Evaluation of diagnostic criteria for severe asthma described in a public health directive regulating the free distribution of medications for the maintenance treatment of asthma

OBJECTIVE: To evaluate the capacity of the criteria described in Complementary Directive SAS/MS 12, issued on November 12, 2002, to identify patients with severe asthma, describing and comparing clinical, functional and treatment data of such patients. METHODS: This was a nested case-control study using a structured database for adult asthma outpatients. We defined cases as asthma patients who met the inclusion criteria described in the directive, defining controls as those who did not. We collected and compared data related to the following: demographic characteristics; history of asthma; medications in use; comorbidities; history of tobacco use; number of exacerbations within the last 12 months, asthma-related hospitalizations and intensive care unit admissions within the last 12 months; spirometry; and sputum cytology. RESULTS: The case and control groups consisted of 29 and 31 patients, respectively. The number of asthma exacerbations and emergence room visits within the last 12 months, as well as the number of patients that received at least one pulse of oral corticosteroids, was significantly higher in the case group than in the control group. In addition, prebronchodilator FVC was lower among the cases than among the controls. Furthermore, cytology revealed that eosinophil counts were significantly higher in the induced sputum of cases than in that of controls. CONCLUSIONS: The criteria described in the directive are suited to stratifying patients with severe asthma.OBJETIVO: Avaliar a capacidade dos critérios descritos na Portaria Complementar SAS/MS nº12, de 12 de novembro de 2002, em identificar pacientes asmáticos graves, bem como descrever e comparar dados clínicos, funcionais e de tratamento destes pacientes. MÉTODOS: Estudo caso-controle aninhado em um banco de dados estruturado de atendimento ambulatorial de asmáticos. Foram considerados casos os pacientes asmáticos que preencheram os critérios de inclusão determinados na portaria e considerados controles os que não preencheram os mesmos critérios. Foram coletados e comparados dados demográficos; história pregressa da asma; medicamentos em uso; presença de comorbidades; história de tabagismo; presença, no último ano, de exacerbações, de hospitalizações e de admissões em unidades de terapia intensiva devido à asma; e resultados de espirometria e de citologia de escarro. RESULTADOS: Foram incluídos 29 e 31 pacientes, respectivamente, nos grupos caso e controle. O grupo caso apresentou maior número de exacerbações e maior número de visitas ao pronto-socorro no último ano, maior porcentagem de pacientes que receberam pelo menos um pulso de corticosteroide oral, assim como menores valores de CVF pré-broncodilatador em relação ao grupo controle. O grupo caso também apresentou um aumento significante de eosinófilos na citologia do escarro induzido. CONCLUSÕES: Os critérios de inclusão descritos na portaria são adequados para estratificar pacientes com asma grave.Universidade Federal de São Paulo (UNIFESP) Departamento de Medicina Programa de Pós-Graduação de PneumologiaUNIFESP, Depto. de Medicina Programa de Pós-Graduação de PneumologiaSciEL

Influence of oscillating positive expiratory pressure and the forced expiratory technique on sputum cell counts and quantity of induced sputum in patients with asthma or chronic obstructive pulmonary disease

