Need of information for parents with children suffering from congenital heart defects

INTRODUÇÃO: a equipe de enfermagem deve informar pais de crianças portadoras de cardiopatias no que diz respeito às necessidades decorrentes desta situação. As necessidades mais comuns são: informações a respeito da própria cardiopatia, promoção de atividade física, adequação da alimentação, cuidado à saúde bucal, prevenção da endocardite infecciosa, cuidados nas crises de cianose e na administração de fármacos. OBJETIVO: caracterizar o quanto pais de crianças portadoras de cardiopatia congênita estão informados acerca desta. MÉTODO: mapeamento sistemático de literatura nas bases MEDLINE, Cochrane, CINAHL, LILACS e SciELO, do período de 1997 a 2007 com obtenção de 17 artigos. RESULTADOS: há necessidades pouco exploradas: cuidados por ocasião de crise de cianose, promoção de atividade física e administração de fármacos. As demais concentram a maior parte dos estudos. No entanto, mesmo nestas percebe-se que o conhecimento dos pais é incompleto e fragmentado, e isto ocorre tanto em países desenvolvidos, quanto nos em desenvolvimento. Em sua maior parte os cuidados são prestados por enfermeiros, dentistas e médicos. Programas de capacitação de pais são poucos e apenas um é descrito como exitoso. Há imperiosa necessidade de mudanças em termos de reorganização dos serviços de modo a abranger capacitação e apoio aos pais. Além disto, é necessário validar programas e protocolos de cuidados destinados a promover a capacitação destes. Tais programas devem ser flexíveis de modo a possibilitar a adaptação a cada situação clínica e aos determinantes sociais, cultural e econômico que agem sobre a família.INTRODUCTION: the nursing staff must inform parents with children suffering from congenital heart defects regarding their needs related to this situation. The most common needs are the seven, as follows: Information related to cardiopathy, promotion of physical activities, adequate diet, care with buccal health, prevention of infectious endocarditis, care during cyanosis crisis and drug administration. OBJECTIVE: to characterize how much information these parents have regarding this disorder. METHOD: systematic mapping on the literature in MEDLINE, Cochrane, CINAHL, LILACS and SciELO databases, from 1997 to 2007, obtaining 17 papers. RESULTS: the following needs, cyanosis crisis, promotion of physical activities and drug administration, were not adequately studied. The majority amongst the 17 papers was concentrated on the remaining four needs. Beside this, parent's knowledge is not satisfactory and is fragmented. It happens either in developed countries as well as in the underdeveloped ones. In general, care is performed by nurses, dental physicians and physicians. Training programs for parents are scarce and only one is described as successful. Changes are mandatory in terms of reorganization of services involving training and support for parents. Besides, validation of programs and protocols of care to promote training and development is required. These programs must be flexible to allow adaptation to clinical situation and to social, cultural and economic determinant factors acting on the family

Comparative Evaluation of Phenoloxidase Activity in Different Larval Stages of Four Lepidopteran Pests After Exposure toBacillus thuringiensis

Microbial entomopathogen–based bioinsecticides are recognized as alternatives to synthetic pesticides. Insects defend themselves against microbial pathogens by innate mechanisms, including increased phenoloxidase (PO) activity, but its relationship with microbial bioinsecticides efficacy is little known. This study evaluated the differences in PO activity at different developmental stages of the tobacco budworm Heliothis virescens Fabricius (Lepidoptera: Noctuidae), Indian meal moth Plodia interpunctella (Hübner) (Pyralidae), beet armyworm Spodoptera exigua (Hübner) (Noctuidae), and cabbage looper Trichoplusia ni (Hübner) (Noctuidae). Additionally, 2nd- and 4th-instars were exposed to the LC50 value of the commercial Bacillus thuringiensis (Bt) spray, Biobit®. The percentage of insecticidal activity (IA%) on 2nd-instar Biobit–exposed larvae was approximately the predicted 50 % mortality for all species except S. exigua. With all 4th instar Biobit–exposed larvae, mortality was not significantly different from that of unexposed larvae. Unexposed insects had a significantly higher PO activity in pre–pupae and pupae than early–instar larvae and adults, whereas PO activity was higher in adult females than in males. Correlation analysis between IA% and PO activity revealed significant r–values (p < 0.01) in 2nd instar H. virescens (r = 0.979) and P. interpunctella (r = 0.930). Second instar Biobit–exposed P. interpunctella had 10 times more PO activity than unexposed larvae. Similarly, the amount of total protein was lower in 4th instar Biobit–exposed H. virescens and higher in S. exigua. Therefore, the results indicated a relationship between Biobit susceptibility and PO activity in some cases. This information may be useful if the Biobit application period is timed for a developmental stage with low PO activity. However, more studies are needed to determine the correlation of each insect with a particular bioinsecticide

