Infusão de células-tronco hematopoéticas: tipos, características, reações adversas e transfusionais e implicações para a enfermagem

Hematopoietic stem cell infusion is an important procedure in Hematopoietic Stem Cell Transplantation (HSCT). This study identifies transfusion and other adverse reactions that can occur during infusion and the nursing care related to the procedure. This epidemiologic study used transplantations performed between 2006 and 2008. A total of 166 transplantations were performed: 114 were autologous, 47 allogeneic and five haploidentical. Three transfusion reactions and 96 adverse reactions were observed. Adverse reactions were related to the presence of cryoprotectant, though the infusion rate and quantity of infused cryoprotectant were not related to the occurrence of reactions. The products were fresh and infused within the recommended time when transfusion reactions occurred. In regard to cell source, lower engraftment time was found in peripheral blood. Nursing documentation is relevant for patients' safety as well to planning an infusion in order to minimize the occurrence of reactions.La infusión de las células madre hematopoyéticas es un importante procedimiento en el trasplante de células madre hematopoyéticas. Este estudio se propuso identificar las reacciones adversas y de transfusión que pueden ocurrir durante la infusión y los cuidados de enfermería inherentes al procedimiento. Se trata de un estudio epidemiológico en trasplantes ocurridos en los años de 2006 a 2008. En ese período ocurrieron 166 trasplantes, siendo 114 autólogos, 47 alogénicos y 5 haploidénticos. Se observaron tres reacciones de transfusión y 96 reacciones adversas. Las reacciones adversas están ligadas a presencia del crioprotector. Sin embargo, la velocidad de infusión y la cantidad del crioprotector infundido, no tuvieron relación con la ocurrencia de las reacciones. En las reacciones de transfusión, los productos eran frescos e infundidos con la velocidad preconizada. En cuanto a las fuentes de células, hubo menor tiempo de injerto en la sangre periférica. La documentación de enfermería es relevante tanto para la seguridad del paciente como para la planificación de la infusión, a fin de minimizar la ocurrencia de las reacciones.A infusão de células-tronco hematopoéticas é importante procedimento no transplante de células-tronco hematopoéticas. Este estudo se propôs a identificar as reações adversas e transfusionais que podem ocorrer durante a infusão e os cuidados de enfermagem inerentes ao procedimento. Trata-se de estudo epidemiológico em transplantes, ocorridos entre os anos 2006 e 2008. Ocorreram 166 transplantes, sendo 114 autólogos, 47 alogênicos e 5 haploidênticos. Observaram-se três reações transfusionais e 96 reações adversas. As reações adversas estão ligadas à presença do crioprotetor. No entanto, velocidade de infusão e quantidade do crioprotetor infundido não tiveram relação com a ocorrência das reações. Nas reações transfusionais, os produtos eram frescos e infundidos na velocidade preconizada. Quanto às fontes de células, houve menor tempo de enxertia no sangue periférico. A documentação de enfermagem é relevante tanto para a segurança do paciente como para o planejamento da infusão, a fim de minimizar a ocorrência das reações

Intratidal variability and transport of petroleum aromatic hydrocarbons in an anthropized tropical estuarine system: the Suape estuary (8.4S 35W)

A instalação do Complexo Industrial Portuário de Suape (CIPS) modificou algumas características físicas, químicas e biológicas do Estuário de Suape. Este estudo apresenta a primeira caracterização física deste sistema, focando na hidrodinâmica local, transporte de materiais e a influência destes sobre algumas propriedades locais. Os parâmetros físicos também foram associados aos hidrocarbonetos de petróleo dissolvidos e/ou dispersos (HPDDs). Durante um ciclo completo de maré (13 h), foram registrados o nível, fluxo e propriedades da água (salinidade, temperatura, material em suspensão - MS -, clorofila e oxigênio dissolvido), além da velocidade e direção das correntes, usando ADCP e CTD. Os HPDDs foram investigados nas águas superficiais e de fundo, através de espectrofluorescência. Os resultados revelaram uma estrutura vertical homogênea, um regime de maré semidiurno e um padrão térmico diurno. As concentrações de HPDDs na superfície e no fundo são baixas e similares, devido à ação da maré. A fonte mais provável é o CIPS, uma vez que o transporte residual dos hidrocarbonetos de petróleo, da clorofila e do oxigênio dissolvido são no sentido do estuário do Massangana. Um padrão oposto foi observado para o transporte residual da salinidade e MS, no sentido da lagoa. Estes resultados indicam que a hidrodinâmica local é essencial para entender o transporte e troca de materiais entre os vários segmentos do estuário. Estudos mais completos são necessários para se obter conclusões mais consistentes.The Suape Estuary encompasses the Suape Industrial Port Complex (SIPC), a major industrial development in Brazil's Northeast region, which, in order to be implanted, caused drastic environmental changes in this system. This study presents the first physical characterization of the Suape estuarine system, focusing on the local hydrodynamics, material transport and its influence on some specific properties. Physical properties were also associated to dissolved dispersed petroleum hydrocarbons (DDPHs). A study was undertaken during a complete semi-diurnal tidal cycle (13 hr), during which water level, water flow, current velocity and direction, water properties (salinity, temperature, suspended particulate matter - SPM -, chlorophyll and dissolved oxygen) were recorded using ADCP and CTD systems. The DDPHs were investigated in surface and bottom waters, by spectrofluorescence, using Carmópolis oil and chrysene as analytical standards. Results showed a well-mixed vertical structure, a semi-diurnal tide regime and a diurnal thermal pattern. There was no statistical difference between DDPH concentrations at surface and bottom, due to the tide acting as an important homogenizer. DDPHs were low and the main contribution seems to be that from SIPC, as the residual transport of DDPHs, chlorophyll and dissolved oxygen, was towards the Massangana estuary. An opposite pattern was observed for salinity and SPM, whose residual transport was towards the lagoon. The results pointed local hydrodynamics as an essential tool for understanding material transport and exchanges among the estuarine segments. A longer time series should be studied in order to obtain more robust conclusions

