relA enhances the adherence of enteropathogenic Escherichia coli

Enteropathogenic Escherichia coli (EPEC) is a known causative agent of diarrhea in children. In the process of colonization of the small intestine, EPEC synthesizes two types of adhesins, the bundle-forming pilus (BFP) and intimin. The BFP pilus is an adhesin associated with the initial stages of adherence of EPEC to epithelial cells, while the outer membrane protein intimin carries out the intimate adherence that takes place at the third stage of infection. BFP is encoded by the bfp operon located in plasmid EAF, present only in typical EPEC isolates, while eae, the gene that encodes intimin is situated in the LEE, a chromosomal pathogenicity island. Transcription of bfp and eae is regulated by the products of the perABC operon, also present in plasmid EAF. Here we show that deletion of relA, that encodes a guanosine penta and tetraphosphate synthetase impairs EPEC adherence to epithelial cells in vitro. In the absence of relA, the transcription of the regulatory operon perABC is reduced, resulting in lower levels of BFP and intimin. Bacterial adherence, BFP and intimin synthesis and perABC expression are restored upon complementation with the wild-type relA allele.Fundação de Amparo a Pesquisa do Estado de São Paulo (FAPESP)CNPqCAPE

Familial history and prevalence of BRCA1, BRCA2 and TP53 pathogenic variants in HBOC Brazilian patients from a public healthcare service

Cancer; Genetics; Risk factorsCáncer; Genética; Factores de riesgoCàncer; Genètica; Factors de riscSeveral studies have demonstrated the cost-effectiveness of genetic testing for surveillance and treatment of carriers of germline pathogenic variants associated with hereditary breast/ovarian cancer syndrome (HBOC). In Brazil, seventy percent of the population is assisted by the public Unified Health System (SUS), where genetic testing is still unavailable. And few studies were performed regarding the prevalence of HBOC pathogenic variants in this context. Here, we estimated the prevalence of germline pathogenic variants in BRCA1, BRCA2 and TP53 genes in Brazilian patients suspected of HBOC and referred to public healthcare service. Predictive power of risk prediction models for detecting mutation carriers was also evaluated. We found that 41 out of 257 tested patients (15.9%) were carriers of pathogenic variants in the analyzed genes. Most frequent pathogenic variant was the founder Brazilian mutation TP53 c.1010G > A (p.Arg337His), adding to the accumulated evidence that supports inclusion of TP53 in routine testing of Brazilian HBOC patients. Surprisingly, BRCA1 c.5266dupC (p.Gln1756fs), a frequently reported pathogenic variant in Brazilian HBOC patients, was not observed. Regarding the use of predictive models, we found that familial history of cancer might be used to improve selection or prioritization of patients for genetic testing, especially in a context of limited resources.We are very thankful to all patients and their families who participated in this study. We thank Eliana Abdelhay for providing the Ion AmpliSeq customized panel and funding the sequencing costs for this panel. And we also thank the Bioinformatics Core Facility (INCA-RJ), in special Dr. Nicole Scherer, for their support in this study. This work was supported by Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq, Brazil: project 304339/2018-0), Fundação Carlos Chagas Filho de Amparo à Pesquisa do Estado do Rio de Janeiro (FAPERJ, Brazil: projects 200.928/2021 and 211.309/2021), Fundação Ary Frauzino para Pesquisa e Controle do Câncer (Brazil), SWISS-BRIDGE Foundation, and Ministry of Health (Brazil)

ESTUDO COMPARATIVO DE BIOMATERIAIS TIPO XENOENXERTO E ENXERTO ALOPLÁSTICO PARA CIRURGIA RECONSTRUTIVA ALVEOLAR COM TÉCNICA DE SINUS LIFT COM JANELA LATERAL

