Protein Kinase C δ: a Gatekeeper of Immune Homeostasis

Human autoimmune disorders present in various forms and are associated with a life-long burden of high morbidity and mortality. Many different circumstances lead to the loss of immune tolerance and often the origin is suspected to be multifactorial. Recently, patients with autosomal recessive mutations in PRKCD encoding protein kinase c delta (PKC) have been identified, representing a monogenic prototype for one of the most prominent forms of humoral systemic autoimmune diseases, systemic lupus erythematosus (SLE). PKC is a signaling kinase with multiple downstream target proteins and with functions in various signaling pathways. Interestingly, mouse models have indicated a special role of the ubiquitously expressed protein in the control of B-cell tolerance revealed by the severe autoimmunity in Prkcd / knockout mice as the major phenotype. As such, the study of PKC deficiency in humans has tremendous potential in enhancing our knowledge on the mechanisms of B-cell tolerance.(VLID)347918

HUMOR GRÁFICO Y EDUCACIÓN AMBIENTAL: IRREVERENCIA Y CREATIVIDAD EN LAS PRÁCTICAS PEDAGÓGICAS CON NIÑOS

Este artigo discorre sobre a aproximação do humor gráfico e da educação ambiental em ações e práticas pedagógicas, nas quais exercícios críticos de reflexão e de produção de desenhos potencializam as relações da criança com o ambiente. Dessa forma, aciona a sua capacidade criativa e outras formas de pensar e compreender a realidade e nela agir.This paper is derived from a Master’s thesis entitled “ Humor Gráfico: linguagem e crítica para uma Educação Ambiental sem fronteiras” (Graphic Humor: language and criticism for an Environmental Education without frontiers). The object of research was the 1ª Mostra Internacional de Humor sobre Educação Ambiental (First International Exhibition of Humor on Environmental Education) carried out during the V Colóquio de Pesquisadores em Educação Ambiental da Região Sul do Brasil (V Colloquim of Researchers in Environmental Education in the South Region of Brazil - V CPEASUL) and the IV Encontro e Diálogos com a Educação Ambiental (IV Meeting and Dialogs with Environmental Education - IV EDEA). Both events were organized by the Post-graduate Program in Environmental Education of the Universidade Federal do Rio Grande, located in Rio Grande, RS, Brazil, in 2012. This paper deals with the interface between graphic humor and Environmental Education, through the use of cartoons shown in the event, and also through the work of cartoonists Edgar Vasques and Renato Canini, as examples of how satirical caricatures, cartoons, comic strips and comic books can trigger reflection and the aesthetic production of drawings in order to potentialize the child’s relationship with the environment. In this process, the child’s creative capacity and other ways of thinking, understanding and interacting with the realities of the world will be activated.Este artículo deriva de la Disertación de Maestría intitulada “Humor Gráfico: lenguaje y crítica para una Educación Ambiental sin fronteras”, cuyo objeto de investigación fue la 1ª Muestra Internacional de Humor sobre Educación Ambiental, realizada durante el V CPEASUL – Coloquio de Investigadores en Educación Ambiental de la Región Sur de Brasil y el IV EDEA – Encuentro y Diálogos con la Educación Ambiental, promovidos por el Programa de Posgrado en Educación Ambiental de la Universidad Federal de Rio Grande en 2012. El presente artículo trata de la aproximación entre el humor gráfico y la Educación Ambiental, utilizando las historietas que integraron la muestra y el trabajo de los dibujantes Edgar Vasques y Renato Canini a título de ejemplo de cómo la caricatura, la historieta, las tiras y las viñetas pueden constituir disparadores de la reflexión y de la estética de producción de dibujos para potencializar las relaciones del niño con el ambiente. En ese proceso será accionada la capacidad creativa y otras formas de pensar, comprender e interactuar con las realidades del mundo

