1. Google-driven search for big data in autoimmune geoepidemiology: analysis of 394,827 patients with systemic autoimmune diseases.

    PubMed

    Ramos-Casals, Manuel; Brito-Zerón, Pilar; Kostov, Belchin; Sisó-Almirall, Antoni; Bosch, Xavier; Buss, David; Trilla, Antoni; Stone, John H; Khamashta, Munther A; Shoenfeld, Yehuda

    2015-08-01

    Systemic autoimmune diseases (SADs) are a significant cause of morbidity and mortality worldwide, although their epidemiological profile varies significantly country by country. We explored the potential of the Google search engine to collect and merge large series (>1000 patients) of SADs reported in the Pubmed library, with the aim of obtaining a high-definition geoepidemiological picture of each disease. We collected data from 394,827 patients with SADs. Analysis showed a predominance of medical vs. administrative databases (74% vs. 26%), public health system vs. health insurance resources (88% vs. 12%) and patient-based vs. population-based designs (82% vs. 18%). The most unbalanced gender ratio was found in primary Sjögren syndrome (pSS), with nearly 10 females affected per 1 male, followed by systemic lupus erythematosus (SLE), systemic sclerosis (SSc) and antiphospholipid syndrome (APS) (ratio of nearly 5:1). Each disease predominantly affects a specific age group: children (Kawasaki disease, primary immunodeficiencies and Schonlein-Henoch disease), young people (SLE Behçet disease and sarcoidosis), middle-aged people (SSc, vasculitis and pSS) and the elderly (amyloidosis, polymyalgia rheumatica, and giant cell arteritis). We found significant differences in the geographical distribution of studies for each disease, and a higher frequency of the three SADs with available data (SLE, inflammatory myopathies and Kawasaki disease) in African-American patients. Using a "big data" approach enabled hitherto unseen connections in SADs to emerge.

  2. Nutritional screening; control of clinical undernutrition with analytical parameters.

    PubMed

    de Ulíbarri Pérez, José Ignacio; Fernández, Guillermo; Rodríguez Salvanés, Francisco; Díaz López, Ana María

    2014-01-13

    Objetivo: Actualizar el cribado nutricional. La alta prevalencia del desequilibrio nutricional que genera la Desnutrición Clínica (DC), especialmente en hospitales y residencias asistidas, obliga al uso de herramientas de cribado y a controlar su evolución para combatirla sobre la marcha. La DC deriva menos de la carencia nutricional que de los efectos de la enfermedad y sus tratamientos, pero los actuales sistemas de cribado buscan más la desnutrición ya establecida que el riesgo nutricional existente. Las alteraciones metabólicas del equilibrio nutricional que constituyen la trofopatía se pueden captar en el plasma sin demoras, automáticamente, permitiendo rectificar actitudes terapéuticas demasiado agresivas o complementarlas con el adecuado soporte nutricional. Con los sistemas manuales de cribado, solo pasados días o semanas se evidenciarán, tardíamente, los cambios somáticos expresivos de esa desnutrición. La concentración de la albúmina plasmática es un parámetro muy valioso en el control nutricional. Su disminución, cualquiera que sea la causa, expresa un posible déficit pero también el riesgo nutricional a que se ve sometida la célula, antes de que la desnutrición se manifieste somáticamente. La precocidad de la detección del riesgo nutricional, anticipándose a la desnutrición y su gran capacidad pronóstica hacen de las herramientas basadas en parámetros analíticos, el procedimiento más útil, ergonómico, seguro y eficiente para el cribado y pronóstico nutricional en el entorno clínico. Conclusión: es hora de actualizar conceptos, deshacer mitos y optar por sistemas modernos de cribado eficientes, única manera de alcanzar el sueño de controlar la DC en nuestras poblaciones enfermas y frágiles.

  3. La implantacion del enfoque constructivista en el aula de ciencia: Estudio de caso multiple

    NASA Astrophysics Data System (ADS)

    Arroyo Betancourt, Luz I.

    Esta investigacion estudia la implantacion del enfoque constructivista en tres aulas de ciencia del contexto puertorriqueno. Se auscultaron las practicas educativas que utilizan maestras consideradas constructivistas y la correspondencia de sus practicas educativas con los elementos esenciales de la didactica que proponen los teoricos de los planteamientos constructivistas. Se ausculto, ademas, a que vision del enfoque constructivista responden las expresiones de las maestras acerca de su practica educativa y como compara con su quehacer, a la luz de los elementos esenciales de las visiones constructivistas piagetiana, social y radical. Se utilizo el diseno de estudio descriptivo de caso multiple. El estudio se baso en entrevistas a profundidad, revision de documentos y observacion no participativa a la sala de clases. El contexto fueron tres escuelas publicas de la Region Educativa de San Juan, una elemental, una intermedia y una superior. Los resultados confirmaron que la transicion hacia el enfoque constructivista es un proceso que toma tiempo, dedicacion y la participacion en adiestramientos y readiestramientos acerca del nuevo enfoque. Las maestras coinciden en la mayoria de las practicas educativas que utilizan para implantar el enfoque constructivista de ensenanza y difieren en algunas debido, probablemente, a que han tenido que adaptarlas a los correspondientes niveles de ensenanza: elemental, intermedio y superior. Dos de las maestras planifican por conceptos generadores, mientras que una de ellas planifica siguiendo la guia que recibe del Departamento de Educacion. Difieren ademas, en el enfasis que confieren al inquirir cientifico. Con relacion a la correspondencia entre la vision manifestada por las maestras a la luz de las visiones piagetiana, social y radical, aparentemente, las preguntas del protocolo de entrevistas no lograron evocar la informacion con suficiente profundidad, por lo que la investigadora tuvo que inferir las visiones de las

