A contribuição da risoterapia na terceira idade em uma instituição de longa permanência em um município do interior de Pernambuco / The contribution of risoterapia in the elderly in an institution of long stay in a municipality of Pernambuco interior

O presente estudo teve como objetivo evidenciar o protagonismo da enfermagem ao desenvolver atividades que possam elevar a autoestima de idosos institucionalizados através de atividades lúdicas que estimulassem a risoterapia. Trata-se de um estudo descritivo, transversal e de abordagem quantitativa, realizado com 22 idosos em uma instituição filantrópica de longa permanência para idosos no interior de Pernambuco. A pesquisa foi realizada através de questionários em duas etapas, uma sobre a vida do idoso e outra sobre as atividades de risoterapia, aplicados de maneira individual, em ambiente aberto. Os resultados apontam que o sexo feminino prevaleceu, a idade variou entre 74 e 78 anos, solteiros, sem filhos, a maioria mora na instituição há anos e refere ter uma vida boa. Sobre as atividades de risoterapia a maioria disse sentir alegria e entusiasmo ao participar, metade mencionou o desejo de voltar a participar dessas atividades outras vezes. Portanto devemos promover atividades lúdicas com o intuito de oferecer momentos de distração e alegria para as pessoas da terceira idade, inclusive para os idosos moradores de instituições de longa permanência

Análise morfométrica de micronúcleos e colágeno intersticial em tumores de mama

The present work aims to establish the density of micronucleus and interstitial collagen distribution of benign and malign tumoral diseases from human breast. The Feulgen reaction and Thricromic of Masson histochemical methods associated to digital image analysis were used. Slices (4 µm) were selected containing biopy fragments, diagnosed as Fibroadenoma (FA), Fibrocystic disease (FD) and Infiltrated ductal carcinoma (IDC). The results of the mean number of micronucleus exhibited similar values in FA (90.8 ± 4.5), FD (80.3 ± 4.0) and normal tissue (83.0 ± 4.1). However, significantly lower values than those were found in IDC (176.5 ± 88). The interstitial collagen distribution showed a significant increase (p < 0,001) in the FA (8101.4 ± 405.07) and FD (7046.78 ± 352.33) cases, when compared to the normal mammary tissue (1733.13 ± 86.65) and IDC (2165.94 ± 108.29). These findings suggested that the Feulgen reaction associated with digital image analysis can be used to evidence important and specific nuclear and extracellular alterations in the breast tumor diseases.O presente trabalho estabeleceu a densidade de micronúcleos e a distribuição do colágeno intersticial no tecido tumoral benigno e maligno de mama humana. Foram utilizadas a reação histoquímica de Feulgen e tricrômico de Masson, e a análise digital de imagens. Foram selecionados fragmentos de tecido mamário, diagnosticados como Fibroadenoma (FA), Doença fibrocística (DF) e Carcinoma Ductal Infiltrante (CDI). Para controle, foram utilizadas amostras de plástica mamária com tecido normal. A reação histoquímica foi realizada através da reação de Feulgen, para evidenciação dos micronúcleos, e, para a análise de colágeno intersticial, foi utilizada a coloração tricrômico de Masson. O número médio de micronúcleos exibiu valores semelhantes em amostra de FA (90,8 ± 4,5), DF (80,3 ± 4,0) e tecido normal (83,0 ± 4,1). Entretanto, valores significativamente menores que aqueles foram encontrados no CDI (176,5 ± 88,3). Quanto à distribuição do colágeno intersticial, constatou-se um aumento estatisticamente significante (p< 0,001) nos casos de FA (8101,4 ± 405,07) e DF (7046,78 ± 352,33), quando comparados ao tecido mamário normal (1733,13 ± 86,65) e ao CDI (2165,94 ± 108,29). Pode-se concluir que tanto o método de análise de imagem como a reação de Feulgen mostraram-se eficientes para evidenciar as alterações do núcleo celular e da matriz extracelular de tumores de mama

Roles of non-coding RNA in sugarcane-microbe interaction

Studies have highlighted the importance of non-coding RNA regulation in plant-microbe interaction. However, the roles of sugarcane microRNAs (miRNAs) in the regulation of disease responses have not been investigated. Firstly, we screened the sRNA transcriptome of sugarcane infected with Acidovorax avenae. Conserved and novel miRNAs were identified. Additionally, small interfering RNAs (siRNAs) were aligned to differentially expressed sequences from the sugarcane transcriptome. Interestingly, many siRNAs aligned to a transcript encoding a coppertransporter gene whose expression was induced in the presence of A. avenae, while the siRNAs were repressed in the presence of A. avenae. Moreover, a long intergenic non-coding RNA was identified as a potential target or decoy of miR408. To extend the bioinformatics analysis, we carried out independent inoculations and the expression patterns of six miRNAs were validated by quantitative reverse transcription-PCR (qRT-PCR). Among these miRNAs, miR408—a copper- microRNA—was downregulated. The cleavage of a putative miR408 target, a laccase, was confirmed by a modified 50RACE (rapid amplification of cDNA ends) assay. MiR408 was also downregulated in samples infected with other pathogens, but it was upregulated in the presence of a beneficial diazotrophic bacteria. Our results suggest that regulation by miR408 is important in sugarcane sensing whether microorganisms are either pathogenic or beneficial, triggering specific miRNA-mediated regulatory mechanisms accordingly

Genomic Surveillance of Yellow Fever Virus Epizootic in São Paulo, Brazil, 2016 – 2018

São Paulo, a densely inhabited state in southeast Brazil that contains the fourth most populated city in the world, recently experienced its largest yellow fever virus (YFV) outbreak in decades. YFV does not normally circulate extensively in São Paulo, so most people were unvaccinated when the outbreak began. Surveillance in non-human primates (NHPs) is important for determining the magnitude and geographic extent of an epizootic, thereby helping to evaluate the risk of YFV spillover to humans. Data from infected NHPs can give more accurate insights into YFV spread than when using data from human cases alone. To contextualise human cases, identify epizootic foci and uncover the rate and direction of YFV spread in São Paulo, we generated and analysed virus genomic data and epizootic case data from NHPs in São Paulo. We report the occurrence of three spatiotemporally distinct phases of the outbreak in São Paulo prior to February 2018. We generated 51 new virus genomes from YFV positive cases identified in 23 different municipalities in São Paulo, mostly sampled from NHPs between October 2016 and January 2018. Although we observe substantial heterogeneity in lineage dispersal velocities between phylogenetic branches, continuous phylogeographic analyses of generated YFV genomes suggest that YFV lineages spread in São Paulo at a mean rate of approximately 1km per day during all phases of the outbreak. Viral lineages from the first epizootic phase in northern São Paulo subsequently dispersed towards the south of the state to cause the second and third epizootic phases there. This alters our understanding of how YFV was introduced into the densely populated south of São Paulo state. Our results shed light on the sylvatic transmission of YFV in highly fragmented forested regions in São Paulo state and highlight the importance of continued surveillance of zoonotic pathogens in sentinel species

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030