NURSE ROLE AS NA EDUCATOR IN HIV PREVENTION IN THE ELDERLY: A NEW PERSPECTIVE FOR THE HEALTH CARE OF THE ELDERLY

Objective: Reflect the nurse role as an educator in HIV prevention in the elderly. Methods: This is a qualitative, descriptive and exploratory study. An online bibliographic survey was carried out in the databases of the Virtual Health Library (VHL), Latin American and Caribbean Literature in Health Sciences (Lilacs) and Scientific Electronic Library Online (SciELO). The descriptors were used: “Assistance to the Elderly”; “Nursing”; “HIV” and “Public Health”. The inclusion criteria defined for the selection of articles were: articles published in Portuguese, articles in full that portrayed the theme and articles published in the referred databases in the last ten years. Results: When reading the eleven selected articles, it was possible to observe the high rate of elderly people with HIV. The profile of sexual behavior is commonly described only in people up to 59 years of age, abstaining from the population above 60 years, which favors forgetting this age group. From the perspective of HIV in the health of the elderly, the multidisciplinary team has an importance, especially the nurse, as its role is directed to the maintenance and restoration of health, leading them to self-care with a focus on health education practices. Conclusion: In the studies that were analyzed, the relevance of the nurse’s role as an educator was explicit, because unfortunately there is still a “taboo” when sexuality is explained in the elderly, and the nurse exercising his / her health education function may be adding knowledge of prevention and treatment for this population that is neglected by society

Influence of eco-materials on Indoor Air Quality

A growing strategy to reduce the energy consumption of buildings involves a combination of increased air tightness and high levels of insulation. However, an undesirable consequence of this approach is a deterioration of the Indoor Air Quality and accumulation of airborne pollutants, resulting from the reduction in ventilation. The chemical nature and concentration of indoor air pollutants is dependent on the building materials and activities of the occupiers. Recent studies have raised awareness of the effect of Indoor Air Quality on the perceived comfort levels, health and well-being of humans. This paper investigates the role of commercially available natural building materials including lime mortars, natural fibres and wood panels on the Indoor Air Quality. Initially the emissions of Volatile Organic Compounds (VOCs) from building materials were identified and measured. Subsequent tests then considered the adsorption and re-emission behaviour of four VOCs; toluene, limonene, dodecane and formaldehyde. The significance of this paper lies in its demonstration that emissions are dependent on the chemical composition of building materials and the production process, whereas the adsorption/desorption characteristics are related to material microstructure and polarity of the VOCs. The results allow the performance of a construction material, in terms of its influence on indoor air quality, to be deduced from a knowledge of chemical composition and microstructure. This paper provides a new approach for assessing the influence of different building materials on indoor air quality when exposed to gaseous pollutants

Effect of clinical pathways on antibiotic prescriptions in an emergency department: Italian pediatric antimicrobial stewardship starts here

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A BMPR2/YY1 Signaling Axis Is Required for Human Cytomegalovirus Latency in Undifferentiated Myeloid Cells.

Human cytomegalovirus (HCMV) presents a major health burden in the immunocompromised and in stem cell transplant medicine. A lack of understanding about the mechanisms of HCMV latency in undifferentiated CD34+ stem cells, and how latency is broken for the virus to enter the lytic phase of its infective cycle, has hampered the development of essential therapeutics. Using a human induced pluripotent stem cell (iPSC) model of HCMV latency and patient-derived myeloid cell progenitors, we demonstrate that bone morphogenetic protein receptor type 2 (BMPR2) is necessary for HCMV latency. In addition, we define a crucial role for the transcription factor Yin Yang 1 (YY1) in HCMV latency; high levels of YY1 are maintained in latently infected cells as a result of BMPR2 signaling through the SMAD4/SMAD6 axis. Activation of SMAD4/6, through BMPR2, inhibits TGFbeta receptor signaling, which leads to the degradation of YY1 via induction of a cellular microRNA (miRNA), hsa-miR-29a. Pharmacological targeting of BMPR2 in progenitor cells results in the degradation of YY1 and an inability to maintain latency and renders cells susceptible to T cell killing. These data argue that BMPR2 plays a role in HCMV latency and is a new potential therapeutic target for maintaining or disrupting HCMV latency in myeloid progenitors. IMPORTANCE Understanding the mechanisms which regulate HCMV latency could allow therapeutic targeting of the latent virus reservoir from where virus reactivation can cause severe disease. We show that the BMPR2/TGFbeta receptor/YY1 signaling axis is crucial to maintain HCMV latency in undifferentiated cells and that pharmacological reduction of BMPR2 in latently infected cells leads to reactivation of the viral lytic transcription program, which renders the infected cell open to immune detection and clearance in infected individuals. Therefore, this work identifies key host-virus interactions which regulate HCMV latent infection. It also demonstrates a potential new therapeutic approach to reduce HCMV reactivation-mediated disease by the treatment of donor stem cells/organs prior to transplantation, which could have a major impact in the transplant disease setting