Mycetoma em paciente HIV positivo

Os autores relatam um caso de actinomicetoma em pacientes HIV positivo. Apesar das infecções fúngicas oportunistas serem freqüentemente observadas em pacientes infectados pelo HIV, a associação com micetoma nunca foi descrita. O diagnóstico foi confirmado pelo exame micolígico direto de grãos obtidos da secreção e de exame anátomo-patológico. Não foi possível identificar o agente, mas as características sugerem tratar-se de actinomiceto. Os autores acreditam que a localização no membro superior possa estar relacionada com o uso de seringas e agulhas contaminadas para injeção de drogas EV.Although oportunistic fungal infections occur commonly in immunocompromised hosts, mycetoma has never been reported in association with HIV infection. The authors present a case that to their knowledge is the first reported case of mycetoma associated with HIV infection. Diagnosis was confirmed by direct examination of grains and histologic examination. Precise identification of the agent, an actinomycete, was not possible. The unusual site of infection may probably be related to the use of contaminated needless and sirynges for HIV drug injection

Contaminação de telefones celulares da equipe multiprofissional em uma unidade de terapia intensiva

Observa-se o uso indiscriminado de celulares pelos profissionais de saúde dentro da Unidade de Terapia Intensiva (UTI). Os objetivos deste estudo são investigar se há contaminação bacteriana por Staphylococcus nos telefones celulares da equipe multiprofissional de uma UTI e identificar se estes profissionais realizam algum tipo de desinfecção em seus aparelhos celulares. Foram coletados 50 swabs para amostras da superfície de aparelhos celulares de membros da equipe da UTI de um hospital da região sul fluminense. Para identificar se os profissionais realizavam algum tipo de limpeza em seu aparelho, foi aplicado um questionário semiestruturado. Verificou-se que em 100% (50) dos aparelhos analisados cresceu Staphylococcus, 72% (36) das amostras eram coagulase negativo (S. spp), e 28% (14) amostras eram coagulase positiva (S. aureus). Em relação à sensibilidade à oxacilina, identificou-se em 18% (9) dos aparelhos o S. aureus resistente a meticilina (MRSA). Mais ainda, apenas 24% (12) dos profissionais têm o hábito de realizar a desinfecção seu aparelho celular. Este fato pode vir a ser um fator de propagação e disseminação destes microrganismos dentro do ambiente hospitalar e na comunidade em geral. Entende-se que há uma necessidade urgente da conscientização, através da educação continuada, desta comunidade hospitalar

Micronutrient supplementation adherence and influence on the prevalences of anemia and iron, zinc and vitamin A deficiencies in preemies with a corrected age of six months

OBJECTIVE: To analyze adherence to the recommended iron, zinc and multivitamin supplementation guidelines for preemies, the factors associated with this adherence, and the influence of adherence on the occurrence of anemia and iron, zinc and vitamin A deficiencies. METHODS: This prospective cohort study followed 58 preemies born in 2014 until they reached six months corrected age. The preemies were followed at a referral secondary health service and represented 63.7% of the preterm infants born that year. Outcomes of interest included high or low adherence to iron, zinc and multivitamin supplementation guidelines; prevalence of anemia; and prevalences of iron, zinc, and vitamin A deficiencies. The prevalence ratios were calculated by Poisson regression. RESULTS: Thirty-eight (65.5%) preemies presented high adherence to micronutrient supplementation guidelines. At six months of corrected age, no preemie had vitamin A deficiency. The prevalences of anemia, iron deficiency and zinc deficiency were higher in the low-adherence group but also concerning in the high-adherence group. Preemies with low adherence to micronutrient supplementation guidelines were 2.5 times more likely to develop anemia and 3.1 times more likely to develop zinc deficiency. Low maternal education level increased the likelihood of nonadherence to all three supplements by 2.2 times. CONCLUSIONS: Low maternal education level was independently associated with low adherence to iron, zinc and vitamin A supplementation guidelines in preemies, which impacted the prevalences of anemia and iron and zinc deficiencies at six months of corrected age

Nutritional profile of newborns with microcephaly and factors associated with worse outcomes

