Os benefícios do ômega 3 no tratamento de crianças portadoras do transtorno do espectro do autismo / The benefits of omega 3 in the treatment of children with autism spectrum disorder

Introdução: O Transtorno do Espectro Autista (TEA) é uma condição neurológica e comportamental que o indivíduo apresenta nos primeiros anos de vida. As causas do autismo podem ser divididas em idiopática (90%-95%) dos casos e secundária incluindo fatores ambientais, anormalidades cromossômicas e doenças monogênicas. Por meio de interações físicas, neuronais, sensoriais, imunológicas endócrinas e parácrinas via peptídeos entéricos, há uma relação complexa e bidirecional entre o      sistema nervoso central e o trato gastrointestinal, ou seja, afecções e alterações psíquicas podem interferir em processos digestivos interligados ao eixo intestino e cérebro como no autismo. Dessa forma, o presente estudo objetiva analisar a interação do eixo intestino e cérebro e a intervenção nutricional por meio da suplementação do ômega 3 como terapia nutricional da patologia. A pesquisa foi realizada através de revisões bibliográficas embasadas na literatura, realizando uma busca eletrônica em plataformas virtuais ScieELO, Google Scholar, Pubmed, livros e revistas já publicados. Conclui-se que pacientes com TEA apresentam uma demanda maior de alguns nutrientes tendo em vista sua disfunção mitocondrial, intestinal e imunológica. Contudo, normalmente as deficiências nutricionais mais comuns em TEA são de ômega-3, vitaminas do complexo B, minerais e aminoácidos, que são essenciais na formação de neurotransmissores e responsáveis por trazer equilíbrio no sistema nervoso central. A suplementação de ácidos graxos ômega 3 pode melhorar hiperatividade, letargia e estereotipia em crianças com distúrbios do espectro do autismo além ser um ótimo probiótico regulador do intestino e consequentemente do cérebro por possuir níveis DHA associados a manutenção do campo cognitivo. 

O enfermeiro e os cuidados paliativos proporcionados ao idoso terminal internado em UTI / Nursery and palliative care provided to the old injured terminal in UTI

O presente estudo observou através de revisão bibliográfica os cuidados paliativos em idoso terminal internado em UTI. O cuidado paliativo tem por objetivo promover a qualidade de vida de pacientes e familiares, que enfrentam doenças que ameacem a continuidade da vida, ajustando a prevenção e o alivio do sofrimento. Atualmente enfrentamos um momento de baixa na natalidade tendo por uma das consequências um crescente número de pessoas com mais de 60 anos. Esse envelhecimento não tem se dado necessariamente pela a melhora da qualidade de vida e da saúde e sim por meio da intensa luta em descobrir a cura de patologias que atingem essa idade outro fator é aceitar a morte cada vez menos. Usuários de cuidados paliativos são acompanhados por uma equipe interdisciplinar sendo que o profissional da saúde que tem maior contato com esses pacientes e seus familiares. Os enfermeiros devem apresentar um atendimento humanizado ao seu paciente, onde precisa respeita-lo e oferecer apoio a ele e aos seus familiares, usando como estratégia a Sistematização de Assistência de Enfermagem, levantando os diagnósticos, elaborando o planejamento, implementando os cuidados e avaliando os resultados, pois o que se busca é um fim de vida tranquilo e digno para o enfermo.

Antiretroviral drugs saquinavir and ritonavir reduce inhibitory concentration values of itraconazole against Histoplasma capsulatum strains in vitro

Recent studies have shown that some drugs that are not routinely used to treat fungal infections have antifungal activity, such as protease inhibitor antiretroviral drugs. This study investigated the in vitro susceptibility of Histoplasma capsulatum var. capsulatum to saquinavir and ritonavir, and its combination with the antifungal itraconazole. The susceptibility assay was performed according to Clinical and Laboratory Standards Institute guidelines. All strains were inhibited by the protease inhibitor antiretroviral drugs. Saquinavir showed minimum inhibitory concentrations ranging from 0.125 to 1 mu g mL(-1) for both phases, and ritonavir presented minimum inhibitory concentrations ranging from 0.0312 to 4 mu g mL(-1) and from 0.0625 to 1 mu g mL(-1) for filamentous and yeast phase, respectively. Concerning the anti fungal itraconazole, the minimum inhibitory concentration values ranged from 0.0019 to 0.125 mu g mL(-1) and from 0.0039 to 0.0312 mu g mL(-1) for the filamentous and yeast phase, respectively. The combination of saquinavir or ritonavir with itraconazole was synergistic against H. capsulatum, with a significant reduction in the minimum inhibitory concentrations of both drugs against the strains (p < 0.05). These data show an important in vitro synergy between protease inhibitors and itraconazole against the fungus H. capsulatum. (C) 2016 Published by Elsevier Editora Ltda.CNPqCAPESUniv Fed Ceara, Postgrad Program Med Microbiol, Specialized Med Mycol Ctr, Fortaleza, CE, BrazilUniv Fed Ceara, Postgrad Program Med Sci, Fortaleza, CE, BrazilUniv Estadual Ceara UECE, Postgrad Program Vet Sci, Fortaleza, CE, BrazilUniv Fed Ceara, Dept Stat & Appl Math, Fortaleza, CE, BrazilUniv Fed Sao Paulo UNIFESP, Dept Microbiol Immunol & Parasitol, Sao Paulo, SP, BrazilHosp Sao Jose, Fortaleza, CE, BrazilUniv Fed Sao Paulo UNIFESP, Dept Microbiol Immunol & Parasitol, Sao Paulo, SP, BrazilCNPq: 303396/2014-8CNPq: 552161/2011-0CAPES: AE1 - 0052-000630100/11Web of Scienc

Rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART): Study protocol for a randomized controlled trial

Background: Acute respiratory distress syndrome (ARDS) is associated with high in-hospital mortality. Alveolar recruitment followed by ventilation at optimal titrated PEEP may reduce ventilator-induced lung injury and improve oxygenation in patients with ARDS, but the effects on mortality and other clinical outcomes remain unknown. This article reports the rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART). Methods/Design: ART is a pragmatic, multicenter, randomized (concealed), controlled trial, which aims to determine if maximum stepwise alveolar recruitment associated with PEEP titration is able to increase 28-day survival in patients with ARDS compared to conventional treatment (ARDSNet strategy). We will enroll adult patients with ARDS of less than 72 h duration. The intervention group will receive an alveolar recruitment maneuver, with stepwise increases of PEEP achieving 45 cmH(2)O and peak pressure of 60 cmH2O, followed by ventilation with optimal PEEP titrated according to the static compliance of the respiratory system. In the control group, mechanical ventilation will follow a conventional protocol (ARDSNet). In both groups, we will use controlled volume mode with low tidal volumes (4 to 6 mL/kg of predicted body weight) and targeting plateau pressure &lt;= 30 cmH2O. The primary outcome is 28-day survival, and the secondary outcomes are: length of ICU stay; length of hospital stay; pneumothorax requiring chest tube during first 7 days; barotrauma during first 7 days; mechanical ventilation-free days from days 1 to 28; ICU, in-hospital, and 6-month survival. ART is an event-guided trial planned to last until 520 events (deaths within 28 days) are observed. These events allow detection of a hazard ratio of 0.75, with 90% power and two-tailed type I error of 5%. All analysis will follow the intention-to-treat principle. Discussion: If the ART strategy with maximum recruitment and PEEP titration improves 28-day survival, this will represent a notable advance to the care of ARDS patients. Conversely, if the ART strategy is similar or inferior to the current evidence-based strategy (ARDSNet), this should also change current practice as many institutions routinely employ recruitment maneuvers and set PEEP levels according to some titration method.Hospital do Coracao (HCor) as part of the Program 'Hospitais de Excelencia a Servico do SUS (PROADI-SUS)'Brazilian Ministry of Healt

COVID-19 symptoms at hospital admission vary with age and sex: results from the ISARIC prospective multinational observational study

Background: The ISARIC prospective multinational observational study is the largest cohort of hospitalized patients with COVID-19. We present relationships of age, sex, and nationality to presenting symptoms. Methods: International, prospective observational study of 60 109 hospitalized symptomatic patients with laboratory-confirmed COVID-19 recruited from 43 countries between 30 January and 3 August 2020. Logistic regression was performed to evaluate relationships of age and sex to published COVID-19 case definitions and the most commonly reported symptoms. Results: ‘Typical’ symptoms of fever (69%), cough (68%) and shortness of breath (66%) were the most commonly reported. 92% of patients experienced at least one of these. Prevalence of typical symptoms was greatest in 30- to 60-year-olds (respectively 80, 79, 69%; at least one 95%). They were reported less frequently in children (≤ 18 years: 69, 48, 23; 85%), older adults (≥ 70 years: 61, 62, 65; 90%), and women (66, 66, 64; 90%; vs. men 71, 70, 67; 93%, each P &lt; 0.001). The most common atypical presentations under 60 years of age were nausea and vomiting and abdominal pain, and over 60 years was confusion. Regression models showed significant differences in symptoms with sex, age and country. Interpretation: This international collaboration has allowed us to report reliable symptom data from the largest cohort of patients admitted to hospital with COVID-19. Adults over 60 and children admitted to hospital with COVID-19 are less likely to present with typical symptoms. Nausea and vomiting are common atypical presentations under 30 years. Confusion is a frequent atypical presentation of COVID-19 in adults over 60 years. Women are less likely to experience typical symptoms than men

T-cell-predominant lymphoid hyperplasia in a tattoo.

