Musculoskeletal injuries among operating room nurses: results from a multicenter survey in Rome, Italy

Aim: Chronic disorders of the musculoskeletal system, particularly low back pain (LBP), are increasing and represent a social and economic problem of growing importance, especially if correlated with working conditions. Health care workers are at higher risk of developing LBP during work shifts in the hospital. The aim of this study was to assess the prevalence of LBP among operating room nurses and to investigate the risk factors for musculoskeletal injuries in the operating room. Methods: We carried out a cross-sectional study that included operating room nurses from nine hospitals. Information on sociodemographic characteristics, lifestyle habits, working activity and psychological attitude of nurses was collected using an anonymous self-administered structured questionnaire. We evaluated the association of frequency, localization and intensity of LBP (FLI) with qualitative variables, making use of univariate analysis, chi-square test and Fisher's exact test. Multiple logistic regression analysis was performed to identify the variables that affected the FLI. The covariates included in the model were the variables that had a p 35 years vs. age <35 (OR = 2.68; 95% CI = 1.17–6.18) and diurnal work shift vs. diurnal/ nocturnal (OR = 4.00; 95% CI = 1.72–9.0) represent risk factors associated with FLI, while physical activity is a protective factor (OR = 0.47; 95% CI = 0.20–1.08). Conclusion: The data suggest that it is important to promote new programs of prevention based on professional training and physical activity among nurses and to improve the organization of work shifts in the hospital

Neutralizing antibodies to Omicron after the fourth SARS-CoV-2 mRNA vaccine dose in immunocompromised patients highlight the need of additional boosters

IntroductionImmunocompromised patients have been shown to have an impaired immune response to COVID-19 vaccines.MethodsHere we compared the B-cell, T-cell and neutralizing antibody response to WT and Omicron BA.2 SARS-CoV-2 virus after the fourth dose of mRNA COVID-19 vaccines in patients with hematological malignancies (HM, n=71), solid tumors (ST, n=39) and immune-rheumatological (IR, n=25) diseases. The humoral and T-cell responses to SARS-CoV-2 vaccination were analyzed by quantifying the anti-RBD antibodies, their neutralization activity and the IFN-γ released after spike specific stimulation.ResultsWe show that the T-cell response is similarly boosted by the fourth dose across the different subgroups, while the antibody response is improved only in patients not receiving B-cell targeted therapies, independent on the pathology. However, 9% of patients with anti-RBD antibodies did not have neutralizing antibodies to either virus variants, while an additional 5.7% did not have neutralizing antibodies to Omicron BA.2, making these patients particularly vulnerable to SARS-CoV-2 infection. The increment of neutralizing antibodies was very similar towards Omicron BA.2 and WT virus after the third or fourth dose of vaccine, suggesting that there is no preferential skewing towards either virus variant with the booster dose. The only limited step is the amount of antibodies that are elicited after vaccination, thus increasing the probability of developing neutralizing antibodies to both variants of virus.DiscussionThese data support the recommendation of additional booster doses in frail patients to enhance the development of a B-cell response directed against Omicron and/or to enhance the T-cell response in patients treated with anti-CD20

Isolation and biochemical characterization of components from Tityus serrulatus venom with action on the complement system

