Influenza A(H1N1)pdm09 Resistance and Cross-Decreased Susceptibility to Oseltamivir and Zanamivir Antiviral Drugs

Neuraminidase inhibitors (NAIs) oseltamivir and zanamivir are currently the only effective antiviral drugs available worldwide for the management of influenza. The potential development of resistance is continually threatening their use, rationalizing and highlighting the need for a close and sustained evaluation of virus susceptibility. This study aimed to analyze and characterize the phenotypic and genotypic NAIs susceptibility profiles of A(H1N1)pdm09 viruses circulating in Portugal from 2009 to 2010/2011. A total of 144 cases of A(H1N1)pdm09 virus infection from community and hospitalized patients were studied, including three suspected cases of clinical resistance to oseltamivir. Oseltamivir resistance was confirmed for two of the suspected cases. Neuraminidase (NA) H275Y resistant marker was found in viruses from both cases but for one it was only present in 26.2% of virus population, raising questions about the minimal percentage of resistant virus that should be considered relevant. Cross-decreased susceptibility to oseltamivir and zanamivir (2-4 IC50 fold-change) was detected on viruses from two potentially linked community patients from 2009. Both viruses harbored the NA I223V mutation. NA Y155H mutation was found in 18 statistical non-outlier viruses from 2009, having no impact on virus susceptibility. The mutations at NA N369K and V241I may have contributed to the significantly higher baseline IC50 value obtained to oseltamivir for 2010/2011 viruses, compared to viruses from the pandemic period. These results may contribute to a better understanding of the relationship between phenotype and genotype, which is currently challenging, and to the global assessment of A(H1N1)pdm09 virus susceptibility profile and baseline level to NAIs

Biossegurança e segurança do paciente: visão de professores e estudantes de enfermagem

Objective To identify the understanding of biosafety and patient safety from the perspective of nursing teachers and students in Brazil and Portugal. Methods This is a qualitative study involving 14 teachers and 44 students from 3 public educational institutions (2 in Brazil and 1 in Portugal). The study included students in their final year of high school as well as students enrolled in undergraduate and licensure courses because, by this stage of their studies, they had already covered topics related to biosafety and patient safety. It also included teachers of these subjects. Triangulation was used to collect data through interviews and observation. For organization and analysis, resources of the Atlas.ti 22 qualitative research software program were used in conjunction with the principles of thematic content analysis. Results It was evident in both countries that the teachers and students recognized the premises that involved biosafety and patient safety and that these should form part of nursing education in its transversality, emphasizing that biosafety and safety were interrelated in the prevention of adverse events. The importance of caring for oneself and others, the influence of the regulatory framework in guiding practice, and the existence of gaps in knowledge and practical application were all factors mentioned by the interviewees. Conclusion Biosafety and patient safety education and regulations, as well as the knowledge of teachers and students on these topics, affect safe practice and the quality of nursing care. Having a good understanding of these areas is therefore essential in health crises, especially for preventing infection, and it is important to raise awareness of the duty of safe health practices.info:eu-repo/semantics/publishedVersio

Usefulness of information and communication technologies : portuguese nurses' look

