SENTIMIENTOS DESPERTADOS EN FAMILIARES DE PERSONAS INTERNADAS EN LA UNIDAD DE TERAPIA INTENSIVA

Esta es una investigación exploratoria, descriptiva, de carácter cualitativo, desarrollada con ocho familiares depersonas internadas en la Unidad de Terapia Intensiva de un hospital medio, ubicado en la región central de Rio Grande doSul, en el período de agosto a septiembre de 2010, cuyo objetivo fue conocer los sentimientos despertados en familiares acercadel ambiente y de los profesionales de salud. Los datos, obtenidos por medio de entrevista semiestructurada, fueron analizadospor el método de análisis de contenido, y del cual resultaron las categorías Impotencia delante de la hospitalización del familiar,Inseguridad relacionada a la proximidad de la muerte, Inflexibilidad del equipo de salud delante del familiar, y Ausencia dediálogo con los familiares. El cuidado a los familiares es una necesidad que debe se extender del desarrollo profesional parael cotidiano del servicio de os profesionales. De ese modo, se vuelve posible ayudar los familiares en el afrontamiento de laenfermedad y adaptación de la hospitalización, desmitificando la asociación de este ambiente al evento de la muerte.Trata-se de uma pesquisa exploratória, descritiva, de caráter qualitativo, desenvolvida com oito familiares de pessoas internadas na Unidade de Terapia Intensiva de um hospital de médio porte localizado na região central do Rio Grande do Sul, no período de agosto e setembro de 2010, que objetivou conhecer os sentimentos despertados em familiares em relação ao ambiente e aos profissionais de saúde. Os dados, coletados por meio de entrevista semiestruturada, foram analisados pelo método de análise de conteúdo e do qual emergiram as categorias Impotência frente à hospitalização do familiar, Insegurança relacionada à proximidade com morte, Inflexibilidade da equipe de saúde diante do familiar, eAusência de diálogo com os familiares.O cuidado aos familiares é uma necessidade que deve se estender do desenvolvimento profissional para o cotidiano do serviço dos profissionais. Assim, torna-se possível auxiliar os familiares no enfrentamento da doença e adaptação da hospitalização, desmistificando a associação deste ambiente ao evento da morte.This is exploratory, descriptive research with a qualitative character, undertaken with eight family members of persons hospitalized in the Intensive Care Unit of a medium-size hospital located in the central region of Rio Grande do Sul, in the period August – September 2010, which aimed to investigate the feelings aroused in family members in relation to the environment and the health professionals. The data, collected through semi-structured interviews, was analyzed using the method of content analysis, from which emerged the categories Impotence in the face of the family member’s hospitalization, Insecurity related to the closeness of death, Inflexibility of the health team regarding the family member, and Absence of dialog with the family members. The care for the family members is a need which must extend from professional development to the professionals’ routine work. Thus, it becomes possible to assist the family members in coping with the illness and adapting to the hospitalization, demystifying the association of this environment with the event of death

Use Of Co2 Laser In Lingual And Labial Frenectomy

Ankiloglossia or frenum lingual alteration leads to important tongue dysfunction, which, besides discomfort and pain during function, is generally responsible for the difficulty to express specific phonemes. In other cases, a heavy muscular abnormal attachment of labial frenum can promote clinical changes. In such case, an eventual orthodontic therapy is indicated and aesthetic alteration is observed. In both cases, surgical removal is indicated. The surgery, for prevention purposes, must be done as soon as possible, but considering that the majority of patients are young (5-14 years old), difficulties during surgery are expected to occur. Correction of speech or orthodontic dysfunction in advanced ages is much more complex and difficult than in childhood. In the present work we demonstrate that the use of CO2 lasers in these cases are advantageous and simple. The laser energy causes the tissue of the frenum to open in the classic shape with no bleeding and no need for suture, reducing the risk of cross-contamination and of postoperative infection. Scarring and other complications are also minimized. A CO2 laser (continuous, 8 W, 10.6 micrometers) was used assisted with local anesthesia. The major advantage of laser is the possibility of its application in early ages, preventing further problems.391011712

