OS CUIDADOS PALIATIVOS E A INVESTIGAÇÃO SOBRE O CUIDADO INTEGRAL MULTIDISCIPLINAR NO DEPARTAMENTO DE EMERGÊNCIA

Segundo a Organização Mundial da Saúde, os Cuidados Paliativos são uma abordagem que visa melhorar a qualidade de vida dos pacientes que enfrentam doenças ameaçadoras da vida e de seus familiares. Em 31 de outubro de 2018 por meio da Resolução de Nº 41, o Ministério da Saúde afirma que os cuidados paliativos deverão ser ofertados inclusive no Departamento de Urgência e Emergência, com foco no conforto, dignidade, melhores práticas e na Atenção Hospitalar no controle de sintomas. O presente trabalho objetiva investigar os cuidados ofertados no pronto-socorro de um complexo hospitalar de urgência e emergência referência em trauma em Minas Gerais, tendo como premissa os cuidados paliativos. Trata-se de uma pesquisa realizada por meio de seleção de amostra por conveniência, que incluiu 52 profissionais de saúde no pronto-socorro deste hospital. A coleta dos dados foi realizada no período de 07 de setembro a 02 de outubro de 2021, através de um questionário estruturado, com 16 questões fechadas e 1 (uma) questão aberta de preenchimento opcional. Os dados foram apresentados em gráficos e realizada análise descritiva e qualitativa dos resultados. A pesquisa demonstrou que já existe uma prática em cuidados paliativos sendo realizada, mesmo sem nenhuma formação específica na área, o que acaba levando a algumas deficiências de abordagem dessa prática de cuidado. Os entrevistados se mostram confortáveis em atuar usando essa abordagem e acham válida a ideia de que haja a existência de uma equipe de Cuidados Paliativos para auxiliá-los buscando melhores práticas.Palavras-chave: Cuidado Paliativo; Serviços Médicos de Emergência; Pronto-socorro. 

Cell recruitment and cytokines in skin mice sensitized with the vaccine adjuvants : saponin, incomplete Freund's adjuvant, and monophosphoryl Lipid A.

Vaccine adjuvants are substances associated with antigens that are fundamental to the formation of an intense, durable, and fast immune response. In this context, the use of vaccine adjuvants to generate an effective cellular immune response is crucial for the design and development of vaccines against visceral leishmaniasis. The objective of this study was to evaluate innate inflammatory response induced by the vaccine adjuvants saponin (SAP), incomplete Freund’s adjuvant (IFA), and monophosphoryl lipid A (MPL). After a single dose of adjuvant was injected into the skin of mice, we analyzed inflammatory reaction, selective cell migration, and cytokine production at the injection site, and inflammatory cell influx in the peripheral blood. We found that all vaccine adjuvants were able to promote cell recruitment to the site without tissue damage. In addition, they induced selective migration of neutrophils, macrophages, and lymphocytes. The influx of neutrophils was notable at 12 h in all groups, but at other time points it was most evident after inoculation with SAP. With regard to cytokines, the SAP led to production of interleukin (IL)-2, IL-6, and IL-4. IFA promoted production of tumor necrosis factor (TNF)-α, interferon (IFN)-γ, IL-6, IL-17, IL-4, and IL-10. We also observed that MPL induced high production of IL-2, TNF-α, and IFN-γ, in addition to IL-6, IL-17, and IL-10. In peripheral blood, values of certain cell populations in the local response changed after stimulation. Our data demonstrate that the three vaccine adjuvants stimulate the early events of innate immune response at the injection site, suggesting their ability to increase the immunogenicity of co-administered antigens. Moreover, this work provides relevant information about elements of innate and acquired immune response induced by vaccine adjuvants administered alone

Cell recruitment and cytokines in skin mice sensitized with the vaccine adjuvants: saponin, incomplete freund s adjuvant, and monophosphoryl Lipid A

