A fenomenologia de van Kaam: contributosteórico-metodológicos para a investigação em enfermagem

Objetivo: Discutir sobre o contributo teórico-metodológico da fenomenologia de van Kaam para a investigação em enfermagem.Métodos: Reflexão teórica baseada na literatura científica.Resultados e discussão: A intencionalidade emerge como um conceito central e foram desenvolvidas as 7 etapas do método de van Kaam modificado por Moustakas: horizontalização; redução e eliminação; categorização e tematização dos constituintes invariantes; aplicação e validação; construção da descrição textural individual; construção da descrição estrutural individual; e descrição composta.Considerações finais: O referencial teórico-metodológico de van Kaam permite um olhar distinto sobre o fenómeno, pois o conhecimento produzido provém da essência textural e estrutural da experiência vivida, numa descrição composta, considerando as suas diversas dimensões perceptivas. Palavras-chave: Pesquisa qualitativa. Pesquisa em enfermagem. Cuidados de enfermagem. Filosofia

The Use of Flavylium Salts as Dynamic Inhibitor Moieties for Human Cb5R

Authors would like to acknowledge the Biochemistry Department in the Faculty of Medicine at the Universidad Autónoma de Madrid for the equipment and support for some of the required reagent purchases. FCT/MCTES is also acknowledged for supporting the National Portuguese NMR Network (ROTEIRO/0031/2013-PINFRA/22161/2016, co-financed by FEDER through COMPETE 2020, POCI, PORL. We thank José Paulo da Silva for the HRMS-ESI analysis. Publisher Copyright: © 2022 by the authors.Cytochrome b5 reductase (Cb5R) is a flavoprotein that participates in the reduction of multiple biological redox partners. Co-localization of this protein with nitric oxide sources has been observed in neurons. In addition, the generation of superoxide anion radical by Cb5R has been observed. A search for specific inhibitors of Cb5R to understand the role of this protein in these new functions has been initiated. Previous studies have shown the ability of different flavonoids to inhibit Cb5R. Anthocyanins are a subgroup of flavonoids responsible for most red and blue colors found in flowers and fruits. Although usually represented by the flavylium cation form, these species are only stable at rather acidic pH values (pH ≤ 1). At higher pH values, the flavylium cation is involved in a dynamic reaction network comprising different neutral species with the potential ability to inhibit the activities of Cb5R. This study aims to provide insights into the molecular mechanism of interaction between flavonoids and Cb5R using flavylium salts as dynamic inhibitors. The outcome of this study might lead to the design of improved specific enzyme inhibitors in the future.publishersversionpublishe

A estiagem do outono 2020 em Santa Catarina: a atuação da Epagri, da medição do dado à análise da informação

Esta conjuntura relata a situação da seca que atingiu o estado catarinense em 2020. São demonstrados os dados de chuva e de nível dos rios que caracterizaram esse evento climático que impactou o campo e a cidade em Santa Catarina, bem como a atuação da Epagri no monitoramento da situação

The Importance of C4d in Biopsies of Kidney Transplant Recipients

Antibody-mediated rejection (AMR) is highly detrimental to the prolonged survival of transplanted kidneys. C4d has been regarded as a footprint of AMR tissue damage, and the introduction of C4d staining in daily clinical practice aroused an ever-increasing interest in the role of antibody-mediated mechanisms in allograft rejection. Despite the general acceptance of the usefulness of C4d in the identification of acute AMR, the data for C4d staining in chronic AMR is variable. The presence of C4d in the majority of the biopsies with features of chronic antibody-mediated rejection is reported, but this rejection without C4d staining is observed as well, suggesting that C4d is specific but not sensitive. Further studies on AMR with positive C4d staining in biopsy specimens are really important, as well as the study of novel routine markers that may participate in the pathogenesis of this process

Abordagem terapêutica em mulheres com Vaginismo: revisão de literatura / Therapeutic approach in women with Vaginism: literature review