Objective: to identify nurses’ perception on the usefulness of information and communication technologies in their professional practice, as well as in communication among the multidisciplinary team. Method: this is a quantitative, descriptive study, of exploratory character, carried through with 3.451 nurses from 36 hospital institutions of Portugal. A questionnaire was used as a data collection instrument. In data analysis, using SPSS® resorted to descriptive statistics. Results: of the nine technologies under study, we found that regarding their usefulness in professional practice, nurses qualified as useful or very useful: Intranet (84.3%), email (79.5%), SClínico® (74.8%), Nursing Practice Support System (70.9%), Physician Support System (63.2%), newsletter (62.9), ALERT® (59.4%), Health Data Platform (42.8%) and SONHO® (31.8). Regarding its usefulness in communication among the multidisciplinary team, nurses qualified as useful or very useful: email (75.2%), Intranet (74.2%), SClínico (72.5%), Nursing Practice Support System (67.1%), Physician Support System (63.6%), ALERT® (58.9%), newsletter (57.2), Health Data Platform (40.1%) and SONHO® (29.4%). Conclusion: despite the usefulness of technologies presenting relevant percentages, it is pertinent to analyze why nurses’ perceived usefulness is superior to Intranet and email when compared with specific technologies of care data used in the hospital context.Objetivo: identificar a percepção dos enfermeiros sobre a utilidade das tecnologias de informação e comunicação na sua prática profissional, bem como na comunicação entre a equipe multidisciplinar. Método: estudo quantitativo, descritivo, de caráter exploratório, realizado com 3.451 enfermeiros, de 36 instituições hospitalares de Portugal Continental. Como instrumento de coleta de dados foi utilizado um questionário. Na análise dos dados, utilizando o SPSS®, recorreu-se à estatística descritiva. Resultados: das nove tecnologias em estudo constata-se que relativamente à sua utilidade na prática profissional, os enfermeiros qualificaram como útil ou muito útil a Intranet (84,3%), o Correio Eletrônico (79,5%), o SClínico® (74,8), o Sistema de Apoio à Prática de Enfermagem (70,9%), o Sistema de Apoio ao Médico (63,2%), o Boletim informativo (62,9), o ALERT® (59,4%), a Plataforma de Dados da Saúde (42,8%) e o SONHO® (31,8). No que se refere à sua utilidade no âmbito da comunicação entre a equipe multidisciplinar, os enfermeiros qualificaram como útil ou muito útil o Correio Eletrônico (75,2%), a Intranet (74,2%), o SClínico (72,5%), o Sistema de Apoio à Prática de Enfermagem (67,1%), o Sistema de Apoio ao Médico (63,6%), o ALERT® (58,9%), o Boletim informativo (57,2), a Plataforma de Dados da Saúde (40,1%) e o SONHO® (29,4%). Conclusão: apesar da utilidade das tecnologias apresentar percentuais relevantes, torna-se pertinente analisar o motivo pelo qual a percepção de utilidade dos enfermeiros é superior para a Intranet e para o Correio Eletrônico quando comparados com as tecnologias específicas de dados assistenciais utilizadas no contexto hospitalar.Objetivo: identificar la percepción de los enfermeros sobre la utilidad de las tecnologías de la información y la comunicación en su práctica profesional, así como en la comunicación entre el equipo multidisciplinario. Método: estudio cuantitativo, descriptivo, exploratorio, realizado con 3.451 enfermeros, de 36 instituciones hospitalarias de Portugal. Como instrumento de recolección de datos se utilizó un cuestionario. En el análisis de datos, usando el SPSS®, fue utilizado estadística descriptiva. Resultados: de las nueve tecnologías estudiadas, encontramos que en relación a su utilidad en la práctica profesional, los enfermeros describieron la Intranet (84,3%), el correo electrónico (79,5%), el SClínico® (74,8%), el Sistema de Apoyo a la Práctica de Enfermería (70,9%), el Sistema de Apoyo al Médico (63,2%), el boletín informativo (62,9), el ALERT® (59,4%), el Plataforma de Datos de Salud (42,8%) y el SONHO® (31,8). En cuanto a su utilidad en el contexto de comunicación entre el equipo multidisciplinar, los enfermeros calificaron el correo electrónico (75,2%), la Intranet (74,2%), el SClínico® (72,5%), el Sistema de Apoyo a la Práctica de Enfermería (67,1%), el Sistema de Apoyo al Médico (63,6%), el ALERT® (58,9%), el boletín informativo (57,2%), la Plataforma de Datos de Salud (40,1%) y el SONHO® (29,4%). Conclusión: a pesar de la utilidad de las tecnologías para presentar porcentajes relevantes, es pertinente analizar la razón por la cual la percepción de utilidad de las enfermeras es superior para la Intranet y para el Correo Electrónico cuando se compara con las tecnologías específicas de datos asistenciales utilizadas en el contexto hospitalario.info:eu-repo/semantics/publishedVersio

Superpulsed low-level laser therapy protects skeletal muscle of mdx mice against damage, inflammation and morphological changes delaying dystrophy progression.

Aim: To evaluate the effects of preventive treatment with low-level laser therapy (LLLT) on progression of dystrophy in mdx mice. Methods: Ten animals were randomly divided into 2 experimental groups treated with superpulsed LLLT (904 nm, 15 mW, 700 Hz, 1 J) or placebo-LLLT at one point overlying the tibialis anterior muscle (bilaterally) 5 times per week for 14 weeks (from 6th to 20th week of age). Morphological changes, creatine kinase (CK) activity and mRNA gene expression were assessed in animals at 20th week of age. Results: Animals treated with LLLT showed very few morphological changes in skeletal muscle, with less atrophy and fibrosis than animals treated with placebo-LLLT. CK was significantly lower (p = 0.0203) in animals treated with LLLT (864.70 U.l−1, SEM 226.10) than placebo (1708.00 U.l−1, SEM 184.60). mRNA gene expression of inflammatory markers was significantly decreased by treatment with LLLT (p<0.05): TNF-α (placebo-control = 0.51 µg/µl [SEM 0.12], - LLLT = 0.048 µg/µl [SEM 0.01]), IL-1β (placebo-control = 2.292 µg/µl [SEM 0.74], - LLLT = 0.12 µg/µl [SEM 0.03]), IL-6 (placebo-control = 3.946 µg/µl [SEM 0.98], - LLLT = 0.854 µg/µl [SEM 0.33]), IL-10 (placebo-control = 1.116 µg/µl [SEM 0.22], - LLLT = 0.352 µg/µl [SEM 0.15]), and COX-2 (placebo-control = 4.984 µg/µl [SEM 1.18], LLLT = 1.470 µg/µl [SEM 0.73]). Conclusion: Irradiation of superpulsed LLLT on successive days five times per week for 14 weeks decreased morphological changes, skeletal muscle damage and inflammation in mdx mice. This indicates that LLLT has potential to decrease progression of Duchenne muscular dystrophy

