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Objective To evaluate the informative value of the carrier status for allelic variations that determine the sensitivity of tissues to calcitriol (VDR) and are involved in familial thrombophilia and hypofibrinolysis (PAI-1) as molecular genetic markers of avascular necrosis of the femoral head (AVNFH). Material and methods A clinical and laboratory study of 300 AVNFH patients, residents of European Russia, was carried out. A comparative analysis of the alleles and genotypes frequency distribution of polymorphisms rs11568820 and rs1544410 of the VDR gene, as well as rs1799889 of the PAI-1 gene in AVNFH patients was performed. Results AVNFH patients showed a significant increase in the frequencies of the G/G genotype (P = 3.0E-9) and the G allele (P = 0.05) of the rs11568820 VDR polymorphism (P = 2.10E-08) as compared to controls. The frequency of the A/A genotype of the rs1544410 VDR locus in AVNFH individuals was higher than that in controls (P = 0.05). Discussion Carriers of the genotype G / G A-3731G (Cdx2) of the VDR gene were shown to have a 2.1-fold increased risk of developing AVNFH; carriers of the G allele appeared to have a 2.3-fold increased risk of AVNFH. The findings showed that the carriership of the 5G allele of the polymorphic locus PAI-1 -675 4G > 5G (rs1799889) is detected 1.4 times more often in AVNFH patients than in individuals from the population sample. The risk of developing the pathology is increased 2 times with the carriership of the 5G/5G genotype of this polymorphic locus. Conclusion Carriers of genotypes G/G rs11568820 VDR (allele G), A/A rs1544410 VDR and 5G/5G (allele 5G) at the polymorphic locus rs1799889 PAI-1 have an increased risk of developing AVNFH. This allows the use of the molecular genetic markers in the early diagnosis of AVNFH in individuals who are at greater risk for the disease.

Unilateral adrenal infarction is a rare cause of acute abdomen in pregnancy (AAP). Its presentation is non-specific and requires a high index of suspicion with a low threshold to obtain radiographic imaging for diagnosis. Evaluating AAP is challenging as diagnostic radiographic imaging is often limited in relation to radiation exposure to the developing fetus. We describe a case of a 24-year-old pregnant female who presented with severe acute abdominal pain. The patient’s pain was refractory to intravenous analgesics and ultrasonography was inconclusive. Computed tomography (CT) scan was not obtained due to the risk of radiation exposure to the developing fetus. Due to the persistence of pain and suspicions for other serious etiologies, magnetic resonance imaging (MRI) was completed and the patient was diagnosed with acute unilateral adrenal infarction. In this case report, unilateral adrenal infarction was likely secondary to elevated plasma factor VIII levels. Even with the physiological elevation of factor VIII levels during pregnancy, levels greater than 150 IU/dL confer greater than five-fold increased risk of venous thrombosis. Once hemorrhage is excluded, patients should be started on therapeutic anticoagulation to prevent progression of adrenal infarct or infarction of the contralateral adrenal gland. Prompt recognition and treatment of acute adrenal infarction during pregnancy are of paramount importance to prevent adverse outcomes for both the mother and fetus.

Jijun Fu,1,* Qianni Wu,1,* Yuanye Dang,1,* Xueping Lei,1 Guining Feng,1 Mingyue Chen,2 Xi-Yong Yu1 1The Key Laboratory of Molecular Target & Clinical Pharmacology, School of Pharmaceutical Sciences, The First Affiliated Hospital of Guangzhou Medical University, The Fifth Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, 511436, People’s Republic of China; 2Foshan Nanhai Vocational School of Health, Foshan, 528211, People’s Republic of China*These authors contributed equally to this workCorrespondence: Jijun Fu Email fujj@gzhmu.edu.cnIntroduction: Traditional antitumor chemotherapy faces great challenges, such as multi-drug resistance (MDR) and poor penetration into tumor tissues. The newly emerging nitric oxide (NO)-based gas therapy has been recognized to reduce MDR and has improved permeation into tumor tissue.Methods: In this study, NO-generating prodrug sodium nitroprusside (SNP) was doped to hollow mesoporous Prussian blue (PB) nanoparticles to fabricate NO-generating nanoparticles (NO-PB), which was further loaded with doxorubicin (DOX).Results: DOX loaded NO-PB (DOX-NO-PB) was released quicker at pH 6 compared with neutral pH, suggesting NO-PB may facilitate the release of loaded drug in acidic tumor tissue. The capacity of NO production by NO-PB was measured, and the results showed the presence of NO in the culture medium from 4T1 cells incubated with NO-PB and inside the cells. NP-PB could be detected by photoacoustic imaging (PAI) in tumor tissue in 4T1 tumor bearing mice, suggesting this nanoparticle may serve as contrast agent for the noninvasive diagnosis of tumor tissues. NO-PB suppressed the growth of tissues in 4T1 tumor bearing mice. DOX-NO-PB showed more potent anti-tumor effects in 4T1 cells and tumor bearing mice compared with free DOX and NO-PB alone, indicating that the combination of DOX and NO-PB exhibited synergistic effects on tumor suppression.Conclusion: This study provides a novel nanocarrier for gas therapy with additional PAI imaging capacity. This nanocarrier can be utilized for combination therapy of NO and chemotherapeutics which may serve as theranostic agents.Keywords: gas therapy, nitric oxide, NO, photoacoustic imaging, PAI, sodium nitroprusside, SNP, hollow mesoporous Prussian blue (PB) nanoparticles

BackgroundPatients with primary adrenal insufficiency (PAI) suffer reduced quality of life (QoL), but comparisons with large-scale normative data are scarce. The clinical characteristics associated with reduced QoL are largely unknown.MethodsCross-sectional data on clinical characteristics and QoL scores from 494 patients were included. QoL was measured using RAND-36 (generic) and AddiQoL (-30 and -8, disease-specific). RAND-36 is reported as subdomain scores as well as physical (PCS) and metal (MCS) summary scores and compared with normative data.ResultsPerception of physical role was consistently decreased across age groups in patients with PAI compared with normative data [75 (0-100) vs. 100 (50-100), pvs. 100 (75-100), pvs. 100 (50-100), pvs. 82 ± 13, pvs. 80-89 years: PCS 59 [50-62] vs. 46 [37-53], pvs.. 45 (38-54), pvs. 50 (43-58), pConclusionQoL is reduced in patients with PAI, especially perception of physical role in women and social functioning in men. Among patients with PAI, female sex, higher age, non-autoimmune etiology, and autoimmune comorbidity was associated with lower QoL-scores.