Xerostomia na população idosa, do diagnóstico ao tratamento: revisão da literatura

Saliva is important for the preservation and maintenance of normal physiological conditions of oral tissues, and factors influencing its decrease are associated with the risk for oral diseases. Xerostomia is the subjective sensation of oral dryness, which can be influenced by etiological factors including the use of several types of medications, Sjogren’s and metabolic syndromes, head and neck irradiation, among others. Treatment methods for xerostomia vary and can be local or systemic. The aim of this article is to present the results of a literature review addressing the correlation between xerostomia and its incidence and prevalence in the older adult population. Results of this review highlight the importance of diagnosis and appropriate management, and briefly describe treatment modalities and etiological factors such as medications, Sjogren’s syndrome, metabolic syndrome, and head and neck irradiation.A saliva é importante para a preservação e manutenção das condições fisiológicas normais dos tecidos bucais, e os fatores que influenciam sua diminuição estão associados ao risco de doenças bucais. Xerostomia é a sensação subjetiva de secura oral, que pode ser influenciada por fatores etiológicos, incluindo o uso de vários tipos de medicamentos, síndromes metabólicas e de Sjögren, irradiação de cabeça e pescoço, entre outros. Os métodos de tratamento para xerostomia variam e podem ser locais ou sistêmicos. O objetivo deste artigo é apresentar os resultados de uma revisão bibliográfica abordando a correlação entre xerostomia e sua incidência e prevalência na população idosa. Os resultados desta revisão destacam a importância do diagnóstico e do manejo adequado e descrevem brevemente as modalidades de tratamento e fatores etiológicos, como medicamentos, síndrome de Sjögren, síndrome metabólica e irradiação de cabeça e pescoço

Post-natal prognostic factors in CDH: experience of 11 years in a referral center in Brazil

Objective: To describe post-natal risk factors associated with death in Newborns (NB) with Congenital Diaphragmatic Hernia (CDH) in a Brazilian reference center. Methods: In this retrospective cohort study, post-natal clinical factors of all NB diagnosed with CDH were reviewed in an 11-year period (2007‒2018). The primary outcome was death. Secondary outcomes included clinical features, prognostic indexes, type of mechanical ventilation, complications during hospitalization and surgical repair. Results: After applying the exclusion criteria, the authors analyzed 137 charts. Overall mortality was 59% (81/137), and the highest rates were observed for low-birth-weight NB (87%), syndromic phenotype (92%), and those with major malformations (100%). Prognostic indexes such as Apgar, SNAPPE-II and 24hOI (best oxygenation index in 24 hours) were all associated with poor evolution. In a multivariate analysis, only birth weight and 24hOI were statistically significant risk factors for mortality, with a reduction in mortality risk of 17.1% (OR = 0.829, 95% IC 0.72‒0.955, p = 0.009) for each additional 100g at birth and an increase by 26.5% (OR = 1.265, 95% IC 1.113‒1.436, p = 0.0003) for each unitary increase at the 24hOI. Conclusion: Prognostic indexes are an important tool for predicting outcomes and improving resource allocation. Post-natal risk factors may be more suitable for settings where antenatal diagnosis is not universal. Classical risk factors, such as prematurity, low birth weight, higher need for supportive care, and poorer prognostic indexes were associated with mortality in our CDH population

