23 research outputs found

    Factors Contributing to the Biofilm-Deficient Phenotype of Staphylococcus aureus sarA Mutants

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    Mutation of sarA in Staphylococcus aureus results in a reduced capacity to form a biofilm, but the mechanistic basis for this remains unknown. Previous transcriptional profiling experiments identified a number of genes that are differentially expressed both in a biofilm and in a sarA mutant. This included genes involved in acid tolerance and the production of nucleolytic and proteolytic exoenzymes. Based on this we generated mutations in alsSD, nuc and sspA in the S. aureus clinical isolate UAMS-1 and its isogenic sarA mutant and assessed the impact on biofilm formation. Because expression of alsSD was increased in a biofilm but decreased in a sarA mutant, we also generated a plasmid construct that allowed expression of alsSD in a sarA mutant. Mutation of alsSD limited biofilm formation, but not to the degree observed with the corresponding sarA mutant, and restoration of alsSD expression did not restore the ability to form a biofilm. In contrast, concomitant mutation of sarA and nuc significantly enhanced biofilm formation by comparison to the sarA mutant. Although mutation of sspA had no significant impact on the ability of a sarA mutant to form a biofilm, a combination of protease inhibitors (E-64, 1-10-phenanthroline, and dichloroisocoumarin) that was shown to inhibit the production of multiple extracellular proteases without inhibiting growth was also shown to enhance the ability of a sarA mutant to form a biofilm. This effect was evident only when all three inhibitors were used concurrently. This suggests that the reduced capacity of a sarA mutant to form a biofilm involves extracellular proteases of all three classes (serine, cysteine and metalloproteases). Inclusion of protease inhibitors also enhanced biofilm formation in a sarA/nuc mutant, with the combined effect of mutating nuc and adding protease inhibitors resulting in a level of biofilm formation with the sarA mutant that approached that of the UAMS-1 parent strain. These results demonstrate that the inability of a sarA mutant to repress production of extracellular nuclease and multiple proteases have independent but cumulative effects that make a significant contribution to the biofilm-deficient phenotype of an S. aureus sarA mutant

    Trasplante de hígado: estrategias de enseñanza utilizadas con pacientes que esperan por la cirugía

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    O objetivo deste estudo é descrever os resultados de aprendizagem da experiência de implementação de estratégias de ensino com os pacientes que serão submetidos a transplante de fígado. Uma delas é a entrega de um manual de orientação aos pacientes que entram no programa, com posterior aplicação de questionário relacionado ao conteúdo do manual. Analisou-se 13 pacientes em lista de espera para transplante de fígado, todos ocupando as primeiras posições no cadastro técnico. Em relação às respostas obtidas dos questionários aplicados, a média de acertos foi de 80,6%, sendo que apenas um paciente acertou todas as questões. Durante a correção e esclarecimento das dúvidas, concluiu-se que a leitura do manual de orientação e a aplicação do questionário proporcionam esclarecimento melhor dos pacientes e de seus familiares em relação aos aspectos mais importantes da cirurgia. _________________________________________________________________________________________ ABSTRACT: This study aims to describe the learning results of the implementation of teaching strategies involving patients who will be submitted to liver transplantation. One of these strategies is to give the patients a manual with orientations and the subsequent application of a questionnaire related to the content of the manual. Authors analyzed 13 patients who were waiting for liver transplantation. With respect to the answers regarding the questionnaire, an average of 83.8% of correct responses was given and only one patient got all the questions right. During the correction and the time to clarify their doubts, authors concluded that the opportunity of reading the manual and applying the questionnaire allowed patients and families to get a better understanding about the surgery's most important aspects _________________________________________________________________________________________ RESUMEN: Este estudio tiene como objetivo describir la experiencia de implementación de estrategias de enseñanza con pacientes que van a ser sometidos al trasplante de hígado. Una de ellas es la entrega de un manual de orientación a los pacientes que empiezan el programa, con la posterior aplicación de un cuestionario relacionado al contenido del manual. Fueron analizados 13 pacientes que estaban aguardando el trasplante de hígado, ocupando las primeras posiciones en el registro técnico. Con relación a las respuestas obtenidas de los cuestionarios aplicados, el promedio de respuestas correctas fue del 83.8%, siendo que solamente un paciente tuvo todas las respuestas correctas. Durante la revisión de las respuestas y aclaración de las dudas, los autores concluyeron que la lectura del manual de orientación y la aplicación del cuestionario proporcionan una aclaración a los pacientes y sus familiares con respecto a los aspectos más importantes de la cirugí