Aim To assess and correlate three distinct states of severely painful endodontically derived inflammation with their depiction on periapical radiographs using periapical index (PAI) scores. Methodology During a period of 15 months, 368 consecutively enrolled patients with suspected endodontic emergency conditions were examined at the University of Zurich, Center of Dental Medicine. Cases with a severely painful (numeric rating scale, NRS‐11 > 6) endodontically involved tooth and a clear pulpal and apical diagnosis (n = 162) were selected (one tooth per patient). Teeth were divided into three groups according to the clinically diagnosed main location of the inflammatory process: level 1: pulp (positive response to cold test), level 2: periodontium (no response to cold without swelling) and level 3: periapical tissues (no response to cold with swelling). Periapical radiographs were obtained using a digital unit and analysed by two calibrated observers. For level 2, which had the highest PAI variance (n = 76), the PAI scores were further scrutinized regarding their dependence on tooth location and the duration of pain. Data were analysed using chi‐squared and non‐parametric tests, alpha = 0.05. Results Overall, the PAI scores correlated well with the clinically diagnosed main location of periapical inflammation (Spearman’s rho = 0.5131, P

Thromboembolism is a clinical finding that occurs due to thrombus; formed in the vascular system and has various etiological factors. It can be classified as central and peripheral thromboembolism. Our objective in this study is to explore genetic risk factors in central and peripheral thromboembolism and reveal the differences. 342 thromboembolism patients were retrospectively included to the study between January 2016 and December 2019. Demographic characteristics, risk factors for thromboembolism and genetic mutations in central and peripheral thromboembolism groups were overviewed. The genetic mutations evaluated in patients were Factor V Leiden G1691A, Factor V HR1299R, Factor II (Prothrombin) G20210A, MTHFR (Methylenetetrahydrofolate reductase) C677T, MTHFR A1298C, PAI 4G/5G. Within the scope of the study, genetic analyzes of 106 patients were reached and included in the study. Seventy-two central thromboembolism (69.8%), 34 (31.2%) peripheral thromboembolisms were detected. Sixty-three of the central thromboembolisms were from arterial and nine were from venous origin. There was no significant difference between age, gender and risk factors of central thromboembolism and peripheral thromboembolism patients (p˃0.05), but smoking was more common in central thromboembolism patients (p: 0.041). 4G/5G polymorphism was observed more frequently in patients with central thromboembolism (p: 0.039). Thromboembolism is a multifactorial disease, PAI-1 4G/5G polymorphism is a medium risk factor for thromboembolism. We conclude that PAI-1 4G/5G polymorphism is more frequent in central thromboembolism than peripheral thromboembolism and its evaluation can give more information about the thromboembolic risk analyze.

Nico C Grossmann,1,2 Victor M Schuettfort,1,3 Benjamin Pradere,1,4 Marco Moschini,5 Fahad Quhal,1,6 Hadi Mostafaei,1,7 Francesco Soria,8 Satoshi Katayama,1,9 Ekaterina Laukhtina,1,10 Keiichiro Mori,1,11 Reza Sari Motlagh,1,12 Cédric Poyet,2 Mohammad Abufaraj,1,13 Pierre I Karakiewicz,14 Shahrokh F Shariat,1,10,15– 19 David D’Andrea1 1Department of Urology, Comprehensive Cancer Center, Vienna General Hospital, Medical University of Vienna, Vienna, Austria; 2Department of Urology, University Hospital Zurich, Zurich, Switzerland; 3Department of Urology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; 4Department of Urology, University Hospital of Tours, Tours, France; 5Department of Urology, Luzerner Kantonsspital, Luzern, Switzerland; 6Department of Urology, King Fahad Specialist Hospital, Dammam, Saudi Arabia; 7Research Center for Evidence Based Medicine, Tabriz University of Medical Sciences, Tabriz, Iran; 8Department of Urology, Molinette Hospital, University of Turin, Turin, Italy; 9Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan; 10Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia; 11Department of Urology, The Jikei University School of Medicine, Tokyo, Japan; 12Men’s Health and Reproductive Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran; 13Division of Urology, Department of Special Surgery, Jordan University Hospital, The University of Jordan, Amman, Jordan; 14Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montreal Health Center, Montreal, Canada; 15Department of Urology, Weill Cornell Medical College, New York, NY, USA; 16Department of Urology, University of Texas Southwestern, Dallas, TX, USA; 17Department of Urology, Second Faculty of Medicine, Charles University, Prague, Czech Republic; 18Karl Landsteiner Institute of Urology and Andrology, Vienna, Austria; 19European Association of Urology Research Foundation, Arnhem, NetherlandsCorrespondence: Shahrokh F ShariatDepartment of Urology, Comprehensive Cancer Center, Vienna General Hospital, Medical University of Vienna, Währinger Gürtel 18-20, Vienna 1090, AustriaTel +4314040026150Fax +4314040023320Email shahrokh.shariat@meduniwien.ac.atPurpose: The Plasminogen Activation System (PAS) plays a role in tumor growth, invasion and metastasis and has been associated with oncological outcomes in urinary bladder carcinoma (UBC). The use of the different components of this system as molecular markers could improve our understanding of the heterogeneous behavior of UBC and might enable earlier disease detection, individual risk stratification, more accurate outcome prediction and be a rationale for new targeted therapies.Methods: A comprehensive literature search including relevant articles up to October 2020 was performed using the MEDLINE/PubMed database.Results: The components of the PAS axis are involved in tumor progression through their signaling processes during angiogenesis, cell migration, metastasis and adhesion. The body of evidence shows an association of PAS component overexpression with adverse pathological features and clinical outcome in UBC. Overexpressed PAS components correlate with a higher pathological tumor grade and advanced tumor stage. In non-muscle-invasive bladder cancer (NMIBC), the PAS components were associated with disease outcome while in muscle-invasive bladder cancer (MIBC), it was associated with disease outcome and pathological features. Possible therapeutic approaches in the PAS for the treatment of UBC have only been sparsely investigated in in vitro and in vivo studies. Intravesical plasminogen activator inhibitor 1 (PAI-1) instillation in animal models yielded interesting results and warrant further exploration in Phase II studies.Conclusion: The overexpression of PAS components in UBC tumor tissue is associated with adverse pathological features and worse oncological outcomes. These findings are mainly based on preclinical studies and retrospective series, which requires further prospective studies to translate the PAS into clinically useful biomarkers and therapeutic targets.Keywords: urothelial cancer, uPA, uPAR, PAI, therapy, review