Submitted by Nuzia Santos ([email protected]) on 2014-07-11T18:03:34Z No. of bitstreams: 1 Cell recruitment and cytokines in skin mice sensitized with the vaccine adjuvants.pdf: 2545471 bytes, checksum: 2785908525bceb24da2cf57bc50476aa (MD5)Made available in DSpace on 2014-07-11T18:03:34Z (GMT). No. of bitstreams: 1 Cell recruitment and cytokines in skin mice sensitized with the vaccine adjuvants.pdf: 2545471 bytes, checksum: 2785908525bceb24da2cf57bc50476aa (MD5) Previous issue date: 2012Universidade Federal de Minas Gerais. Instituto de Ciências Biológicas. Departamento de Parasitologia. Belo Horizonte, MG, Brasil/Universidade Federal de Ouro Preto. Núcleo de Pesquisas em Ciências Biológicas. Laboratório de Imunopatologia. Ouro Preto, MG, BrazilUniversidade Federal de Minas Gerais. Instituto de Ciências Biológicas. Departamento de Parasitologia. Belo Horizonte, MG, BrasilUniversidade Federal de Minas Gerais. Instituto de Ciências Biológicas. Departamento de Parasitologia. Belo Horizonte, MG, BrasilUniversidade Federal de Ouro Preto. Núcleo de Pesquisas em Ciências Biológicas. Laboratório de Imunopatologia. Ouro Preto, MG, BrazilUniversidade Federal de Ouro Preto. Núcleo de Pesquisas em Ciências Biológicas. Laboratório de Imunopatologia. Ouro Preto, MG, BrazilUniversidade Federal de Ouro Preto. Núcleo de Pesquisas em Ciências Biológicas. Laboratório de Imunopatologia. Ouro Preto, MG, BrazilUniversidade Federal de Ouro Preto. Núcleo de Pesquisas em Ciências Biológicas. Laboratório de Imunopatologia. Ouro Preto, MG, BrazilUniversidade Federal de Ouro Preto. Núcleo de Pesquisas em Ciências Biológicas. Laboratório de Imunopatologia. Ouro Preto, MG, BrazilUniversidade Federal de Ouro Preto. Núcleo de Pesquisas em Ciências Biológicas. Laboratório de Imunopatologia. Ouro Preto, MG, BrazilFundação Oswaldo Cruz. Centro de Pesquisas René Rachou. Laboratório de Biomarcadores de Diagnóstico e Monitoração. Belo Horizonte, MG, BrazilUniversidade Federal de Ouro Preto. Escola de Farmácia. Departamento de Análises Clínicas. Ouro Preto, MG, BrazilUniversidade Federal de Ouro Preto. Escola de Farmácia. Departamento de Análises Clínicas. Ouro Preto, MG, Brazil/Universidade Federal de Ouro Preto. Núcleo de Pesquisas em Ciências Biológicas. Laboratório de Imunopatologia. Ouro Preto, Minas Gerais, BrazilVaccine adjuvants are substances associated with antigens that are fundamental to the formation of an intense, durable, and fast immune response. In this context, the use of vaccine adjuvants to generate an effective cellular immune response is crucial for the design and development of vaccines against visceral leishmaniasis. The objective of this study was to evaluate innate inflammatory response induced by the vaccine adjuvants saponin (SAP), incomplete Freund’s adjuvant (IFA), and monophosphoryl lipid A (MPL). After a single dose of adjuvant was injected into the skin of mice, we analyzed inflammatory reaction, selective cell migration, and cytokine production at the injection site, and inflammatory cell influx in the peripheral blood. We found that all vaccine adjuvants were able to promote cell recruitment to the site without tissue damage. In addition, they induced selective migration of neutrophils, macrophages, and lymphocytes. The influx of neutrophils was notable at 12 h in all groups, but at other time points it was most evident after inoculation with SAP. With regard to cytokines, the SAP led to production of interleukin (IL)-2, IL-6, and IL-4. IFA promoted production of tumor necrosis factor (TNF)-α, interferon (IFN)-γ, IL-6, IL-17, IL-4, and IL-10. We also observed that MPL induced high production of IL-2, TNF-α, and IFN-γ, in addition to IL-6, IL-17, and IL-10. In peripheral blood, values of certain cell populations in the local response changed after stimulation. Our data demonstrate that the three vaccine adjuvants stimulate the early events of innate immune response at the injection site, suggesting their ability to increase the immunogenicity of co-administered antigens. Moreover, this work provides relevant information about elements of innate and acquired immune response induced by vaccine adjuvants administered alone

Hematological profile of peripheral blood from mice after sensitization with vaccine adjuvants: saponin (SAP), incomplete Freund’s adjuvant (IFA), and monophosphoryl lipid A (MPL) at 1, 12, 24, 48, 96, 168, and 336 h after stimulation.

<p>The control group (C) was inoculated with 0.9% sterile saline. The absolute numbers (mm³) of total leukocytes and their subsets (neutrophils, monocytes, and lymphocytes) are expressed as mean ± standard deviation from groups of five animals/evaluation time. Significant differences (p<0.05) between groups are represented by the letters a, b, c, and d, referring to the C, SAP, IFA, and MPL groups, respectively.</p

Enumeration of the different cell types (neutrophils, macrophages, and lymphocytes) in the inflammatory focus in mouse skin after sensitization with vaccine adjuvants: saponin (SAP; light gray), incomplete Freund’s adjuvant (IFA; medium gray), and monophosphoryl lipid A (MPL; dark gray) at 1, 12, 24, 48, 96, 168, and 336 h after stimulation.