Introdução: o vaginismo é caracterizado por contrações involuntárias dos músculos do assoalho pélvico, que pode ocasionar redução da qualidade e satisfação nas relações sexuais, e consequentemente, predispor a diminuição do bem-estar das mulheres portadoras desse distúrbio doloroso. Experiências sexuais negativas, opressões, abuso e medos são alguns dos fatores que desencadeiam essa doença, sendo o tratamento individualizado, estabelecido por meio de uma equipe multidisciplinar e com múltiplas modalidades. Objetivo: revisar as modalidades terapêuticas utilizadas para o tratamento do vaginismo, descritas na literatura. Método: trata-se de uma revisão descritiva e exploratória de literatura. O levantamento de dados foi realizado por meio de pesquisas de artigos delimitados entre os anos de 2016 e 2021, indexados em bases de dados como, PubMed, Scielo, Cochrane Library e Elsevier. Desenvolvimento: o vaginismo é uma desordem de esfera dolorosa e emocional, caracterizada pelo receio quanto à penetração, devido à presença de desconforto durante o ato sexual. A epidemiologia acerca da dor gênito-pélvica ainda é muito escassa, e por mais difícil que seja avaliar a precisão da frequência, a grande maioria dos autores colocam entre 1% a 2% de ocorrência nas mulheres em contexto mundial. Dispareunia, desconforto, dor, ardência e medo são os sintomas mais relatados entre as mulheres com vaginismo. Após estabelecido o diagnóstico, deve ser definida uma equipe multidisciplinar para acompanhamento dessa paciente, visto que a melhor estratégia terapêutica é resultante de combinações de múltiplas modalidades. Intervenções fisioterapêuticas, terapia cognitiva- comportamental, eletroterapia, estímulo por biofeedback e aplicação de toxina botulínica estão entre as mais aplicadas segundo a literatura pesquisada. Conclusão: com essa revisão de literatura, conclui-se que existem várias modalidades terapêuticas utilizadas atualmente para o tratamento do vaginismo. Independente da causa dessa doença, é indispensável uma abordagem multidisciplinar e individualizada, levando em consideração que esse transtorno doloroso pode afetar a vida da paciente e de sua família em vários aspectos. É fundamental a disseminação de maiores informações acerca do vaginismo para que não seja tratado como tabu, a fim de facilitar o diagnóstico e tratamento dessas mulheres

Incidence and risk factors for tuberculosis in people living with HIV: cohort from HIV referral health centers in Recife, Brazil.

OBJECTIVE: To identify the incidence of and risk factors for tuberculosis in people living with HIV (PLHIV). DESIGN: Observational, prospective cohort study. METHODS: A total of 2069 HIV-infected patients was observed between July 2007 and December 2010. The Kaplan-Meier method was used to estimate the probability of survival free of tuberculosis, and Cox regression analysis to identify risk factors associated with the development of tuberculosis. RESULTS: Survival free of tuberculosis (TB) was 91%. The incidence rate of tuberculosis was 2.8 per 100 persons/years. Incidence of tuberculosis was higher when subjects had CD4 cell count <200 cells/mm(3); were not on antiretroviral therapy; in those who had, a body mass index <18.5 kg/m(2), anemia (or were not tested for it), were illiterate or referred previous tuberculosis treatment at entry into the cohort. Those not treated for latent TB infection had a much higher risk (HR = 7.9) of tuberculosis than those with a negative tuberculin skin test (TST). Having a TST≥5 mm but not being treated for latent TB infection increased the risk of incident tuberculosis even in those with a history of previous tuberculosis. CONCLUSIONS: Preventive actions to reduce the risk of TB in people living with HIV should include an appropriate HAART and treatment for latent TB infection in those with TST≥5 mm. The actions towards enabling rigorous implementation of treatment of latent TB infection and targeting of PLHIV drug users both at the individual and in public health level can reduce substantially the incidence of TB in PLHIV

Validating a scoring system for the diagnosis of smear-negative pulmonary tuberculosis in HIV-infected adults.