Este trabalho relata o isolamento e caracterização bioquímica parcial de componentes do veneno de Tityus serrulatus (VTs) com ação sobre o sistema complemento (SC). O procedimento de purificação envolveu uma cromatografia de troca iônica do VTs em CM-celulose-52, em pH 7,8 e doze frações foram obtidas, denominadas de I a XIII. A fração I, que apresenta atividade sobre o SC sérico, foi filtrada em Sephacryl S-200 e dez subfrações foram obtidas e denominadas I-1 a I-10. A subfração I-1 foi recromatografada em uma coluna de DEAE-Sepharose, em pH 7,8. Cinco subfrações foram obtidas (DE-1 a DE-5) e as subfrações DE-2, DE-3 e DE-4 incubadas com soro humano normal (SHN) induziram redução da atividade lítica da via clássica/lectina (VC/L) de forma concentração-dependente. A subfração DE-2 apresentou uma banda eletroforética única no gel de eletroforese de poliacrilamida com SDS (SDS-PAGE), com peso molecular (PM) de aproximadamente 247.000 na ausência de b-mercaptoetanol e seis bandas na presença de b-mercaptoetanol. O procedimento de purificação dos componentes ativos da subfração I-4 envolveu basicamente uma cromatografia de troca iônica em Mono-Q, em pH 7,1. Sete subfrações (MQ-1 a MQ-7) foram obtidas neste passo cromatográfico. As proteínas MQ-5 e MQ-7 da subfração I-4 induziram redução da atividade hemolítica das VC/L e via alternativa (VA). Com o objetivo de investigar o mecanismo de ação sobre o SC, SHN foi incubado com a subfração I-4 ou seus componentes (MQ-5 e MQ-7). A imunoeletroforese mostrou a clivagem do fator B e de C3 por estas proteínas, similar ao induzido pela incubação de SHN com zimosan, o que confirma a hipótese de que MQ-5 e MQ-7 induzem a ativação do SC. A capacidade de gerar fatores quimiotáticos no soro foi investigada. Nas condições experimentais, a incubação de SHN com a subfração I-4, proteínas MQ-5 e MQ-7 induziu a migração de neutrófilos similar a induzida pela incubação de soro com zimosan, demonstrando que estas proteínas induzem clivagem de C3 e C5, gerando os fragmentos ativos de C3a e C5a. As proteínas MQ-5 e MQ-7 não foram capazes de lisar eritrócitos de coelho e carneiro. MQ-5 e MQ-7 não induziram redução da atividade hemolítica da VC/L após o aquecimento a 100ºC, portanto a ação destas proteínas não é conseqüência da presença de produtos bacterianos, como lipopolissacarídeos (LPS). As proteínas MQ-5 e MQ-7 apresentaram atividade fibrinogenolítica e caseinolítica e são metaloproteases, já que a atividade fibrinogenolítica foi inibida por EDTA, EGTA e 1,10-fenantrolina. Ambas proteínas apresentaram uma banda eletroforética única por SDS-PAGE, com um PM aproximado de 24.500 na ausência de b-mercaptoetanol, 33.100 na presença de b-mercaptoetanol e um ponto isoelétrico de 4,2. A seqüência N-terminal (Degradação de Edman) e a seqüência de peptídeos trípticos (Espectrometria de massa ESI-MS/MS) de MQ-5 e MQ-7 foram determinadas. Ambas proteínas apresentaram seqüência similar de aminoácidos. Em resumo, este trabalho mostrou que o VTs contém proteases (MQ-5 e MQ-7, metaloproteases) que são capazes de ativar o SC e podem ser importantes no processo inflamatório que ocorre em conseqüência do envenenamento. Além disso, estas proteínas podem ser usadas para depledar o SC em modelos experimentais de doenças em que este sistema está envolvido.This work reports the isolation and partial biochemical characterization of components from Tityus serrulatus venom (TsV) with action on the complement system (CS). The purification procedure involved an ion-exchange chromatography of TsV on CM-celullose-52, at pH 7.8, twelve fractions were obtained and named I to XIII. Fraction I, showing activity on the serum CS, was filtered on Sephacryl S200 and ten subfractions were obtained and denominated I-1 to I-10. The subfraction I-1 was rechromatographed on a column of DEAE-sepharose, at pH 7.8. Five subfractions were obtained (DE-1 to DE-5) and subfractions DE-2, DE-3 and DE-4 incubated with NHS induced a concentration-dependent reduction in lytic activity of CP/L. Subfraction DE-2 showed a single electrophoretic band by SDS-PAGE, with a molecular weight (MW) of approximately 247,000 in the absence of -mercaptoethanol and six bands in the presence of -mercaptoethanol. The purification procedure of the active compounds of subfraction I-4 involved basically an ion-exchange chromatography on Mono-Q, at pH 7.1. Seven subfractions (MQ-1 to MQ-7) were obtained in this chromatography step. We found that proteins MQ-5 and MQ-7 of subfraction I-4 induced reduction in hemolytic activity for CP/L and AP. In order to investigate the mechanism of action on the CS, NHS was incubated with subfraction I-4 or its components (MQ-5 and MQ-7). The immunoelectrophoresis showed cleavage of factor B and C3 by these proteins, similar to that induced by incubation of NHS with zymosan, which corroborated the hypothesis that MQ-5 and MQ-7 induce activation of the CS. Their capacitiy to elicit serum-induced chemotaxis was then investigated. Under our assay conditions, incubation of NHS with subfraction I-4, protein MQ-5 and MQ-7 induced neutrophil migration similar to that induced by incubation of serum with zymosan, showing that the proteins induce cleavage of C3 and C5, thereby generating the active fragments C3a and C5a. Proteins MQ-5 and MQ-7 alone were unable to lyse rabbit or sheep erythrocytes. MQ-5 and MQ-7 did not induce reduction in hemolytic activity for CP/L after being heated to 100ºC, therefore the action of these proteins is not a consequence of the presence of bacterial products, such as lipopolyssaccharides (LPS). Proteins MQ-5 and MQ-7 showed fibrinogenolytic and caseinolytic activities and they probably are metalloproteases, since its fibrinogenolytic activity was inhibited by EDTA, EGTA and 1,10-phenantroline. Both MQ-5 and MQ-7 showed a single electrophoretic band by SDS-PAGE, with an approximate MW of 24,500 in the absence of -mercaptoethanol, 33,100 in the presence of -mercaptoethanol and an isoelectric point of 5.9. The N-terminal sequence (Edman Degradation) and the sequence of tryptic peptides (Mass spectrometry- ESI-MS/MS) from MQ-5 e MQ-7 were determined. The proteins MQ-5 e MQ-7 showed similar sequence of aminoacids. In summary, this work showed that the TsV venom contains proteases (MQ-5 and MQ-7, metalloproteases) which are able to activate the CS, and may therefore be important in the context of the inflammatory process occurring in consequence of envenomation. In addition these proteins may be used to deplete complement in experimental models of diseases involving participation of this system

