Balance between maternal antiviral response and placental transfer of protection in gestational SARS-CoV-2 infection

The intricate interplay between maternal immune response to SARS-CoV-2 and the transfer of protective factors to the fetus remains unclear. By analyzing mother-neonate dyads from second and third trimester SARS-CoV-2 infections, our study shows that neutralizing antibodies (NAbs) are infrequently detected in cord blood. We uncovered that this is due to impaired IgG-NAb placental transfer in symptomatic infection and to the predominance of maternal SARS-CoV-2 NAbs of the IgA and IgM isotypes, which are prevented from crossing the placenta. Crucially, the balance between maternal antiviral response and transplacental transfer of IgG-NAbs appears to hinge on IL-6 and IL-10 produced in response to SARS-CoV-2 infection. In addition, asymptomatic maternal infection was associated with expansion of anti-SARS-CoV-2 IgM and NK cell frequency. Our findings identify a protective role for IgA/IgM-NAbs in gestational SARS-CoV-2 infection and open the possibility that the maternal immune response to SARS-CoV-2 infection might benefit the neonate in 2 ways, first by skewing maternal immune response toward immediate viral clearance, and second by endowing the neonate with protective mechanisms to curtail horizontal viral transmission in the critical postnatal period, via the priming of IgA/IgM-NAbs to be transferred by the breast milk and via NK cell expansion in the neonate.info:eu-repo/semantics/publishedVersio

Satisfação dos utentes face à prestação de cuidados de saúde

Introdução – A prestação de cuidados de saúde de qualidade é uma questão actual e cada vez mais premente, sendo entendida como uma necessidade intrínseca aos próprios serviços, uma vez que estes existem para servir os utentes. Em consequência, é fundamental ir de encontro às suas necessidades, expectativas e conseguir um elevado grau de satisfação dos mesmos com os cuidados. Com a realização deste trabalho pretendemos: descrever as características sócio-demográficas e clínicas da amostra em estudo; determinar a satisfação dos utentes face à prestação de cuidados de saúde, no serviço de Ortopedia da ULSG; identificar as variáveis que mais influenciam a satisfação dos doentes com os cuidados recebidos; e contribuir para a reflexão sobre a problemática. Métodos – Conceptualizámos um estudo transversal, descritivo-correlacional, de natureza quantitativa. Recorremos a uma amostra não probabilística por conveniência, constituída por 52 indivíduos, na sua maioria mulheres, com idades compreendidas entre os 22 e os 89 anos (x=61,56; Dp=18,74). O instrumento de colheita de dados incorporou uma ficha de caracterização sóciodemográfia e clínica, o questionário EQ-5D para avaliação da qualidade de vida e o questionário INPATSAT32, da European Organization for Research and Treatment of Cancer, para a mensuração da percepção dos cuidados recebidos. Resultados – Os receptores de cuidados caracterizaram a sua qualidade de vida como mediana (56,56), sendo que 44,2% apresentam alguns problemas em deambular e 38,5% em lavar-se/despir-se, 40,4% no desempenho das actividades habituais, 61,5% apresentam dores/mal-estar moderados e 50% estão moderadamente ansiosos/deprimidos. A satisfação dos utentes face à prestação de cuidados de saúde apresenta um efeito significativo apenas quando cruzados com os grupos etários 60-79 e 80-99. Verificámos que os mais velhos apresentam melhor percepção sobre os cuidados, isto para as dimensões dos cuidados médicos (p=0.015) e dos cuidados de enfermagem (p=0.015). Constatámos também a existência de relação entre a satisfação e os dias de internamento, sendo muito significativa na correlação com cuidados da equipa médica (p=0.002) e com a satisfação global (p=0.004), sendo menos significativa a correlação com a organização dos serviços (p=0,040). Na sua globalidade os indivíduos da amostra referem-se menos satisfeitos com a disponibilidade e a informação fornecida, contrariamente às competências técnicas e interpessoais. O pior item de avaliação é a acessibilidade/acessos (38,5). Na avaliação global sobre os cuidados de saúde recebidos, verificamos um score de 65,4. O grupo profissional dos enfermeiros é o que tem melhor avaliação (68). Conclusões – A qualidade dos cuidados de saúde implica conhecer o grau de satisfação dos utentes e o sentimento de bem-estar da comunidade em geral. A satisfação com os cuidados é uma componente central na avaliação da qualidade dos cuidados de saúde na perspectiva do utilizador. PALAVRAS-CHAVE Qualidade, Satisfação, Cuidados, Utentes.ABSTRACT Introduction-The health care quality management is a topical issue and increasingly urgent and is viewed as an intrinsic services necessity, since they exist to serve the users. It is therefore essential to meet users needs, expectations and a high degree of satisfaction. With this work we intend to: describe the socio-demographic and clinical sample under study; evaluate the satisfaction with health care services of Orthopaedics ULSG; identify the variables that most influence patient satisfaction with the care received and contribute to the debate on the issue. Methods – We conceptualized a cross-sectional descriptive, correlational, quantitative study. We use a non-probabilistic convenience sample consisting of 52 individuals, mostly women, aged between 22 and 89 years (x = 61.56, SD = 18.74). The data collection instrument incorporated a socio-demographic and clinical, the EQ-5D questionnaire for assessing quality of life and IN-PATSAT32 questionnaire (the European Organization for Research and Treatment of Cancer), to measure the perception of care received. Results - The health care receivers characterized the quality of life as median (56.56), 44.2% had some problems in walking, 38.5% in washing and undressing, 40.4% in performance of usual activities, 61.5% had pain/discomfort and 50% are moderately anxious/depressed. The satisfaction with health care revealed a significant effect only when crossed with the age groups 60-79 and 80-99. We found that older people have a better perception of care, for the dimensions of care (p=0.015) and nursing care (p=0.015). We also noted the existence of a relevant relationship between satisfaction and hospital days, a marked significant correlation with the medical care team (p = 0.002) and overall satisfaction (p = 0.004), and a less significant correlation with the organization of services (p = 0.040). In general individuals in the sample refer less satisfied with the availability and the information provided, contrary to the technical and interpersonal skills. The worst grade item is affordability/access (38.5). In the overall evaluation of health care received, we found a score of 65.4. The professional group of nurses was better scored (68). Conclusions - The quality of health care means knowing the degree of user satisfaction and sense of well-being of the community in general. Satisfaction with care is a central component in assessing the quality of health care from the user perspective. KEYWORDS Quality, Satisfaction, Health Care Users