  4. Enzyme activity of superoxide dismutase and zincemia in women with preeclampsia.

    PubMed

    Araújo Brito, José; do Nascimento Marreiro, Dilina; Moita Neto, José Machado; Michelle Costa e Silva, Danilla; Gonçalves de Sousa Almondes, Kaluce; Valadares Neto, João de Deus; do Nascimento Nogueira, Nadir

    2013-01-01

    Introducción: La preeclampsia es un síndrome de origen desconocido del punto de vista etiológico. Se caracteriza clínicamente por una tríada de síntomas: edema, hipertensión y proteinuria. Los conceptos actuales sobre la patogénesis de la preeclampsia incluyen la disfunción endotelial y el estrés oxidativo. Objetivo: En este estudio se evaluó la relación entre la actividad de la superóxido dismutasa, zincemia y preeclampsia. Métodos: Este estudio de casos y controles se llevó a cabo con 94 mujeres, con un rango de edad situado entre 17 y 44 AÑOs, los que fueron divididos en dos grupos: mujeres con preeclampsia (n = 44) y grupo control, las mujeres con embarazo normal (n = 50). La actividad de la superóxido dismutasa se llevó a cabo según el kit Ransod. Las concentraciones de zinc en plasma y los eritrocitos fue realizada según el metodo de espectrofotometría de absorción atómica de llama, ambos determinados antes del nacimiento y después del parto. La prueba de la t de Student y la prueba t pareada fue utilizada para el análisis estadístico (p < 0,05). Resultados: El estudio reveló hypozincemia en el plasma, con valores más altos en las mujeres con preeclampsia severa (p < 0,05). Esta situación no fue observada en los eritrocitos, cuya concentración se mantuvo estable antes del parto y en el puerperio, en las mujeres con preeclampsia y en las con embarazo normal. La actividad antioxidante de la superóxido dismutasa, se encontró elevada en las mujeres con y sin preeclampsia (p > 0,05), con una reducción significativa en la actividad en el periodo postparto (p < 0,05) en ambos grupos (p > 0,05). Conclusiones: Este estudio revelló que hay cambios en los parámetros bioquímicos de zinc en mujeres con preeclampsia. La actividad de la superóxido dismutasa se revelló que este marcador no se puede utilizar para predecir la progresión de la enfermedad.

  5. El rol de Ia colaboracion y el Modelo de Aprendizaje Basado en Proyectos (ABPr) mediante el lente de la Teoria de Actividad (CHAT): un estudio de caso con estudiantes de 9no grado

    NASA Astrophysics Data System (ADS)

    Delgado, Isabel C.

    Los modelos de eensenanza y aprendizaje constructivistas conceptualizan el aprendizaje como un proceso activo. El modelo de Aprendizaje Basado en Proyectos (ABPr) se distingue por una serie de componentes, entre los cuales se destaca el aspecto colaborativo y cooperativo como un reto al momento de su implantacion. Son pocas las investigaciones que se concentran en este aspecto del modelo. En este estudio, se analizaron las diversas interacciones que surgen durante la implantacion de una unidad curricular sobre el tema de Geologia de Puerto Rico, la cual se diseno con el modelo ABPr cuyo enfoque es orientacion a proyectos. Particularmente, se examinaron las interacciones sociales que surgen entre los pares y entre pares y docente durante el proceso de planificacion y desarrollo de los productos finales, al igual que las interacciones entre los estudiantes y el material didactico en estas etapas del modelo. La investigacion es de tipo cualitativo e incorpora como diseno el estudio de caso. Las diversas interacciones constituyen la unidad de analisis. En el estudio participaron 19 estudiantes de 9no grado, a quienes se organizaron en 5 grupos colaborativos por temas de interes (Pangea, Placas tectonicas, Volcanes, Tsunamis y Terremotos). Las tecnicas que se utilizaron para recopilar los datos fueron: observaciones participativas, grupos focales y analisis de documentos (cuadernos reflexivos y respuestas de los estudiantes a la pregunta central del proyecto). Para el analisis de los datos se aplico la teoria de actividad (CHAT) que concentra la unidad de analisis en la actividad humana en un contexto particular. Los resultados del estudio senalan que las interacciones entre pares, entre pares y docente, asi como entre estudiantes y material didactico son fundamentales en el proceso de aprendizaje. Una mayor interaccion entre pares durante las etapas de planificar y desarrollar los productos finales de la unidad, promueve una mejor comprension de los conceptos de la

  6. Cowpea protein reduces LDL-cholesterol and apolipoprotein B concentrations, but does not improve biomarkers of inflammation or endothelial dysfunction in adults with moderate hypercholesterolemia.

