DIAGNÓSTICOS DE ENFERMAGEM ENTRE USUÁRIOS DE ANTICOAGULANTE ORAL ACOMPANHADOS EM AMBULATÓRIO

Objetivo: identificar o perfil sociodemográfico e clínico, bem como principais diagnósticos de enfermagem entre usuários de anticoagulantes de uso oral acompanhados em ambulatório. Método: pesquisa descritiva, transversal de abordagem quantitativa. Realizada com 128 usuários elegíveis acompanhados em ambulatório de hospital universitário público do Paraná, Brasil. Foram coletadas, em consulta de enfermagem e fonte documental, variáveis sociodemográficas e clínicas, bem como identificados diagnósticos de enfermagem segundo taxonomia da NANDAInternational. Resultados: a amostra foi predominantemente idosa; casada; de baixa escolaridade; com indicação de anticoagulação oral por fibrilação atrial e trombose venosa profunda; com adequado tempo médio de coagulação, expresso pela Razão Normalizada Internacional. Os cinco diagnósticos de enfermagem elencados pertenciam às classes de respostas cardiovasculares/pulmonares; infecção; ingestão; e controle da saúde. Conclusão: os diagnósticos de enfermagem identificados coadunam-se ao perfil clínico dos usuários de anticoagulantes de uso oral acompanhados em ambulatório, o que reflete um cenário mais focado nas questões orgânico-funcionais, ainda que a necessidade de melhor controle da própria saúde e de domínio da promoção de saúde tenham emergido em menor proporção.Descritores: Diagnóstico de enfermagem. Anticoagulantes. Ambulatório hospitalar. Processos de enfermagem

CARACTERIZAÇÃO SOCIODEMOGRÁFICA E CLÍNICA EPIDEMIOLÓGICA DAS MENINGITES EM UM HOSPITAL DE ENSINO NO PARANÁ

Objective: to carry out a sociodemographic and clinical epidemiological characterization of patients notified of meningitis in SINAN admitted to a teaching hospital in the western region of Paraná in the period 2017-2019. Materials and Methods: this is a quantitative, retrospective, descriptive cross-sectional study carried out through the notifiable diseases information system (SINAN) of patients admitted to a teaching hospital in the western region of Paraná, from January 1, 2017, to December 31, 2019. Results: in the study, 225 notifications of meningitis to SINAN were identified, predominantly from male patients, younger than one year old, of the Caucasian race. The most prevalent symptoms were fever, headache, and vomiting, with chemocytological confirmation criteria, higher notifications of aseptic meningitis, and final Evolution, with emphasis on hospital discharge. Conclusion: the study allowed us to aggregate information, bringing data from the last three years on meningitis in a teaching hospital, using data from the SINAN notification form as a secondary source. Furthermore, in is suggested the importance of intensifying actions and prevention and regarding the signs and symptoms, and improvement in filling out the notification forms reinforced by health professionals, through preventive actions.Objetivo: realizar uma caracterización deciodemográfica y clínico epidemiológica de los pacientes notificados de meningitis en el región occidental de Paraná en el período 2017-2019. Materiales y Métodos: se trata de um estúdio transversal cuantitativo, retrospectivo, desriptivo, realizado a través del sistema de información em salud de notificación obligatoria (SINAN) de pacientes ingressados em um hospital escuela de la región occidental de Paraná, del 1 de enero de 2017 al 31 diciembre de 2019. Resultados: em el estúdio fueran indetificadas 225 notificaciones de meningitis al SINAN, predominantemente de pacientes del sexo masculino, menores de um año, de raza caucásica. Los síntomas más prevalentes fueron: fiebre, cefalea y vómitos, com critérios de confirmatión quimiocitológica, mayor notificación de meningitis asséptica y evolución final, com énfasis em el alta hospitalaria. Conclusión: el studio permitió agregar información, trayendo datos de los últimos tres años sobre meningitis en un hospital universitário, utilizando como fuente secundaria los datos del formulario de notificacion del SINAN. Además, se sugiere la importância de intensificar las acciones y la prevención em cuanto a los signos y sintomas, y la mejora em el llenado de los formulários de notificatión reforzados por los profisionales de la salud, a través de acciones preventivas.Objetivo: realizar uma caracterização sociodemográfica e clínica epidemiológica de pacientes notificados por meningites no SINAN internados em hospital de ensino da região oeste do Paraná no período de 2017-2019. Materiais e Métodos: trata-se de um estudo quantitativo, retrospectivo, descritivo do tipo transversal realizado através do sistema de informações de agravos de notificação (SINAN) de pacientes internados em um hospital de ensino da região oeste do Paraná, no período de 01 de janeiro de 2017 a 31 de dezembro de 2019. Resultados: no estudo foram identificadas 225 notificações por meningites ao SINAN, predominantemente de pacientes do sexo masculino, menores de um ano, da raça branca. Os sintomas mais prevalentes foram: febre, cefaleia e vômitos, com critério de confirmação quimiocitológico, maiores notificações de meningites assépticas, e evolução final, com destaque na alta hospitalar. Conclusão: o estudo permitiu agregar informações, trazendo dados dos últimos três anos sobre as meningites em um hospital de ensino, tendo como fonte secundária dados da ficha de notificação do SINAN. Além disso, sugerir a intensificação de ações e prevenção, acerca dos sinais e sintomas, e aprimoramento no preenchimento das fichas de notificação reforçado pelos profissionais da saúde, por meio de ações preventivas

