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1.
Water Res ; 243: 120381, 2023 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-37517150

RESUMO

Bioretention systems have the potential of simultaneous runoff volume reduction and nitrogen removal. Internal water storage (IWS) layers and real-time control (RTC) strategies may further improve performance of bioretention systems. However, optimizing the design of these systems is limited by the lack of effective models to simulate nitrogen transformations under the influences of IWS design and environment conditions including soil moisture and temperature. In this study, nitrogen removal models (NRMs) are developed with two complexity levels of nitrogen cycling: the Single Nitrogen Pool (SP) models and the more complex 3 Nitrogen Pool (3P) models. The 0-order kinetics, 1st order kinetics, and the Michaelis-Menten equations are applied to both SP and 3P models, creating six different NRMs. The Storm Water Management Model (SWMM), in combination with each NRM, is calibrated and validated with a lab dataset. Results show that 0-order kinetics are not suitable in simulating nitrogen removal or transformations in bioretention systems, while 1st order kinetics and Michaelis-Menten equation models have similar performances. The best performing NRM (referred to as 3P-m) can accurately predict nitrogen event mean concentrations in bioretention effluent for 20% more events when compared to SWMM. When only calibrated with soil moisture conditions in bioretention systems without internal storage layers, 3P-m was sufficiently adaptable to predict cumulative nitrogen mass removal rates from systems with IWS or RTC rules with less than ±7% absolute error, while the absolute error from SWMM prediction can reach -23%. In general, 3P models provide higher prediction accuracy and improved time series of biochemical reaction rates, while SP models improve prediction accuracy with less required user input for initial conditions.


Assuntos
Desnitrificação , Nitrogênio , Nitrogênio/análise , Chuva , Solo , Água
2.
Int J Mol Sci ; 24(3)2023 Jan 27.
Artigo em Inglês | MEDLINE | ID: mdl-36768808

RESUMO

PiZZ (Glu342Lys) α1-antitrypsin deficiency (AATD) is characterized by intrahepatic AAT polymerization and is a risk factor for liver disease development in children. The majority of PiZZ children are disease free, hence this mutation alone is not sufficient to cause the disease. We investigated Z-AAT polymers and the expression of fibrosis-related genes in liver tissues of PiZZ children with different clinical courses. Liver biopsies obtained during 1979-2010 at the Department of Paediatrics, Karolinska University Hospital, Sweden, were subjected to histological re-evaluation, immunohistochemistry and NanoString-based transcriptome profiling using a panel of 760 fibrosis plus 8 bile acid-related genes. Subjects were divided into three groups based on clinical outcomes: NCH (neonatal cholestasis, favourable outcome, n = 5), NCC (neonatal cholestasis, early cirrhosis and liver transplantation, n = 4), and NNCH (no neonatal cholestasis, favourable outcome, n = 5, six biopsies). Hepatocytes containing Z-AAT polymers were abundant in all groups whereas NCC showed higher expression of genes related to liver fibrosis/cirrhosis and lower expression of genes related to lipid, aldehyde/ketone, and bile acid metabolism. Z-AAT accumulation per se cannot explain the clinical outcomes of PiZZ children; however, changes in the expression of specific genes and pathways involved in lipid, fatty acid, and steroid metabolism appear to reflect the degree of liver injury.


Assuntos
Colestase , Deficiência de alfa 1-Antitripsina , Humanos , Criança , Recém-Nascido , Deficiência de alfa 1-Antitripsina/patologia , Fígado/metabolismo , Cirrose Hepática/genética , Cirrose Hepática/patologia , Colestase/metabolismo , Biópsia , Progressão da Doença , Lipídeos
3.
Curr Opin Pharmacol ; 59: 85-94, 2021 08.
Artigo em Inglês | MEDLINE | ID: mdl-34161852

RESUMO

There is an urgent need for better treatment of lung diseases that are a major cause of morbidity and mortality worldwide. This urgency is illustrated by the current COVID-19 health crisis. Moderate-to-extensive lung injury characterizes several lung diseases, and not only therapies that reduce such lung injury are needed but also those that regenerate lung tissue and repair existing lung injury. At present, such therapies are not available, but as a result of a rapid increase in our understanding of lung development and repair, lung regenerative therapies are on the horizon. Here, we discuss existing targets for treatment, as well as novel strategies for development of pharmacological and cell therapy-based regenerative treatment for a variety of lung diseases and clinical studies. We discuss how both patient-relevant in vitro disease models using innovative culture techniques and other advanced new technologies aid in the development of pulmonary regenerative medicine.