    PubMed

    Frota, Karoline de Macedo Gonçalves; dos Santos Filho, Raul Dias; Ribeiro, Valdenir Queiroz; Arêas, José Alfredo Gomes

    2015-04-01

    Introducción: Los riesgos de las enfermedades cardiovasculares, la principal causa de muerte en el mundo, pueden ser reducidos con la dieta. Proteína caupí en hámsters redujo el colesterol total, LDL-colesterol, así como la esteatosis hepática de manera significativa. Objetivo: Este estudio de prueba de concepto fue verificar si el consumo de proteína de frijol mejora el perfil de lípidos y actúa sobre los biomarcadores de inflamación y disfunción endotelial en pacientes con hipercolesterolemia moderada. Métodos: En un diseño aleatorio doble ciego cruzado, 38 sujetos con hipercolesterolemia (colesterol-LDL = 182,5 ± 2,7 mg/dL) consumieron 25 g / día de aislado de proteína de frijol o 25 g / día de caseína (grupo control) durante seis semanas cada uno, y un intervalo de lavado de cuatro semanas Se recogieron muestras de sangre en ayunas al comienzo y al final de cada período de dieta. Los lípidos (colesterol total, LDL-colesterol, triglicéridos, HDL-colesterol) se determinaron por métodos enzimáticos, apolipoproteínas (apoA-I y apoB) por inmunoensayos normalizados, biomarcadores de inflamación (proteína C reactiva) por turbidimetría y los biomarcadores de disfunción endotelial (molecule-1 de adhesión intercelular y de molécula-1 de adhesión celular vascular) por técnicas de ensayo de inmunoabsorción ligados a enzimas. Resultados y discusión: El consumo de proteínas caupí redujo significativamente el colesterol total (12%), el colesterol LDL (18,9%), colesterol no HDL (16%), apoB (14%), y aumentó el colesterol HDL (2,7%). No se observaron diferencias significativas relacionadas con el grupo de tratamiento para cualquiera de los biomarcadores inflamatorios y de disfunción endotelial. Conclusión: Los presentes hallazgos demostraron el efecto favorable del consumo de proteína caupí en lípidos séricos pro-aterogénicas y apoB en sujetos con hipercolesterolemia moderada, de manera similar a lo observado en un trabajo previo con

  7. Forms of Appropriation of Tools for the Astronomy Education in Continuous Training of Teachers. (Spanish Title: Formas de Apropriación de Herramientas Para la Enseñanza de la Astronomía en la Formación Docente Continua.) Formas de Apropriação de Instrumentos Para o Ensino de Astronomia na Formação Continuada de Professores

    NASA Astrophysics Data System (ADS)

    Marques Soares, Leonardo; Sousa Nascimento, Silvania

    2012-07-01

    The main focus of this article is to present some impressions about the way some teachers appropriated of the tools from the ASTRONOMY TEACHING KIT (KITPEA). The subjects of this research were teachers that took part in the astronomy teaching specialization course offered by the Continuing Education Project (FOCO) at Math and Science Teaching Center (CECIMIG) from the School of Education of Federal University of Minas Gerais (FaE/UFMG). The data was collected with the use of a questionnaire and of an interview applied to these teachers. The analysis of the data was structured with the aid of the Activity Theory and the Mediated Action Theory. We interpret the teachers' speech using the constitutive aspects of the activity system and the concepts of appropriation and domain as an analytical device. It was possible to recognize the appropriation of the tools in 7 narratives among the 11 individuals who took part in the research. El objetivo principal de ese artículo es presentar indicaciones sobre la manera como algunos maestros se apropiaron de las herramientas del KIT PARA LA ENSEÑANZA DE LA ASTRONOMÍA (KITPEA). Los sujetos de esa investigación son docentes que participaron del curso de especialización en enseñanza de astronomía ofrecido por el Proyecto de Formación Continua (Foco) en el Centro de Enseñanza de Ciencias y Matemática (CECIMIG) de la Facultad de Educación de la Universidad Federal de Minas Gerais (FaE/UFMG). Recogimos las informaciones a través de un cuestionario y de una encuesta, aplicados a esos docentes. Estructuramos el análisis de esas informaciones con la ayuda de la Teoría de la Actividad y de la Teoría de la Acción Mediada. Interpretamos os discursos de los docentes usando como dispositivo analítico los elementos constitutivos del sistema de actividad y los conceptos apropiación y dominio. Entre los 11 sujetos que participaron de la investigación, fue posible interpretar con claridad la apropiación de las herramientas en

  8. Is the Dark Side of the Moon Ever Illuminated by the Sun? (Breton Title: O Lado Escuro da Lua Nunca Apanha Sol?) El Lado Oscuro de la Luna Nunca Toma Sol?

    NASA Astrophysics Data System (ADS)

    Giovannini, Odilon; Pellenz, Daiana; Catelli, Francisco

    2014-07-01

    y los elementos básicos que componen una "respuesta correcta". Estas cuestiones se tratan inicialmente a partir de una revisión bibliográfica de la investigación en el área; seguidamente, y también sobre la base de ésta revisión, se propone un modelo didáctico que ejemplifica los movimientos relativos del sistema Tierra - Luna - Sol. Se describe a continuación una aplicación de este modelo en un entorno de aprendizaje con alumnos del ciclo primario. Los conceptos iniciales presentados en la literatura se confirman y las cuestiones planteadas por los estudiantes durante la implementación del modelo proporcionan evidencia de que se ha producido un aprendizaje significativo, al menos en cierta medida.

