Leishmania infantum detection in Nyssomyia neivai and dogs in Southern Brazil.

BACKGROUND: The sand fly Nyssomyia neivai is one of the most abundant species in Southern Brazil. It is frequently found in areas that are foci of visceral leishmaniasis in the state of Santa Catarina, caused by Leishmania infantum. In this region, the main vector of L. infantum, Lutzomyia longipalpis, has not been detected. In the absence of L. longipalpis, this study aimed to identify the sand fly fauna and diagnose any potential Leishmania spp. infection in sand flies and in dogs in a region of Southern Brazil that experienced a recent canine visceral leishmaniasis outbreak. METHODS: This report includes a survey of the sand fly fauna at the Zoonosis Control Center of the Municipality of Tubarão (Santa Catarina, Brazil). Molecular tests were conducted to investigate Leishmania spp. natural infection in sand flies using polymerase chain reaction (PCR). In positive females, in addition to morphological identification, molecular analysis through DNA barcoding was performed to determine the sand fly species. Additionally, the dogs were tested for the presence of Leishmania spp. using a non-invasive technique for the collection of biological material, to be assessed by PCR. RESULTS: A total of 3419 sand flies, belonging to five genera, were collected. Nyssomyia neivai was the most abundant species (85.8%), followed by Migonemyia migonei (13.3%), Pintomyia fischeri (0.8%), Evandromyia edwardsi (< 0.1%), and species of the genus Brumptomyia. (0.1%). Out of the 509 non-engorged females analyzed by PCR, two (0.4%) carried L. infantum DNA. The naturally infected females were identified as Ny. neivai, in both morphological and molecular analysis. In addition, two out of 47 conjunctival swabs from dogs tested positive for L. infantum, yielding an infection rate of 4.2%. CONCLUSIONS: These results confirm the presence of Ny. neivai naturally infected with L. infantum in an area where dogs were also infected by the parasite, suggesting its potential role as a vector in Southern Brazil.

Critical Factors Associated with Morbimortality in COVID-19 Patients Attended at a Brazilian Public Hospital: a Cross-Sectional Study / Fatores Críticos Associados à Morbimortalidade em Pacientes com COVID-19 Atendidos em um Hospital Público Brasileiro: um Estudo Transversal

The association between death from Covid-19 and case management, especially in small and medium-sized municipalities, is still uncertain. To analyze sociodemographic, clinical, and pharmacological factors associated with death in patients with Coronavirus Disease 2019 (COVID-19), from a Brazilian referral public hospital. This is a cross-sectional study, with data from the hospital records of patients (≥ 18 years old) diagnosed with COVID-19, from March 2020 to March 2021. The sample was classified according to the clinical outcome into two groups (death and discharge), among which statistical associations were performed with the variables of interest, with a 5% significance level. Factors such as need for intensive care, use of mechanical ventilation, and total length of hospital stay was related to higher hospital mortality, as well as the permanence of changes in clinical laboratory testing, including lactic acid, D-dimer, markers of hepatic and renal function, C-Reactive protein, anemia, leukocytosis, lymphopenia, thrombocytopenia, pH, and blood oxygen saturation (SpO2) (P < 0.05). Medications used most frequently in the studied hospital for the treatment of COVID-19, such as enoxaparin, dexamethasone, ivermectin, acetylcysteine, chloroquine, and clarithromycin were correlated with morbimortality (P < 0.05). Clinical outcome was influenced by patient-related factors, such as age and comorbidities, however, therapeutic interventions and the choice of medication also impacted morbimortality. These results reinforce the need for preventive actions and adequate clinical protocols in the treatment of hospitalized COVID-19 patients.(AU)

A associação entre o óbito pela Covid-19 e o manejo dos casos, principalmente em municípios de pequeno e médio porte, ainda é incerta. Analisar os fatores sociodemográficos, clínicos e farmacológicos associados à morte em pacientes com a doença do Coronavírus 2019 (COVID-19) em um hospital público brasileiro de referência. Trata-se de um estudo transversal realizado com dados dos prontuários de pacientes (≥ 18 anos) diagnosticados com COVID-19 no período de março de 2020 a março de 2021. A amostra foi classificada de acordo com o desfecho clínico em dois grupos (óbito e alta) e foram realizados testes de associação estatística com as variáveis de interesse com nível de significância de 5%. Fatores como necessidade de terapia intensiva, uso de ventilação mecânica e tempo total de internação estiveram relacionados com maior mortalidade hospitalar, assim como a permanência de alterações nos exames laboratoriais clínicos, incluindo ácido lático, D-dímero, marcadores de função hepática e renal, proteína C reativa, anemia, leucocitose, linfopenia, trombocitopenia, pH e saturação de oxigênio no sangue (SpO2) (P < 0,05). Os medicamentos utilizados com maior frequência no hospital para o tratamento de COVID-19, como enoxaparina, dexametasona, ivermectina, acetilcisteína, cloroquina e claritromicina, foram correlacionados com morbimortalidade (P < 0,05). O desfecho clínico foi influenciado por fatores relacionados ao paciente, como idade e comorbidades, porém as intervenções terapêuticas e a escolha dos medicamentos também impactaram na morbimortalidade. Esses resultados reforçam a necessidade de ações preventivas e protocolos clínicos adequados no tratamento de pacientes hospitalizados com COVID-19.(AU)