The materials that we can use as grafting material can have different origins, which in turn conditions their different properties and behaviors. Depending on their ability to interact with the surrounding bone, they can be classified as bioinert or bioactive materials. Bioactive materials are capable of stimulating the formation of bone tissue, bonding directly to the bone, thus forming a strong and unique interface between bone and biomaterial. The graft material, on the other hand, must be biocompatible and resorbable to be integrated into the newly formed bone, which is structurally similar to bone, osteoconductive and, if possible, also osteoinductive and osteogenic. When we work on the bone regeneration process, we must also take its structure into account.Os materiais que podemos utilizar como material de enxerto podem ter origens diversas, o que por sua vez condiciona as suas diferentes propriedades e comportamentos. Dependendo da sua capacidade de interagir com o osso circundante, podem ser classificados como materiais bioinertes ou bioativos. Os materiais bioativos são capazes de estimular a formação de tecido ósseo, unindo-se diretamente ao osso, formando assim uma interface forte e única entre osso e biomaterial. O material de enxerto, por outro lado, deve ser biocompatível e reabsorvido para ser integrado ao osso neoformado, que é estruturalmente semelhante ao osso, osteocondutor e, se possível, também osteoindutor e osteogênico. Quando atuamos no processo de regeneração óssea devemos também levar em consideração a sua estrutura

A IMPORTÂNCIA DA IMPLEMENTAÇÃO DOS CUIDADOS PALIATIVOS NA UNIDADE DE TERAPIA INTENSIVA

To discuss the importance of implementing palliative care in the intensive care unit through the existing literature. Methods: This is a qualitative integrative literature review. The search for the works involved in the research was carried out in the following databases: SCIELO, LILACS, BDENF and MEDLINE, using the health sciences descriptors: "Hospice care", "Palliative care" and "Intensive care unit". The inclusion criteria were: published between 2013 and 2023, with free access to full texts, articles in Portuguese, English and Spanish and related to the theme. Exclusion criteria were: duplicate articles, incomplete articles, abstracts, reviews, debates, articles published in event proceedings and unavailable in full. Results: This care has some principles that guarantee its effectiveness when implemented in the ICU, such as promoting individual and continuous care for patients, involving family members in this process, respecting the autonomy of the patient, establishing an environment conducive to the necessary care, among others. Conclusion: The study in question concludes that the implementation of palliative care in the ICU, despite having numerous barriers, promotes a less painful dying process when applied correctly by health professionals, among these aspects, the participation of the family in this process is emphasized.Discutir por meio da literatura existente acerca da importância da implementação dos cuidados paliativos na unidade de terapia intensiva. Métodos: Trata-se de uma revisão integrativa da literatura de caráter qualitativo. A busca dos trabalhos envolvidos na pesquisa foi realizada nas seguintes bases de dados: SCIELO, LILACS, BDENF e MEDLINE, a partir dos descritores em ciências da saúde: “Assistência hospitalar”, “Cuidados paliativos” e “Unidade de terapia intensiva”. Os critérios de inclusão foram: publicados no período entre 2013 e 2023, cujo acesso ao periódico era livre aos textos completos, artigos em idioma português, inglês e espanhol e relacionados a temática. Critérios de exclusão foram: artigos duplicados, incompletos, resumos, resenhas, debates, artigos publicados em anais de eventos e indisponíveis na íntegra. Resultados: Esses cuidados possuem alguns princípios que garantem a sua efetividade na implementação na UTI como promover o cuidado individual e continuo aos pacientes, envolver os familiares nesse processo, respeitar a autonomia do enfermo, estabelecer um ambiente propício aos cuidados necessários dentre outros. Conclusão: O estudo em questão conclui que a implementação dos cuidados paliativos na UTI apesar de possui inúmeras barreiras ele promover um processo de morrer menos doloroso quando aplicado corretamente por meio dos profissionais de saúde, dentre esses aspectos enfatiza-se a participação da família nesse processo

The Family Health Support Core (NASF) And Health Practices: Are There Many Challenges To Be Overcome?