  9. Sky Observation with the Use of the Software Stellarium for Teaching Astronomy in Classes of Youth and Adult Education. (Spanish Title: Observación del Cielo con la Utilización del Software Stellarium en Las Clases de Educación de Jóvenes y Adultos.) Observação do Céu Aliada À Utilização do Software Stellarium no Ensino de Astronomia em Turmas de Educação de Jovens e Adultos (EJA)

    NASA Astrophysics Data System (ADS)

    Oliveira Bernardes, Adriana

    2010-12-01

    The aim of this paper is to present a project developed through a partnership between the Astronomy Club of Itaocara Marcos Pontes (CAIMP) and Jaime de Souza Queiroz College, both located in the town of Itaocara, in the Northwest Fluminense, to disseminate Astronomy in adult education (Education for Youth and Adult). Given the interdisciplinary nature of Astronomy, we have developed this work to motivate the learning of this science by students in adult education, who attend the subjects Chemistry, Physics and Biology. Initially, we conducted a research in the school to assess the prior knowledge of Astronomy class of adult education, noting that there is little knowledge of basic concepts of the discipline. With these data, we were able to elaborate several activities that would enable a greater involvement of students with this science, performing in the school a work of improvement of scientific literacy, whose activities will be presented in this article. El objetivo de este artículo es presentar los resultados de un proyecto realizado por el Club de Astronomía de Itaocara "Marcos Pontes" (CAIMP), conjuntamente con el Colegio Estatal" Jaime de Souza Queiroz", ambos de la ciudad de Itaocara (Noroeste Fluminense - RJ, Brasil), para la difusión de la Astronomía entre los estudiantes, tanto adultos como adolescentes. Teniendo en cuenta la naturaleza interdisciplinaria de la Astronomía, se determinó motivar el estudio de esta ciencia en los estudiantes adultos de nivel secundario matriculados en las asignaturas de Química, Física y Biología. Como primer paso, se investigó el grado de conocimiento sobre astronomía del estudiante. Este estudio inicial mostró niveles de conocimiento muy bajos de los conceptos básicos de esta ciencia, muchos de los cuales deberían haber sido asimilados dentro del plan curricular del curso de Física. Este estudio previo permitió determinar las actividades adecuadas para promover un mayor envolvimiento de los estudiantes

  10. The Moon Phases in a Paper Box. (Spanish Title: Las Fases de la Luna en Una Caja de Cartón.) As Fases da Lua Numa Caixa de Papelão

    NASA Astrophysics Data System (ADS)

    de Fátima O. Saraiva, Maria; Amador, Cláudio B.; Kemper, Érico; Goulart, Paulo; Muller, Angela

    2007-12-01

    We present a very simple concrete model to demonstrate the concept of phases of an illuminated body. The main objective of our model is to help the understanding of the Moon phases as viewed from the perspective of an observer on Earth. The material allows the visualization of two important effects: (1st) even though all the time half Moon is illuminated by the Sun, we see different fractions of the illuminated Moon surface, depending on our angle of sight; (2nd) the orientation of the convex part of the Moon in the crescent and waning phases on the sky also depends on our perspective from Earth. The use of a closed box allows one to see the contrast among the different phases with no need of a dark room. We also present a text on the Moon phases, emphasizing the dependence of the aspect of the bright part on the angle of sight. En este trabajo proponemos la construcción de material didáctico de bajo costo para demostración del concepto de fases de un cuerpo iluminado. El principal objetivo de nuestro material es facilitar la comprensión de las fases de la Luna desde la perspectiva de un observador en la Tierra. El material ayuda la visualización de dos efectos importantes: (1º) a pesar de tener siempre la mitad de la Luna (representada por una bolita de espuma plástica o de ping-pong), iluminada por el Sol ( representado por una fuente de luz natural o artificial), vemos diferentes fracciones de su superficie iluminada, dependiendo del ángulo por el cual la vemos; (2º) la orientación del borde convexo de la Luna en las fases Creciente y Menguante también depende de la perspectiva por la cual la miramos desde la Tierra. El uso de una caja cerrada permite observar el contraste entre las diferentes fases sin necesidad de estar en un recinto oscuro. Presentamos también un texto explicativo sobre las fases de la Luna, enfatizando la dependencia de la apariencia de la parte iluminada con el ángulo de visión. Neste trabalho propomos a construção de

  11. Breast Cancer Epidemiology in Puerto Rico

    DTIC Science & Technology

    2012-06-01

    residencial, el uso de vitaminas y medicinas , informacion sobre Ia menstruaci6n y los hijos que ha tenido, al igual que algunas preguntas sobre diagnostico y...historial residencial, uso de vitaminas y medicinas , informacion sobre Ia menstruacion y los embarazos y alguna informacion sobre el diagnostico y

  12. Development of Educational Resources to Include the Teaching of Astronomy in the First Years of the Basic Education. (Spanish Title: Desarrollo de Recursos Pedagógicos Para Incluir la Enseñanza de la Astronomía en los Primeros Años de la Educación Básica.) Desenvolvimento de Recursos Pedagógicos Para Inserir o Ensino de Astronomia nas Séries Iniciais do Ensino Fundamental