Electrochemical Oxidation of Metolazone at a Glassy Carbon Electrode

Metolazone is a diuretic agent used in patients with edematous states and/or hypertension. The electrochemical behavior of metolazone on a glassy carbon electrode was investigated using cyclic, differential pulse, and square-wave voltammetry at different pHs. The pH dependent oxidation of metolazone occurs in two consecutive steps in a diffusion-controlled mechanism and involves the formation of a main oxidation product. The first oxidation process is reversible, and involves two electrons and two protons corresponding to the oxidation of nitrogen in the sulfonamide moiety. The second oxidation process is irreversible, also occurs in the sulfonamide moiety, involves a one electron-transfer, and is followed by deprotonation to produce a cation radical, which reacts with water and yields a hydroxylated product. The diffusion coefficient of metolazone was calculated to be 3.43×10-6 cm2 s-1 in pH 7.0 0.1 M phosphate buffer

A reabilitação da pessoa com doença oncológica: enquadramento da atuação do enfermeiro especialista em enfermagem de reabilitação

Introdução: As inovações ocorridas nas últimas décadas nas diferentes modalidades terapêuticas, onde se destacam as estratégias de tratamentos usadas na doença oncológica, têm acarretado um interesse progressivo pelo tema da reabilitação na pessoa com cancro, pois trata-se de uma população específica e com necessidades únicas. Objetivos: Esta revisão tem como intuito refletir sobre o esforço realizado pela enfermagem de reabilitação, no sentido de delinear o seu papel na reabilitação da pessoa com cancro. Esta reflexão engloba quer a prática clínica especializada, quer a educação, investigação e o papel das organizações profissionais. Métodos: Realizada uma revisão narrativa da literatura. Resultados: O Enfermeiro Especialista em Enfermagem de Reabilitação (EEER) possui competências para prestar cuidados a pessoas acometidas por doença oncológica com limitações no seu autocuidado, redução da mobilidade e da participação social, em situações transitórias ou irreversíveis de doença, bem como nas limitações resultantes do próprio envelhecimento. Conclusões: A intervenção do EEER neste contexto específico da prática, contribui para o controlo de sintomas, minimiza as manifestações da doença oncológica e/ou as sequelas associadas ao seu tratamento e promove a autonomia. Assim, auxilia as pessoas a viver com sentido e com qualidade de vida, em todas as fases da sua doença, podendo esta ser transitória, avançada e progressiva ou irreversível.Introducción: Las innovaciones que se han producido en las últimas décadas, en las diferentes modalidades terapéuticas, en donde se destacan las estrategias de tratamiento utilizadas en enfermedades oncológicas, han llevado a un interés progresivo en el tema de la rehabilitación en personas con cáncer, ya que se trata de una población específica y con necesidades únicas. Objetivos: Esta revisión tiene como objetivo reflexionar sobre el esfuerzo realizado por la enfermería de rehabilitación, con el fin de describir su papel en la rehabilitación de las personas con cáncer. Esta reflexión, abarca tanto la práctica clínica especializada, la educación, la investigación y el papel de las organizaciones profesionales. Métodos: Se ha procedido a una revisión narrativa de la bibliografía. Resultados: El Enfermero Especialista en Enfermería de Rehabilitación (EEER) tiene competencias para proporcionar cuidados a personas con enfermedades oncológicas que tengan limitaciones en su autocuidado, movilidad reducida y en la participación social, en situaciones de enfermedad transitoria o irreversible, así como las limitaciones resultantes del propio envejecimiento. Conclusións: La intervención del EEER en este contexto específico de la práctica, tiene como objetivo contribuir al control de los síntomas, minimizar las manifestaciones de la enfermedad oncológica y/o las secuelas asociadas a su tratamiento y promover la autonomía. Por lo tanto, ayuda a las personas a vivir con sentido y calidad de vida, en todas las etapas de su enfermedad, pudiendo ser transitoria, avanzada y progresiva o irreversible