Cyclodextrins (CDs) are naturally occurring cyclic oligosaccharides consisting of multiple glucose subunits. CDs are widely used in host–guest chemistry and biochemistry due to their structural advantages, biocompatibility, and ability to form inclusion complexes. Recently, CDs have become of high interest in the field of medical imaging as a potential scaffold for the development of a large variety of the contrast agents suitable for magnetic resonance imaging, ultrasound imaging, photoacoustic imaging, positron emission tomography, single photon emission computed tomography, and computed tomography. The aim of this review is to summarize and highlight the achievements in the field of cyclodextrin-based contrast agents for medical imaging.

Aim: This 60-month prospective study aimed to evaluate tooth survival and healing rates after root canal treatment in patients taking bisphosphonates (BPs). Secondary outcomes were complications and clinical variables observed during and after treatment. Methods: Root canal treatment was performed using manual K-file canal instrumentation and a carrier-based filling technique with an epoxy resin-based sealer. Teeth without adequate root/crown integrity were restored by trained operators at the tissue level (TL group) to prevent occlusal/mechanical stress and to enable periapical lesion healing without the risk of root fracture. Other teeth were restored with normal occlusal contacts (OC group). Healthy patients who had undergone one or more root canal treatments of the same type constituted the control group. The relationships of the following variables to survival and health status were examined (chi-squared test and multivariate analysis, P=0.05): age, gender, smoking habit, tooth location, treatment type, BPs treatment, BPs exposure, initial periapical index (PAI) and occlusal restoration. Survival curves were constructed using Kaplan–Meier analysis, with extraction serving as the end-point. Results: In total, 65 patients with 109 root canal-treated teeth who were taking BPs were included. At 60months, data from 57 patients (52F, 5M; median age 65.7±8.6years) who had undergone 96 root canal treatments were analysed (drop-out rate=16.9%). The survival rate was 85%, and the success rate was 76%. The control group consisted of 46 patients (21F, 25M; median age 60.3±7.2years) who had undergone 102 root canal treatments. The survival rate was 88%, with 12 teeth lost during follow-up. The success rate was 73%. In the BP group, 55 teeth were restored normally (OC group) and 41 teeth were restored at the tissue level (TL group). No difference in the success or survival rate was observed between the BP and control groups (P>0.05). Univariate Kaplan–Meier analysis revealed that only tooth type significantly affected survival status in the BP group. The analysis revealed the clinical relevance of smoking, tooth location and initial PAI on patients’ health status (P&nbsp

Enquadramento: existem, atualmente, mudanças paradigmáticas em relação ao foco da enfermagem em saúde materna, sendo o papel predominante do pai um dos principais focos do cuidado. Objetivo: identificar a importância dada ao pai e o seu papel durante a gravidez. Metodologia: realizada uma revisão integrativa nas bases de dados CINAHL®, Medline® e Psychology and Behavioral Science®. Dos 601 artigos obtidos apenas 10 foram incluídos nesta revisão. Resultados: os artigos incluídos aludem para a gravidez como um período exigente, sendo considerado como uma transição para a paternidade. Da análise emergiram quatro subáreas: a representação mental do pai; como a gravidez se torna real para o pai; a maneira como os pais se comprometeram com a paternidade e o papel do pai na vida familiar. Conclusão: os resultados evidenciam a importância do pai durante a gestação e a necessidade emergente de centrar o cuidado na família diante de uma transição. A participação e inclusão do pai durante a gravidez desempenha um papel fundamental aumentando a confiança e conduzindo a uma melhor gestão do stress causado pela transição para a parentalidade de todos os membros da família.

The tumour microenvironment (TME) is a complex cellular ecosystem subjected to chemical and physical signals that play a role in shaping tumour heterogeneity, invasion and metastasis. Studying the roles of the TME in cancer progression would strongly benefit from non-invasive visualisation of the tumour as a whole organ in vivo, both preclinically in mouse models of the disease, as well as in patient tumours. Although imaging techniques exist that can probe different facets of the TME, they face several limitations, including limited spatial resolution, extended scan times and poor specificity from confounding signals. Photoacoustic imaging (PAI) is an emerging modality, currently in clinical trials, that has the potential to overcome these limitations. Here, we review the biological properties of the TME and potential of existing imaging methods that have been developed to analyse these properties non-invasively. We then introduce PAI and explore the preclinical and clinical evidence that support its use in probing multiple features of the TME simultaneously, including blood vessel architecture, blood oxygenation, acidity, extracellular matrix deposition, lipid concentration and immune cell infiltration. Finally, we highlight the future prospects and outstanding challenges in the application of PAI as a tool in cancer research and as part of a clinical oncologist's arsenal., Summary: This Review details the potential of photoacoustic imaging to visualise features of the tumour microenvironment such as blood vessels, hypoxia, fibrosis and immune infiltrate to provide unprecedented insight into tumour biology.