    NASA Astrophysics Data System (ADS)

    da Silva Morett, Samara; de Oliveira Souza, Marcelo

    2010-07-01

    ía y la vida cotidiana de los estudiantes. La inclusión de la astronomía en la escuela primaria es una manera de demostrar a los estudiantes cómo este campo está presente de forma activa en su vida cotidiana. Las clases que participan en el proyecto participaron en un estudio con el objetivo de proporcionar información a los conocimientos previos que tenían sobre los temas de la astronomía que se examinaron durante el proyecto. Con los experimentos realizados, y la ayuda de las nuevas tecnologías, conceptos astronómicos fueron presentados a los estudiantes de 4to y 5to año de la educación básica de una escuela municipal de Campos dos Goytacazes (RJ). Después de las presentaciones nuevos datos fueran colectados y se han llevado a cabo con el fin de verificar el nivel de aprendizaje alcanzado y se observó que el método utilizado fue una herramienta importante para ayudar al proceso de enseñanza y aprendizaje. El proyecto logró resultados satisfactorios. Neste trabalho será apresentado o desenvolvimento de recursos pedagógicos para a apresentação de conceitos de astronomia nas séries iniciais do ensino fundamental. Este material é composto por apresentações realizadas com o uso de novos recursos tecnológicos, pela fabricação de experimentos e a discussão de curiosidades relativas a esta área de conhecimento. Os experimentos foram construídos com material de baixo custo com o objetivo de permitir que os alunos envolvidos pudessem refazê-los em outras ocasiões. O material apresentado busca enfatizar a relação entre a astronomia e o cotidiano dos alunos. A inclusão da astronomia no ensino fundamental e uma forma de demonstrar aoestudante como esta área está presente de forma ativa em seu cotidiano. As turmas envolvidas no projeto participaram de uma pesquisa com o objetivo de obter dados relativos ao conhecimento prévio que possuíam sobre os tópicos de astronomia que foram considerados no decorrer do projeto. Com os experimentos

  13. Educacion, Salud y Bienestar para el Nino Preescolar y la Familia (7 de Enero--29 de Febrero de 1996). Informe Curso sobre (Education, Health and Welfare for Small Children. January 7 - February 29, 1996. Report of a Course.)

    ERIC Educational Resources Information Center

    Golda Meir Mount Carmel International Training Centre, Haifa (Israel).

    This Spanish-language report (with an English summary) describes a course on interagency cooperation held at the Golda Meir Mount Carmel International Training Center in Haifa, Israel. The course, with 30 Central and South American participants, discusses the necessity of pooling resources and sharing responsibility among institutions in various…

  14. Role of Systematic Formative Assessment on Students' Views of Their Learning (El papel de la evaluación formativa en las percepciones de los estudiantes sobre su aprendizaje)

    ERIC Educational Resources Information Center

    Areiza Restrepo, Hugo Nelson

    2013-01-01

    This article presents a partial report of a small qualitative research study that explored the students' views of their learning during and after the implementation of formative procedures such as self-assessment, feedback, and conferences. The article also includes their perceptions about this implementation. The research was carried out with a…

  15. The Effect of Direct and Indirect Corrective Feedback on Students' Spelling Errors (El efecto de la retroalimentación directa e indirecta sobre los errores de ortografía de los estudiantes)

    ERIC Educational Resources Information Center

    Baleghizadeh, Sasan; Dadashi, Mehdi

    2011-01-01

    The study presented here is an attempt to examine the role of indirect feedback in promoting junior high school students' spelling accuracy in English. It compares the effect of direct feedback with indirect feedback on students' written work dictated by their teacher from their textbooks. Two classes were selected from the Zanjanrood District in…

  16. Aspectos de biología y tablas de vida de Cephalonomia stephanoderis y Prorops nasuta (Himenoptera: Bethilidae) sobre su hospedero la broca del café criada en la dieta artificial Cenibroca modificada.

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Biological aspects and demographic parameters of the African bethylid wasps Cephalonamia stephanoderis Betrem and Prorops nasuta Waterson (Hymenopterans: Bethylidae) were investigated using diet-reared hosts of Hypothenemus hampei Ferrari (Coleoptera: Scolytidae). The life cycle (28.40 ± SE 0.486 a...

  17. Todo Alumno: Un Manual de Recursos de PEER sobre Educacion Basada en Normas y Alumnos con Discapacidades (Every Single Student: A PEER Resource Manual on Standards-Based Education and Students with Disabilities).

    ERIC Educational Resources Information Center

    Landau, Julia K., Ed.; Romano, Carolyn A., Ed.; Vohs, Janet R., Ed.

    This manual in Spanish covers thirteen different topics relevant to the education of students with disabilities in the era of educational reform and standards-based education. Sections include: (1) "Raising Standards of Learning: Standards-Based Education and Students with Disabilities" (Janet R. Vohs, Julia K. Landau, and Carolyn…

  18. Relatorio Final Sobre o Ensino Bilingue: Resultados da Avaliacao Externa da Experiencia de Escolarizacao Bilingue em Mocambique (PEBIMO) (Final Report on Bilingual Education: Results of External Evaluation of an Experiment in Bilingual Education in Mozambique).

    ERIC Educational Resources Information Center

    Benson, Carolyn J.