Objective: Describe and characterize NASF health practices. Method: It is a review of current literature carried out by consulting the database Lilacs and Virtual Library of SciELO in the period from December 2016 to January 2017. Conclusion: It is concluded that, although the NASF is recognized as a support to the Family Health Strategy (FHS), still does not act in an articulated way, being fundamental that changes take place in the organization of the services and in the conduct of the health professionals who contemplate it. Descriptors: Primary Health Care. Family Health; Public Health Policies. Nursing

Difficulties Found By Persons Living With Diabetes Mellitus: A Quantitative Analysis

Goal: to know the main difficulties faced by DM patients, characterizing the socioeconomic situation of the interviewees, identifying the type of care received by DM patients. Method: It was a research of the descriptive exploratory type with quantitative approach that was carried out in the Basic Health Care of the city of Camutanga/PE. The population was formed by one hundred (100) diabetic patients enrolled at the FHS of said municipality, the sample will be formed by one hundred (100) of diabetics from UBS Mini Posto. The instrument for data collection was a form. The data collection took place in September and October 2016 after approval by the Research Ethics Committee of the Faculdade de Enfermagem Nova Esperança (FACENE). CAAE: 59111616.1.0000.517 Results and Discussion: the data obtained in the research show that 65% of the study participants are between the age group over 65 years; 67% have primary education; 53% are retired; 62% reported receiving a minimum wage. About the data related to the issue 31% report that they have diabetes between 05 to 10 years; 79% prevail with type 2; 100% make use of medication; 43% use glibenclamide and metformin. Conclusion: in view of the foregoing, it is concluded that this municipality presents several positive points in caring for the patients, but there are still gaps to provide adequate care to the carriers.              Descriptors: Diabetes Mellitus. Primary Health Care. Nursing

Worldwide trends in underweight and obesity from 1990 to 2022: a pooled analysis of 3663 population-representative studies with 222 million children, adolescents, and adults

Background Underweight and obesity are associated with adverse health outcomes throughout the life course. We estimated the individual and combined prevalence of underweight or thinness and obesity, and their changes, from 1990 to 2022 for adults and school-aged children and adolescents in 200 countries and territories. Methods We used data from 3663 population-based studies with 222 million participants that measured height and weight in representative samples of the general population. We used a Bayesian hierarchical model to estimate trends in the prevalence of different BMI categories, separately for adults (age ≥20 years) and school-aged children and adolescents (age 5–19 years), from 1990 to 2022 for 200 countries and territories. For adults, we report the individual and combined prevalence of underweight (BMI <18·5 kg/m2) and obesity (BMI ≥30 kg/m2). For schoolaged children and adolescents, we report thinness (BMI <2 SD below the median of the WHO growth reference) and obesity (BMI >2 SD above the median). Findings From 1990 to 2022, the combined prevalence of underweight and obesity in adults decreased in 11 countries (6%) for women and 17 (9%) for men with a posterior probability of at least 0·80 that the observed changes were true decreases. The combined prevalence increased in 162 countries (81%) for women and 140 countries (70%) for men with a posterior probability of at least 0·80. In 2022, the combined prevalence of underweight and obesity was highest in island nations in the Caribbean and Polynesia and Micronesia, and countries in the Middle East and north Africa. Obesity prevalence was higher than underweight with posterior probability of at least 0·80 in 177 countries (89%) for women and 145 (73%) for men in 2022, whereas the converse was true in 16 countries (8%) for women, and 39 (20%) for men. From 1990 to 2022, the combined prevalence of thinness and obesity decreased among girls in five countries (3%) and among boys in 15 countries (8%) with a posterior probability of at least 0·80, and increased among girls in 140 countries (70%) and boys in 137 countries (69%) with a posterior probability of at least 0·80. The countries with highest combined prevalence of thinness and obesity in school-aged children and adolescents in 2022 were in Polynesia and Micronesia and the Caribbean for both sexes, and Chile and Qatar for boys. Combined prevalence was also high in some countries in south Asia, such as India and Pakistan, where thinness remained prevalent despite having declined. In 2022, obesity in school-aged children and adolescents was more prevalent than thinness with a posterior probability of at least 0·80 among girls in 133 countries (67%) and boys in 125 countries (63%), whereas the converse was true in 35 countries (18%) and 42 countries (21%), respectively. In almost all countries for both adults and school-aged children and adolescents, the increases in double burden were driven by increases in obesity, and decreases in double burden by declining underweight or thinness. Interpretation The combined burden of underweight and obesity has increased in most countries, driven by an increase in obesity, while underweight and thinness remain prevalent in south Asia and parts of Africa. A healthy nutrition transition that enhances access to nutritious foods is needed to address the remaining burden of underweight while curbing and reversing the increase in obesit