Code of practice for medical autopsies: a minimum standard position paper for pathology departments performing medical (hospital) autopsies in adults.

The medical autopsy (also called hospital or clinical autopsy) is a highly specialised medical procedure, which requires professional expertise and suitably equipped facilities. To ensure high standards of performance, the Working Group of Autopsy Pathology of the European Society of Pathology (ESP) suggests a code of practice as a minimum standard for centres performing medical autopsies. The proposed standards exclusively address autopsies in adults, and not forensic autopsies, perinatal/or paediatric examinations. Minimum standards for organisation, standard of premises, and staffing conditions, as well as minimum requirements for level of expertise of the postmortem performing specialists, documentation, and turnaround times of the medical procedure, are presented. Medical autopsies should be performed by specialists in pathology, or by trainees under the supervision of such specialists. To maintain the required level of expertise, autopsies should be performed regularly and in a number that ensures the maintenance of good practice of all participating physicians. A minimum number of autopsies per dedicated pathologist in a centre should be at least 50, or as an average, at least one autopsy per working week. Forensic autopsies, but not paediatric/perinatal autopsies may be included in this number. Turnaround time for final reports should not exceed 3 weeks (14 working days) for autopsies without fixation of brain/spinal cord or other time-consuming additional examinations, and 6 weeks (30 working days) for those with fixation of brain/spinal cord or additional examinations

Forest residues in cattle feed

The ruminants are capable of converting low-quality food, when they are complementes with high-energy source. Through the use of regional agricultural residues is possible to conduct more economical production systems, since energetic foods have high cost in animal production. There is very abundant availability of residues in agroforestry activities worldwide, so that if a small fraction of them were used with appropriate technical criteria they could largely meet the needs of existing herds in the world and thus meet the demands of consumption of protein of animal origin. The Southwest Region of São Paulo State has large area occupied by reforestation and wide availability of non-timber forest residues, which may represent more concentrated energetic food for ruminant production. This experiment aimed to evaluate the acceptability of ground pine (20, 30 and 40%), replacing part of the energetic food (corn), present in the composition of the concentrate and was performed at the Experimental Station of Itapetininga - Forest Institute / SMA, in the dry season of 2011. It were used four crossbred steers, mean 18 months old, average body weight of 250 kg, housed in a paddock provided with water ad libitum and covered troughs for supplementation with the experimental diet. The adjustment period of the animals was of 07 days and the measurement of the levels of consumption, physiological changes, acceptability and physiological parameters were observed during the following 25 days. The concentrate supplement was formulated based on corn (76.2%), Soybean Meal (20%), urea (2%), Ammonium sulfate (0.4%), calcite (1.4%), Mineral Core (1%) and finely ground Pine Cone, replacing corn. In preparing food, the formulas were prepared to make them isoproteic/energetic, containing the following nutrient levels: 22% Crude Protein (CP) and 79% of Total Nutrients (TDN). The animals received the supplement in three steps for each level of cone replaced, being offered in the amount of 1% over the live weight + 10% of intake. The results of the first phase of the research, for steers supplemented in pasture, showed good acceptability and consumption in the three levels of substitution, with an average of 3.0 kg of concentrate per head. No rejection was observed for consumption of the mixture, as well as any physiological negative / change and clinical levels tested The pine cone (strobilus) without the pine nuts (seeds) was obtained as a residue of genetically improved seed collection. Likely source of tannins and fiber, dried and triturated pine cones can contribute to lower production costs due to the substitution of an ingredient in feed formulation, as an aid in control of internal parasites and also in the possible mitigation of methane gas production, resulting from digestion of ruminants, one of the gases responsible for the greenhouse effect. The potential use of pine cone as an ingredient in replacement of roughage and concentrate in the diet of ruminants qualifies as a new source of revenue in pine forestry activity, since no such product currently has no commercial value timber and its accumulation along the dried leaves among the trees, increase the risk of forest fires. Finally, these technological and social innovations result in remarkable potential to leverage Regional Programs Sustainable Development