We investigated the scientific production dedicated to the analysis of the relationship between daughters with eating disorders and their fathers. An integrative review was performed on PsycINFO, CINAHL, PubMed and LILACS databases. We reviewed studies published between January 2000 and June 2014. Twenty-seven studies were included in the review. Most were from European countries and were comprised of quantitative studies. An unstable relationship with the father figure and an emotionally distant relationship between father and daughter were recurring themes in the selected publications. Studies showed the importance of investigating and ensuring the participation of fathers in the treatment of eating disorders, but none of them investigated father involvement in terms of assistance. Further research is needed in order to explore qualitative studies in the Brazilian context., Investigou-se a produção científica dedicada ao estudo da relação entre pai e filha com transtornos alimentares. Foi realizada uma revisão integrativa nas bases PsycINFO, CINAHL, PubMed e LILACS, no período de janeiro de 2000 a junho de 2014. Foram selecionados 27 artigos, a maioria proveniente de países europeus e constituída de estudos quantitativos. A vinculação pouco segura com a figura paterna e o relacionamento emocionalmente distante entre pai e filha foram aspectos recorrentes nas publicações selecionadas. Os estudos apontaram a importância de se investigar e assegurar a participação do pai no tratamento. Porém, nenhum dos artigos revisados investigou o envolvimento paterno no contexto da assistência. Destaca-se a necessidade de investir em estudos qualitativos e no contexto brasileiro.

The link between father and child is fundamental, the presence of the former in the birthing room being essential to closer links between the triad. The purpose of this study is to identify the benefits for the father from their involvement during the labor and birth sequence. An integrational review of the literature was carried out together with research on the databases: PubMed, LILACS, SciELO, Institutional Holdings and Digital Libraries and EBSCO Host published between 2000 e 2014. The results demonstrate the existence of a ‘new’ father who is involved in the consultations during the pregnancy and preparations for the birth, his presence in the birthing room making him feel that he is playing an active part in the process encourages him to develop closer and more intimate links leading to a consolidation of the family unit, the assumption of a parental role in addition to being able to share the experience of the birth with the mother and contribute to her well-being. The team of health professionals has a crucial role in the integration of the father into the process of maternity with his presence also being reflected in the humanization of health care. It may be concluded that there are many benefits from paternal involvement in the birth when accompanying the mother from the moment of pregnancy with an active presence during the birth and enjoying the entire process by sharing emotions and feelings and contributing to the humanization of care and an affective link between the triad. The performance of the Specialist Nursing Staff in the areas of Maternal health and Obstetrics is reflected in the inclusion of the father in the birthing room and in the de-mythification of taboos. The Portuguese Foundation for Science and Technology (FCT) through the project PEst-OE/CED/UI4016/2014, and the Centre for Studies in Education, Technologies and Health (CI&DETS). info:eu-repo/semantics/publishedVersion

A paternidade implica em transformações, o homem, nesse trajeto de sua vida, nunca conviveu de forma direta com as práticas de cuidar de uma mulher grávida, puérpera e, consequentemente, de um recém-nascido, excluindo-se de tais funções, deixando sob as responsabilidades da mulher, parentes e amigas. Asse sendo, o presente estudo teve como objetivo analisar as percepções do homem sobre suas atribuições de pai durante o período que vai da gestação ao puerpério. Trata-se de um estudo de campo exploratório-descritivo, com uma abordagem qualitativa, realizada com 11 pais nas Unidades Básicas de Saúde (UBS) da cidade de São João do Sóter-MA. A coleta de dados foi realizada por meio de entrevista semiestruturada com perguntas fechadas e abertas. Os dados foram analisados de acordo com a análise de conteúdo proposta por Bardin. Quantos aos resultados, a notícia da paternidade, para alguns homens, acaba sendo uma barreira de difícil transposição, pois para estes o ato de ser pai é simplesmente ser o provedor de recursos financeiros no elo familiar. A realidade mostra que a maioria dos pais não participa de forma ativa da gestação nos primeiros dias de vida de seu filho; e na busca de compreender o momento, o pai isola-se tentando responder suas indagações. O presente estudo possibilitou evidenciar a real concepção do homem/pai perante o processo gravídico/puerperal e sugere que os enfermeiros da Atenção Primária à Saúde reflitam sobre os achados desta pesquisa. Por fim, outros trabalhos afins tornam-se necessários para que haja uma maior compreensão do tema aqui estudado.

Resumo: A família é um dos pilares da vida psicológica dos indivíduos, influenciando os padrões de comportamento, o sentimento de pertencimento social e a saúde psíquica. Tal estrutura pode ser abalada quando há um membro com microcefalia associada ao Zika vírus, que ocorre quando o menino apresenta perímetro cefálico igual ou inferior a 31,9cm, e a menina, igual ou inferior a 31,5cm. Esta pesquisa visa analisar o impacto do diagnóstico de microcefalia do bebê na função paterna. Para tanto, foram realizadas entrevistas com cinco pais de crianças com microcefalia em três municípios do interior da Paraíba, Brasil. Os instrumentos foram questionário e entrevista semiestruturada gravada, submetida à análise temático-categorial. Todos os pais entrevistados participam da rotina dos filhos, sendo esse envolvimento “condicionado” pelo trabalho, bem como pela severidade da deficiência. Alguns aspectos são comuns, como reação ao diagnóstico e preocupações.