The Polycomb Group Protein L3MBTL1 Represses a SMAD5-Mediated Hematopoietic Transcriptional Program in Human Pluripotent Stem Cells

SummaryEpigenetic regulation of key transcriptional programs is a critical mechanism that controls hematopoietic development, and, thus, aberrant expression patterns or mutations in epigenetic regulators occur frequently in hematologic malignancies. We demonstrate that the Polycomb protein L3MBTL1, which is monoallelically deleted in 20q- myeloid malignancies, represses the ability of stem cells to drive hematopoietic-specific transcriptional programs by regulating the expression of SMAD5 and impairing its recruitment to target regulatory regions. Indeed, knockdown of L3MBTL1 promotes the development of hematopoiesis and impairs neural cell fate in human pluripotent stem cells. We also found a role for L3MBTL1 in regulating SMAD5 target gene expression in mature hematopoietic cell populations, thereby affecting erythroid differentiation. Taken together, we have identified epigenetic priming of hematopoietic-specific transcriptional networks, which may assist in the development of therapeutic approaches for patients with anemia

Necessidades humanas básicas afetadas e diagnósticos de enfermagem da nanda-i para pacientes graves com covid-19

Objective: Identify Psychobiological Basic Human Needs and NANDA-I Nursing Diagnoses for patients with COVID-19 admitted to an intensive care unit. Method: descriptive, documentary, cross-sectional and quantitative study, carried out in an intensive care unit for patients diagnosed with COVID-19, using the patient’s electronic medical record as a data source. Descriptive statistics were used for data analysis, with absolute and relative frequency, mean and standard deviation being evaluated. Results: seven Psychobiological Basic Human Needs and 15 most frequent Nursing Diagnoses were identified. Conclusion: the use of the Systematization of Nursing Care and the operationalization of the Nursing Process helps in the individualized planning of care aimed at critical patients with COVID-19 hospitalized in intensive care units. Identifying these needs contributes to the management of care and improves the quality of nursing care.Objetivo: Identificar as Necessidades Humanas Básicas Psicobiológicas e os Diagnósticos de Enfermagem da NANDA-I para pacientes com covid-19 internados em unidade de terapia intensiva. Método: estudo descritivo, documental, transversal e quantitativo, realizado em uma unidade de terapia intensiva para pacientes com diagnóstico de covid-19, utilizando como fonte de dados o prontuário eletrônico do paciente. Para análise dos dados utilizou-se estatística descritiva, sendo avaliado frequência absoluta e relativa, média e desvio padrão. Resultados: foram identificadas sete Necessidades Humanas Básicas Psicobiológicas e 15 Diagnósticos de Enfermagem mais frequentes. Conclusão: o uso da Sistematização da Assistência de Enfermagem e a operacionalização do Processo de Enfermagem auxilia no planejamento individualizado do cuidado voltado à pacientes críticos com covid-19 internados em unidades de terapia intensiva. A identificação dessas necessidades contribui para o gerenciamento do cuidado e melhora a qualidade da assistência de enfermagem

