Prevalence and risk factors for Giardia duodenalis infection among children: A case study in Portugal

<p>Abstract</p> <p>Background</p> <p><it>Giardia duodenalis </it>is a widespread parasite of mammalian species, including humans. The prevalence of this parasite in children residing in Portugal is currently unknown. This study intended to estimate <it>G. duodenalis </it>infection prevalence and identify possible associated risk factors in a healthy paediatric population living in the District of the Portuguese capital, Lisbon.</p> <p>Methods</p> <p>Between February 2002 and October 2008, 844 children were randomly selected at healthcare centres while attending the national vaccination program. A stool sample and a questionnaire with socio-demographic data were collected from each child. <it>Giardia </it>infection was diagnosed by direct examination of stools and antigen detection by ELISA.</p> <p>Results</p> <p>The population studied revealed a gender distribution of 52.8% male and 47.2% female. Age distribution was 47.4% between 0-5 years and 52.6% between 6-15 years.</p> <p>The prevalence of <it>Giardia </it>infection was 1.9% (16/844) when estimated by direct examination and increased to 6.8% (57/844) when ELISA results were added. The prevalence was higher among children aged 0-5 years (7.8%), than among older children (5.8%), and was similar among genders (6.9% in boys and 6.5% in girls). The following population-variables were shown to be associated risk factors for <it>G. duodenalis </it>infection: mother's educational level (odds ratio (OR)= 4.49; confidence interval (CI): 1.20-16.84), father's educational level (OR = 12.26; CI: 4.08-36.82), presence of <it>Helicobacter pylori </it>infection (OR = 1.82; CI: 1.05-3.15), living in houses with own drainage system (OR = 0.10; CI: 0.02-0.64) and reported household pet contact, especially with dogs (OR = 0.53; CI: 0.31-0.93).</p> <p>Conclusion</p> <p>The prevalence of giardiasis in asymptomatic children residing in the region of Lisbon is high. Several risk factors were associated with <it>Giardia </it>prevalence and highlight the importance of parents' education and sanitation conditions in the children's well being. The association between <it>G. duodenalis </it>and <it>H. pylori </it>seems an important issue deserving further investigation in order to promote prevention or treatment strategies.</p

A Family of Diverse Kunitz Inhibitors from Echinococcus granulosus Potentially Involved in Host-Parasite Cross-Talk

The cestode Echinococcus granulosus, the agent of hydatidosis/echinococcosis, is remarkably well adapted to its definitive host. However, the molecular mechanisms underlying the successful establishment of larval worms (protoscoleces) in the dog duodenum are unknown. With the aim of identifying molecules participating in the E. granulosus-dog cross-talk, we surveyed the transcriptomes of protoscoleces and protoscoleces treated with pepsin at pH 2. This analysis identified a multigene family of secreted monodomain Kunitz proteins associated mostly with pepsin/H+-treated worms, suggesting that they play a role at the onset of infection. We present the relevant molecular features of eight members of the E. granulosus Kunitz family (EgKU-1 – EgKU-8). Although diverse, the family includes three pairs of close paralogs (EgKU-1/EgKU-4; EgKU-3/EgKU-8; EgKU-6/EgKU-7), which would be the products of recent gene duplications. In addition, we describe the purification of EgKU-1 and EgKU-8 from larval worms, and provide data indicating that some members of the family (notably, EgKU-3 and EgKU-8) are secreted by protoscoleces. Detailed kinetic studies with native EgKU-1 and EgKU-8 highlighted their functional diversity. Like most monodomain Kunitz proteins, EgKU-8 behaved as a slow, tight-binding inhibitor of serine proteases, with global inhibition constants (KI*) versus trypsins in the picomolar range. In sharp contrast, EgKU-1 did not inhibit any of the assayed peptidases. Interestingly, molecular modeling revealed structural elements associated with activity in Kunitz cation-channel blockers. We propose that this family of inhibitors has the potential to act at the E. granulosus-dog interface and interfere with host physiological processes at the initial stages of infection

Filosofia e marco conceitual: estruturando coletivamente a sistematização da assistência de enfermagem