BACKGROUND: The challenge of diagnosing smear-negative pulmonary TB (tuberculosis) in people living with HIV justifies the use of instruments other than the smear test for diagnosing the disease. Considering the clinical-radiological similarities of TB amongst HIV-infected adults and children, the proposal of this study was to assess the accuracy of a scoring system used to diagnose smear-negative pulmonary TB in children and adolescents, in HIV-infected adults suspected of having smear-negative pulmonary TB. METHODS: A Phase III validation study aiming to assess the diagnostic accuracy of a scoring system for diagnosing smear-negative pulmonary TB in HIV-infected adults. The study assessed sensitivity, specificity, positive and negative likelihood ratios, and positive and negative predictive values of the scoring system. Three versions of the scoring system were tested. RESULTS: From a cohort of 2,382 (HIV-infected adults), 1276 were investigated and 128 were diagnosed with pulmonary TB. Variables associated with the diagnosis of TB were: coughing, weight loss, fever, malnutrition, chest X-ray, and positive tuberculin test. The best diagnostic performance occurred with the scoring system with new scores, with sensitivity = 81.2% (95%-CI 74.5% -88%), specificity = 78% (75.6% -80.4%), PPV = 29.2% (24.5% -33.9%) and NPV = 97.4% (96.4% -98.4%), LR+ = 3.7 (3.4-4.0) and LR- = 0.24 (0.2-0.4). CONCLUSION: The proposed scoring system (with new scores) presented a good capacity for discriminating patients who did not have pulmonary TB, in the studied population. Further studies are necessary in order to validate it, thus permitting the assessment of its use in diagnosing smear-negative pulmonary TB in HIV-infected adults

Influence of the expression of inflammatory markers on kidney after fetal programming in an experimental model of renal failure

Objective. To evaluate the expression of inflammatory markers in experimental renal failure after fetal programming. Methods. The offspring aged two and fivemonths were divided into four groups: CC (control dams, control offspring)DC (diabetic dams, control offspring)CFA (control dams, folic acid offspring, 250 mg/Kg)and DFA (diabetic dams, folic acid offspring). Gene expression of inflammatory markersMCP-1, IL-1, NOS3, TGF-beta, TNF-alpha, and VEGF was evaluated by RT-PCR. Results. MCP-1 was increased in the CFA and DFA groups at two and fivemonths of age, as well as in DC5 when compared to CC5. There was a higher expression of IL-1 in the CFA2, DFA2, and DC2 groups. There was a decrease in NOS3 and an increase in TNF-alpha in DFA5 in relation to CFA5. The gene expression of TGF-beta increased in cases that had received folic acid at two and five months, and VEGF decreased in the CFA5 and DFA5 groups. DC5 showed increased VEGF expression in comparison with CC5. Conclusions. Gestational diabetes mellitus and folic acid both change the expression of inflammatory markers, thus demonstrating that the exposure to harmful agents in adulthood has a more severe impact in cases which underwent fetal reprogramming.Conselho Nacional de Desenvolvimento Cientifico e Tecnologico (CNPq)Coordenacao de Aperfeicoamento de Pessoal de Nivel Superior (CAPES)Fundacao de Amparo a Pesquisa do Estado de Minas Gerais (FAPEMIG)Fundacao de Ensino e Pesquisa de Uberaba (FUNEPU)Discipline of General Pathology, Institute of Biological and Natural Sciences, Federal University of Triângulo Mineiro, Uberaba, MG, BrazilDepartment of Health Sciences, Lavras Federal University, Lavras, MG, BrazilDiscipline of Physiology, Institute of Biological and Natural Sciences, Federal University of Triângulo Mineiro, Uberaba, MG, BrazilNephrology Division, Federal University of São Paulo (UNIFESP), São Paulo, SP, BrazilDepartment of Immunology, Institute of Biomedical Sciences IV, University of São Paulo (USP), São Paulo, SP, BrazilDepartment of General Pathology, Institute of Tropical Pathology and Public Health, Federal University of Goiás, Goiânia, GO, BrazilNephrology Division, Federal University of São Paulo (UNIFESP), São Paulo, SP, BrazilWeb of Scienc