Quality of life of patients with hemophilia treated in a hematology clinic

O objetivo deste trabalho foi caracterizar a qualidade de vida de pacientes hemofílicos em acompanhamento ambulatorial em serviço especializado. Foi feita abordagem quantitativa da qualidade de vida (QV) de pacientes hemofílicos acompanhados em ambulatório de hematologia de um hemocentro regional. A coleta de dados foi realizada por meio de entrevistas utilizando-se o Whoqol-bref e questionário adicional com variáveis sociodemográficas e clínico-epidemiológicas. Para análise dos dados utilizaram-se o Epi-info 6.04d e o SPSS, cujos resultados foram expressos através de distribuição simples, medidas de tendência central e dispersão, proporções e correlação de Pearson entre facetas e domínios. Foram entrevistados 23 pacientes, com média de idade de 21 anos; todos moravam com familiares, 47,8% eram residentes na cidade sede do hemocentro. Do total, 78,3% eram solteiros, 69,6% estudavam, sendo que 45,5% possuíam o 1º grau incompleto e 82,6% não trabalhavam. A maioria (91,3%) possuía hemofilia A. Quanto à avaliação da QV, 47,8% responderam ser boa e 55% possuíam um bom nível de satisfação com a saúde. O domínio psicológico apresentou o maior escore médio e o menor foi o do domínio meio ambiente. Com esse estudo conseguiu-se salientar a magnitude de alguns problemas dos hemofílicos.The objective of this work was to characterize the quality of life of hemophilic patients being followed up in a specialized service. A cross-sectional study of hemophilic patients in a Regional Blood Bank of Brazil was carried out to evaluate their quality of life. The data were obtained by interviews employing the WHO QOL-brief questionnaire, which was analyzed using SPSS and Epi-info 6.04d computer programs. Twenty-three male patients with a mean age of 21 years old were interviewed. All reported that they live with their families, 47.8% were residents in Uberaba, 78.3% were single, 69.6% were students with 45.5% having a low level of education and 82.6% did not work. Of the 23 cases, 91.3% had hemophilia A. In respect to quality of life, 47.8% responded that their quality of life was good and 55% had a good level of satisfaction with their health. The psychological dominion presented the highest average score and the environment presented the lowest. This study highlights the magnitude of some problems of hemophilic patients

Avaliação da aprendizagem com games: uma proposta didática com o Kahoot no curso de Jornalismo

Este artigo trata das contribuições do aplicativo Kahootno curso de Jornalismo da Faculdade Estácio de São Luís. Analisa a inserção e o uso do Kahoot para avaliar em tempo real os conhecimentos dos alunos na disciplina Práticas de Jornalismo Multimídia. Versa sobre um estudo exploratório e descritivo, que utiliza a pesquisa bibliográfica para discutir os aspectos conceituais a respeito da inserção estratégica do app- learning [aprendendo com aplicativos] na educação. Descreve o Kahoot e apresenta suas funcionalidades. Utiliza como instrumento de coleta de dados a realização de um grupo focal. Verifica que o uso doKahoot despertou a curiosidade e o engajamento dos alunos, aumentou o interesse pelos estudos e tornou o processo de avaliação da aprendizagem mais motivacional, colaborativo, interativo e, principalmente, significativo

Avaliação da aprendizagem com games: uma proposta didática com o Kahoot no curso de Jornalismo

Este artigo trata das contribuições do aplicativo Kahootno curso de Jornalismo da Faculdade Estácio de São Luís. Analisa a inserção e o uso do Kahoot para avaliar em tempo real os conhecimentos dos alunos na disciplina Práticas de Jornalismo Multimídia. Versa sobre um estudo exploratório e descritivo, que utiliza a pesquisa bibliográfica para discutir os aspectos conceituais a respeito da inserção estratégica do app- learning [aprendendo com aplicativos] na educação. Descreve o Kahoot e apresenta suas funcionalidades. Utiliza como instrumento de coleta de dados a realização de um grupo focal. Verifica que o uso doKahoot despertou a curiosidade e o engajamento dos alunos, aumentou o interesse pelos estudos e tornou o processo de avaliação da aprendizagem mais motivacional, colaborativo, interativo e, principalmente, significativo

Análise Funcional de Comportamentos Verbais Inapropriados de um Esquizofrênico

The present study registered the inappropriate verbalizations of a schizophrenic male adult. The inappropriate verbal behaviors were observed during periods of brief exposure to four conditions: attention, non-contingent attention, demand and alone. Results indicated that these conditions affected the inadequate verbalizations in different ways. These results are discussed in terms of their implications for functional evaluations before the psychological interventions.  O presente estudo registrou as verbalizações inapropriadas de um esquizofrênico adulto e do sexo masculino. Os comportamentos verbais inapropriados foram observados durante breves períodos de exposição a quatro condições: atenção, atenção não contingente, demanda e sozinho. Os resultados indicaram que as condições afetaram os comportamentos verbais inapropriados diferentemente. Esses resultados são discutidos em termos das suas implicações para as avaliações funcionais antes de intervenções psicológicas. &nbsp