Resíduos florestais na alimentação de bovinos

O artigo não apresenta resmo em português

Captação e tratamento de esterco de caprinos

O artigo não apresenta resumo em português

Capture and treatment of goat manure

The appropriate management and disposal of feces and urine derived from goat production systems can help minimize the environmental impact of the activity reflecting in animal welfare, good sanitary conditions, viable indexes and increase revenue by aggregating the activity value of the manure generated. Aiming to take advantage of zootechnical installation already used for the manure in rabbits’ husbandry, it was carried out the suitability of a 15.40 m² pen (5.7 x 2.7 meters, filled with dirt) in the goat rearing of UPD Itapetininga/APTA-SAA being deployed on slatted floor system for capturing and processing goat manure. It was dug in the floor of the bay rectangular holes with 15 m² of surface and 80 cm of depth for capturing of the excrements, filled with layers of gravel (0.20 m), coal (0.20 m), medium sand (0, 15 m) and clay (0.05 m) being the surface in direct contact with feces and urine. The gap of 40 cm between the back of the slatted floor and the last layer allowed the accumulation of manure during the occupation of the stall. We used the pens for 10 consecutive months for the management of newly calved Saanen and crossbred Saanen/Boer goats for 10 to 15 days postpartum in controlled feeding and termination of 27 confined kids. The maintenance of the collection system and treatment of manure was done through constant sweeps in the slatted floor and periodical aplication of 30 g of superphosphate per m² directly in feces, in order to acidifying the compound. This measure contributed to the ambience and animal comfort, controlling flies and neutralizing odors and harmful actions of ammonia coming from the urine. To carry out the sanitary break in the stall, needed for new production cycle, the frames of the slatted floor were raised and about 2500 kg of manure was removed, followed by cleaning and disinfection of floors and pillars of support and rest for 45 days unused until the entry of the new batch of goats recently calved. Using this new manure system we observed great decrease in the occurrence of typical confined kids diseases, like diarrhea, pneumonia and omphalophlebitis, and lower overall mortality rate until slaughter when compared with goats reared in pens with dirt and litter. The investment for installation of the system was assessed $722.50 (U.S.$ 48.16/m²). Considering the potential use of the stall, placing 10 adult animals (1.5 m²/head), with average production of the adult animal of 600 kg of manure/year, can be obtained easily, 6000 kg of manure, with average price of $0.13/kg., which could revert to$ 780.00/production cycle, this feature would pay the investment in about two years. In order to improve the investment cost it can be used in the construction of treated pine wooden pallets, in view of durability, ease of working wood and the lowest price. In order to facilitate a return on investment, can be treated pine used in the construction of wooden pallets, in view of its durability, workability and lower price, which can replace other more expensive types of wood, with the same efficiency and advantage of being lighter, which facilitates the management and operational cleaning of pallets. Furthermore, the capture system can be strong allies on the aggregation of producers of small ruminants, increasing the production of humus, energy source for anaerobic digesters, manure crops and organic manure use in integrated agriculture systems, pastures and forest. The validated system made possible the manpower needed to maintain the stall tested, improving the management and performance of goats, other income generating activities for productive and sustainable

Functional progression in post-osteoporotic fracture: A case study

Introduction: Osteoporosis is characterized by a loss of bone mass along with alterations in its structure, with subsequent increase in bone fragility and susceptibility to fractures, ultimately reinforcing the importance of its prevention by the reduction of the risk of falling.In this paper we propose to analyze the functional progression of a patient, integrated in a multidisciplinary program (TOMBO-Therapeutic Occupational Multidisciplinary approach to the Benefit of Osteoporosis), after an osteoporotic fracture.Methods: Retrospective descriptive case-study of the first patient included in the TOMBO program. Data were gathered for Time Up and Go Test (TUGT), Sit to Stand in 30 secs. (SS-30), 10m Walking Test (10m-WT), Barthel Index (BI) and Morse Scale (MS) in 3 different moments: baseline (ward, at discharge: M0), 2 and 6-months after surgery (multidisciplinary appointments: MD2, MD6).Results: TUGT- M0: no capability; MD2: 18,8 secs.; MD6: 8 seg. SS-30 - M0: no capability; MD2: 9 stands; MD6: 10 stands. 10m-WT - M0: 30 secs.; MD2: 13 secs.; MD6: 8 secs. BI - M0: 60; MD2, 80; MD6: 100. MS - M0: 85, MD2: 50; MD6: 15.Conclusion: This case-study revealed us that the first patient admitted to this innovative multidisciplinary approach improved some functional parameters (level of dependency and risk of falling) as shown by its favorable progression on the tests and scales applied.</p