Assuntos
Pneumopatias/terapia , Pulmão/fisiologia , Regeneração , Animais , Humanos , Transplante de Células-Tronco , Células-Tronco
4.
J Biol Rhythms ; 35(6): 598-611, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-32915671

RESUMO

Artificial light exposure is associated with dyslipidemia in humans, which is a major risk factor for the development of atherosclerotic cardiovascular disease. However, it remains unclear whether artificial light at night can exacerbate atherosclerosis. In this study, we exposed female APOE*3-Leiden.CETP mice, a well-established model for human-like lipid metabolism and atherosclerosis, to either a regular light-dark cycle or to constant bright light for 14 weeks. Mice exposed to constant light demonstrated a minor reduction in food intake, without any effect on body weight, body composition, or the weight of metabolic organs. Constant light increased the plasma levels of proatherogenic non-high-density lipoprotein (HDL) cholesterol but did not increase the size or severity of atherosclerotic lesions in the aortic root. Mice exposed to constant light did show lower immune cell counts, which could explain the absence of an effect of atherosclerosis despite increased non-HDL cholesterol levels. Behavioral analysis demonstrated variability in the response of mice to the light intervention. Constant light completely blunted behavioral rhythms in some mice, while others extended their behavioral period. However, rhythm strength was not an important determinant of atherosclerosis. Altogether, these results demonstrate that constant bright light does not affect atherosclerosis in APOE*3-Leiden.CETP mice. Whether artificial light exposure contributes to cardiovascular disease risk in humans remains to be investigated.


Assuntos
Apolipoproteínas E/genética , Aterosclerose/genética , Proteínas de Transferência de Ésteres de Colesterol/genética , Ritmo Circadiano/efeitos da radiação , Iluminação , Animais , Feminino , Humanos , Inflamação/genética , Iluminação/efeitos adversos , Camundongos , Camundongos Transgênicos
5.
Thorax ; 73(6): 565-574, 2018 06.
Artigo em Inglês | MEDLINE | ID: mdl-29653970

RESUMO

COPD is characterised by tissue destruction and inflammation. Given the lack of curative treatments and the progressive nature of the disease, new treatments for COPD are highly relevant. In vitro cell culture and animal studies have demonstrated that mesenchymal stromal cells (MSCs) have the capacity to modify immune responses and to enhance tissue repair. These properties of MSCs provided a rationale to investigate their potential for treatment of a variety of diseases, including COPD. Preclinical models support the hypothesis that MSCs may have clinical efficacy in COPD. However, although clinical trials have demonstrated the safety of MSC treatment, thus far they have not provided evidence for MSC efficacy in the treatment of COPD. In this review, we discuss the rationale for MSC-based cell therapy in COPD, the main findings from in vitro and in vivo preclinical COPD model studies, clinical trials in patients with COPD and directions for further research.


Assuntos
Transplante de Células-Tronco Mesenquimais , Doença Pulmonar Obstrutiva Crônica/imunologia , Doença Pulmonar Obstrutiva Crônica/terapia , Animais , Modelos Animais de Doenças , Progressão da Doença , Humanos
6.
BMC Complement Altern Med ; 16(1): 302, 2016 Aug 22.
Artigo em Inglês | MEDLINE | ID: mdl-27550200