OBJECTIVE: To describe the nutritional profile of newborns with microcephaly and factors associated with worse outcomes during the first 14 days of life. METHODS: This investigation is a longitudinal, descriptive study carried out in 21 full-term neonates exposed vertically to the Zika virus and hospitalized in a neonatal intensive care unit from February to September 2016. Patients receiving parenteral nutrition were excluded. Data analysis was performed using a generalized estimating equation model and Student’s t-test to evaluate the association between worsening weight-for-age z-scores and independent clinical, sociodemographic and nutritional variables during hospitalization, with po0.05 indicating significance. RESULTS: During hospitalization, there was a decrease in the mean values of the weight-for-age z-scores. The factors associated with worse nutritional outcomes were symptomatic exposure to the Zika virus, low maternal schooling, absence of maternal income and consumption of infant formula (po0.05). Calcification and severe microcephaly were also associated with poor nutritional outcomes. Energy and macronutrient consumption remained below the recommendations and had an upward trend during hospitalization. CONCLUSION: The presence of cerebral calcification, the severity of microcephaly and symptomatic maternal exposure to Zika virus affected the nutritional status of newborns. In terms of nutritional factors, human milk intake had a positive impact, reducing weight loss in the first days of life. Other known factors, such as income and maternal schooling, were still associated with a poor nutritional status

PREVALÊNCIA DE INFECÇÃO DO TRATO URINÁRIO E PERFIL DE SENSIBILIDADE BACTERIANA AOS ANTIMICROBIANOS PRESCRITOS PARA GESTANTES DO HOSPITAL ESCOLA DE VALENÇA

Introdução: A ITU é a terceira ocorrência clínica mais comum durante a gestação, podendo estar associado a complicações maternas como a hipertensão/préeclâmpsia, corioamnionite e endometrite. Os profissionais responsáveis pelo prénatal enfrentam problemas diante do tratamento das ITUs, devido a restrita opção de antibióticos considerando a toxidade de algumas substâncias para o embrião. Objetivo- Os objetivos deste trabalho foram avaliar a prevalência de ITU em gestantes atendidas no Hospital Escola de Valença-RJ, identificar as bactérias causadoras da infecção, avaliar o perfil de sensibilidade das cepas aos antimicrobianos prescritos e avaliar a relação sociocultural das gestantes. Materiais e Métodos- O estudo contou com a participação de gestantes em acompanhamento pré-natal apresentando sintomatologia clínica compatível com infecção urinária em qualquer período gestacional. Foram analisados os resultados de urinocultura com antibiograma e aplicado um questionário sócio-cultural-clínico para evidenciar tratamentos pregressos de ITU e condições socioeconômicas desta população. Resultados- Nosso estudo demonstrou que, dentro do espectro bacteriano que pode causar ITU na gestante, Escherichia coli é o uropatógeno mais comum, responsável por aproximadamente 80% dos casos. A análise de sensibilidade bacteriana aos antibióticos confirma que a prescrição de antibioticoterapia empírica é segura e eficaz para o tratamento das ITUs nas gestantes. Conclusão: Este estudo dará ao médico subsídio para prescrever empiricamente com maior grau de certeza visando a eficácia do tratamento

Eficácia do álcool gel na desinfecção de estetoscópios contaminados por Staphylococcus aureus resistente à meticilina