Synergistic roles of climate warming and human occupation in Patagonian megafaunal extinctions during the Last Deglaciation

The causes of Late Pleistocene megafaunal extinctions (60,000 to 11,650 years ago, hereafter 60 to 11.65 ka) remain contentious, with major phases coinciding with both human arrival and climate change around the world. The Americas provide a unique opportunity to disentangle these factors as human colonization took place over a narrow time frame (~15 to 14.6 ka) but during contrasting temperature trends across each continent. Unfortunately, limited data sets in South America have so far precluded detailed comparison. We analyze genetic and radiocarbon data from 89 and 71 Patagonian megafaunal bones, respectively, more than doubling the high-quality Pleistocene megafaunal radiocarbon data sets from the region.We identify a narrowmegafaunal extinction phase 12,280 ± 110 years ago, some 1 to 3 thousand years after initial human presence in the area. Although humans arrived immediately prior to a cold phase, the Antarctic Cold Reversal stadial, megafaunal extinctions did not occur until the stadial finished and the subsequent warming phase commenced some 1 to 3 thousand years later. The increased resolution provided by the Patagonian material reveals that the sequence of climate and extinction events in North and South America were temporally inverted, but in both cases, megafaunal extinctions did not occur until human presence and climate warming coincided. Overall, metapopulation processes involving subpopulation connectivity on a continental scale appear to have been critical for megafaunal species survival of both climate change and human impacts.Fil: Metcalf, Jessica L.. University of Adelaide; Australia. State University of Colorado Boulder; Estados UnidosFil: Turney, Chris. University of New South Wales; AustraliaFil: Barnett, Ross. University of Oxford; Reino Unido. Universidad de Copenhagen; DinamarcaFil: Martin, Fabiana. Universidad de Magallanes. Instituto de la Patagonia. Centro de Estudios del Hombre Austral; ChileFil: Bray, Sarah C.. University of Adelaide; Australia. University of South Australia; AustraliaFil: Vilstrup, Julia T.. Universidad de Copenhagen; DinamarcaFil: Orlando, Ludovic. Universidad de Copenhagen; DinamarcaFil: Salas-Gismondi, Rodolfo. Université de Montpellier. Institut des Sciences de l’Evolution; Francia. Universidad Nacional Mayor de San Marcos; PerúFil: Loponte, Daniel Marcelo. Secretaría de Cultura de la Nación. Dirección Nacional de Cultura y Museos. Instituto Nacional de Antropología y Pensamiento Latinoamericano; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Medina, Matias Eduardo. Centro de Estudios Históricos ; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: de Nigris, Mariana Eleonor. Secretaría de Cultura de la Nación. Dirección Nacional de Cultura y Museos. Instituto Nacional de Antropología y Pensamiento Latinoamericano; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Civalero, Maria Teresa. Secretaría de Cultura de la Nación. Dirección Nacional de Cultura y Museos. Instituto Nacional de Antropología y Pensamiento Latinoamericano; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Fernández, Pablo Marcelo. Secretaría de Cultura de la Nación. Dirección Nacional de Cultura y Museos. Instituto Nacional de Antropología y Pensamiento Latinoamericano; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Gasco, Alejandra Valeria. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad Nacional de Cuyo. Facultad de Ciencias Exactas y Naturales. Laboratorio de Paleoecología Humana; ArgentinaFil: Duran, Victor Alberto. Universidad Nacional de Cuyo. Facultad de Ciencias Exactas y Naturales. Laboratorio de Paleoecología Humana; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Seymour, Kevin L.. Royal Ontario Museum. Department of Natural History; CanadáFil: Otaola, Clara. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Saavedra 15. Instituto Multidisciplinario de Historia y Ciencias Humanas; ArgentinaFil: Gil, Adolfo Fabian. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Mendoza. Instituto Argentino de Nivología, Glaciología y Ciencias Ambientales. Museo de Historia Natural de San Rafael - Ianigla | Provincia de Mendoza. Instituto Argentino de Nivología, Glaciología y Ciencias Ambientales. Museo de Historia Natural de San Rafael - Ianigla | Universidad Nacional de Cuyo. Instituto Argentino de Nivología, Glaciología y Ciencias Ambientales. Museo de Historia Natural de San Rafael - Ianigla; ArgentinaFil: Paunero, Rafael. Universidad Nacional de La Plata; ArgentinaFil: Prevosti, Francisco Juan. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Regional de Investigaciones Científicas y Transferencia Tecnológica de La Rioja. - Universidad Nacional de La Rioja. Centro Regional de Investigaciones Científicas y Transferencia Tecnológica de La Rioja. - Universidad Nacional de Catamarca. Centro Regional de Investigaciones Científicas y Transferencia Tecnológica de La Rioja. - Secretaría de Industria y Minería. Servicio Geológico Minero Argentino. Centro Regional de Investigaciones Científicas y Transferencia Tecnológica de La Rioja. - Provincia de La Rioja. Centro Regional de Investigaciones Científicas y Transferencia Tecnológica de La Rioja; ArgentinaFil: Bradshaw, Corey J. A.. University of Adelaide; AustraliaFil: Wheeler, Jane C.. Instituto de Investigación y Desarrollo de Camélidos Sudamericanos; PerúFil: Borrero, Luis Alberto. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Saavedra 15. Instituto Multidisciplinario de Historia y Ciencias Humanas; ArgentinaFil: Austin, Jeremy J.. University of Adelaide; AustraliaFil: Cooper, Alan. University of Adelaide; Australia. University of Oxford; Reino Unid