Virulence and resistance properties of E. coli isolated from urine samples of hospitalized patients in Rio de Janeiro, Brazil - The role of mobile genetic elements

Extraintestinal pathogenic E. coli (ExPEC) is the most frequent etiological agent of urinary tract infections (UTIs). Particular evolutionary successful lineages are associated with severe UTIs and higher incidences of multidrug resistance. Most of the resistance genes are acquired by horizontal transfer of plasmids and other mobile genetic elements (MGEs), and this process has been associated with the successful dissemination of particular lineages. Here, we identified the presence of MGEs and their role in virulence and resistance profiles of isolates obtained from the urine of hospitalized patients in Brazil. Isolates belonging to the successful evolutionary lineages of sequence type (ST) 131, ST405, and ST648 were found to be multidrug-resistant, while those belonging to ST69 and ST73 were often not. Among the ST131, ST405, and ST648 isolates with a resistant phenotype, a high number of mainly IncFII plasmids was identified. The plasmids contained resistance cassettes, and these were also found within phage-related sequences and the chromosome of the isolates. The resistance cassettes were found to harbor several resistance genes, including blaCTX-M-15. In addition, in ST131 isolates, diverse pathogenicity islands similar to those found in highly virulent ST73 isolates were detected. Also, a new genomic island associated with several virulence genes was identified in ST69 and ST131 isolates. In addition, several other MGEs present in the ST131 reference strain EC958 were identified in our isolates, most of them exclusively in ST131 isolates. In contrast, genomic islands present in this reference strain were only partially present or completely absent in our ST131 isolates. Of all isolates studied, ST73 and ST131 isolates had the most similar virulence profile. Overall, no clear association was found between the presence of specific MGEs and virulence profiles. Furthermore, the interplay between virulence and resistance by acquiring MGEs seemed to be lineage dependent. Although the acquisition of IncF plasmids, specific PAIs, GIs, and other MGEs seemed to be involved in the success of some lineages, it cannot explain the success of different lineages, also indicating other (host) factors are involved in this process. Nevertheless, the detection, identification, and surveillance of lineage-specific MGEs may be useful to monitor (new) emerging clones

SAMARAS OF AUSTROPLENCKIA POPULNEA (CELASTRACEAE): NEW CONSTITUENTS AND EFFECT OF EXTRACTS AND FRIEDELIN ON GERMINATION OF BIDENS PILOSA (ASTERACEAE)

Objective: Evaluation of the impact of extracts and constituents from samaras of Austroplenckia populnea on percentage of seed germination (%SG), germination speed index (GSI), length of rootlets (LR), seedling length (SL), and on dry mass (DM) of Bidens pilosa L weed.Methods: The  powder  of  samaras  was  extracted  with  organic  solvents  providing  the  hexane  (SAPEH),  chloroform  (SAPEC),  ethyl  acetate  (SAPEAE) and ethanol  (SAPEE)  extracts. The terpene 1 was isolated from SAPEH by means of column and thin layer chromatography and identified through NMR spectroscopy. Each extract and 1 were subjected to growth inhibition assays evaluating the following parameters: %SG, GSI, LR, SL and DM, with five repetitions.Results: The compounds Friedelin (1), 7-hydroxy-clerodan-3-en-16,15:18,20-diolide (2), 3,5,7,4'-tetrahydroxy-6-methoxy-8-prenylflavanone (3), tetradecanamide (4), and 4-hydroxy-1,6,15-acetyloxy-8,9-benzoyloxy-agarofurane (5) were isolated from hexane extract of samaras of A. populnea and identified by spectroscopic data. The compounds 2, 3 and 5 were not previously described as being chemical constituents from Celastraceae family. In addition, the novel compounds 3 and 5 were described here for the first time. Substantial effect on the germination of B. pilosa L. (picão-preto) was observed after treatment of seeds with nonpolar extracts from Samaras of A. populnea. Friedelin inhibited the seed germination in the tested concentrations showing toxic properties against picão-preto.Conclusion: The germination inhibition of seeds was higher using nonpolar extracts than polar extract. Friedelin inhibited the seed germination in the tested concentrations showing toxic properties against B. pilosa.Â

Microtomographic, histomorphometric, and molecular features show a normal alveolar bone healing process in iNOS-deficient mice along a compensatory upregulation of eNOS and nNOS isoforms