O objetivo deste artigo é selecionar, avaliar e interpretar criticamente as publicações que tiveram como foco principal o estresse vivenciado pelos pais/cuidadores de crianças com paralisia cerebral. Revisão integrativa da literatura. A busca foi conduzida na Biblioteca Virtual em Saúde (BVS), no United States National Library of Medicine (PubMED) e busca manual de referências nos estudos selecionados. Optou-se por selecionar aqueles publicados no período de 1998 a 2011. Integraram a amostra 13 artigos. Pais de crianças com paralisia cerebral apresentam níveis de estresse maiores do que os de sem deficiência. Os problemas de comportamento, os distúrbios psicológicos e emocionais das crianças foram os fatores mais comumente associados aos maiores níveis de estresse. A satisfação com apoio social, satisfação com o papel de pai/mãe, o bom funcionamento familiar, o vínculo afetivo pai/mãe-filho, o apoio do cônjuge e o sentimento de participar ativamente da vida social contribuem para reduzir os níveis de estresse. A saúde dos pais de crianças com paralisia cerebral está comprometida pelos maiores níveis de estresse. Desta forma, profissionais da saúde devem oferecer uma atenção especial a eles.

This study examined the effect of coaching upon participants’ ability to ‘fake-good’ on the PAI. Ninety-eight adults were recruited from a local government school. A between-groups design was used to compare the performance of three groups under the following conditions:(1) Standard, (2) Fake-Good No-Coaching and (3) Fake-Good Coaching. It was predicted that the results of the Fake-Good Coaching group would be indistinguishable from the Standard group and that the Fake-Good No-Coaching group results would be significantly elevated. Results supported the first hypothesis. The findings are discussed in terms of the sample, the nature of the task and the level of coaching. Refereed/Peer-reviewed

doi: 10.5216/ree.v12i3.6929A participação do pai durante o aleitamento materno pode encorajar a parceira a amamentar e evitar o desmame precoce. O estudo objetivou investigar o conhecimento do pai acerca do aleitamento materno, orientações oferecidas a ele durante o pré-natal e analisar a sua participação nesse processo. Estudo descritivo de abordagem qualitativa, realizado em Goiânia/Goiás. A coleta de dados foi realizada entre abril e junho de 2009, com nove pais que acompanhavam seus filhos, com idade de até 24 meses, em serviços da rede pública de saúde, por meio de entrevista utilizando-se roteiro semi-estruturado. Após análise temática dos dados foram criadas as três categorias que revelam que, de modo geral o pai não está envolvido no processo de amamentação, apenas dois foram orientados na assistência pré-natal. A maioria dos entrevistados desejava ser pai e que seus filhos fossem amamentados, reconhecem os benefícios do aleitamento para a criança, mas desconhecem os benefícios da amamentação para a mãe. Os dados mostram que não há uma participação ativa desses na amamentação. Concluímos que os serviços de saúde devem estabelecer metas claras, devendo, instituir uma política de capacitação da equipe de saúde como padrão de qualidade da assistência prestada à mulher, a criança e ao pai. Descritores: Aleitamento Materno; Pai; Promoção da Saúde.

OBJECTIVES: to reveal the guiding influences and through these to draw up a proposal to stimulate the participation of men in breast feeding, identifying strategies at the various phases in a man's life, from childhood to fatherhood. METHODS: a descriptive, exploratory and qualitative study was carried out, whose guidelines and proposals were based on examination of statements gathered in the course of semi-structured interviews conducted with 17 couples, living on the Bode favela, in Recife, in the State of Pernambuco, Brazil. The statements were interpreted using manifest content analysis, based on the theoretical notion of the historical, social and cultural construction of fatherhood, and subsequently used to determine the guiding influences and draw up proposals. RESULTS: the principal guiding influences were found to be the family, the school and the health unit, all of which help to draw up a proposal for the initiation of breast feeding at the outpatients clinic (during prenatal family consultations when the child is aged six months) and the socialization of male and female children in favor of breast feeding. This proposal includes activities that aim to involve the father in breast feeding. CONCLUSIONS: some significant features of the guiding influences tend to exclude men from the breast feeding process. The essence of this proposal is therefore to serve as a model for stimulating the participation of fathers in breast feeding and for building up a health program to be introduced in schools and health units, as a way of changing the culture of breast feeding and extending its duration.

Pesquisa qualitativaa que teve como objetivo conhecer a representação social do pai diante do filho prematuro. Os dados foram coletados no período de maio a junho de 2008 por meio de entrevista semi-estruturada, junto a 17 pais cujos filhos prematuros estavam internados na UTIN de duas instituições públicas de natal-RN. Os depoimentos foram tratados e analisados com base na teoria das representações sociais (TRS). Os resultados revelaram que os pais ao estarem com seus filhos internados vivenciam emoções que são traduzidas por medo, angústia, ansiedade, solidão e se entremeiam a fé, alegria e esperança. Para o pai a UTIN representa um ambiente assustador, mas necessário aos cuidados especializados requeridos pelas condições do recém nascido prematuro. Qualitative study that aimed at understanding the social representation of a parent with a premature child. The data were collected between May and June 2008, in a semi-structured interview with 17 parents whose premature children were hospitalized in the NICU of two public institutions in Natal, Brazil. The reports were analyzed based on the Social Representations Theory (SRT). The results reveal that the hospitalization of their children causes parents to experience emotions of fear, anguish, anxiety, loneliness interspersed with those of faith, joy and hope. For a parent the NICU is a frightening environment, albeit necessary for the specialized care that the conditions of the premature newborn require. Investigación cualitativa tiene como objetivo conocer la representación social del padre frente del hijo prematuro. Los datos fueron tomados en el periodo de mayo a junio de 2008 mediante entrevista semi-estructurada a 17 padres con hijos prematuros internados en la UTIN de dos instituciones públicas de Natal-RN. Las declaraciones fueron tratadas y analizadas con base en la teoría de las representaciones sociales (TRS). Los resultados revelaron que los padres al acompañar a sus hijos internados viven emociones que se traducen en miedo, angustia, ansiedad, soledad y se entreveran con fe, alegría y esperanza. Para el padre la UTIN representa un ambiente amedrentador, pero necesario.