OBJECTIVE: To evaluate whether respiratory therapy techniques influence the number of cells within and quantity of induced sputum in patients with asthma or chronic obstructive pulmonary disease (COPD). METHODS: Randomized clinical trial, in which patients with asthma or COPD under intervention (n = 16 and 10, respectively) were compared with control groups (n = 16 and 10). Patients in the asthma/intervention (A/I) and COPD/intervention (C/I) groups were submitted to oscillating positive expiratory pressure maneuvers for 5 min, followed by 10 forced expiratory technique sequences. These patients were also submitted to an induced sputum protocol with inhaled hypertonic saline (3%, 4% or 5%; A/I group) or inhaled isotonic saline (C/I group). The asthma/control (A/C) and COPD/control (C/C) groups were submitted only to the standard induced sputum protocol. RESULTS: The final mean weight of the sputum samples was significantly greater in the A/I group than in the A/C group (2,767.25 ± 998.08 mg vs. 1,689.17 ± 1,189.96 mg; p = 0.03). The mean/median total cell counts (×10(6)/mL) were higher in the A/I and C/I groups than in the A/C and C/C groups (4.06/0.95 and 0.63/0.39, p = 0.05, vs. 5.08/1.77 and 0.64/0.40, p = 0.02). There were no statistically significant differences among the groups in terms of cell viability. CONCLUSIONS: The use of respiratory therapy techniques can increase sputum sample weight in asthma patients, as well as increasing total cell counts in patients with asthma or COPD.OBJETIVO: Avaliar se técnicas fisioterápicas interferem no número de células e na quantidade do escarro obtido por coleta induzida, em pacientes com asma e doença pulmonar obstrutiva crônica (DPOC). MÉTODOS: Ensaio clínico prospectivo e randomizado, no qual os pacientes com asma ou DPOC sob intervenção (n = 16 e 10, respectivamente) foram comparados com grupos controle (n = 16 e 10). Pacientes dos grupos asma/intervenção (A/I) e DPOC/intervenção (D/I) foram submetidos a manobras de pressão expiratória positiva oscilante por 5 min, seguidas de 10 repetições da técnica de expiração forçada. Além disso, esses pacientes foram submetidos a um protocolo de indução de escarro com a inalação de solução salina hipertônica (3%, 4% e 5%), no caso dos A/I, e de solução salina isotônica, no caso dos D/I. Os grupos asma/controle(A/C) e DPOC/controle (D/C) foram somente submetidos ao protocolo padrão de indução de escarro. RESULTADOS: Houve aumento significante do peso média final de escarro no grupo A/I vs. grupo A/C (2.767,25 ± 998,08 mg e 1.689,17 ± 1.189,96 mg, respectivamente; p = 0,03). O número absoluto de células (×10(6)/mL) foi maior nos grupos A/I e D/I do que nos grupos A/C e D/C (média/mediana, 4,06/0,95 e 0,63/0,39, respectivamente; p = 0,05; e 5,08/1,77 e 0,64/0,40; p = 0,02). A viabilidade celular não apresentou diferença estatisticamente significante entre os grupos. CONCLUSÕES: O uso de técnicas respiratórias pode aumentar o peso do escarro em pacientes com asma, assim como aumentar o número absoluto de células em pacientes com asma ou DOPC.Universidade Regional IntegradaUniversidade Federal de São Paulo (UNIFESP)UNIFESPSciEL

KIF13A mediates influenza a virus ribonucleoproteins trafficking

The deposited article version contains attached the supplementary materials within the pdf. This publication hasn't any creative commons license associated. The deposited article version is a "JCS Advance Online Article" provided by The Company of Biologists, and it is the "Accepted manuscript" posted online on 23 October 2017.Influenza A is a rapid evolving virus, successful in provoking periodic epidemics and occasional pandemics in humans. Viral assembly is complex as the virus incorporates an eight-partite segmented genome of RNA (in the form of viral ribonucleoproteins, vRNPs). Genome assembly, with implications to public health, is not completely understood. It was reported that vRNPs are transported to the cell surface on Rab11 vesicles using microtubules, but no molecular motor has been assigned to the process. Here, we have identified KIF13A, a member of the kinesin-3 family, as the first molecular motor efficiently transporting vRNP-Rab11 vesicles during IAV infection. Depletion of KIF13A resulted in reduced viral titres and less accumulation of vRNPs at the cell surface, without interfering with the levels of other viral proteins at sites of viral assembly. In addition, in overexpression conditions and using two artificial methods able to displace vRNP-Rab11 vesicles, KIF13A augmented vRNP levels at the plasma membrane. Together our results show that KIF13A is an important host factor promoting influenza A vRNP transport, which is a crucial step for viral assembly.Fundação para a Ciência e a Tecnologia grants: (PTDC/IMI-MIC/1142/2012, IF/00899/2013, SFRH/BPD/62982/2009, SFRH/BPD/94204/2013); Instituto Calouste Gulbenkian; Fundação Calouste Gulbenkian; Fondation pour la Recherche Médicale grant: (Equipe FRM DEQ20140329491 Team label); Fondation ARC pour la Recherche sur le Cancer grant: (PJA20161204965); CNRS; INSERM; Institut Curie.info:eu-repo/semantics/acceptedVersio