    Association Between mRNA Vaccination and Infection From SARS-CoV-2 During the Delta and Omicron BA.1 Waves: A Population-Level Analysis

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    Introduction: COVID-19 mRNA vaccine protection against the Omicron variant of SARS-CoV-2 has been shown to be attenuated. Previous research in Shelby County, Tennessee found that vaccine effectiveness might differ by age in the Omicron surge, a finding not reported for other variants. To assess whether patterns in vaccine effectiveness by age group differed on the basis of the predominant strain of SARS-CoV2, we evaluated vaccine effectiveness in Shelby County, Tennessee by age group in the Delta wave and Omicron BA.1 (Omicron) wave. Methods: Case and vaccination statuses of residents were assessed using COVID-19 surveillance data. Age was stratified as 18–34, 35–64, and ≥65 years. Vaccination groups included unvaccinated, fully vaccinated, and fully vaccinated + booster. Person time was counted in each wave by vaccination status until the time of a positive reported COVID-19 test or until the end of the study period. Results: Incidence of COVID-19 was much higher during the Omicron wave than during the Delta wave across all vaccination groups. During the Delta wave, among adults, 79.2% fewer cases were identified in those fully vaccinated and 94.8% fewer in those fully vaccinated + booster, compared with 40.2% and 66.7%, respectively, in the Omicron wave, compared with those who were unvaccinated. Conclusions: This study found evidence that vaccine effectiveness differed by age group during the Omicron wave, where the same pattern was not prominent in the Delta wave. Further analysis investigating the influence of behavior patterns and other potential confounders on vaccine effectiveness would be useful in further understanding the relationship between age and vaccine effectiveness

    O sentido da sexualidade de mulheres submetidas a histerectomia: uma contribuição da enfermagem para a integralidade da assistência ginecológica

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    A histerectomia é um procedimento cirúrgico irreversível, realizado por indicação médica, com a finalidade de restabelecer a saúde ou mesmo salvar a vida da mulher. Ser submetida a esta cirurgia acarreta modificações em seu cotidiano porque as recomendações pertinentes ao pós-operatório de histerectomia impõem implicações em seu mundo-vida. Este estudo de natureza qualitativa teve como objetivo analisar o sentido da sexualidade de mulheres após a histerectomia à luz do pensamento de Martin Heidegger. Foram depoentes 25 mulheres submetidas à retirada total do útero; a entrevista fenomenológica ocorreu num tempo variado, de 4 a 19 meses após o procedimento cirúrgico. A interpretação da estrutura de significação "a atividade sexual foi considerada" desvelou que na dinâmica assistencial, médica e de enfermagem, as rotineiras orientações de abstinência sexual determinadas pelo pós-operatório devem ser consideradas a partir da subjetividade da mulher que será/foi submetida à histerectomia.La histerectomia es un procedimiento quirúrgico irreversible realizado por indicación médica con la finalidad de restablecer la salud o mismo salvar la vida de la mujer. Ser sometida a esta cirurgía acarrea modificaciones en su cotidiano porque las recomendaciones para después de una operación de histerectomia imponen implicaciones en su mundo-vida. Este estudio de naturaleza cualitativa tuvo como objetivo analizar el sentido de la sexualidad de mujeres tras la histerectomia a la luz del pensamiento de Martin Heidegger. Fueron oídas 25 mujeres sometidas a la retirada total de útero siendo que la encuesta fenomenológica ocurrió en un tiempo entre cuatro y diecinueve meses tras el procedimiento quirúrgico. La interpretación de la estructura de la significación "la actividad sexual fue considerada" enseñó que en la dinámica asistencial médica y de enfermería, las orientaciones de rutina de abstinencia sexual determinada por el periodo que sigue a la operación deben ser consideradas a partir de la subjetividad de la mujer que será/fue sometida a histerectomiaHisterectomy is a irreversible surgical procedure carried through by medical indication with the purpose to reestablish the health or even to save the woman´s life. To be submitted to this surgery causes modifications at woman´s daily life because the pertinent recommendations to the Histerectomy post operative impose implications in her world-life. This qualitative study had as object to analyze the meaning of women's sexuality after Histerectomy, supported by Martin Heidegger´s thoughts. The informants were 25 women submitted to a total withdrawal of the uterus between nineteen to four months before the data collection. The interpretation of the meaning structure "sexual activity was considered", showed that in the medical and nursing assistential dynamics the routine orientations of sexual abstinence determined by the post operative must be considered from the subjectivity of the woman who will /was submitted to the Histerectomy