Salmonella Pathogenicity Island-7 (SPI-7) is a large, mosaic, genetic island, found in several serovars of Salmonella enterica subsp. enterica associated with systemic disease. As well as encoding genes which may aid its own transmission, it carries genes for potential virulence factors such as Vi antigen, SopE effector and type IVB pili. The stability of SPI-7 is of interest with respect to typhoid fever and related vaccines.

Made available in DSpace on 2018-12-11T17:26:47Z (GMT). No. of bitstreams: 0 Previous issue date: 2015-12-01. Added 1 bitstream(s) on 2019-10-09T18:32:23Z : No. of bitstreams: 1 S0102-86502015001200831.pdf: 373079 bytes, checksum: 38d2e2d962307d54a495f810a8be0dfc (MD5) PURPOSE: To investigate the analgesic effect of acupuncture (AP) or micro-dose pharmacopuncture (PA), using carprofen or morphine, in bitches undergoing ovariohysterectomy (OHE). METHODS: Thirty five dogs were randomly assigned to five groups after sedation with acepromazine IM: AP, 0.5 mg.kg -1 of morphine subcutaneously (SC), 4 mg.kg -1 of carprofen SC, and PA with 0.05 mg.kg-1 of morphine or 0.4 mg.kg -1 of carprofen. Anaesthesia was induced with propofol and maintained with isoflurane. Pain was assessed after OHE by a blind observer for 24h, by dynamic visual analogue scale (DIVAS), Glasgow (CMPS-SF), Melbourne (UMPS) and Colorado University pain scale (CSU). Animals reaching 33% of the UMPS score received rescue analgesia with morphine IM. Non parametric data were analysed by Kruskal-Wallis or Friedman tests where applicable, followed by Dunn´s test. Parametric data were analysed by two way ANOVA, followed by Tukey test. RESULTS: There were no differences among groups in number of rescue analgesia. Except for the DIVAS score where animals treated with morphine had the lowest score compared with AP and carprofen, at 1h after surgery, there were no other differences among groups. CONCLUSION: Acupuncture or pharmacopuncture were equally effective as morphine or carprofen to control postoperative pain in bitches undergoing ovariohysterectomy. Department of Veterinary Surgery and Anesthesiology Universidade Estadual Paulista (UNESP) Department of Clinical Science School of Veterinary Medicine University of Naples “Federico II” Unidade Acadêmica de Garanhuns Universidade Federal Rural de Pernambuco (UFRPE) Instituto de Bioética Department of Veterinary Surgery and Anesthesiology UNESP Department of Veterinary Surgery and Anesthesiology Universidade Estadual Paulista (UNESP) Department of Veterinary Surgery and Anesthesiology UNESP

Background: Eating disorders are complex disorders that involve medical and psychological symptoms. Understanding the psychological factors associated with different eating disorders is important for assessment, diagnosis, and treatment. Methods: This study sought to determine on which of the 22 Personality Assessment Inventory (PAI) scales patients with anorexia nervosa, bulimia nervosa, and eating disorder not otherwise specified (EDNOS) differed, and whether the PAI can be used to classify eating disorder subtypes. Because we were interested in both whether the PAI could be used to differentiate eating disorder subtypes from each other, as well as from other disorders, we also included a group of patients with major depression. Results: The three eating disorder groups did differ significantly from each other, and from the patients with depression, on a number of the PAI scales. Only two PAI scales (Anxiety and Depression), however, exceeded a T-score of 70 for the patients with anorexia nervosa, no scales exceeded a T-score of 70 for the patients with bulimia nervosa or EDNOS, and only two exceeded a T-score of 70 for the patients with depression (Depression and Suicide). A discriminant function analysis revealed an overall correct classification between the groups of 81.6%. Conclusions: The PAI helps to understand the psychological factors associated with eating disorders and can be used to assist with assessment. Continued investigation using the PAI in an eating disordered population is supported.

Depression is a multidimensional condition encompassing affective, physiological, and cognitive symptoms. Although depression's high comorbidity with both epileptic and psychogenic nonepileptic seizures (ES and PNES) has been established, few studies have addressed whether the types of depressive symptoms experienced differ by seizure type (ES and PNES). This study compared the self-reported depressive symptomatology of patients (n=60 ES and 59 PNES) who underwent video-EEG monitoring and completed self-reported objective measures of psychopathology (PAI and BDI-II). Differences in depressive symptoms were also compared by gender and among several subgroups with ES. Results revealed the PNES group, particularly PNES females, endorsed a significantly higher level of physiological symptoms of depression as measured by the PAI DEP-P subscale than the ES group; the BDI-II did not differ between groups. These findings have potential clinical implications for the identification and management of depressive symptoms among these patient groups.

O pai é a fonte de apoio materno mais importante durante a transição decorrente do nascimento de filhos. Este estudo objetiva descrever a percepção de 45 mulheres grávidas e 42 mães com bebês de até seis meses sobre a participação e apoio paterno, durante a gestação e nascimento de filhos. A coleta de dados consistiu da aplicação, às mães, de um questionário de caracterização do sistema familiar e de uma entrevista semiestruturada, visando obter informações sobre o pai "real" e o "ideal". Os resultados mostram que, apesar de os pais serem percebidos como pouco participativos, as mães estavam satisfeitas com o seu envolvimento. Os dados sugerem que é necessário estimular a participação do pai, por ocasião do nascimento de filhos. The father is a major figure on mother's support network during childbirth transition. This study aims to report father's participation and support during the pregnancy and the birth of their children, according to the point of view of 45 pregnant women and 42 women with six-month-old children. Data was collected through the administration of a family questionnaire and a semi-structured interview answered by the mothers in order to get information about the "real" and the "ideal" father. The results show that, although the mothers were satisfied with the fathers' role in family life, they thought fathers were not as participative as they should be. Data suggest that it is necessary to stimulate father's participation during childbirth.