    The PEBIMO project was designed to determine whether bilingual education could improve the quality of primary education in Mozambique, recognizing that Portuguese is not the native language of the majority of Mozambican students. The project began in 1992 with 8 cohorts of first grade in 2 provinces; during this investigation, students were in…

  19. The Use of Blogs in English Language Learning: A Study of Student Perceptions (El uso de bitácoras o "blogs" en el aprendizaje del idioma inglés: un estudio sobre las percepciones del estudiante)

    ERIC Educational Resources Information Center

    Ahluwalia, Gurleen; Gupta, Deepti; Aggarwal, Deepak

    2011-01-01

    In this article we present an investigation that focused on the students' perception of using Blogs as a means to supplement in-class language learning activities. Blogs are easy to manage and enable students to publish their work in a chronological manner. They help students to engage in online exchanges and promote learner autonomy. This study…

  20. Guia para Evaluar y Ubicar a Estudiantes de Idiomas Minoritarios. Para Padres/sobre Padres (A Guide to Assessing and Placing Language Minority Students. For Parents/about Parents).

    ERIC Educational Resources Information Center

    Schwartz, Wendy

    This guide helps parents understand how schools assess their child's English language ability and suggests ways for them to help schools place their children in the most useful language program. All districts must decide which students to test, and then how to test them. Some schools attempt to find out the English skills of all students, and…

  1. Exploring Authorship Development among Mexican EFL Teacher-Researchers (Exploración sobre el desarrollo de la autoría en los profesores-investigadores de inglés como lengua extranjera)

    ERIC Educational Resources Information Center

    Trujeque Moreno, Eva Estefania; Encinas Prudencio, Fátima; Thomas-Ruzic, Maria

    2015-01-01

    This article presents a multi-theoretical model to address processes of "authorship development" in the English as a foreign language teaching profession. Working within a sociocultural perspective of second-language teacher education, the authors examined six experienced nonnative English-speaking teacher-researchers. Perceptions of…

  2. Head Start Program Performance Standards on Services for Children with Disabilities (45-CFR 1308) [and] Normas de Ejecucion del Programa Head Start Sobre Servicios para Ninos con Discapacidades (45-CFR 1308).

    ERIC Educational Resources Information Center

    Administration for Children, Youth, and Families (DHHS), Washington, DC. Head Start Bureau.

    This document consolidates, clarifies, and updates federal regulations on Head Start services for children with disabilities. The regulations are designed to complement the Head Start Program Performance Standards governing services to all enrolled children. Specifically, these regulations require Head Start programs to: (1) design comprehensive…

  3. Ten Facts Every Parent Should Know about the No Child Left Behind Act = Diez datos que cada padre debe saber sobre La Ley. Que Ningun Nino Se Quede Atras.

    ERIC Educational Resources Information Center

    Department of Education, Washington, DC.

    The No Child Left Behind Act (NCLB) is President George W. Bush's education reform law passed by Republicans and Democrats in Congress. This flier, in both English and Spanish, details 10 facts concerning NCLB to inform parents as to the goals of the Act and how they will affect their child's school. The flier highlights how the Act: (1) gives…

  4. International Symposium on Visually Handicapped Infants and Young Children: Birth to Seven (2nd, Aruba, 1987). "The First Steps." Proceedings = Simpasio Internacional sobre Ninos Visualmente Deficientes de Nacimiento hasta Siete Anos (2nd, Aruba, 1987). "Los Primeros Pasos."

    ERIC Educational Resources Information Center

    Palmer, Lillian, Ed.; And Others

    This symposium focused on the special needs of visually handicapped infants and young children. Texts of 48 papers are presented, including keynote addresses by W. Aubrey Webson ("The First Steps") and Heather Hewitt ("First Steps--Parenting, Prevention and Programming"). Regional reports are provided for Japan, Bangladesh, the…

  5. A Look at the Decisions Hispanic Families Make after the Diagnosis of Deafness = Un estudio sobre las decisiones que toman las familias hispanas despues de un diagnostico de sordera.

    ERIC Educational Resources Information Center

    Steinberg, Annie; Bain, Lisa; Li, Yuelin; Montoya, Louise; Ruperto, Vivian

    This study, written in both English and Spanish, examined the decision-making process of Hispanic families living in the United States who have a child with a hearing loss. Twenty-nine families in four different geographical areas shared their experiences in learning about their child's disability, searching for appropriate interventions, and…

  6. A Baseline Study of Strategies to Promote Critical Thinking in the Preschool Classroom (Un Estudio de Base sobre Estrategias para la Promoción de Pensamiento Critico en las Aulas de Preescolar)

    ERIC Educational Resources Information Center

    León, Jenny Melo

    2015-01-01

    The purpose of this study was to identify the different incidents of critical thinking in five preschool classrooms in one school, and the instructional strategies preschool teachers employed in the development of children's critical thinking. The participants in this study were five self-contained preschool teachers and their corresponding…

  7. Fortalecete! Pensamientos e ideas sobre el desarrollo de curriculo para maestras de educacion basica en espanol ("Get Energized! Thoughts and Ideas on Curriculum Development for Spanish Basic Education Teachers").

    ERIC Educational Resources Information Center

    Holyoke JUNTOS Adult Basic Education Collaborative, MA.