Palaeoproteomics resolves sloth relationships

The living tree sloths Choloepus and Bradypus are the only remaining members of Folivora, a major xenarthran radiation that occupied a wide range of habitats in many parts of the western hemisphere during the Cenozoic, including both continents and the West Indies. Ancient DNA evidence has played only a minor role in folivoran systematics, as most sloths lived in places not conducive to genomic preservation. Here we utilize collagen sequence information, both separately and in combination with published mitochondrial DNA evidence, to assess the relationships of tree sloths and their extinct relatives. Results from phylogenetic analysis of these datasets differ substantially from morphology-based concepts: Choloepus groups with Mylodontidae, not Megalonychidae; Bradypus and Megalonyx pair together as megatherioids, while monophyletic Antillean sloths may be sister to all other folivorans. Divergence estimates are consistent with fossil evidence for mid-Cenozoic presence of sloths in the West Indies and an early Miocene radiation in South America

Canine distemper virus induces apoptosis in cervical tumor derived cell lines

Apoptosis can be induced or inhibited by viral proteins, it can form part of the host defense against virus infection, or it can be a mechanism for viral spread to neighboring cells. Canine distemper virus (CDV) induces apoptotic cells in lymphoid tissues and in the cerebellum of dogs naturally infected. CDV also produces a cytopathologic effect, leading to apoptosis in Vero cells in tissue culture. We tested canine distemper virus, a member of the Paramyxoviridae family, for the ability to trigger apoptosis in HeLa cells, derived from cervical cancer cells resistant to apoptosis. To study the effect of CDV infection in HeLa cells, we examined apoptotic markers 24 h post infection (pi), by flow cytometry assay for DNA fragmentation, real-time PCR assay for caspase-3 and caspase-8 mRNA expression, and by caspase-3 and -8 immunocytochemistry. Flow cytometry showed that DNA fragmentation was induced in HeLa cells infected by CDV, and immunocytochemistry revealed a significant increase in the levels of the cleaved active form of caspase-3 protein, but did not show any difference in expression of caspase-8, indicating an intrinsic apoptotic pathway. Confirming this observation, expression of caspase-3 mRNA was higher in CDV infected HeLa cells than control cells; however, there was no statistically significant change in caspase-8 mRNA expression profile. Our data suggest that canine distemper virus induced apoptosis in HeLa cells, triggering apoptosis by the intrinsic pathway, with no participation of the initiator caspase -8 from the extrinsic pathway. In conclusion, the cellular stress caused by CDV infection of HeLa cells, leading to apoptosis, can be used as a tool in future research for cervical cancer treatment and control