Qualitative study performed with five pregnant couples to identify the meaning of being a father and the strengths and weaknesses of the aspects involved. Data were collected through interviews. The analysis revealed two meanings: being the breadwinner, and the affective father involved with the birth and his children. The fathers’ participation depended on their availability and presence in the educational groups, and on the encouragement to participate from wives and health professionals. The identified weaknesses were: male chauvinism, need to work, lack of knowledge regarding their rights, wife’s opposition, lack of preparation of health professionals, and insufficient educational activities. When a man becomes involved with the pregnancy, wife and child, he builds and establishes the role of father, benefiting the pscyho-affective development of his child. Support and welcoming on behalf of the wife and health professionals are essential. This study may serve as support to changing health practices. Descriptors: Paternity; Nursing; Health Education; Pregnancy; Fathers.

Contains fulltext : 87400.pdf (Publisher’s version ) (Closed access) Phenotypic modulation of endothelium to a dysfunctional state contributes to the pathogenesis of atherosclerosis, partly through the activation of the transcription factor NFkB. Several data indicate that magnesium deficiency caused by prolonged insufficient intake and/or defects in its homeostasis may be a missing link between diverse cardiovascular risk factors and atherosclerosis. Here we report that endothelial cells cultured in low magnesium rapidly activate NFkB, an event which is prevented by exposure to the anti-oxidant trolox. It is well known that NFkB activation correlates with marked alterations of the cytokine network. In the present study, we show that exposure of endothelial cells to low magnesium increases the secretion of RANTES, interleukin 8 and platelet derived growth factor BB, all important players in atherogenesis. Moreover, we describe the increased secretion of matrix metalloprotease-2 and -9 and of their inhibitor TIMP-2. Interestingly, by zymography we show that metalloprotease activity predominated over the inhibitory effect of TIMP-2. These results indicate that low magnesium promotes endothelial dysfunction by inducing pro-inflammatory and pro-atherogenic events. 01 november 2010

Contains fulltext : 48024.pdf (Publisher’s version ) (Closed access) OBJECTIVE: To determine whether the presence of cells of the monocyte-macrophage system affects the fibrinolytic response of peritoneal mesothelial cells to lipopolysaccharide (LPS) in the presence and absence of sodium hyaluronate. DESIGN: Controlled laboratory experiment. SETTING: Cell cultures in an academic laboratory research environment. PATIENT(S): Human peritoneal mesothelial cells were harvested from patients undergoing a laparotomy for noninfectious reasons and were cultured in vitro. Co-cultures were formed by adding U-937 human monocyte-like cells to a monolayer of mesothelial cells. INTERVENTION(S): After 24 hours, cultures were treated with 10 ng/mL of LPS, and sodium hyaluronate was added in a final concentration of 0.2%. Controls received medium without sodium hyaluronate. MAIN OUTCOME MEASURE(S): After 24 hours' incubation, tissue plasminogen activator (tPA), urokinase plasminogen activator (uPA), and plasminogen activator inhibitor-1 (PAI-1) levels were determined in medium and cell lysates by using ELISA techniques. RESULT(S): In medium of co-cultures, tPA and PAI-1 concentrations were statistically significantly increased compared with the case of monocultures, whereas uPA concentration was statistically significantly decreased. In cell lysates of co-cultures, PAI-1 concentration was statistically significantly increased compared with the case of monocultures, whereas tPA and uPA were unaffected. Treatment with sodium hyaluronate statistically significantly decreased PAI-1 and uPA concentrations in medium of monocultures but decreased uPA concentration only in medium of co-cultures, compared with the case of controls. CONCLUSION(S): Cells of the monocyte-macrophage system modulate the fibrinolytic capacity of LPS treated human peritoneal mesothelial cells and interfere in the hyaluronan-associated changes in mesothelial fibrinolytic capacity.

Colonization by the commensal Escherichia coli strain A0 34/86 (O83 : K24 : H31) has proved to be safe and efficient in the prophylaxis and treatment of nosocomial infections and diarrhoea of preterm and newborn infants in Czech paediatric clinics over the past three decades. In searching for traits contributing to this beneficial effect related to the gut colonization capacity of the strain, the authors have analysed its genome by DNA–DNA hybridization to E. coli K-12 (MG1655) genomic DNA arrays and to ‘Pathoarrays’, as well as by multiplex PCR, bacterial artificial chromosome (BAC) library cloning and shotgun sequencing. Four hundred and ten E. coli K-12 ORFs were absent from A0 34/86, while 72 out of 456 genes associated with pathogenicity islands of E. coli and Shigella were also detected in E. coli A0 34/86. Furthermore, extraintestinal pathogenic E. coli-related genes involved in iron uptake and adhesion were detected by multiplex PCR, and genes encoding the HlyA and cytotoxic necrotizing factor toxins, together with 21 genes of the uropathogenic E. coli 536 pathogenicity island II, were identified by analysis of 2304 shotgun and 1344 BAC clone sequences of A0 34/86 DNA. Multiple sequence comparisons identified 31 kb of DNA specific for E. coli A0 34/86; some of the genes carried by this DNA may prove to be implicated in the colonization capacity of the strain, enabling it to outcompete pathogens. Among 100 examined BAC clones roughly covering the A0 34/86 genome, one reproducibly conferred on the laboratory strain DH10B an enhanced capacity to persist in the intestine of newborn piglets. Sequencing revealed that this BAC clone carried gene clusters encoding gluconate and mannonate metabolism, adhesion (fim), invasion (ibe) and restriction/modification functions. Hence, the genome of this clinically safe and highly efficient colonizer strain appears to harbour many ‘virulence-associated’ genes. These results highlight the thin line between bacterial ‘virulence’ and ‘fitness' or ‘colonization’ factors, and question the definition of enterobacterial virulence factors.