RESUMO

BACKGROUND: Catharanthus roseus, a medicinal plant, is known to produce secondary metabolites, vincristine and vinblastine, which are terpenoid indole alkaloids. Previously we have reported that Eutypella spp - CrP14 isolated from stem cutting of this plant had shown significant antiproliferative activity when tested in vitro against HeLa cell line. The present study was conducted to identify the anticancer compound responsible for the anti-proliferative activity of the fungal extract and to evaluate its in vitro anticancer and apoptotic effects. METHODS: The anti-proliferative activity of the fungal anticancer compound, vincristine was analyzed by MTT assay against different cancer cell lines. We examined its efficacy of apoptotic induction on A431 cells. The parameters examined included cell cycle distribution, loss of mitochondrial membrane potential (MMP), DNA fragmentation and reactive oxygen species (ROS) generation. RESULTS: The presence of vincristine in fungal culture filtrate was confirmed through chromatographic and spectroscopic analyses, and the amount was estimated to be 53 ± 5.0 µg/l. The partially purified fungal vincristine had strong cytotoxic activity towards human squamous carcinoma cells - A431 in the MTT assay. Furthermore, we showed that the fungal vincristine was capable of inducing apoptosis in A431 cells through generation of reactive oxygen species and activation of the intrinsic pathway leading to loss of MMP. CONCLUSIONS: We have demonstrated for the first time that the vincristine from Eutypella spp - CrP14 is an efficient inducer of apoptosis in A431 cells, meriting its further evaluation in vivo.


Assuntos
Antineoplásicos/farmacologia , Apoptose/efeitos dos fármacos , Catharanthus/microbiologia , Vincristina/farmacologia , Xylariales/química , Antineoplásicos/química , Carcinoma de Células Escamosas , Linhagem Celular Tumoral , Humanos , Vincristina/química
8.
PLoS One ; 10(12): e0144476, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26697875

RESUMO

Endophytic fungi isolated from Catharanthus roseus were screened for the production of vincristine and vinblastine. Twenty-two endophytic fungi isolated from various tissues of C. roseus were characterized taxonomically by sequence analysis of the internal transcribed spacer (ITS) region of rDNA and grouped into 10 genera: Alternaria, Aspergillus, Chaetomium, Colletotrichum, Dothideomycetes, Eutypella, Eutypa, Flavodon, Fusarium and Talaromyces. The antiproliferative activity of these fungi was assayed in HeLa cells using the MTT assay. The fungal isolates Eutypella sp--CrP14, obtained from stem tissues, and Talaromyces radicus--CrP20, obtained from leaf tissues, showed the strongest antiproliferative activity, with IC50 values of 13.5 µg/ml and 20 µg/ml, respectively. All 22 endophytic fungi were screened for the presence of the gene encoding tryptophan decarboxylase (TDC), the key enzyme in the terpenoid indole alkaloid biosynthetic pathway, though this gene could only be amplified from T. radicus--CrP20 (NCBI GenBank accession number KC920846). The production of vincristine and vinblastine by T. radicus--CrP20 was confirmed and optimized in nine different liquid media. Good yields of vincristine (670 µg/l) in modified M2 medium and of vinblastine (70 µg/l) in potato dextrose broth medium were obtained. The cytotoxic activity of partially purified fungal vincristine was evaluated in different human cancer cell lines, with HeLa cells showing maximum susceptibility. The apoptosis-inducing activity of vincristine derived from this fungus was established through cell cycle analysis, loss of mitochondrial membrane potential and DNA fragmentation patterns.


Assuntos
Apoptose/efeitos dos fármacos , Catharanthus/microbiologia , Talaromyces/química , Vimblastina/metabolismo , Vincristina/metabolismo , Ciclo Celular/efeitos dos fármacos , Proliferação de Células/efeitos dos fármacos , Fragmentação do DNA/efeitos dos fármacos , Células HeLa , Humanos , Potencial da Membrana Mitocondrial/efeitos dos fármacos , Talaromyces/isolamento & purificação , Talaromyces/metabolismo , Vimblastina/isolamento & purificação , Vimblastina/farmacologia , Vincristina/isolamento & purificação , Vincristina/farmacologia
9.
Invest Ophthalmol Vis Sci ; 56(5): 3371-82, 2015 May.
Artigo em Inglês | MEDLINE | ID: mdl-26024122

