Search

Objective: to identify damages resulting from incidents with the Hickman® catheter., Method: descriptive, retrospective, qualitative approach. The source of data were the notifications of incidents that occurred between January 2012 and May 2015, as well as the information available on the medical records of patients involved in incidents with the Hickman® catheter., Results: the incidents related to the Hickman® catheter with the greatest impact on patient care were obstruction, fracture and traction. All incidents caused damage to patients, in a greater or lesser degree, in the dimensions of physical damage and subjective damage., Final Considerations: damage or potential risk of damage was present in all incidents analyzed. The need to revise cleaning and obstruction protocols for the maintenance of the permeability of Hickman® catheters was demonstrated.

There has been a very limited number of high-throughput screening campaigns carried out with Leishmania drug targets. In part, this is due to the small number of suitable target genes that have been shown by genetic or chemical methods to be essential for the parasite. In this perspective, we discuss the state of genetic target validation in the field of Leishmania research and review the 200 Leishmania genes and 36 Trypanosoma cruzi genes for which gene deletion attempts have been made since the first published case in 1990. We define a quality score for the different genetic deletion techniques that can be used to identify potential drug targets. We also discuss how the advances in genome-scale gene disruption techniques have been used to assist target-based and phenotypic-based drug development in other parasitic protozoa and why Leishmania has lacked a similar approach so far. The prospects for this scale of work are considered in the context of the application of CRISPR/Cas9 gene editing as a useful tool in Leishmania.

Purpose: This study evaluated the dimensional stability of a complete-arch prosthesis processed by conventional method in water bath or microwave energy and polymerized by two different curing cycles., Materials and Methods: Forty maxillary complete-arch prostheses were randomly divided into four groups (n = 10): MW1 - acrylic resin cured by one microwave cycle; MW2 - acrylic resin cured by two microwave cycles: WB1 - conventional acrylic resin polymerized using one curing cycle in a water bath; WB2 - conventional acrylic resin polymerized using two curing cycles in a water bath. For evaluation of dimensional stability, occlusal vertical dimension (OVD) and area of contact points were measured in two different measurement times: before and after the polymerization method. A digital caliper was used for OVD measurement. Occlusal contact registration strips were used between maxillary and mandibular dentures to measure the contact points. The images were measured using the software IpWin32, and the differences before and after the polymerization methods were calculated. The data were statistically analyzed using the one-way ANOVA and Tukey test (α = .05)., Results: he results demonstrated significant statistical differences for OVD between different measurement times for all groups. MW1 presented the highest OVD values, while WB2 had the lowest OVD values ( P <.05). No statistical differences were found for area of contact points among the groups ( P =.7150)., Conclusion: The conventional acrylic resin polymerized using two curing cycles in a water bath led to less difference in OVD of complete-arch prosthesis.

S ubclinical systolic and diastolic left ventricular (LV) dysfunction has been reported in previous echocardiographic studies on congenital bicuspid aortic valve (BAV). Patients with BAV commonly undergo evaluation with magnetic resonance imaging, and feature-tracking cardiovascular magnetic resonance (CMR-FT) is an emerging technique that assesses myocardial strain using standard cine sequences. This study investigated differences in myocardial strain between patients with BAV with preserved ejection fraction (EF) and controls using CMR-FT. Patients with isolated BAV and preserved EF, who had previously undergone CMR (n = 42; mean age, 41.2 ± 13.9) were compared with controls (n = 19; 36.6 ± 9.8; P = .2). Investigational CMR-FT strain analysis software was used to measure circumferential systolic and diastolic strain values, as well as standard LV volumetric and functional parameters. The majority of patients with BAV had mild or no valve dysfunction, and LV myocardial mass end-diastolic volume indices were similar between groups. Peak diastolic circumferential strain rate was lower in patients with BAV than in controls (0.89 ± 0.27 vs 1.21 ± 0.21 s -1 , P = .003). After adjusting for covariates, only myocardial mass index was independently associated with peak circumferential systolic strain and diastolic strain rate. Feature-tracking CMR can identify abnormalities of LV strain in a clinical cohort of asymptomatic patients with BAV with preserved EF. Decreases in circumferential diastolic strain rate in patients with BAV suggest evidence of early diastolic dysfunction.