Aim: Helicobacter pylori (H pylori) is associated with increased gastric inflammatory and epithelial expression of macrophage migration inhibitory factor (MIF) and gastric epithelial cell proliferation. This study aimed at determining whether H pylori directly stimulates release of MIF in monocytes, whether the cag pathogenicity island (PAI) is involved for this function, and whether MIF stimulated by H pylori increases gastric epithelial cell proliferation in vitro. Methods: A cytotoxic wild-type H pylori strain (TN2), its three isogenic mutants (TN2Δcag, TN2ΔcagA and TN2ΔcagE) were co-cultured with cells of a human monocyte cell line, THP-1, for 24 h at different organism/cell ratios. MIF in the supernatants was measured by an ELISA. Cells of a human gastric cancer cell line, MKN45, were then co-cultured with the supernatants, with and without monoclonal anti-MIF antibody for 24 h. The cells were further incubated for 12 h after addition of 3H-thymidine, and the levels of incorporation of 3H-thymidine were measured with a liquid scintillation counter. Results: The wild-type strain and the isogenic mutants, TN2ΔcagA and TN2ΔcagE, increased MIF release at organism/cell ratios of 200 /1 and 400/1, but not at the ratios of 50/1 and 100/1. However, the mutant TN2Δcag did not increase the release of MIF at any of the four ratios. 3H-thymidine readings for MKN-45 cells were significantly increased with supernatants derived from the wild-type strain and the mutants TN2ΔcagA and TN2ΔcagE, but not from the mutant TN2Δcag. Moreover, in the presence of monoclonal anti-MIF antibody, the stimulatory effects of the wild-type strain on cell proliferation disappeared. Conclusion: H pylori stimulates MIF release in monocytes, likely through its cag PAI, but not related to cagA or cagE. H pylori-stimulated monocyte culture supernatant increases gastric cell proliferation, which is blocked by anti-MIF antibody, suggesting that MIF plays an important role in H pylori-induced gastric epithelial cell proliferation. © 2005 The WJG Press and Elsevier Inc. All rights reserved., published_or_final_version

In the HTLV-I seroscreening of blood donor sera by gelatin particle agglutination (PA), more than 50% (55.6%) of the PA-positive sera were negative by immunofluorescence assay (IF). However, when donors were divided into age groups, there were increasing numbers of IF-positive/PA-positive donors with age. Among the PA-positive donors in the 50-64 age group, 65.9% were IF-positive compared to 16.0% in the 16-19 age group. The serological specificities of the IF-negative/PA-positive specimens were tested by using a newly developed PA inhibition (PAI) test. The HTLV-I specificity of the PAI test was confirmed by the observation that agglutinations with anti-HTLV-I p19 and gp21 monoclonal antibodies as well as IF-positive sera were specifically inhibited with HTLV-I preparations or HTLV-I-positive cell extracts and not with HTLV-I-negative cell extracts. Sixty of the 104 specimens collected randomly from the IF-negative/PA-positive donors were PAI-positive. The majority (80%) of such PAI-positive sera showed more than two bands of HTLV-I gag-encoded polypeptide, p19, p24, p28 and p53 on Western blotting. Some of the PAI-positive sera were also positive by enzyme immunoassay. These results indicate that at least some of the IF-negative/PA-positive donors possess HTLV-I-specific antibody and may be potential HTLV-I carriers who will become IF-positive at a later age.

Objective: To understand the perception of the multiprofessional health care team regarding the inclusion of fathers in the care of preterm infants who are in Intensive Care Units (ICUs). Methods: This is a descriptive study with a qualitative approach, using a semi-structured interview with 12 health care professionals of a neonatal ICU, from February to July 2017. The data were analyzed according to the Discourse of the Collective Subject. Results: Seven main ideas (MI) emerged from the text analysis, which were grouped into two themes: 1) the role of the father according to the multiprofessional health care team views (MI1: parent provider, MI2: shared care, MI3: supportive father); 2) perception of the father caring for the hospitalized preterm infant (MI4: father does not change diapers; MI5: father conquering new spaces; MI6: strengthening the bonding; MI7: father providing maternal security. Conclusions: The results of this study point out to the importance of including the father figure in the humanized care of preterm infants. Professional health care team should be more aware of fathers’ importance in the care of hospitalized preterm infants. RESUMO Objetivo: Compreender a percepção da equipe multiprofissional referente à inserção do pai no cuidado ao filho prematuro hospitalizado na Unidade de Terapia Intensiva (UTI). Métodos: Estudo descritivo de abordagem qualitativa, por meio de entrevista semiestruturada feita com 12 profissionais que atuam na UTI neonatal, realizado no período de fevereiro a julho de 2017. Os dados foram trabalhados de acordo com o Discurso do Sujeito Coletivo. Resultados: Emergiram sete ideias centrais (IC), que foram agrupadas em dois temas: 1) o papel do pai na visão da equipe multiprofissional (IC1: pai provedor; IC2: o cuidado compartilhado; IC3: pai apoiador); 2) percebendo o pai no cuidado do prematuro hospitalizado (IC4: pai não troca fraldas; IC5: o pai conquistando novos espaços; IC6: fortalecendo o vínculo; IC7: o pai proporcionando segurança à mãe). Conclusões: Os resultados deste estudo apontam para a importância da inserção da figura paterna como proposta de assistência humanizada, estando os profissionais mais conscientes da importância do pai no cuidado do filho prematuro hospitalizado.

Peritoneal adhesions describe a condition in which pathological bonds form between the omentum, the small and large bowels, the abdominal wall, and other intra-abdominal organs. Different classification systems have been proposed, but they do not resolve the underlying problem of ambiguity in the quantification and definition of adhesions. We therefore propose a standardized classification system of adhesions to universalize their definition based on the macroscopic appearance of adhesions and their diffusion to different regions of the abdomen. By scoring with these criteria, the peritoneal adhesion index (PAI) can range from 0 to 30, unambiguously specifying precise adhesion scenarios. The standardized classification and quantification of adhesions would enable different studies to more meaningfully integrate their results, thereby facilitating a more comprehensive approach to the treatment and management of this pathology.