Increased efficacy and extended shelf life of spinosad formulated in phagostimulant granules against Spodoptera frugiperda

Abstract BACKGROUND:SpinosadisrecommendedforcontrolofSpodopterafrugiperda(J.E.Smith)larvae;itsapplicationwithphagostimulants may reduce the quantity of active ingredient required for effective pest control. Spinosad (Tracer®) was formulated inmaizeflourmatrixgranulesandthreefieldtestscompared10–100ppma.i.granules(equivalentto0.24–2.4ga.i.ha–1)with Tracerasanaqueousspray(200ppma.i.;60ga.i.ha–1),andtherecommendedapplicationratesofBacillusthuringiensis,achemicalandanuntreatedcontrolswereperformed. RESULTS:The100ppmspinosadgranulesresultedinsimilarS.frugiperdamortalitycomparedwiththechemicaltreatmentsin allthreefieldtrials,andresultedinasignificantlyhighermaizegrainyieldcomparedwithunformulatedandcontroltreatments (4141vs.2857and2407kgha–1,respectively)thatwassimilartothechemicaltreatment(3778kgha–1).Bioassaysofgranules stored at room and cold temperatures showed that after 5years, ∼ 70% of the original activity remained (OAR) of spinosad whenformulatedasgranules.Nevertheless,after9years,efficacywasreduced(26.2%and48.5%OAR)atbothroom(25∘C)and refrigeratedtemperatures(4∘C). CONCLUSION:Spinosad,inthegranularphagostimulantformulationsevaluatedinthisstudy,hadadvantagesmeasuredashigh efficacyandlongshelflife

Encefalite secundária à infecção do SARS-CoV-2

Introduction: All the methodological processes that involve the discussion about the neurological complications of Covid-19, and in particular encephalitis, indicate that although the clinical characteristics most observed in patients infected with SARS-CoV-2 are associated with the respiratory system, systemic and systemic changes can also occur in these patients. Methodology: This is an integrative literature review study carried out in the VHL, PMC and IPTODATE, which are online databases of the virtual health library. The following scientific descriptors were used to capture the sample: “Encephaliti”, “viral Encephalophaty” and Covid-19”. The study sample consisted of 54 articles, of which only 19 articles published between the dates of September 2020 and August 2021 comprised the study sample after applying the eligibility criteria. National and international articles available in full were included. Results: The results presented were of great significance regarding the learning of theoretical and practical concepts in the discipline about the occurrence of neurological impacts of Covid-19. Discussion: The study of the subject allowed to observe the neurological complications of covid infection 19, mainly regarding encephalitis and the mechanisms in which Sars-CoV-2 has to reach the central nervous system, its epidemiology, clinical manifestations and treatment. Conclusion: Therefore, it was shown how Sars-CoV-2 virus infection can result in encephalitis, in addition to presenting important data such as its main signs and symptoms, its prevalence and treatment. However, there is still little literature that addresses these repercussions of Covid-19, mainly related to encephalitis. Therefore, more in-depth approaches and research are needed in order to better understand the mechanisms related to the entry of the virus into the central nervous system and how it generates such complications. &nbsp;Introdução: Todos os processos metodológicos que envolvem a discussão sobre as complicações neurológicas da Covid-19, e em especial a encefalite, indicam que por mais que as características clínicas mais observadas em pacientes infectados pelo SARS-CoV-2 estejam associadas ao sistema respiratório, também podem ocorrer alterações sistêmicas e neurológicas nesses pacientes. Metodologia: Trata-se de um estudo de revisão integrativa da literatura realizado na BVS, PMC e UPTODATE, sendo elas bases de dados online da biblioteca virtual de saúde. Foram utilizados os seguintes descritores científicos para a captação da amostra: “Encephalitis”, “Viral encephalopathy” e “Covid-19”. A amostragem do estudo foi composta por 54 artigos, cujo qual apenas 19 artigos publicados entre as datas de setembro de 2020 a agosto de 2021 compuseram a amostra do estudo após aplicação dos critérios de elegibilidade. Foram incluídos artigos nacionais e internacionais disponíveis na íntegra. Resultados: Os resultados apresentados foram de grande significância com relação ao aprendizado dos conceitos teóricos e práticos na disciplina sobre a ocorrência dos impactos neurológicos da Covid-19. Discussão: O estudo do tema permitiu que fosse observado as complicações neurológicas da infecção do Covid-19, principalmente a respeito da encefalite e os mecanismos em que o Sars-CoV-2 dispõe para atingir o sistema nervoso central, sua epidemiologia, manifestações clínicas e o tratamento. Conclusão: Diante disso, foi mostrado como a infecção pelo vírus Sars-CoV-2 pode resultar na encefalite, além de apresentar dados importantes como os seus principais sinais e sintomas, sua prevalência e tratamento. Entretanto, ainda há pouca literatura que aborda essas repercussões da Covid-19, principalmente relacionado a encefalite. Por isso, se faz necessário abordagens e pesquisas mais aprofundadas a fim de compreender de forma mais explanada os mecanismos relacionados à entrada do vírus no sistema nervoso central e como gera tais complicações. &nbsp