The drywood termite Cryptotermes brevis (Walker, 1853) (Kalotermitidae) is one of the most important wood structural pest in the world. Substances from the secondary metabolism of plants (e.g., essential oils) have been considered an environmentally safer form of control for urban pests, such as termites. In the present study, we analyzed the lethal and sub-lethal effects of essential oil of Lippia sidoides and its major components on C. brevis pseudergates in two routes of exposure (contact and fumigation). The essential oil of L. sidoides and thymol were more toxic to C. brevis pseudergates when applied by contact (LD 50 = 9.33 and 8.20µgmg -1 , respectively) and by fumigation (LC 50 = 9.10 and 23.6µLL -1 , respectively). In general, treatments changed the individual and collective behaviors of C. brevis pseudergates, as well as the displacement and walking speed. The essential oil of L. sidoides and its major components showed a high potential to control C. brevis pseudergates, due to the bioactivity in the two routes of exposure and the sub-lethal effects on the behavior and walking, important activities for the cohesion of C. brevis colonies., (Copyright © 2017 Elsevier Inc. All rights reserved.)

This is qualitative research that investigates the social representations of adolescent mothers on child eating habits in the first year of life. Its subjects were 10 adolescent mothers, whose children were aged seven to twelve months. Data were collected through semi-structured interview, besides the use of visual material. The analysis followed the technique of content analysis, relying on the framework of Social Representations Theory. That analysis revealed four themes: the conflict of breastfeeding versus consecration of porridge; establishing complementary feeding of the child; crystallized speech: "yogurt is better than a little steak"; the (un)definition of maternal eating habits: implications for infant feeding. The representations that drive maternal practices in selecting, preparing and offering food follow a particular logic, where adolescents reinterpret technical speeches in terms of their culture.

This descriptive study was performed to identify the nursing diagnoses in the records of the inpatients of an adult intensive care unit, and map the most frequent diagnosis according to the Fundamental Human Needs. The sample consisted of 44 patient records. A total of 1,087 nursing diagnoses were identified. After excluding the repetitions, 28 different diagnoses were identified. Twenty-five diagnoses were related to psychobiological needs, and three to psychosocial needs. Further studies should identify, among the formulated nursing diagnoses and the affected human needs, which problems were solved and for what needs the care is predominantly developed. The present study results are important for the organization of teaching content for students and nurses, preparing them to consider human beings as a whole when providing care, considering their biological, emotional, and spiritual aspects.

Local innate immunity plays a key role in initiating and coordinating homeostatic and defense responses in the heart. We have previously reported that the cardiotropic parasite Trypanosoma cruzi, the etiological agent of Chagas disease, protects cardiomyocytes against growth factor deprivation-induced apoptosis. In this study, we investigated cardiomyocyte innate immune response to T. cruzi infection and its role in cellular protection from apoptosis. We found that Toll-like receptor (TLR) 2-expressing cells were strongly increased by the parasite in BALB/c neonatal mouse cardiomyocyte cultures. Using a dominant-negative system, we showed that TLR2 mediated cardiomyocyte survival and the secretion of interleukin (IL) 6, which acted as an essential anti-apoptotic factor. Moreover, IL6 released by infected cells, as well as the recombinant bioactive cytokine, induced the phosphorylation of the signal transducers and activators of transcription-3 (STAT3) in cultured cardiomyocytes. In accord with the in vitro results, during the acute phase of the infection, TLR2 expression increased 2.9-fold and the anti-apoptotic factor Bcl-2 increased 4.5-fold in the cardiac tissue. We have clearly shown a cross-talk between the intrinsic innate response of cardiomyocytes and the pro-survival effect evoked by the parasite.