Cardiovascular effects of arginase inhibition in spontaneously hypertensive rats with fully developed hypertension

Aims Growing evidence suggests that arginase misregulation plays a key role in the pathophysiology of essential hypertension. In the present study, we investigated the potential cardiovascular therapeutic effects of a long-term treatment with an arginase inhibitor in adult spontaneously hypertensive rats (SHR) with fully developed hypertension. Methods and results Treatment of 25-week-old SHR with the arginase inhibitor Nω-hydroxy-nor-l-arginine (nor-NOHA, 40 mg/day for 10 weeks) sustainably reduced systolic blood pressure (−30 mmHg, P < 0.05). The antihypertensive effect of nor-NOHA was associated with changes on mesenteric artery reactivity including the restoration of angiotensin-II-induced contraction and acetylcholine-induced vasodilation to the values of normotensive Wistar Kyoto rats. Both nitric oxide synthase and cyclooxygenase-dependent mechanisms account for the improvement of endothelial function afforded by the arginase inhibitor, which in addition blunted hypertension-induced endothelial arginase I overexpression in mesenteric arteries. Nor-NOHA also prevented the remodelling of aorta as measured by collagen content and media/lumen ratio, and improved the compliance of carotid artery in SHR. Cardiac fibrosis assessed by collagen content of left heart ventricle was reduced by nor-NOHA, with no significant effect on cardiac hypertrophy. Conclusion Our results report that a long-term treatment with an arginase inhibitor reduced blood pressure, improved vascular function, and reduced cardiac fibrosis in SHR with fully developed hypertension. These data suggest that arginase represents a promising novel target for pharmacological intervention in essential hypertensio

SJL Mice Infected with Acanthamoeba castellanii Develop Central Nervous System Autoimmunity through the Generation of Cross-Reactive T Cells for Myelin Antigens

We recently reported that Acanthamoeba castellanii (ACA), an opportunistic pathogen of the central nervous system (CNS) possesses mimicry epitopes for proteolipid protein (PLP) 139–151 and myelin basic protein 89–101, and that the epitopes induce experimental autoimmune encephalomyelitis (EAE) in SJL mice reminiscent of the diseases induced with their corresponding cognate peptides. We now demonstrate that mice infected with ACA also show the generation of cross-reactive T cells, predominantly for PLP 139–151, as evaluated by T cell proliferation and IAs/dextramer staining. We verified that PLP 139–151-sensitized lymphocytes generated in infected mice contained a high proportion of T helper 1 cytokine-producing cells, and they can transfer disease to naïve animals. Likewise, the animals first primed with suboptimal dose of PLP 139–151 and later infected with ACA, developed EAE, suggesting that ACA infection can trigger CNS autoimmunity in the presence of preexisting repertoire of autoreactive T cells. Taken together, the data provide novel insights into the pathogenesis of Acanthamoeba infections, and the potential role of infectious agents with mimicry epitopes to self-antigens in the pathogenesis of CNS diseases such as multiple sclerosis

Implicit and conventional large eddy simulation of flow around a circular cylinder at Reynolds number of 3900

The implicit Large Eddy Simulation (iLES) incorporating an unstructured 3rd-order Weighted Essential Non-Oscillatory (WENO) reconstruction method and the conventional Large Eddy Simulation with Wall Adapting Local Eddy-Viscosity (WALE) are investigated on the flow around a circular cylinder at a Reynolds number of 3900. Simulations are carried out in the framework of open-source package OpenFOAM with a 2nd-order Euler implicit time integration and Pressure-Implicit Splitting-Operator (PISO) algorithm is used for the pressure-velocity coupling. The results are compared to the high fidelity experiment and DNS data, and demonstrated a favourable performance for iLES with a 3rd-order WENO scheme on the instantaneous flow structure. The conventional LES on the prediction of mean surface pressure coefficient and velocity profiles on the wake can be beneficial by reducing the effect of Rhie-Chow interpolation. The spectral analysis reveals that the current simulations are also capturing Von Karman shedding frequencies and shear layer frequencies. Finally, distinct features of iLES and LES are discussed