    This booklet outlines approaches to adult basic education Spanish literacy. It includes the following: explanatory note for English (non-Spanish) readers; general goals of a Spanish language literacy (SLL) program in Holyoke, Massachusetts; checklists; learning objectives for reading and writing; SLL lesson plan guide; outline for SLL curriculum…

  8. Western Hemisphere Conference on Persons with Disabilities. Conference Proceedings (Washington, D.C., March 14-18, 1993) = Conferencia Hemisferica Occidental sobre Personas con Discapacidades. Actas de la Conferencia. (Washington, D.C., 14 al 18 de Marzo de 1993).

    ERIC Educational Resources Information Center

    Kelley, Jerry D., Ed.; And Others

    This document presents the proceedings of a conference which brought together delegates and First Ladies representing western hemisphere nations to address needs and issues affecting people with disabilities in the Americas. It presents the texts of two keynote addresses: "Small Triumphs, Big Victories: A Global View of Persons with…

  9. Manual de Adiestramiento sobre Terapia de Rehidratacion Oral y Control de las Enfermedades Diarreicas (Oral Rehydration Therapy and the Control of Diarrheal Diseases). Training for Development. Peace Corps Information Collection & Exchange Training Manual No. T-53.

    ERIC Educational Resources Information Center

    Clark, Mari; And Others

    This Spanish-language manual was developed to train Peace Corps volunteers and other community health workers in Spanish-speaking countries in oral rehydration therapy (ORT) and the control of diarrheal diseases. Using a competency-based format, the manual contains three training modules (organized in seven sessions) that focus on interrelated…

  10. La Ninez en Puerto Rico: Resultados del Censo 2000. Un informe de KIDS COUNT/PRB sobre el Censo 2000 (Children in Puerto Rico: Results from the 2000 Census. A KIDS COUNT/PRB Report on Census 2000).

    ERIC Educational Resources Information Center

    Mather, Mark

    This Spanish-language report provides data on children in Puerto Rico based on the 2000 U.S. Census. It compares the situation of Puerto Rico's children with that of children living in the 50 states and the District of Columbia, noting how characteristics of Puerto Rican children have changed over time. Between 1990-2000, the number of Puerto…

  11. Grupo de Trabajo Para la Preparacion del Proyecto Sobre el Desarrolo de Servicias de Bibliotecas y de Informacion Cientifica y Tecnica (Working Group for the Preparation of the Proposal on the Development of Library Services and Scientific and Technical Information).

    ERIC Educational Resources Information Center

    Oficina de Educacion Iberoamericana, Madrid (Spain).

    The Office of Iberoamerican Education, an intergovernmental body based on educational and cultural cooperation for the purpose of disseminating information, documentation, advice, and assistance in the field of education, co-sponsors (with UNESCO) the work represented in this study of library and information planning and facilities in the Andean…

  12. Como Promover el Exito de las Ninas y las Minorias en las Ciencias y en las Matematicas. Para Padres/sobre Padres (How To Promote the Science and Mathematics Achievement of Females and Minorities. For Parents/about Parents).

    ERIC Educational Resources Information Center

    Schwartz, Wendy

    Some minority and female students traditionally have not been given the help they need to enroll and succeed in mathematics and science classes. Now, however, various approaches are available to give these students the extra attention they need. Parents can help children develop an interest in science and mathematics by: (1) identifying role…

  13. Receta para el Exito. Una Guia Actualizada para Padres sobre el Mejoramiento de las Escuelas de Colorado y Logros Estudiantiles (Recipe for Success: An Updated Parents' Guide to Improving Colorado Schools and Student Achievement).

    ERIC Educational Resources Information Center

    Taher, Bonnie; Durr, Pamela

    This Spanish language guide describes ways that parents can help improve student achievement and school quality. It answers such questions as: how to choose the right early-education opportunity for a preschooler; how to make sure a 5-year-old is ready for school; how to help a daughter do well in school; how to work with a daughter's or son's…

  14. Percepciones de los estudiantes de education en Venezuela sobre su preparacion e intervencion en violencia domestica. [Perceptions of Education Students in Venezuela about Their Preparation and Intervention in Domestic Violence].

    ERIC Educational Resources Information Center

    McArthur, Anna P.; Cellitti, Anarella; Perez de Linares, Sonia

    1999-01-01

    This study investigated Venezuelan university students' perceptions regarding domestic violence and possible encounters with domestic violence in programs for young children. Students indicated that they expected to encounter only those situations they were prepared to confront, indicating needs for curriculum changes in teacher-training programs.…

  15. [The EMECAM project: a discussion of the results in the participating cities. Estudio Multicéntrico Español sobre la Relación entre la Contaminación Atmosférica y la Mortalidad].