Estratégia de telemonitoramento frente à pandemia do SARS-CoV-2

The aim of this study is to identify whether, in the perception of the Academic Scholars of Nursing and Medicine, the practical knowledge that was the object of desire at the time of enrollment for the academic scholar 2020 was achieved, since due to the pandemic of COVID-19 there was a need for the Secretariat Municipal Health Department of Rio de Janeiro to implement a new internship model, in the Telemonitoring modality. Methodology: a descriptive study with a descriptive and exploratory qualitative and quantitative approach. The research was carried out with three Family Clinics of the Basic Health Network of the City of Rio de Janeiro and 11 Academic Nursing and Medicine Scholars participated in the research. Data collection took place between September and November 2020 through semi-structured interviews using online questionnaires, using the Bardin methodology where the organization, coding and categorization of the data was carried out. It became evident that the internship in the Telemonitoring modality does not meet the expectations of Scholarship Scholars, it is important to note that, of these 63.7% did not fulfill their entire internship period in this modality, being directed to their units after the relaxation of the policies of social distance to carry out the practical internship.O objetivo desse estudo é identificar se na percepção dos Acadêmicos Bolsistas de Enfermagem e Medicina o conhecimento prático que era objeto de desejo no momento de inscrição para o acadêmico bolsista 2020 foi atingido, já que devido a pandemia da COVID-19 houve a necessidade da Secretaria Municipal de Saúde do Rio de Janeiro de implementar um novo modelo de estágio, na modalidade de Telemonitoramento. Metodologia: estudo do tipo descritivo, com abordagem qualiquantitativa descritiva e exploratória. A pesquisa foi realizada com três Clínicas da Família da Rede Básica de Saúde da Cidade do Rio de Janeiro e participaram da pesquisa 11 Acadêmicos Bolsistas de Enfermagem e Medicina. A coleta de dados ocorreu entre setembro e novembro de 2020 através de entrevistas semiestruturadas por meio de questionários on-line, utilizando a metodologia de Bardin onde foi realizada a organização, codificação e categorização dos dados. Evidenciou-se que o estágio na modalidade de Telemonitoramento não supre as expectativas dos Acadêmicos Bolsistas, sendo importante ressaltar que, destes 63,7% não cumpriram todo o seu período de estágio nesta modalidade, sendo direcionados as suas unidades após o relaxamento das políticas de distanciamento social para realização do estágio prático

Vocal repertoire and consistency of call features in the meagre Argyrosomous regius (Asso, 1801)

Passive Acoustic Monitoring (PAM) is a non-intrusive and cost-effective method capable of providing high-resolution, long-term information on the status and health of vocal populations and communities. To successfully monitor the same species over wide geographical and temporal scales, it is necessary to characterise the range of sound variability, as well as the consistency of sound features between populations. The meagre (Argyrosomus regius, Asso 1801) is an interesting case study because recent investigations suggest a wider vocal repertoire than previously described. In this study, meagre vocalizations were recorded and analysed from a variety of settings, ranging from rearing facilities to wild populations to provide a comprehensive characterisation of its vocal repertoire, while investigating the consistency of spawning sound features between populations. All sounds presented a similar acoustic structure in their basic unit (i.e. the pulse), while an important variability was found in the number of pulses; the meagre can emit sounds made of one single pulse or many pulses (up to more than 100). High level of overlap in the Principal Component Analysis made difficult to differentiate sound type clusters. Despite this, two sound types were identifiable: knocks (sounds from 1 to 3 pulses) and long grunts (sounds with more than 29 pulses). Discriminant Analysis carried out on PCA residuals showed that knock had the highest proportion of correct placement (92% of the observations correctly placed) followed by long grunts (80%). All other previously described sound types (intermediate grunt, short grunt and disturbance sounds) could not be separated and presented low levels of correct placement, suggesting that care should be taken when defining these as independent sound types. Finally, acoustic features consistency was found in meagre grunts emitted by different populations during spawning nights; statistical differences could be explained by recording settings and fish conditions. The results of this study provide important information for fostering PAM programs of wild meagre populations, while contributing to the discussion around the definition of fish sound types in vocal fish communities. Studies of this kind, which evaluate both variability and consistency of sound features, are of fundamental importance for maximising PAM efforts in the wild, at both the specific and the community level.info:eu-repo/semantics/publishedVersio

Defining basic rules for hardening influenza A virus liquid condensates

In biological systems, liquid and solid-like biomolecular condensates may contain the same molecules but their behaviour, including movement, elasticity and viscosity, is different on account of distinct physicochemical properties. As such, it is known that phase transitions affect the function of biological condensates and that material properties can be tuned by several factors including temperature, concentration and valency. It is, however, unclear if some factors are more efficient than others at regulating their behaviour. Viral infections are good systems to address this question as they form condensates de novo as part of their replication programmes. Here, we used influenza A virus liquid cytosolic condensates, A.K.A viral inclusions, to provide a proof of concept that liquid condensate hardening via changes in the valency of its components is more efficient than altering their concentration or the temperature of the cell. Liquid IAV inclusions may be hardened by targeting vRNP interactions via the known NP oligomerizing molecule, nucleozin, both in vitro and in vivo without affecting host proteome abundance nor solubility. This study is a starting point for understanding how to pharmacologically modulate the material properties of IAV inclusions and may offer opportunities for alternative antiviral strategies.info:eu-repo/semantics/publishedVersio

Quercetin protects Saccharomyces cerevisiae against oxidative stress by inducing trehalose biosynthesis and the cell wall integrity pathway