RESUMO

PURPOSE: Retinopathy is an important manifestation of trifunctional protein (TFP) deficiencies but not of other defects of fatty acid oxidation. The common homozygous mutation in the TFP α-subunit gene HADHA (hydroxyacyl-CoA dehydrogenase), c.1528G>C, affects the long-chain 3-hydroxyacyl-CoA dehydrogenase (LCHAD) activity of TFP and blindness in infancy. The pathogenesis of the retinopathy is unknown. This study aimed to utilize human induced pluripotent stem cell (hiPSC) technology to create a disease model for the disorder, and to derive clues for retinopathy pathogenesis. METHODS: We implemented hiPSC technology to generate LCHAD deficiency (LCHADD) patient-specific retinal pigment epithelial (RPE) monolayers. These patient and control RPEs were extensively characterized for function and structure, as well as for lipid composition by mass spectrometry. RESULTS: The hiPSC-derived RPE monolayers of patients and controls were functional, as they both were able to phagocytose the photoreceptor outer segments in vitro. Interestingly, the patient RPEs had intense cytoplasmic neutral lipid accumulation, and lipidomic analysis revealed an increased triglyceride accumulation. Further, patient RPEs were small and irregular in shape, and their tight junctions were disorganized. Their ultrastructure showed decreased pigmentation, few melanosomes, and more melanolysosomes. CONCLUSIONS: We demonstrate that the RPE cell model reveals novel early pathogenic changes in LCHADD retinopathy, with robust lipid accumulation, inefficient pigmentation that is evident soon after differentiation, and a defect in forming tight junctions inducing apoptosis. We propose that LCHADD-RPEs are an important model for mitochondrial TFP retinopathy, and that their early pathogenic changes contribute to infantile blindness of LCHADD.


Assuntos
Células-Tronco Pluripotentes Induzidas/citologia , 3-Hidroxiacil-CoA Desidrogenase de Cadeia Longa/deficiência , Doenças Retinianas/patologia , Epitélio Pigmentado da Retina/patologia , Biomarcadores/metabolismo , Linhagem Celular , Células Cultivadas , Células Epiteliais/metabolismo , Células Epiteliais/ultraestrutura , Humanos , Imuno-Histoquímica , Lipídeos/análise , Espectrometria de Massas , Mitocôndrias/enzimologia , Doenças Retinianas/metabolismo , Epitélio Pigmentado da Retina/metabolismo
10.
Brain Dev ; 37(1): 107-13, 2015 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-24613099

RESUMO

BACKGROUND: Malonyl-CoA decarboxylase (MLYCD, EC 4.1.1.9) deficiency is a rare autosomal recessive disorder that is widely diagnosed by neonatal screening. METHODS: We report long term follow up of a patient with MLYCD deficiency showing signs of neonatal hypoglycemia, mental retardation, developmental delay and rheumatoid arthritis. Brain MRI revealed patchy, symmetrical hyperintensity of the deep white matter with periventricular white matter and subcortical arcuate fibers being spared. MLCYD gene sequence analysis was done to identify possible mutations. Expression analyses at mRNA and protein levels were also performed. Further, immunocytochemical studies were implemented to check for its subcellular localization. RESULTS: MLYCD gene sequencing identified a novel compound heterozygous mutation (c.22 T>A, p.M1K, c.454 C>A; pH152N) in our patient and a heterozygous mutation in the healthy mother c.22 T>A; pM1K. Reduced expression of RNA and protein levels was observed. Immunocytochemical analysis showed diffused staining across the cytoplasm with apparent signs of intracellular mislocalization to the nucleus. RESULTS also indicated subcellular colocalization of MLCYD with mitochondria was scant compared to control. CONCLUSION: Our patient was identified with a novel compound heterozygous MLYCD mutation at the N-terminal helical domain. This study indicates that protein mislocalization is a characteristic feature of MLYCD deficiency in our patient.


Assuntos
Carboxiliases/deficiência , Erros Inatos do Metabolismo/genética , Adolescente , Idade de Início , Sequência de Bases , Western Blotting , Carboxiliases/genética , Criança , Pré-Escolar , Análise Mutacional de DNA , Feminino , Humanos , Imuno-Histoquímica , Lactente , Malonil Coenzima A/genética , Erros Inatos do Metabolismo/fisiopatologia , Ácido Metilmalônico , Dados de Sequência Molecular , Mutação , Reação em Cadeia da Polimerase
11.
J Nutr Biochem ; 24(8): 1423-30, 2013 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-23337345