Glycosylated mouse cystatin C (mCysC), an endogenous inhibitor of cysteine cathepsin proteases (CP), has been suggested as a cofactor of β-FGF to induce the differentiation of mouse embryonic stem cells into neural progenitor cells (NPCs). To investigate the possible role of CP in neural differentiation, we treated embryoid bodies (EBs) with (i) E64, an inhibitor of papain-like CP and of calpains, (ii) an inhibitor of cathepsin L (iCatL), (iii) an inhibitor of calpains (iCalp), or (iv) cystatins, and their ability to differentiate into neural cells was assessed. We show that the inhibition of CP induces a significant increase in Pax6 expression in EBs, leading to an increase in the number of nestin-positive cells after 3 days. Fourteen days after E64 treatment, we observed increased numbers of β-III-tubulin-positive cells, showing greater percentage of immature neurons, and this feature persisted up to 24 days. At this point, we encountered higher numbers of neurons with inward Na(+) current compared with untreated EBs. Further, we show that mCysC and iCatL, but not unglycosylated egg white cystatin or iCalp, increased the numbers of NPCs. In contrast to E64 and iCatL, mCysC did not inhibit CP in EBs and its neural-inducing activity required β-FGF. We propose that the inhibition of CP induces the differentiation of mouse embryonic stem cells into NPCs and neurons through a mechanism that is distinct from CysC-induced neural differentiation.

The study aimed to examine the relevant published literature to food practices in the first year of life of teenage mothers' children, through an integrative review within Lilacs, Medline and Cochrane, databases from 2000 to 2010. We used the keywords: adolescent, breastfeeding, mixed feeding and infant nutrition, from which we selected eleven articles that composed the study sample. The results indicated the paucity of published research on the proposed topic, especially for those focusing on complementary feeding, revealing a gap in global production on the subject. New researches, therefore, need to be developed with a focus on teenage mothers, exploring infant feeding in all its dimensions.

We review Clan CA Family C1 peptidases of kinetoplastid parasites (Trypanosoma and Leishmania) with respect to biochemical and genetic diversity, genomic organization and stage-specificity and control of expression. We discuss their contributions to parasite metabolism, virulence and pathogenesis and modulation of the host's immune response. Their applications as vaccine candidates and diagnostic markers as well as their chemical and genetic validation as drug targets are also summarized.

To identify the causes of changes in therapeutic regimens for treating AIDS in children infected through vertical transmission. This was a case-control study in which the control group consisted of 49 children who had not had any changes to their antiretroviral regimen and the case group consisted of 62 children who had had changes between January 2000 and December 2005. Data from the patients' medical files and a semistructured interview were used. The data analysis was carried out using the SPSS software, and the chi-square test and logistic regression were applied. The main causes of changes in treatment were: increased viral load (48.4%), poor immunological response (46.6%) and clinical worsening (35.5%) of the patients. The adjustment of the data through logistic regression analysis showed that drug intolerance was the variable that contributed most to the change in medication ((adjusted) OR: 79.94; 95% CI: 6.28 -1034.55). Adherence was not shown to be responsible for changes in the anti-retroviral therapy, and this was attributable to the organization of the service and actions of the interdisciplinary team.

The inelastic bandage is an adaptation of the manual lymphatic drainage, which substitutes the circular movements of the fingers. A patient with lymphoedema underwent 20 sessions using the modified lymphatic drainage technique. Perimetric measurements were taken before and after each session, and volumetric measurements at the first, 10th, and 20th sessions. Limb circumference was significantly reduced at three points on the perimeter (10, 15 and 25 cm): 2.5 cm (7.3%), 2.5 cm (6.5%) and 1.5 cm (5%), respectively. Volumetry decrease of 26.4% from initial limb volume was observed. The use of the inelastic bandage proved to be an effective adaptation when compared with the results using other techniques described.