First two unrelated cases of isolated sedoheptulokinase deficiency: A benign disorder?

We present the first two reported unrelated patients with an isolated sedoheptulokinase (SHPK) deficiency. The first patient presented with neonatal cholestasis, hypoglycemia, and anemia, while the second patient presented with congenital arthrogryposis multiplex, multiple contractures, and dysmorphisms. Both patients had elevated excretion of erythritol and sedoheptulose, and each had a homozygous nonsense mutation in SHPK. SHPK is an enzyme that phosphorylates sedoheptulose to sedoheptulose-7-phosphate, which is an important intermediate of the pentose phosphate pathway. It is questionable whether SHPK deficiency is a causal factor for the clinical phenotypes of our patients. This study illustrates the necessity of extensive functional and clinical workup for interpreting a novel variant, including nonsense variants

Protocol for a scoping review of skin self-care of people with spinal cord injury

In recent years, increasing methodological references have been used in scientific research; these are points of support in the search for evidence, formulation and elaboration of instruments, scales, guideline and protocols. However, significant variability currently exists in scoping review conduct and reporting, thus limiting the potential of the methodology to advance research and practice about skin self-care of people with spinal cord injury (SCI). Our objective was to perform a scoping review protocol within the health rehabilitation context of people with SCI, focusing on skin self-care.info:eu-repo/semantics/publishedVersio

Lusophone community in the digital age: the ambiguous place of scepticism and performance

(Excerto) "This article addresses the setting up of the political Community of the Portuguese Language Countries (Comunidade dos Países de Língua Portuguesa (CPLP)) and its present-day social and cultural dynamics. As the other articles in this Special Section from Martins, Salgado and Santos also demonstrate, media and communication systems are playing a role in the development of this loose aggregation and in the internal dynamics of the Portuguese language countries."(undefined)info:eu-repo/semantics/publishedVersio

Sialic Acid Glycobiology Unveils Trypanosoma cruzi Trypomastigote Membrane Physiology.

Trypanosoma cruzi, the flagellate protozoan agent of Chagas disease or American trypanosomiasis, is unable to synthesize sialic acids de novo. Mucins and trans-sialidase (TS) are substrate and enzyme, respectively, of the glycobiological system that scavenges sialic acid from the host in a crucial interplay for T. cruzi life cycle. The acquisition of the sialyl residue allows the parasite to avoid lysis by serum factors and to interact with the host cell. A major drawback to studying the sialylation kinetics and turnover of the trypomastigote glycoconjugates is the difficulty to identify and follow the recently acquired sialyl residues. To tackle this issue, we followed an unnatural sugar approach as bioorthogonal chemical reporters, where the use of azidosialyl residues allowed identifying the acquired sugar. Advanced microscopy techniques, together with biochemical methods, were used to study the trypomastigote membrane from its glycobiological perspective. Main sialyl acceptors were identified as mucins by biochemical procedures and protein markers. Together with determining their shedding and turnover rates, we also report that several membrane proteins, including TS and its substrates, both glycosylphosphatidylinositol-anchored proteins, are separately distributed on parasite surface and contained in different and highly stable membrane microdomains. Notably, labeling for α(1,3)Galactosyl residues only partially colocalize with sialylated mucins, indicating that two species of glycosylated mucins do exist, which are segregated at the parasite surface. Moreover, sialylated mucins were included in lipid-raft-domains, whereas TS molecules are not. The location of the surface-anchored TS resulted too far off as to be capable to sialylate mucins, a role played by the shed TS instead. Phosphatidylinositol-phospholipase-C activity is actually not present in trypomastigotes. Therefore, shedding of TS occurs via microvesicles instead of as a fully soluble form