Características do Melanoma Cutâneo e sua incidência na população brasileira / Cutaneous Melanoma Features and its incidence in brazilian population

Sabe-se que o melanoma cutâneo é uma doença maligna que ocorre devido a diversas condições que causam alterações nos melanócitos. A princípio, inicia-se com coloração nivelada e externa na pele e, com o decorrer da doença, ocorre progressão vertical. Dessa forma, mostram-se como métodos eficazes de diagnóstico o exame físico, a dermatoscopia, a biópsia e a tomografia computadorizada. Assim, é importante analisar a assimetria, a irregularidade das bordas, a pigmentação e o diâmetro da lesão. Visto que esta patologia possui índice elevado de mortalidade e considerando que a população desconhece sobre as lesões suspeitas, é relevante que sejam realizadas orientações a respeito da prevenção para reduzir as taxas de incidência desta doença. O objetivo desta revisão de literatura é abordar as particularidades do melanoma cutâneo, abordando as características clínicas e histopatológicas, e analisar as estatísticas do Instituto Nacional do Câncer (INCA) a respeito das estimativas para o ano de 2022. Para isso, foram realizadas pesquisas nas bibliotecas virtuais Scielo e MedLINE, buscando artigos do período de 2017 a 2022 e, ademais, foram realizadas análises das estatísticas do INCA para o ano de 2022

Diabetes Mellitus II como fator de risco à Aterogênese / Diabetes Mellitus II as a risk factor for Atherogenesis

Sabe-se que o diabetes mellitus 2 (DMII) está intimamente ligado aos efeitos aterogênicos da dislipidemia relacionada ao diabetes. Níveis elevados de insulina predispõem ao desenvolvimento de doenças arteriais.  O mecanismo patológico compartilhado entre a aterosclerose e o diabetes tipo 2 inclui a elevação de citocinas como MCP-1 e interleucina-6 (IL-6), que contribuem para a inflamação, evoluindo para progressão acelerada da aterosclerose pré-existente. O objetivo da revisão de literatura é apresentar a relação do DMII como fator de risco para a aterogênese. Foi realizada uma revisão bibliográfica nos bancos de dados Scielo e LILACS por meio da biblioteca BVS/Bireme. Utillizou-se os descritores: “Diabetes Mellitus II”, “aterogênese” e “risco”. É sabido que a cascata de reações causadas pela hiperglicemia corrobora para distúrbios metabólicos responsáveis pela mudança estrutural e funcional nos vasos sanguíneos, contribuindo para a lesão progressiva do endotélio e aterogênese

Whole genome sequencing of the multidrug-resistant Chryseobacterium indologenes isolated from a patient in Brazil