    PubMed

    Ballester Díez, F; Sáez Zafra, M; Pérez-Hoyos, S; Daponte Codina, A; Bellido Blasco, J B; Cañada Martínez, A; Abad Díez, J M; Pérez Boíllos, M J; Alonso Fustel, M E; Taracido Trunk, M; Aguinaga Ontoso, I; Guillén Pérez, J J; Ordóñez Iriarte, J M; Saurina Canals, C; Tenías Burillo, J M

    1999-01-01

    This article draws a comparison and provides a discussion of the findings resulting from the local analyses of the 14 cities participating in the EMECAM Project. An analysis is made of the time series related to mortality, pollutants (particles in suspension, SO2, NO2, O3 and CO), temperature and other factors taken from records of public institutions. By using Poisson autoregressive regression, an estimate has been made of the short-term relationship between the number of deaths and the air pollution indicators in each one of the following cities: Barcelona, metropolitan area of Bilbao, Cartagena, Castellón, Gijón, Huelva, Madrid, Pamplona, Seville, Oviedo, Valencia, Vigo, Vitoria and Saragossa. The findings reveal the air pollution figures in our country to be similar to those of other European cities. The levels of the different pollutants point toward road traffic as being the main source of most of this pollution. A relationship has been found between the mortality and different pollutants in most cities, although the results are not homogeneous among the cities and show variability in the different causes under study. In some cities, especially in those having smaller populations, there have been no findings providing any evidence of a relationship, or the findings themselves are not highly consistent. The meta-analysis will provide estimates for all of the cities as a whole and will allow the possibility of making a more clear-cut assessment of the time lag impact of air pollution on the mortality. Worthy of special mention is the participation in this project of public health officers as actively involved researchers.

  16. Actas de la 4th mesa redonda sobre investigacion en "Lenguas Extranjeras" en la Universidad Autonoma Metropolitana 1996. (Proceedings from the 4th Roundtable on Investigation in Foreign Languages in the Autonomous Metropolitan University 1996).

    ERIC Educational Resources Information Center

    Zoreda, Margaret Lee, Comp.; Diop, Mamoudou Si, Comp.; Vivaldo Lima, Javier, Comp.

    The articles included in this volume were selected as exemplary papers from the conference in Mexico. The goal of the forum was to provide an opportunity for researchers from the three branches of the Universidad Autonoma Metropolitana (UAM) to meet and discuss research projects currently in progress at the university. The works presented here…

  17. Memorias Conferencia Internacional IEEE Mexico 1971, Sobre Sistemas, Redes Y Computadoras. Volumen I and Volumen II. (Proceedings of International Conference of IEEE Concerning Systems, Networks, and Computers. Volume I and Volume II.

    ERIC Educational Resources Information Center

    Concheiro, A. Alonso, Ed.; And Others

    The following papers in English from this international conference may be of particular interest to those in the field of education. T. Nakahara, A. Tsukamota, and M. Matsumoto describe a computer-aided design technique for an economical urban cable television system. W. D. Wasson and R. K. Chitkara outline a recognition scheme based on analysis…

  18. La Seccion de Investigacion sobre Educacion Medica de la Facultad de Medicina de la Universidad National Autonoma de Mexico (The Medical Education Investigation Section of the School of Medicine of UNAM).

    ERIC Educational Resources Information Center

    Campillo Sainz, Carlos; Alvarez, Tostado, Juan

    This document is an English-language abstract (approximately 1,500 words) of a survey of Mexican medical education needs for the future. To plan for these needs, SISEM of UNAM was formed with the objectives of carrying out and promoting investigations in the different areas of medical education. It also wants to distribute the information…

  19. Edades y metalicidades de cinco cúmulos estelares proyectados en dirección a la Nube Menor de Magallanes: implicaciones sobre los procesos de formación y evolución de estos sistemas

    NASA Astrophysics Data System (ADS)

    Piatti, A. E.; Santos, J. F. C.; Clariá, J. J.; Bica, E.; Sarajedini, A.; Geisler, D.

    Washington photometry of the 5 star clusters Lindsay 32, Lindsay 38, Kron 28, Kron 44 and Lindsay 116 and their surrounding fields located towards the Small Magellanic Cloud (SMC) is presented for the first time. From the color-magnitude diagrams, cleaned from field stars contamination, the cluster and SMC field reddenings, ages and metallicities are determined. The ages - derived from the difference in the T1 magnitude betweem the giant clump and the Main Sequence turnoff point - vary between 2 and 6 Gyr, and the metallicities ([Fe/H]) between -1.65 and -1.10. Lindsay 116 is located closer to the Large Magellanic Cloud (LMC) than to the SMC and its fundamental parameters suggests a higher probability of belonging to the LMC. The results obtained in this work, combined with previous estimates of age and metallicity for other seven clusters, allow us to draw the following conclusions: (1) There does not exist an age-position relation in the SMC, but a age-metallicity one. (2) The chemical enrichment in the SMC has been very efficient during the last 5 Gyr. (3) The SMC clusters formation and evolution can be better represented by a bursting star formation process than by a continuum star formation mechanism.

  20. Kathy Talks with Other Mothers about Breastfeeding an Older Baby. Mother-to-Mother Support = Josefa Habla con Otras Mamas sobre el Amamantar a un Bebe Mayorcito. Apoyo Madre a Madre.

    ERIC Educational Resources Information Center

    Magalhaes, Rebecca; Stone-Jimerez, Maryanne; Allen de Smith, Paulina; Smith, Natalia

    These magazine-sized booklets, one in English, one in Spanish, are in cartoon format and designed to be used by people with limited literacy in English or Spanish. The book explains that a 1- or 2-year old breastfed baby is comforted by breastfeeding, breast milk continues to have nutritional value (even if the mother becomes pregnant), and that…