RESUMO Objetivo Construir, com os enfermeiros, a Filosofia de Enfermagem e o Marco Conceitual que servirão como suporte para a implantação da Sistematização da Assistência de Enfermagem em um hospital do Sul do Brasil. Métodos Pesquisa Convergente Assistencial. A coleta de dados ocorreu de julho a outubro de 2014, através de duas oficinas e quatro encontros, com 42 enfermeiros. Foram criados a filosofia de enfermagem, o marco conceitual e foi feita a escolha da teórica. Para análise de dados foi utilizada a proposta de Morse e Field. Resultados A filosofia envolve as crenças de: equipe de enfermagem; trabalho em equipe; cuidado holístico; excelência no atendimento; liderança/coordenação; equipe interdisciplinar, comprometimento. O marco conceitual traz os conceitos de: ser humano; enfermagem; assistência de enfermagem, cuidado seguro. A teórica definida foi Wanda de Aguiar Horta. Conclusões Trouxe como contribuição a construção da filosofia de enfermagem e do marco conceitual da instituição e a definição da teoria de enfermagem

Familiares na sala de espera de uma unidade de terapia intensiva: sentimentos revelados Família en la espera de una unidade de cuidados intensivos: sentimientos reveló Family in the waiting room of an intensive care unit: revealed feelings

Trata-se de um estudo qualitativo que objetivou conhecer quais os sentimentos dos familiares de pacientes internados na Unidade de Terapia Intensiva (UTI). O estudo foi realizado na UTI de um hospital geral de grande porte da região oeste de Santa Catarina. A coleta ocorreu em 2009, com entrevista semiestruturada a 18 familiares. Para o tratamento dos dados utilizou-se o Discurso do Sujeito Coletivo. Dos relatos surgiram dois temas relacionados aos sentimentos: à hospitalização na UTI e os durante a espera para entrar na unidade. A an��lise revelou sentimentos como: dor, angústia, tristeza, impotência, medo, desespero, ansiedade e expectativa infinita. Espera-se que esses resultados possam auxiliar na capacitação dos profissionais, para o acolhimento à família e para a inserção desta no ambiente da UTI, como elemento a ser integrado no cuidado de enfermagem, através de ações acolhedoras, ajudando-os a enfrentarem a hospitalização de um familiar na unidade crítica.<br>Se trata de un estudio cualitativo que tuvo como objetivo comprender lo que los sentimientos de los familiares de pacientes ingresados en la Unidad de Cuidados Intensivos (UCI). El estudio se llevó a cabo en la UCI de un gran hospital general en la región oeste de Santa Catarina. Los datos fueron recolectados en el 2009 con una entrevista semi estructurada a las familias de dieciocho años. Para el tratamiento de datos utilizado el discurso del sujeto colectivo. Los informes surgieron de dos elementos relacionados con los sentimientos: la hospitalización en la UCI y en espera de entrar en la unidad. El análisis reveló sentimientos como el dolor, la angustia, tristeza, impotencia, miedo, desesperación, ansiedad y expectativa infinita. Se espera que estos resultados pueden ayudar en la formación de los profesionales, a la familia de acogida y su inserción en el entorno de la UCI como un elemento para ser integrados en los cuidados de enfermería, a través de acciones de bienvenida, ayudándoles a hacer frente a la hospitalización de un familiar en una unidad de críticos.<br>This is a qualitative study that aimed to understand what the feelings of relatives of patients admitted to the Intensive Care Unit (ICU). The study was conducted in the ICU of a large general hospital in the western region of Santa Catarina. The data collection occurred in 2009 with a semi structured interview to eighteen families. For the data treatment used the collective subject discourse. Reports emerged of two items related to feelings: hospitalization in the ICU and while waiting to enter the unit. The analysis revealed feelings as pain, anguish, sadness, helplessness, fear, despair, anxiety and expectation infinite. It is hoped that these results may assist in the training of professionals, to host the family and its insertion in the ICU environment as an element to be integrated into nursing care, through actions welcoming, helping them to cope with hospitalization of a relative in a critical unit