Submitted by Ana Maria Fiscina Sampaio ([email protected]) on 2014-12-11T16:37:25Z No. of bitstreams: 1 Souza ES T cell predominant....pdf: 275259 bytes, checksum: f846d66508c1966d9fd702a7b36fc6ac (MD5)Approved for entry into archive by Ana Maria Fiscina Sampaio ([email protected]) on 2014-12-11T16:37:34Z (GMT) No. of bitstreams: 1 Souza ES T cell predominant....pdf: 275259 bytes, checksum: f846d66508c1966d9fd702a7b36fc6ac (MD5)Made available in DSpace on 2014-12-11T16:46:19Z (GMT). No. of bitstreams: 1 Souza ES T cell predominant....pdf: 275259 bytes, checksum: f846d66508c1966d9fd702a7b36fc6ac (MD5) Previous issue date: 2014Private clinic. Salvador, BA, BrasilUniversidade Federal da Bahia. Salvador, BA, Brasil / University of Toronto. UofT. Toronto, ON, CanadaFundação Oswaldo Cruz. Centro de Pesquisas Gonçalo Moniz. Salvador, BA, BrasilUniversidade Federal da Bahia. Salvador, BA, BrasilFundação Oswaldo Cruz. Centro de Pesquisas Gonçalo Moniz. Salvador, BA, BrasilConselho Nacional de Desenvolvimento Científico e Tecnológico. CNPq. Brasília, DF, BrasilCutaneous lymphoid hyperplasia (CLH) can be idiopathic or secondary to external stimuli, and is considered rare in tattoos. The infiltrate can be predominantly of B or T-cells, the latter being seldom reported in tattoos. We present a case of a predominantly T CLH, secondary to the black pigment of tattooing in a 35-year-old patient, with a dense infiltrate of small, medium and scarce large T-cells. Analysis of the rearrangement of T-cells receptor revealed a polyclonal proliferation. Since the infiltrate of CLH can simulate a T lymphoma, it is important to show that lesions from tattoos can have a predominance of T-cells

Maternal schistosomiasis: IL-2, IL-10 and regulatory T lymphocytes to unrelated antigen in adult offspring mice

Submitted by Ana Beatriz Oliveira ([email protected]) on 2019-04-16T13:49:32Z No. of bitstreams: 1 Maternal schistosomias.pdf: 1018997 bytes, checksum: c1ec1c407e05afe150263743a6abdda8 (MD5)Approved for entry into archive by Ana Beatriz Oliveira ([email protected]) on 2019-04-16T14:19:17Z (GMT) No. of bitstreams: 1 Maternal schistosomias.pdf: 1018997 bytes, checksum: c1ec1c407e05afe150263743a6abdda8 (MD5)Made available in DSpace on 2019-04-16T14:19:17Z (GMT). No. of bitstreams: 1 Maternal schistosomias.pdf: 1018997 bytes, checksum: c1ec1c407e05afe150263743a6abdda8 (MD5) Previous issue date: 2018Universidade Federal de Pernambuco. Laboratório de Imunopatologia Keizo Asami. Recife, PE, Brasil.Fundação Oswaldo Cruz. Instituto Aggeu Magalhães. Laboratório de Imunologia. Recife, PE, Brasil.Universidade Federal de Pernambuco. Laboratório de Imunopatologia Keizo Asami. Recife, PE, Brasil.Universidade Federal de Pernambuco. Laboratório de Imunopatologia Keizo Asami. Recife, PE, Brasil / Universidade Federal de Pernambuco. Centro de Ciências da Saúde. Departamento de Medicina Tropical. Recife, PE, Brasil. ​Fundação Oswaldo Cruz. Instituto Aggeu Magalhães. Laboratório de Imunologia. Recife, PE, Brasil.Universidade Federal de Pernambuco. Laboratório de Imunopatologia Keizo Asami. Recife, PE, Brasil / Universidade Federal de Pernambuco. Centro de Ciências da Saúde. Departamento de Medicina Tropical. Recife, PE, Brasil. ​Universidade Federal de Pernambuco. Laboratório de Imunopatologia Keizo Asami. Recife, PE, Brasil / Universidade Federal de Pernambuco. Centro de Ciências da Saúde. Departamento de Ciências Farmacêuticas. Recife, PE, Brasil.INTRODUCTION: We evaluated IL-10, IL-2 and regulatory T cells (Treg), in response to ovalbumin (OA), in offspring from schistosomotic mouse mothers. METHODS: We used animals born (BIM) or suckled (SIM) from infected mothers; and mice born/suckled from infected (BSIM) or non-infected mothers (CONTROL). After OA+adjuvant immunization, spleen cells were cultured, with or without OA, and doubly marked for cytometry. RESULTS: BIM showed fewer CD4+/IL-2+ and more B220+/IL-10+ cells, whereas the SIM group showed increased Treg frequency. BSIM had fewer B220+/IL-10+ and Treg cells. CONCLUSIONS: Separately, gestation or nursing induced immunosuppressive cells in infected mothers, but improved anti-OA immunity when combined