Exploration of 2-deoxy-D-ribose and 17β-Estradiol as alternatives to exogenous VEGF to promote angiogenesis in tissue-engineered constructs

Aim: In this study, we explored the angiogenic potential and proangiogenic concentration ranges of 2-deoxy-D-ribose (2dDR) and 17β-Estradiol (E2) in comparison with VEGF. The 2dDR and E2 were then loaded into tissue engineering (TE) scaffolds to investigate their proangiogenic potential when released from fibers. Materials & methods:Ex ovo chick chorioallantoic membrane (CAM) assay was used to evaluate angiogenic activity of 2dDR and E2. Both factors were then introduced into scaffolds via electrospinning to assess their angiogenic potential when released from fibers. Results: Both factors were approximately 80% as potent as VEGF and showed a dose-dependent angiogenic response. The sustained release of both agents from the scaffolds stimulated neovascularization over 7 days in the chorioallantoic membrane assay. Conclusion: We conclude that both 2dDR and E2 provide attractive alternatives to VEGF for the functionalization of tissue engineering scaffolds to promote angiogenesis in vivo

A Randomised, Double-Blind, Controlled Vaccine Efficacy Trial of DNA/MVA ME-TRAP Against Malaria Infection in Gambian Adults

BACKGROUND: Many malaria vaccines are currently in development, although very few have been evaluated for efficacy in the field. Plasmodium falciparum multiple epitope (ME)– thrombospondin-related adhesion protein (TRAP) candidate vaccines are designed to potently induce effector T cells and so are a departure from earlier malaria vaccines evaluated in the field in terms of their mechanism of action. ME-TRAP vaccines encode a polyepitope string and the TRAP sporozoite antigen. Two vaccine vectors encoding ME-TRAP, plasmid DNA and modified vaccinia virus Ankara (MVA), when used sequentially in a prime-boost immunisation regime, induce high frequencies of effector T cells and partial protection, manifest as delay in time to parasitaemia, in a clinical challenge model. METHODS AND FINDINGS: A total of 372 Gambian men aged 15–45 y were randomised to receive either DNA ME-TRAP followed by MVA ME-TRAP or rabies vaccine (control). Of these men, 296 received three doses of vaccine timed to coincide with the beginning of the transmission season (141 in the DNA/MVA group and 155 in the rabies group) and were followed up. Volunteers were given sulphadoxine/pyrimethamine 2 wk before the final vaccination. Blood smears were collected weekly for 11 wk and whenever a volunteer developed symptoms compatible with malaria during the transmission season. The primary endpoint was time to first infection with asexual P. falciparum. Analysis was per protocol. DNA ME-TRAP and MVA ME-TRAP were safe and well-tolerated. Effector T cell responses to a non-vaccine strain of TRAP were 50-fold higher postvaccination in the malaria vaccine group than in the rabies vaccine group. Vaccine efficacy, adjusted for confounding factors, was 10.3% (95% confidence interval, −22% to +34%; p = 0.49). Incidence of malaria infection decreased with increasing age and was associated with ethnicity. CONCLUSIONS: DNA/MVA heterologous prime-boost vaccination is safe and highly immunogenic for effector T cell induction in a malaria-endemic area. But despite having produced a substantial reduction in liver-stage parasites in challenge studies of non-immune volunteers, this first generation T cell–inducing vaccine was ineffective at reducing the natural infection rate in semi-immune African adults

HLA Class I Binding 9mer Peptides from Influenza A Virus Induce CD4+ T Cell Responses