Identification of Thioredoxin Glutathione Reductase Inhibitors That Kill Cestode and Trematode Parasites

Parasitic flatworms are responsible for serious infectious diseases that affect humans as well as livestock animals in vast regions of the world. Yet, the drug armamentarium available for treatment of these infections is limited: praziquantel is the single drug currently available for 200 million people infected with Schistosoma spp. and there is justified concern about emergence of drug resistance. Thioredoxin glutathione reductase (TGR) is an essential core enzyme for redox homeostasis in flatworm parasites. In this work, we searched for flatworm TGR inhibitors testing compounds belonging to various families known to inhibit thioredoxin reductase or TGR and also additional electrophilic compounds. Several furoxans and one thiadiazole potently inhibited TGRs from both classes of parasitic flatworms: cestoda (tapeworms) and trematoda (flukes), while several benzofuroxans and a quinoxaline moderately inhibited TGRs. Remarkably, five active compounds from diverse families possessed a phenylsulfonyl group, strongly suggesting that this moiety is a new pharmacophore. The most active inhibitors were further characterized and displayed slow and nearly irreversible binding to TGR. These compounds efficiently killed Echinococcus granulosus larval worms and Fasciola hepatica newly excysted juveniles in vitro at a 20 µM concentration. Our results support the concept that the redox metabolism of flatworm parasites is precarious and particularly susceptible to destabilization, show that furoxans can be used to target both flukes and tapeworms, and identified phenylsulfonyl as a new drug-hit moiety for both classes of flatworm parasites

Topical Insulin Accelerates Wound Healing in Diabetes by Enhancing the AKT and ERK Pathways: A Double-Blind Placebo-Controlled Clinical Trial

Background: Wound healing is impaired in diabetes mellitus, but the mechanisms involved in this process are virtually unknown. Proteins belonging to the insulin signaling pathway respond to insulin in the skin of rats. Objective: The purpose of this study was to investigate the regulation of the insulin signaling pathway in wound healing and skin repair of normal and diabetic rats, and, in parallel, the effect of a topical insulin cream on wound healing and on the activation of this pathway. Research Design and Methods: We investigated insulin signaling by immunoblotting during wound healing of control and diabetic animals with or without topical insulin. Diabetic patients with ulcers were randomized to receive topical insulin or placebo in a prospective, double-blind and placebo-controlled, randomized clinical trial (NCT 01295177) of wound healing. Results and Conclusions: Expression of IR, IRS-1, IRS-2, SHC, ERK, and AKT are increased in the tissue of healing wounds compared to intact skin, suggesting that the insulin signaling pathway may have an important role in this process. These pathways were attenuated in the wounded skin of diabetic rats, in parallel with an increase in the time of complete wound healing. Upon topical application of insulin cream, the wound healing time of diabetic animals was normalized, followed by a reversal of defective insulin signal transduction. In addition, the treatment also increased expression of other proteins, such as eNOS (also in bone marrow), VEGF, and SDF-1 alpha in wounded skin. In diabetic patients, topical insulin cream markedly improved wound healing, representing an attractive and cost-free method for treating this devastating complication of diabetes.Sao Paulo Research Foundation (FAPESP)Sao Paulo Research Foundation (FAPESP)National Institute of Science and Technology (INCT)National Institute of Science and Technology (INCT)National Council for Scientific and Technological Development (CNPq)National Council for Scientific and Technological Development (CNPq