Chryseobacterium indologenes is a non-glucose-fermenting Gram-negative bacillus. This emerging multidrug resistant opportunistic nosocomial pathogen can cause severe infections in neonates and immunocompromised patients. This study aimed to present the first detailed draft genome sequence of a multidrug-resistant C. indologenes strain isolated from the cerebrospinal fluid of an infant hospitalized at the Neonatal Intensive Care Unit of Brazilian Tertiary Hospital. We first analyzed the susceptibility of C. indologenes strain to different antibiotics using the VITEK 2 system. The strain demonstrated an outstanding resistance to all the antibiotic classes tested, including β-lactams, aminoglycosides, glycylcycline, and polymyxin. Next, C. indologenes was whole-genome-sequenced, annotated using Prokka and Rapid Annotation using Subsystems Technology (RAST), and screened for orthologous groups (EggNOG), gene ontology (GO), resistance genes, virulence genes, and mobile genetic elements using different software tools. The draft genome contained one circular chromosome of 4,836,765 bp with 37.32% GC content. The genomic features of the chromosome present numerous genes related to cellular processes that are essential to bacteria. The MDR C. indologenes revealed the presence of genes that corresponded to the resistance phenotypes, including genes to β-lactamases (blaIND–13, blaCIA–3, blaTEM–116, blaOXA–209, blaVEB–15), quinolone (mcbG), tigecycline (tet(X6)), and genes encoding efflux pumps which confer resistance to aminoglycosides (RanA/RanB), and colistin (HlyD/TolC). Amino acid substitutions related to quinolone resistance were observed in GyrA (S83Y) and GyrB (L425I and K473R). A mutation that may play a role in the development of colistin resistance was detected in lpxA (G68D). Chryseobacterium indologenes isolate harbored 19 virulence factors, most of which were involved in infection pathways. We identified 13 Genomic Islands (GIs) and some elements associated with one integrative and conjugative element (ICEs). Other elements linked to mobile genetic elements (MGEs), such as insertion sequence (ISEIsp1), transposon (Tn5393), and integron (In31), were also present in the C. indologenes genome. Although plasmids were not detected, a ColRNAI replicon type and the most resistance genes detected in singletons were identified in unaligned scaffolds. We provided a wide range of information toward the understanding of the genomic diversity of C. indologenes, which can contribute to controlling the evolution and dissemination of this pathogen in healthcare settings

Identification of genetic variants associated with Huntington's disease progression: a genome-wide association study

Background Huntington's disease is caused by a CAG repeat expansion in the huntingtin gene, HTT. Age at onset has been used as a quantitative phenotype in genetic analysis looking for Huntington's disease modifiers, but is hard to define and not always available. Therefore, we aimed to generate a novel measure of disease progression and to identify genetic markers associated with this progression measure. Methods We generated a progression score on the basis of principal component analysis of prospectively acquired longitudinal changes in motor, cognitive, and imaging measures in the 218 indivduals in the TRACK-HD cohort of Huntington's disease gene mutation carriers (data collected 2008–11). We generated a parallel progression score using data from 1773 previously genotyped participants from the European Huntington's Disease Network REGISTRY study of Huntington's disease mutation carriers (data collected 2003–13). We did a genome-wide association analyses in terms of progression for 216 TRACK-HD participants and 1773 REGISTRY participants, then a meta-analysis of these results was undertaken. Findings Longitudinal motor, cognitive, and imaging scores were correlated with each other in TRACK-HD participants, justifying use of a single, cross-domain measure of disease progression in both studies. The TRACK-HD and REGISTRY progression measures were correlated with each other (r=0·674), and with age at onset (TRACK-HD, r=0·315; REGISTRY, r=0·234). The meta-analysis of progression in TRACK-HD and REGISTRY gave a genome-wide significant signal (p=1·12 × 10−10) on chromosome 5 spanning three genes: MSH3, DHFR, and MTRNR2L2. The genes in this locus were associated with progression in TRACK-HD (MSH3 p=2·94 × 10−8 DHFR p=8·37 × 10−7 MTRNR2L2 p=2·15 × 10−9) and to a lesser extent in REGISTRY (MSH3 p=9·36 × 10−4 DHFR p=8·45 × 10−4 MTRNR2L2 p=1·20 × 10−3). The lead single nucleotide polymorphism (SNP) in TRACK-HD (rs557874766) was genome-wide significant in the meta-analysis (p=1·58 × 10−8), and encodes an aminoacid change (Pro67Ala) in MSH3. In TRACK-HD, each copy of the minor allele at this SNP was associated with a 0·4 units per year (95% CI 0·16–0·66) reduction in the rate of change of the Unified Huntington's Disease Rating Scale (UHDRS) Total Motor Score, and a reduction of 0·12 units per year (95% CI 0·06–0·18) in the rate of change of UHDRS Total Functional Capacity score. These associations remained significant after adjusting for age of onset. Interpretation The multidomain progression measure in TRACK-HD was associated with a functional variant that was genome-wide significant in our meta-analysis. The association in only 216 participants implies that the progression measure is a sensitive reflection of disease burden, that the effect size at this locus is large, or both. Knockout of Msh3 reduces somatic expansion in Huntington's disease mouse models, suggesting this mechanism as an area for future therapeutic investigation