Background: Quercetin is a naturally occurring flavonol with antioxidant, anticancer and anti-ageing properties. In this study we aimed to identify genes differentially expressed in yeast cells treated with quercetin and its role in oxidative stress protection. Methods: A microarray analysis was performed to characterize changes in the transcriptome and the expression of selected genes was validated by RT-qPCR. Biological processes significantly affected were identified by using the FUNSPEC software and their relevance in H2O2 resistance induced by quercetin was assessed. Results: Genes associated with RNA metabolism and ribosome biogenesis were down regulated in cells treated with quercetin, whereas genes associated with carbohydrate metabolism, endocytosis and vacuolar proteolysis were up regulated. The induction of genes related to the metabolism of energy reserves, leading to the accumulation of the stress protectant disaccharide trehalose, and the activation of the cell wall integrity pathway play a key role in oxidative stress resistance induced by quercetin. Conclusions: These results suggest that quercetin may act as a modulator of cell signaling pathways related to carbohydrate metabolism and cell integrity to exert its protective effects against oxidative stress.publishe

O tratamento diretamente observado para tuberculose pode ser substituído e, ainda assim, obter sucesso no tratamento?

The aim of this study was to verify the effectiveness of the application of telemonitoring for monitoring the treatment of patients with TB, according to the nurse's view. A qualitative and quantitative study was carried out in a UBS located in the North Zone of Rio de Janeiro, where 10 professionals (including nurses and nursing residents in their second year of professional residency) evaluated TB treatments underway during the pandemic. Bardin's content analysis was applied in this study. There were different perceptions about this tool used to monitor these patients. It was possible to realize that telemonitoring can be applied as an ally for monitoring patients undergoing treatment for chronic diseases, especially those who have difficulties accessing face-to-face care, although it should be mentioned that there is a certain loss of quality in care because this method does not allow observe information that is not verbalized by the patient.O objetivo deste estudo foi verificar a efetividade da aplicação do telemonitoramento para o acompanhamento do tratamento dos pacientes com TB, segundo a visão do enfermeiro. Foi realizado um estudo qualiquantitativo desenvolvido em uma UBS alocada na Zona Norte do Rio de Janeiro onde 10 profissionais (entre enfermeiros e residentes de enfermagem no curso de seu segundo ano de residência profissional) avaliaram os tratamentos para TB em curso durante a pandemia. Foi aplicada a análise de conteúdo de Bardin neste estudo. Houveram percepções distintas sobre esta ferramenta utilizada para o a acompanhamento desses pacientes. Foi possível perceber que o telemonitoramento pode ser aplicado como aliado para acompanhamento de pacientes em tratamento de doenças crônicas, sobretudo aqueles que possuem dificuldades de acesso ao atendimento presencial, embora deva-se citar que há certa perda de qualidade no atendimento pois esse método não possibilita observar informações que não sejam verbalizadas pelo paciente

Multidisciplinaridade, interdisciplinaridade e transdisciplinaridade: em busca de diálogo entre saberes no campo da saúde pública

Na contemporaneidade, no se pode considerar somente um nvel de realidade e, no mbito da sade pblica, a fuso de conhecimentos das diversas reas que o compem se faz cada vez mais necessria como forma de se lidar com a complexidade inerente a esse campo. As experincias multidisciplinares, interdisciplinares e transdisciplinares apresentam como principal caracterstica comum a aproximao de diferentes disciplinas para a soluo de problemas especficos, como o caso da sade pblica. Nessa lgica de pensamento, cabe salientar a necessidade de se discutir cada vez mais as modalidades do conhecimento inerentes rea. O objetivo do presente estudo refletir, luz de literatura especializada, os conceitos da multidisciplinaridade, interdisciplinaridade e transdisciplinaridade, assim como os desdobramentos relacionados histria, aos aspectos e s caractersticas da aplicabilidade desses conceitos no campo da sade pblica

Multidisciplinaridade, interdisciplinaridade e transdisciplinaridade: em busca de diálogo entre saberes no campo da saúde pública

Na contemporaneidade, não se pode considerar somente um nível de realidade e, no âmbito da saúde pública, a fusão de conhecimentos das diversas áreas que o compõem se faz cada vez mais necessária como forma de se lidar com a complexidade inerente a esse campo. As experiências multidisciplinares, interdisciplinares e transdisciplinares apresentam como principal característica comum a aproximação de diferentes disciplinas para a solução de problemas específicos, como é o caso da saúde pública. Nessa lógica de pensamento, cabe salientar a necessidade de se discutir cada vez mais as modalidades do conhecimento inerentes à área. O objetivo do presente estudo é refletir, à luz de literatura especializada, os conceitos da multidisciplinaridade, interdisciplinaridade e transdisciplinaridade, assim como os desdobramentos relacionados à história, aos aspectos e às características da aplicabilidade desses conceitos no campo da saúde pública