Maternal protein restriction during pregnancy affects gene expression and immunolocalization of intestinal nutrient transporters in rats

Abstract Intrauterine dietary restriction may cause changes in the functioning of offspring organs and systems later in life, an effect known as fetal programming. The present study evaluated mRNA abundance and immunolocalization of nutrient transporters as well as enterocytes proliferation in the proximal, median and distal segments of small intestine of rats born to protein-restricted dams. Pregnant rats were fed hypoproteic (6 % protein) or control (17 % protein) diets, and offspring rats were evaluated at 3 and 16 weeks of age. The presence of SGLT1 (sodium-glucose co-transporter 1), GLUT2 (glucose transporter 2), PEPT1 (peptide transporter 1) and the intestinal proliferation were evaluated by immunohistochemical techniques and the abundance of specific mRNA for SGLT1, GLUT2 and PEPT1 was assessed by the real-time PCR technique. Rats born to protein-restricted dams showed higher cell proliferation in all intestinal segments and higher gene expression of SGLT1 and PEPT1 in the duodenum. Moreover, in adult animals born to protein-restricted dams the immunoreactivity of SGLT1, GLUT2 and PEPT1in the duodenum was more intense than in control rats. Taken together, the results indicate that changes in the small intestine observed in adulthood can be programmed during the gestation. In addition, they show that this response is caused by both up-regulation in transporter gene expression, a specific adaptation mechanism, and intestinal proliferation, an unspecific adaptation mechanism

Maternal protein restriction during pregnancy affects gene expression and immunolocalization of intestinal nutrient transporters in rats

Intrauterine dietary restriction may cause changes in the functioning of offspring organs and systems later in life, an effect known as fetal programming. The present study evaluated mRNA abundance and immunolocalization of nutrient transporters as well as enterocytes proliferation in the proximal, median and distal segments of small intestine of rats born to protein-restricted dams. Pregnant rats were fed hypoproteic (6% protein) or control (17% protein) diets, and offspring rats were evaluated at 3 and 16 weeks of age. The presence of SGLT1 (sodium-glucose co-transporter 1), GLUT2 (glucose transporter 2), PEPT1 (peptide transporter 1) and the intestinal proliferation were evaluated by immunohistochemical techniques and the abundance of specific mRNA for SGLT1, GLUT2 and PEPT1 was assessed by the real-time PCR technique. Rats born to protein-restricted dams showed higher cell proliferation in all intestinal segments and higher gene expression of SGLT1 and PEPT1 in the duodenum. Moreover, in adult animals born to protein-restricted dams the immunoreactivity of SGLT1, GLUT2 and PEPT1in the duodenum was more intense than in control rats. Taken together, the results indicate that changes in the small intestine observed in adulthood can be programmed during the gestation. In addition, they show that this response is caused by both up-regulation in transporter gene expression, a specific adaptation mechanism, and intestinal proliferation, an unspecific adaptation mechanism