Inducible nitric oxide synthase (iNOS) is one of the enzymes responsible for the synthesis of nitric oxide (NO), which is an important signaling molecule with effects on blood vessels, leukocytes, and bone cells. However, the role of iNOS in alveolar bone healing remains unclear. This study investigated the role of iNOS in alveolar bone healing after tooth extraction in mice. Methodology: C57Bl/6 wild type (WT) and iNOS genetically deficient (iNOS-KO) mice were subjected to upper incision tooth extraction, and alveolar bone healing was evaluated by micro-computed tomography (μCT) and histological/histomorphometric, birefringence, and molecular methods. Results: The expression of iNOS had very low control conditions, whereas a significant increase is observed in healing sites of WT mice, where iNOS mRNA levels peak at 7d time point, followed by a relative decrease at 14d and 21d. Regarding bone healing, both WT and iNOS-KO groups showed the usual phases characterized by the presence of clots, granulation tissue development along the inflammatory cell infiltration, angiogenesis, proliferation of fibroblasts and extracellular matrix synthesis, bone neoformation, and remodeling. The overall micro-computed tomography and histomorphometric and birefringence analyses showed similar bone healing readouts when WT and iNOS-KO strains are compared. Likewise, Real-Time PCR array analysis shows an overall similar gene expression pattern (including bone formation, bone resorption, and inflammatory and immunological markers) in healing sites of WT and iNOS-KO mice. Moreover, molecular analysis shows that nNOS and eNOS were significantly upregulated in the iNOS-KO group, suggesting that other NOS isoforms could compensate the absence of iNOS. Conclusion: The absence of iNOS does not result in a significant modulation of bone healing readouts in iNOS-KO mice. The upregulation of nNOS and eNOS may compensate iNOS absence, explaining the similar bone healing outcome in WT and iNOS-KO strains

Genesis of closed depressions in slopes associated with the aluminous duricrust in the south region of Capara? Ridge, Minas Gerais/Espirito Santo.

A origem das depress?es fechadas associadas ? cobertura later?tica aluminosa nos topos dos morros e ao longo das vertentes na regi?o de Espera Feliz, MG, divisa com Esp?rito Santo, foi pesquisada atrav?s de um levantamento geof?sico da cobertura pedol?gica associado ?s an?lises morfol?gicas (macro e micro) de perfi s de solos. O levantamento geof?sico por GPR, realizado em 2 se??es ao longo de uma vertente, abrangeu duas depress?es consecutivas e foi seguido do levantamento sistem?tico da cobertura pedol?gica por meio da abertura de 5 perfi s (N1, L1, L2, N2 e L3). Foram coletadas amostras deformadas para an?lises f?sicas, mineral?gicas e qu?micas e amostras indeformadas para an?lise micromorfol?gica. No interior das depress?es fechadas foi identifi cado o Neossolo Lit?lico h?mico t?pico e entre as depress?es ocorre o Latossolo Vermelho Amarelo distr?fi co h?mico. A an?lise lateral realizada pelo GPR e a interpreta??o conjunta dos atributos da cobertura revelam um sistema pedol?gico cont?nuo do topo a base da vertente. As diferen?as morfol?gicas que levam a exist?ncia de distintas classes de solos traduzem, neste contexto, a evolu??o pedogeomorfol?gica da vertente e consequente g?nese das depress?es, o que teria ocorrido de maneira distinta ao modelo de subsid?ncia por lixivia??o geoqu?mica, mais amplamente conhecido. Dois momentos s?o reconhecidos: i) a origem de uma cobertura latoss?lica relacionada ao avan?o vertical da degrada??o da bauxita e ? bioturba??o sob condi??es clim?ticas ?midas e ii) remo??o de partes dessa cobertura em condi??es clim?ticas (possivelmente ?ridas) posteriores.The origin of the closed depressions associated with the aluminous duricrust occurring on the tops of the hills and along the hillslope in the region of Espera Feliz city, Minas Gerais state, bordering the Esp?rito Santo state, was investigated through a geophysical survey of soil cover associated with the morphological analysis (macro and micro) in soil profi les. Geophysical survey by GPR held in two sections along a slope, covered two consecutive depressions and was followed by systematic survey of soil cover through the opening 5 profi les (N1, L1, L2, N2 and L3), where deformed samples were collected for chemical, physical and mineralogical analysis and undisturbed samples for micromorphological analysis. Humic Neosols were found inside the closed depressions and Humic Ferralsols were found between the closed depressions. The side analysis performed by GPR and the joint interpretation of the soil properties reveals a persistent pedological system from top to bottom of the slope. So the morphological diff erences that would lead to consider two soil classes are related to the occurency of mass moviments. The origin of the horizon (Bw and A) are related to the vertical advance of bauxite degradation conducted by bioturbation. The aluminous duricrust and its transformation into soil are understood as preceding stages of erosive features formation. Thus, the bauxite in the region would have formed under hot and humid weather conditions and removing parts of the cover in later dry weather conditions