    O estilo de vida do cliente com hipertensão arterial e o cuidado com a saúde El estilo de vida del cliente con hipertensión y el cuidado con la salud The arterial hypertension patient's life style and the health care

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    Esta pesquisa tem como objetivo descrever os componentes da história de vida do sujeito que influenciam o cuidado com a saúde. A pesquisa é quantitativa, e sua amostragem é de 220 clientes adultos e idosos de uma Unidade de Saúde de Niterói-RJ. Quatro temáticas foram analisadas: características do grupo, hábitos de vida, comportamentos aditivos e estado emocional. 50% dos clientes tinham entre 50 e 70 anos; 38%, mais de 70 anos. 81% eram do sexo feminino. 65% possuíam o 1º grau incompleto. 54% não praticavam atividades físicas. 46% dos sujeitos já fizeram uso de tabaco. 37% fizeram uso de bebida alcoólica. 41% dos sujeitos consideravam-se tranqüilos, e 59% apresentavam transtornos emocionais. 27% não realizavam atividades de lazer. O estilo de vida é fundamental para a promoção e manutenção da qualidade de saúde, e isso requer estratégias de trabalhos adequadas aos aspectos psicossociais do sujeito.<br>Esta pesquisa ten como objectivos describir los componentes de la história de vida del sujeito que influencian el cuidado con la salud. La investigación és cuantitativa. La muestra fué 220 clientes adultos y ancianos de una Unidad de Salud de Niterói-RJ. Cuatro temáticas fueron analisadas: característica del grupo, hábitos de vida, comportamientos adictivos y estado emocional. 50% de los clientes tenían entre 50 a 70 años, 38% con más de 70 años. 81% era del sexo femenino. 65% tenían el 1º grado incompleto. 54% no praticaban actividades físicas. 46% de los sujeitos habían usado tabaco. 37% usó bebida alcohólica. 41% de los sujetos considéranse tranquilos y 59% presentan transtornos emocionales. 27% no practican actividades de lazer. El estilo de vida és fundamental para la promoción y manutención de la cualidad de salud y eso requiere estrategias de trabajo adecuadas aos aspectos psicosociales del sujeto.<br>The goal is: to research the life history components' patient that influences the care with health. This is a quantitative research. The sample was 220 adult and elder patients in a Health Unit at Niterói-RJ. Four themes were analyzed: group feature, life habit, additional behavior and emotional state. 50% of the patients were from 50 until 70 years old, 38% were more than 70 years old, 81% were feminine sex, 65% have been not completed the first degree, 54% don't practice exercises, 46% have already used tobacco, 37% have been used booze, 41% profess to be peaceful, 59% reports emotional disarrays and 27% don't practice leisure activities. The life style is fundamental to promote and maintain health quality and it necessitate job strategy in keeping with patient psychosocial aspects
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