RESUMO

Resveratrol is a major constituent of traditional Asian medicinal herbs and red wine and is suggested to be a potential antiatherosclerotic drug due to its proposed hypolipidemic, anti-inflammatory and antioxidative properties. The aim of this study was to evaluate whether resveratrol protects against atherosclerosis development in APOE*3-Leiden.CETP (E3L.CETP) mice and adds to the antiatherogenic effect of mild statin treatment, currently the most widely used antiatherogenic therapy. E3L.CETP mice were fed a cholesterol-rich diet without (control) or with resveratrol (0.01% w/w), atorvastatin (0.0027% w/w) or both for 14 weeks. During the study plasma lipid, inflammatory and oxidative stress parameters were determined. Resveratrol reduced atherosclerotic lesion area (-52%) in the aortic root, comparable to atorvastatin (-40%) and the combination of both drugs (-47%). The collagen/macrophage ratio in the atherosclerotic lesion, a marker of plaque stability, was increased by resveratrol (+108%), atorvastatin (+124%) and the combination (+154%). Resveratrol decreased plasma cholesterol levels (-19%) comparable to atorvastatin (-19%) and the combination (-22%), which was completely confined to (very)low-density lipoprotein cholesterol levels in all groups. Post hoc analyses showed that the antiatherogenic effect of atorvastatin could be explained by cholesterol lowering, while the antiatherosclerotic effect of resveratrol could be attributed to factors additional to cholesterol lowering. Markers of inflammation and oxidative stress were not different, but resveratrol improved macrophage function. We conclude that resveratrol potently reduces atherosclerosis development and induces a more stable lesion phenotype in E3L.CETP mice. However, under the experimental conditions tested, resveratrol does not add to the antiatherogenic effect of atorvastatin.


Assuntos
Aterosclerose/tratamento farmacológico , Ácidos Heptanoicos/farmacologia , Pirróis/farmacologia , Estilbenos/farmacologia , Animais , Aterosclerose/patologia , Atorvastatina , Biomarcadores/sangue , Colesterol na Dieta/administração & dosagem , LDL-Colesterol/sangue , Sinergismo Farmacológico , Feminino , Inibidores de Hidroximetilglutaril-CoA Redutases/farmacologia , Inflamação/tratamento farmacológico , Camundongos , Camundongos Transgênicos , Estresse Oxidativo/efeitos dos fármacos , Resveratrol
12.
J Pediatr ; 160(3): 473-479.e1, 2012 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-21962599

RESUMO

OBJECTIVE: To assess the long-term clinical course of carnitine palmitoyltransferase 1A (CPT1A) deficiency, caused by the c.1364A>C (p.K455T) mutation, and the carrier frequency of this mutation in Finland. STUDY DESIGN: This was a long-term follow-up of patients in whom the common mutation was detected. RESULTS: Between 1999 and 2010, 6 cases of CPT1A deficiency were diagnosed and treated with a high-carbohydrate, low-fat diet. The patients experienced their first symptoms during the first years of life, provoked by viral illness and/or fasting. The clinical features included hypoketotic hypoglycemia, hepatopathy, and loss of consciousness, ranging from transient unconsciousness to prolonged hyperlipidemic coma. Five cases carried a homozygous c.1364A>C (p.K455T) mutation, whereas 1 case had a compound c.1364A>C/c.1493A>C (p.Y498S) mutation. During dietary therapy, the patients had few transient decompensations. No carriers of mutation c.1364A>C were detected by minisequencing of 150 control samples. CONCLUSION: Even though CPT1A deficiency may be life-threatening and lead to prolonged coma, the long-term prognosis is good. A genotype-phenotype correlation implies that the mutations detected are disease-causing. Despite Finland's location close to the Arctic polar region, the carrier frequency of the c.1364A>C mutation in Finland is far lower than that of the variants found in Alaskan, Canadian, and Greenland native populations.


Assuntos
Carnitina O-Palmitoiltransferase/genética , Heterozigoto , Mutação de Sentido Incorreto , Adolescente , Adulto , Western Blotting , Carnitina O-Palmitoiltransferase/deficiência , Carnitina O-Palmitoiltransferase/metabolismo , Criança , Desenvolvimento Infantil , Pré-Escolar , Dietoterapia , Feminino , Finlândia/epidemiologia , Seguimentos , Estudos de Associação Genética , Humanos , Masculino , Adulto Jovem
13.
Circ Res ; 108(9): 1093-101, 2011 Apr 29.
Artigo em Inglês | MEDLINE | ID: mdl-21393577