Background and Objectives: Although widely used, little attention has been given to basic-care in handling and disinfection of stethoscopes. Methicillin-resistant Staphylococcus aureus is frequently found and a major risk for hospitalized patients. Alcohol gel contains properties admittedly effective to exterminate germs that are frequently involved in infections. This study aims to verify the effectiveness of alcohol gel in stethoscopes disinfection contaminated with MRSA used by healthcare professionals of a University Hospital in Rio de Janeiro State. Methods: Health care professionals were selected randomly from August to November 2012, and collected samples with sterile swab of 105 stethoscopes before and after cleaning with alcohol gel 70% and performed cultures and bacterial identification. Results: Bacterial contamination was present in 87 (82.85%) of the analyzed stethoscopes. Gram positive bacteria were identified in 76 (72.38%). S. aureus was present in 7.61% of stethoscopes and MRSA in 87.5% of them. After using the alcohol gel, there was a reduction of 71,44% of the general bacterial contamination and MRSA elimination of 100% of the analyzed stethoscopes. Conclusion: One should improve care in cleaning of stethoscopes due to the risk of carrying pathogenic bacteria involved in hospital infections. The alcohol gel showed to be adequate for disinfection of stethoscopes contaminated with MRSA. KEYWORDS: Stethoscopes. Contamination. Ethanol. Disinfection. Methicillinresistant Staphylococcus aureus.Justificatica e Objetivos: Apesar de muito utilizados, pouca atenção tem sido dispensada aos cuidados básicos no manuseio e desinfecção dos estetoscópios. Staphylococcus aureus resistente à meticilina (MRSA) é frequentemente encontrado nestes instrumentos, sendo um grande risco para pacientes hospitalizados. O álcool gel possui propriedades reconhecidamente eficazes para eliminar os microrganismos mais frequentemente envolvidos nas infecções. Esse estudo tem o objetivo de verificar a eficácia do álcool gel na desinfecção dos estetoscópios contaminados por MRSA utilizados pelos profissionais de saúde de um Hospital Universitário do Rio de Janeiro. Métodos: Profissionais de saúde foram selecionados de forma aleatória de agosto a novembro de 2012, sendo coletadas amostras com swab estéril de 105 estetoscópios antes e após a higienização com álcool gel 70% e realizadas culturas e identificação de bactérias. Resultados: A contaminação bacteriana estava presente em 87 (82,85%) estetoscópios analisados, sendo que em 76 (72,38%) foram identificadas bactérias Gram positivas. S. aureus estava presente em 7,61% dos estetoscópios e MRSA em 87,5% destes. Após o uso do álcool gel, houve redução de 71,44%da contaminação bacteriana geral e eliminação de MRSA em 100% dos estetoscópios analisados. Conclusão: Deve-se melhorar o cuidado na higienização dos estetoscópios, pelo risco de carrear bactérias patogênicas envolvidas em infecções hospitalares. O álcool gel mostrou-se adequado para desinfecção de estetoscópios contaminados por MRSA. DESCRITORES: Estetoscópios. Contaminação. Álcool etílico. Desinfecção. Staphylococcus aureus resistente à meticilina

Tactile massage and hypnosis as a health promotion for nurses in emergency care-a qualitative study

<p>Abstract</p> <p>Background</p> <p>This study explores nursing personnel's experiences and perceptions of receiving tactile massage and hypnosis during a personnel health promotion project. Nursing in a short term emergency ward environment can be emotionally and physically exhausting due to the stressful work environment and the high dependency patient care. A health promotion project integrating tactile massage and hypnosis with conventional physical activities was therefore introduced for nursing personnel working in this setting at a large university hospital in Sweden.</p> <p>Methods</p> <p>Four semi-structured focus group discussions were conducted with volunteer nursing personnel participants after the health promotion project had been completed. There were 16 participants in the focus groups and there were 57 in the health promotion intervention. The discussions were transcribed verbatim and analysed with qualitative content analysis.</p> <p>Results</p> <p>The findings indicated that tactile massage and hypnosis may contribute to reduced levels of stress and pain and increase work ability for some nursing personnel. The sense of well-being obtained in relation to health promotion intervention with tactile massage and hypnosis seemed to have positive implications for both work and leisure. Self-awareness, contentment and self-control may be contributing factors related to engaging in tactile massage and hypnosis that might help nursing personnel understand their patients and colleagues and helped them deal with difficult situations that occurred during their working hours.</p> <p>Conclusion</p> <p>The findings indicate that the integration of tactile massage and hypnosis in personnel health promotion may be valuable stress management options in addition to conventional physical activities.</p