Trypanosoma cruzi trypomastigotes rely on the structural diversity of the cruzipain family of cysteine proteases to infect and multiply in nonprofessional phagocytic cells. Herein, we will review studies demonstrating that the interplay of cruzipain with peptidase inhibitors modulate infection outcome in a variety of experimental settings. Studies with a panel of T. cruzi strains showed that parasite ability to invade human smooth muscle cells is influenced by the balance between cruzipain and chagasin, a tight binding endogenous inhibitor of papain-like cysteine proteases. Analysis of T. cruzi interaction with endothelial cells and cardiomyocytes indicated that parasite-induced activation of bradykinin receptors drive host cell invasion by [Ca2+]I-dependent pathways. Clues about the mechanisms underlying kinin generation in vivo by trypomastigotes came from analysis of the dynamics of edematogenic inflammation. Owing to plasma extravasation, the blood-borne kininogens accumulate in peripheral sites of infection. Upon diffusion in peripheral tissues, kininogens (i.e., type III cystatins) bind to heparan sulphate chains, thus constraining interactions of the cystatin-like inhibitory domains with cruzipain. The cell bound kininogens are then turned into facile substrates for cruzipain, which liberates kinins in peripheral tissues. Subjected to tight-regulation by kinin-degrading metallopeptidases, such as angiotensin converting enzyme, the short-lived kinin peptides play a dual role in the host-parasite balance. Rather than unilaterally stimulating pathogen infectivity via bradykinin receptors, the released kinins potently induce dendritic cell maturation, thus stimulating type 1 immune responses. In conclusion, the studies reviewed herein illustrate how regulation of parasite proteases may affect host-parasite equilibrium in the course of IT cruzi infection.

With the objective of evaluating intraplacental vitamin A distribution, 234 placental samples were collected, corresponding to six samples from each of the placentas analyzed: two from the lateral maternal portion, one from the central maternal portion, two from the lateral fetal portion, and one from the central fetal portion. Samples were obtained from 39 adult puerperal mothers with low-risk pregnancies, without vitamin A deficiency or night blindness. Retinol content determination was achieved through spectrophotometry. Retinol values obtained for each region were correlated with the most probable value for each placenta (P < 0.001). Despite differences in retinol content between samples, statistical data analysis showed that intra-tissue variation had no influence on the conversion of data into information. Consequently, any portion of the placenta may be used for retinol level determination purposes, due to the correlation between all portions and the most probable value. The findings of the present study represent an advance for surveys intending to incorporate the collection and dosage of placental vitamin A levels into their analyses, thus increasing the arsenal of pre-pathological or subclinical vitamin A deficiency markers, which can allow for earlier intervention on the maternal-infant group.

This study evaluated the prevalence of gestational nightblindness among postpartum women seen at the University Maternal Hospital of the Federal University in Rio de Janeiro, Brazil and the association of this symptom with a biochemical indicator (serum retinol levels) and sociodemographic, anthropometric and antenatal care variables. In total, 262 postpartum women, who did not receive vitamin A supplementation during pregnancy, were interviewed. Gestational nightblindness was diagnosed through the standardized interview as proposed by WHO. Serum retinol levels were evaluated by spectrophotometry. Gestational nightblindness relating to low levels of serum retinol (<1.05 micromol/L, p = 0.000) was diagnosed in 17.9% of subjects interviewed. Less than five antenatal care appointments (odds ratio [OR] = 2.179; confidence interval [CI] 95% = 1.078 - 4.402) and a history of one or more miscarriage(s) (OR = 2.306; CI 95% = 1.185 - 4.491) were predictors for gestational nightblindness. These findings justify the need for nutritional counselling, aimed at improving the vitamin A nutritional status, especially among pregnant women with a history of previous miscarriages and poor antenatal care.