CUALIDAD DE VIDA DEL FAMILIAR CUIDADOR DE ANCIANO CON ALZHEIMER: CONTRIBUCIÓN DE UN PROYECTO DE EXTENSIÓN

O presente estudo objetivou descrever a percepção dos familiares cuidadores de idosos portadores da doença de Alzheimer, integrantes de um projeto de extensão (AMICA), a respeito da contribuição deste projeto para a melhoria da sua qualidade de vida. Trata-se de uma pesquisa descritiva-exploratória, de caráter qualitativo, desenvolvida por meio de questionário semiestruturado, aplicado entre Abr e maio de 2011, a seis cuidadores/familiares de portadores de Alzheimer. Os dados analisados resultaram nas categorias Qualidade de vida, um bem estar individual e coletivo; Grupo AMICA como promotor da qualidade de vida; e Oportunidade de estabelecer diálogos de saberes resultando em maior compreensão sobre a doença. Neste constructo, o Grupo AMICA tem se mostrado como um importante promotor da qualidade de vida dos familiares cuidadores, os quais reconhecem sua importância. No entanto, torna-se necessário, mais estudos a respeito da qualidade de vida do familiares cuidadores de idosos portadores da doença de Alzheimer.This study aimed to describe the perception of family members caring for elderly relatives suffering from Alzheimer’s disease, members of an extension project (AMICA), concerning the contribution of the project to the improving of their quality of life. It is descriptive-exploratory research, with a qualitative character, carried out through a semi-structured questionnaire, and was applied between April and May of 2011, to six carers/family members of persons with Alzheimer’s disease. The data analyzed resulted in the categories Quality of life, individual and collective well-being; the AMICA Group as a promoter of quality of life; and Opportunity to establish dialogs of knowledge resulting in greater comprehension about the illness. The AMICA Group, in this construct, is shown as an important promoter of the quality of life of family carers, who recognize their importance. However, more studies are necessary on the quality of life of family carers for elderly persons suffering from Alzheimer’s disease.El presente estudio tuvo el objetivo de describir la percepción de los familiares cuidadores de ancianos portadores de la enfermedad de Alzheimer, integrantes de un proyecto de extensión (AMICA), acerca de la contribución de este proyecto para mejorar su cualidad de vida. Esta es una investigación descriptiva-exploratoria, de carácter cualitativo, desarrollada por medio de cuestionario semi estructurado, aplicado entre abril y mayo de 2011, a seis cuidadores/familiares de portadores de Alzheimer. Los datos analizados resultaron en las categorías Cualidad de vida, un bienestar individual y colectivo; Grupo AMICA como promotor de la cualidad de vida; y Oportunidad de establecer diálogos de saberes resultando en mayor comprensión sobre la enfermedad. En este constructo, el Grupo AMICA se muestra un importante promotor de la cualidad de vida de los familiares cuidadores, los cuales reconocen su relevancia. Sin embargo, son necesarios más estudios acerca de la cualidad de vida de los familiares cuidadores de ancianos portadores da enfermedad de Alzheimer

The potential therapeutic use of cord blood in autologous transplants or in special patients: a review and update

Umbilical Cord Blood is a rich source of hematopoietic stem cells widely used as a substitute of bone marrow (BM) in transplants. Cells from umbilical cord blood present advantages over BM cells, mainly as they are younger and a have higher proliferative rate. Besides hematopoietic stem cells, umbilical cord blood contains endothelial and mesenchymal progenitor cells, suggesting their possible application in cell therapy protocols for different tissues. In this paper, we discuss the importance of autologous umbilical cord blood storage and the research on stem cell transplantation for degenerative diseases.O sangue de cordão umbilical e placentário (SCUP) é uma rica fonte de células-tronco (CT) hematopoéticas e é amplamente utilizado como substituto da medula óssea em casos de transplante. As células do SCUP possuem vantagens sobre as células da medula óssea (MO), principalmente por serem mais jovens e apresentarem maior taxa proliferativa. Além dos progenitores hematopoéticos, o sangue de cordão umbilical contém progenitores endoteliais e mesenquimais, sugerindo sua possível aplicação nos novos protocolos de terapia celular para diferentes tecidos. Na presente revisão, discutimos a importância do armazenamento do sangue de cordão umbilical autólogo e as pesquisas desenvolvidas para a sua aplicação em doenças degenerativas.Cryopraxis Criobiologia LtdaUniversidade Federal de São Paulo (UNIFESP), Escola Paulista de Medicina (EPM)Instituto de Traumato-ortopediaSanta Casa de São PauloHospital Samaritano de São PauloUFRJ HUCFFHospital Central do ExércitoUFRJ IPPMGUFRJCollege of Medicine Department of Neurosurgery Center of Excellence for Aging & Brain RepairUNIFESP, EPMSciEL