RESUMO

RATIONALE: Primary cilia are cellular protrusions that serve as mechanosensors for fluid flow. In endothelial cells (ECs), they function by transducing local blood flow information into functional responses, such as nitric oxide production and initiation of gene expression. Cilia are present on ECs in areas of low or disturbed flow and absent in areas of high flow. In the embryonic heart, high-flow regime applies to the endocardial cushion area, and the absence of cilia here coincides with the process of endothelial-to-mesenchymal transition (EndoMT). OBJECTIVE: In this study, we investigated the role of the primary cilium in defining the responses of ECs to fluid shear stress and in EndoMT. METHODS AND RESULTS: Nonciliated mouse embryonic ECs with a mutation in Tg737/Ift88 were used to compare the response to fluid shear stress to that of ciliated ECs. In vitro, nonciliated ECs undergo shear-induced EndoMT, which is accompanied by downregulation of Klf4. This Tgfß/Alk5-dependent transformation is prevented by blocking Tgfß signaling, overexpression of Klf4, or rescue of the primary cilium. In the hearts of Tg737(orpk/orpk) embryos, Tgfß/Alk5 signaling was activated in areas in which ECs would normally be ciliated but now lack cilia because of the mutation. In these areas, ECs show increased Smad2 phosphorylation and expression of α-smooth muscle actin. CONCLUSIONS: This study demonstrates the central role of primary cilia in rendering ECs prone to shear-induced activation of Tgfß/Alk5 signaling and EndoMT and thereby provides a functional link between primary cilia and flow-related endothelial performance.


Assuntos
Cílios/patologia , Cílios/fisiologia , Transição Epitelial-Mesenquimal/fisiologia , Mecanotransdução Celular/fisiologia , Animais , Diferenciação Celular/fisiologia , Células Endoteliais/patologia , Células Endoteliais/fisiologia , Regulação da Expressão Gênica/fisiologia , Fator 4 Semelhante a Kruppel , Fatores de Transcrição Kruppel-Like/genética , Fatores de Transcrição Kruppel-Like/metabolismo , Mesoderma/patologia , Mesoderma/fisiologia , Camundongos , Camundongos Mutantes , Proteínas Serina-Treonina Quinases/genética , Proteínas Serina-Treonina Quinases/metabolismo , Receptor do Fator de Crescimento Transformador beta Tipo I , Receptores de Fatores de Crescimento Transformadores beta/genética , Receptores de Fatores de Crescimento Transformadores beta/metabolismo , Proteína Smad2/metabolismo , Estresse Mecânico , Proteínas Supressoras de Tumor/genética , Proteínas Supressoras de Tumor/metabolismo
18.
Indian Pediatr ; 28(5): 501-5, 1991 May.
Artigo em Inglês | MEDLINE | ID: mdl-1752678

RESUMO

One hundred urban parents were interviewed for their knowledge, attitude and treatment practices towards fever in children. Only 55% parents were aware of the normal body temperature and 23% of the febrile temperature. A total of 58% considered fever as a disease, 91% felt that fever could go on rising if unchecked, and 60% believed that if it is brought down the child would be cured. As home treatment, paracetamol was used by 57% parents, and cold sponging by 29%. Sixty three per cent were of the opinion that a doctor must be consulted for any fever. The understanding of fever and home treatment practices were significantly better in highly educated parents. Above points must be considered while counselling parent of a febrile child, and for formulating health education package for the parents.


PIP: 100 urban parents were interviewed concerning their knowledge, attitude, and treatment practices of fever in children. Only 55% of the parents were aware of the normal body temperature and 23% were aware of what constitutes febrile temperatures. A total of 58% considered fever a disease, 91% felt that it could continue to rise if unchecked, and 60% believed that if it is brought down, the child would be cured. For home treatment, paracetamol was used by 57% of the parents and cold sponging by 29%. 63% were of the opinion that a doctor must be consulted in the event of a fever. The understanding of fever and home treatment practices were significantly greater in parents who were highly educated. The above points must be considered when counseling the parent of a child with a fever, and for formulating a health education package for parents.


Assuntos
Febre/terapia , Educação em Saúde/normas , Conhecimentos, Atitudes e Prática em Saúde , Assistência Domiciliar/normas , Relações Pais-Filho , Adulto , Pré-Escolar , Feminino , Febre/enfermagem , Humanos , Índia , Lactente , Entrevistas como Assunto , Masculino , Fatores Socioeconômicos , População Urbana
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