BACKGROUND: Identification of human leukocyte antigen class I (HLA-I) restricted cytotoxic T cell (CTL) epitopes from influenza virus is of importance for the development of new effective peptide-based vaccines. METHODOLOGY/PRINCIPAL FINDINGS: In the present work, bioinformatics was used to predict 9mer peptides derived from available influenza A viral proteins with binding affinity for at least one of the 12 HLA-I supertypes. The predicted peptides were then selected in a way that ensured maximal coverage of the available influenza A strains. One hundred and thirty one peptides were synthesized and their binding affinities for the HLA-I supertypes were measured in a biochemical assay. Influenza-specific T cell responses towards the peptides were quantified using IFNgamma ELISPOT assays with peripheral blood mononuclear cells (PBMC) from adult healthy HLA-I typed donors as responder cells. Of the 131 peptides, 21 were found to induce T cell responses in 19 donors. In the ELISPOT assay, five peptides induced responses that could be totally blocked by the pan-specific anti-HLA-I antibody W6/32, whereas 15 peptides induced responses that could be completely blocked in the presence of the pan-specific anti-HLA class II (HLA-II) antibody IVA12. Blocking of HLA-II subtype reactivity revealed that 8 and 6 peptide responses were blocked by anti-HLA-DR and -DP antibodies, respectively. Peptide reactivity of PBMC depleted of CD4(+) or CD8(+) T cells prior to the ELISPOT culture revealed that effectors are either CD4(+) (the majority of reactivities) or CD8(+) T cells, never a mixture of these subsets. Three of the peptides, recognized by CD4(+) T cells showed binding to recombinant DRA1*0101/DRB1*0401 or DRA1*0101/DRB5*0101 molecules in a recently developed biochemical assay. CONCLUSIONS/SIGNIFICANCE: HLA-I binding 9mer influenza virus-derived peptides induce in many cases CD4(+) T cell responses restricted by HLA-II molecules

Pharmacogenetics of OATP Transporters Reveals That SLCO1B1 c.388A>G Variant Is Determinant of Increased Atorvastatin Response

Aims: The relationship between variants in SLCO1B1 and SLCO2B1 genes and lipid-lowering response to atorvastatin was investigated. Material and Methods: One-hundred-thirty-six unrelated individuals with hypercholesterolemia were selected and treated with atorvastatin (10 mg/day/4 weeks). They were genotyped with a panel of ancestry informative markers for individual African component of ancestry (ACA) estimation by SNaPshot® and SLCO1B1 (c.388A>G, c.463C>A and c.521T>C) and SLCO2B1 (−71T>C) gene polymorphisms were identified by TaqMan® Real-time PCR. Results: Subjects carrying SLCO1B1 c.388GG genotype exhibited significantly high low-density lipoprotein (LDL) cholesterol reduction relative to c.388AA+c.388AG carriers (41 vs. 37%, p = 0.034). Haplotype analysis revealed that homozygous of SLCO1B1*15 (c.521C and c.388G) variant had similar response to statin relative to heterozygous and non-carriers. A multivariate logistic regression analysis confirmed that c.388GG genotype was associated with higher LDL cholesterol reduction in the study population (OR: 3.2, CI95%:1.3–8.0, p < 0.05). Conclusion: SLCO1B1 c.388A>G polymorphism causes significant increase in atorvastatin response and may be an important marker for predicting efficacy of lipid-lowering therapy

Dissociation between skin test reactivity and anti-aeroallergen IgE: Determinants among urban Brazilian children.

BACKGROUND: The dissociation between specific IgE and skin prick test reactivity to aeroallergens, a common finding in populations living in low and middle-income countries, has important implications for the diagnosis and treatment of allergic diseases. Few studies have investigated the determinants of this dissociation. In the present study, we explored potential factors explaining this dissociation in children living in an urban area of Northeast Brazil, focusing in particular on factors associated with poor hygiene. METHODS: Of 1445 children from low income communities, investigated for risk factors of allergies, we studied 481 with specific IgE antibodies to any of Blomia tropicalis, Dermatophagoides pteronyssinus, Periplaneta americana and Blatella germanica allergens. Data on demographic, environmental and social exposures were collected by questionnaire; serum IgG and stool examinations were done to detect current or past infections with viral, bacterial, protozoan and intestinal helminth pathogens. We measured atopy by skin prick testing (SPT) and specific IgE (sIgE) to aerollergens in serum (by ImmunoCAP). SIgE reactivity to B. tropicalis extract depleted of carbohydrates was measured by an in-house ELISA. Total IgE was measured by in house capture ELISA. SNPs were typed using Illumina Omni 2.5. RESULTS: Negative skin prick tests in the presence of specific IgE antibodies were frequent. Factors independently associated with a reduced frequency of positive skin prick tests were large number of siblings, the presence of IgG to herpes simplex virus, Ascaris lumbricoides and Trichuris trichiura infections, living in neighborhoods with infrequent garbage collection, presence of rodents and cats in the household and sIgE reactivity to glycosylated B. tropicalis allergens. Also, SNP on IGHE (rs61737468) was negatively associated with SPT reactivity. CONCLUSIONS: A variety of factors were found to be associated with decreased frequency of SPT such as unhygienic living conditions, infections, total IgE, IgE response to glycosylated allergens and genetic polymorphisms, indicating that multiple mechanisms may be involved. Our data, showing that exposures to an unhygienic environment and childhood infections modulate immediate allergen skin test reactivity, provide support for the "hygiene hypothesis"