Structural Characterization of N-Linked Glycans in the Receptor Binding Domain of the SARS-CoV-2 Spike Protein and their Interactions with Human Lectins

info:eu-repo/grantAgreement/WT/Physiological Sciences/095700 ERC‐2017‐AdG, 788143‐RECGLYCANMR grant 200077 grant RTI2018‐094751‐B‐C21 GC2018‐098996‐B‐I00 RTI2018‐099592‐B‐C22 RTI2018‐101269‐B‐I00 SEV‐2016‐0644 IF/00780/2015 PTDC/BIA‐MIB/31028/2017 UCIBIO UIDB/04378/2020 Infrastructure project 22161 PD/BD/142847/2018The glycan structures of the receptor binding domain of the SARS-CoV2 spike glycoprotein expressed in human HEK293F cells have been studied by using NMR. The different possible interacting epitopes have been deeply analysed and characterized, providing evidence of the presence of glycan structures not found in previous MS-based analyses. The interaction of the RBD 13C-labelled glycans with different human lectins, which are expressed in different organs and tissues that may be affected during the infection process, has also been evaluated by NMR. In particular, 15N-labelled galectins (galectins-3, -7 and -8 N-terminal), Siglecs (Siglec-8, Siglec-10), and C-type lectins (DC-SIGN, MGL) have been employed. Complementary experiments from the glycoprotein perspective or from the lectin's point of view have permitted to disentangle the specific interacting epitopes in each case. Based on these findings, 3D models of the interacting complexes have been proposed.publishersversionpublishe

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

Serological response and breakthrough infection after COVID-19 vaccination in patients with cirrhosis and post-liver transplant

BACKGROUND: Vaccine hesitancy and lack of access remain major issues in disseminating COVID-19 vaccination to liver patients globally. Factors predicting poor response to vaccination and risk of breakthrough infection are important data to target booster vaccine programs. The primary aim of the current study was to measure humoral responses to 2 doses of COVID-19 vaccine. Secondary aims included the determination of factors predicting breakthrough infection. METHODS: COVID-19 vaccination and Biomarkers in cirrhosis And post-Liver Transplantation is a prospective, multicenter, observational case-control study. Participants were recruited at 4-10 weeks following first and second vaccine doses in cirrhosis [n = 325; 94% messenger RNA (mRNA) and 6% viral vaccine], autoimmune liver disease (AILD) (n = 120; 77% mRNA and 23% viral vaccine), post-liver transplant (LT) (n = 146; 96% mRNA and 3% viral vaccine), and healthy controls (n = 51; 72% mRNA, 24% viral and 4% heterologous combination). Serological end points were measured, and data regarding breakthrough SARS-CoV-2 infection were collected. RESULTS: After adjusting by age, sex, and time of sample collection, anti-Spike IgG levels were the lowest in post-LT patients compared to cirrhosis (p < 0.0001), AILD (p < 0.0001), and control (p = 0.002). Factors predicting reduced responses included older age, Child-Turcotte-Pugh B/C, and elevated IL-6 in cirrhosis; non-mRNA vaccine in AILD; and coronary artery disease, use of mycophenolate and dysregulated B-call activating factor, and lymphotoxin-α levels in LT. Incident infection occurred in 6.6%, 10.6%, 7.4%, and 15.6% of cirrhosis, AILD, post-LT, and control, respectively. The only independent factor predicting infection in cirrhosis was low albumin level. CONCLUSIONS: LT patients present the lowest response to the SARS-CoV-2 vaccine. In cirrhosis, the reduced response is associated with older age, stage of liver disease and systemic inflammation, and breakthrough infection with low albumin level

Genome-wide expression profiling and functional characterization of SCA28 lymphoblastoid cell lines reveal impairment in cell growth and activation of apoptotic pathways

BACKGROUND: SCA28 is an autosomal dominant ataxia associated with AFG3L2 gene mutations. We performed a whole genome expression profiling using lymphoblastoid cell lines (LCLs) from four SCA28 patients and six unrelated healthy controls matched for sex and age. METHODS: Gene expression was evaluated with the Affymetrix GeneChip Human Genome U133A 2.0 Arrays and data were validated by real-time PCR. RESULTS: We found 66 genes whose expression was statistically different in SCA28 LCLs, 35 of which were up-regulated and 31 down-regulated. The differentially expressed genes were clustered in five functional categories: (1) regulation of cell proliferation; (2) regulation of programmed cell death; (3) response to oxidative stress; (4) cell adhesion, and (5) chemical homeostasis. To validate these data, we performed functional experiments that proved an impaired SCA28 LCLs growth compared to controls (p\u2009<\u20090.005), an increased number of cells in the G0/G1 phase (p\u2009<\u20090.001), and an increased mortality because of apoptosis (p\u2009<\u20090.05). We also showed that respiratory chain activity and reactive oxygen species levels was not altered, although lipid peroxidation in SCA28 LCLs was increased in basal conditions (p\u2009<\u20090.05). We did not detect mitochondrial DNA large deletions. An increase of TFAM, a crucial protein for mtDNA maintenance, and of DRP1, a key regulator of mitochondrial dynamic mechanism, suggested an alteration of fission/fusion pathways. CONCLUSIONS: Whole genome expression profiling, performed on SCA28 LCLs, allowed us to identify five altered functional categories that characterize the SCA28 LCLs phenotype, the first reported in human cells to our knowledge. \ua9 2013 Mancini et al.; licensee BioMed Central Ltd