<p>The control group was inoculated with 0.9% sterile saline (C; white). The representative time-lapse graphic demonstrates the major inflammatory cells that migrated to the skin after sensitization: neutrophils (light gray), lymphocytes (medium gray), and macrophages (dark gray). Five mice were used in each group/evaluation time.</p

Leukocyte immunophenotypic profile in peripheral blood of mice sensitized with vaccine adjuvants: saponin (SAP; light gray), incomplete Freund’s adjuvant (IFA; medium gray), and monophosphoryl lipid A (MPL; dark gray) at 24 or 48 h after stimulation.

<p>The control group was inoculated with 0.9% sterile saline (C; white). The bar graphs present the percentage of cells expressing CD14⁺ (monocytes), CD19⁺ (B lymphocytes), and CD4⁺ and CD8⁺ (T-lymphocyte subsets). Significant differences (p<0.05) between groups are represented by the letters a, b, c and d, referring to the C, SAP, IFA, and MPL groups, respectively, and ANOVA following Tukey’s test was employed. Data presented are the mean±SD from groups of five animals/evaluation time.</p

Quantification of the cellular infiltrate in the skin of mice after sensitization with different vaccine adjuvants: saponin (SAP; light gray), incomplete Freund’s adjuvant (IFA; medium gray), and monophosphoryl lipid A (MPL; dark gray) at 1, 12, 24, 48, 96, 168, and 336 h after stimulation.

<p>The control group (C; white) was inoculated with 0.9% sterile saline (A). Significant differences (p<0.05) between groups are represented by the letters a, b, c, and d, referring to the C, SAP, IFA, and MPL groups, respectively, and ANOVA following Tukey’s test was employed. The dashed line represents the average number of cell nuclei quantified in histological sections of the skin mouse sensitized with saline. Data presented are the mean±SD from groups of five animals/evaluation time. (B) Representative photomicrographs of the cellular infiltrate at 48 h is shown at the bottom of <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0040745#pone-0040745-g001" target="_blank">Figure 1</a>. Skin mice sensitized with saline and the vaccine adjuvants: Saponin (B), IFA (C), MPL (D) at a magnification of 20×; bar  = 100 µm.</p

Cytokine pattern in the homogenate of mouse skin after sensitization with vaccine adjuvants saponin (SAP; light gray), incomplete Freund’s adjuvant (IFA; medium gray), and monophosphoryl lipid A (MPL; dark gray) at 12, 48, and 168 h after stimulation.

<p>The control group was inoculated with 0.9% sterile saline (C; white). The results are normalized as the ratio between the levels of cytokine (pg/mL) and weight of tissue (mg). Significant differences (p<0.05) between groups are represented by the letters a, b, c and d, referring to the C, SAP, IFA, and MPL groups, respectively, and ANOVA following Tukey’s test was employed. Data presented are the mean±SD from groups of five animals/evaluation time.</p

Kinetics of pro-inflammatory and regulatory (TNF-α IL-6, IFN-γ IL-2, IL-17, IL-4, and IL-10) cytokines in the skin of mice after sensitization with vaccine adjuvants: saponin (SAP; gray circle), incomplete Freund’s adjuvant (IFA; gray inverted triangle), and monophosphoryl lipid A (MPL; black triangle) at 1, 12, 24, 48, 96, 168, and 336 h after stimuli.

<p>The control group was inoculated with 0.9% sterile saline (C; white square). Significant differences (p<0.05) between groups are represented by the letters a, b, c and d referring to the C, SAP, IFA, and MPL groups, respectively. Five mice were used in each group/evaluation time.</p

Notícias de uma guerra: estratégias, ameaças e orações

Neste artigo pretendo abordar algumas questões observadas durante as eleições municipais de 2004 na Baixada Fluminense, fundamentalmente em Nova Iguaçu, focalizando como a religião, em um momento específico, foi apropriada pelo discurso político objetivando sua potencialidade eleitoral. Assim, descreverei alguns conflitos (políticos) em torno de algumas personalidades da/na Baixada e em que medida o auxílio à temática religiosa, fundamentalmente a evangélica, foi importante para reconfigurar o campo político na região durante o segundo turno das eleições municipais.<br>In this article I propose analyze some questions observed in Baixada Fluminense's 2004 election, basically in Nova Iguaçu, giving emphasis on the religion dimension and how it was appropriated by a political discourse with electoral purposes. Then, I will describe some conflicts (political conflicts) about some Baixada's politicians and how the religion was important to reconfigure the political camp during the election