Diretivas antecipadas de vontade na percepção de estudantes de Medicina / Advance directives in the perception of Medical students

Resumo: Introdução: A autonomia do paciente na tomada de decisões a respeito da sua vida e das condutas diagnósticas e terapêuticas na sua saúde tem sido objeto de valorização social crescente. As diretivas antecipadas de vontade surgem, então, como um meio de o paciente expressar sua última vontade, salvaguardando o princípio da autonomia. No processo de aprendizagem acadêmica, na maioria das escolas médicas, o acadêmico se compromete com a vida, e toda a sua capacitação é fundamentada em aspectos técnicos, e apenas uma pequena parte do currículo, quando presente, abrange conteúdo específico voltado para a terminalidade da vida. A medicina evoluiu com importantes avanços tecnológicos que resultaram em melhorias na qualidade de vida, porém também trouxeram um prolongamento questionável da vida, com tratamentos muitas vezes injustificáveis e com a obstinação terapêutica de manter a vida a qualquer custo. Objetivo: Este estudo teve como objetivo analisar a percepção de estudantes de Medicina sobre as diretivas antecipadas de vontade. Método: O instrumento de pesquisa foi elaborado com uma entrevista individual e semiestruturada, aplicada pela plataforma de pesquisa Google Forms. Por causa do período de pandemia pelo Sars-CoV-2, a pesquisa foi realizada de forma não presencial em conformidade com a legislação vigente nacional. Após fechamento da amostra por exaustão, analisaram-se as respostas de 13 estudantes. Resultado: Em conformidade aos elementos, passos e critérios metodológicos, as informações obtidas foram classificadas e dispostas em duas categorias: dignidade da pessoa humana e autonomia do paciente; e conhecimento sobre diretivas antecipadas de vontade. Conclusão: Essa análise qualitativa trouxe à tona importantes temas, como a regulamentação que norteia as diretivas antecipadas de vontade e os princípios que envolvem a bioética, a fim de consolidar o respeito, a autonomia e a dignidade do paciente que está, ou estará, passando pela terminalidade da vida.

Abstract: Introduction: The patient's autonomy in making decisions about their life and about diagnostic and therapeutic approaches related to their health has been the object of growing social value. Then advanced directives appear to express the patient's last will, safeguarding the Principle of Autonomy. During the undergraduate learning process, students are committed to life, and all of their training is based on technical aspects. Only a small part of the curriculum covers specific contents focused on terminal illness, when present. Medicine has evolved with important technological advances that resulted in quality-of-life improvement, but also brought a questionable extension of life, with often unjustifiable treatments and a therapeutic obstinacy to maintain life at any cost. Objective: The aim of this study is to analyze the perception of medical students about end-of-life directives. Method: A descriptive qualitative research was carried out through an individual and semi-structured interview, applied through Google forms. Due to the period of pandemic caused by the SARS-CoV-2, the survey was carried out remotely, in accordance with current national legislation. After the target was attained through sample exhaustion, the responses of 13 students were analyzed. Results: In accordance with the elements, steps and methodological criteria, the obtained information was classified and arranged into two categories: Human Dignity and Patient Autonomy; Knowledge of Advance Will Directives. Conclusion: This qualitative analysis brought to light important topics such as the regulation that guides advance will directives and principles that involve bioethics, to consolidate the respect, autonomy and dignity of the patient who is, or will be, undergoing the terminality of life.

Aspectos da abordagem terapêutica sobre candidíase vulvovaginal / Aspects of the therapeutic approach to vulvovaginal candidiasis / Aspectos del abordaje terapéutico de la candidiasis vulvovaginal

A candidíase vulvovaginal, é uma infecção da vulva e vagina causada por vários tipos de Candida spp. Essa patologia afeta 75% de todas as mulheres pelo menos uma vez durante a vida, ocorrendo com mais frequência durante a idade fértil. A transmissão dessa infeção fúngica ocorre por meio de contato com mucosas e secreções em pele de portadores ou doentes, contato sexual, água contaminada e transmissão vertical. Alguns outros sintomas característicos mais vistos em casos de CVV, são lesões brancas, cremosas e planas, sendo mais intensos no período pré-menstrual, quando a acidez vaginal aumenta. numerosos antifúngicos estão disponíveis no mercado, os quais são encontrados para administração oral na forma de comprimidos ou, para uso tópico, na forma de cremes, loções, comprimidos vaginais, supositórios e tampões revestidos. O objetivo geral do trabalho foi analisar através da revisão de literatura, tratamentos convencionais e alternativos para abordagem terapêutica da Candidíase Vulvovaginal contextuando a mesma, utilizando definições, dados epidemiológicos e sua sintomatologia frente à sociedade. O presente trabalho é uma revisão integrativa, que teve a coleta de dados realizada de março de 2021 a outubro de 2021 nas bases de dados Lilacs, Scielo, Google acadêmico, A busca resultou em 902 artigos, dos quais 14 atenderam ao critério de inclusão. A busca por tratamentos frente a candidíase vulvovaginal tem se mostrado ampla de acordo com os artigos selecionadas. Concluímos que a patologia candidíase vulvovaginal, vem apresentando resistência em algumas abordagens terapêuticas, assim como algumas mulheres não aderem há algum tipo de tratamento, devido à falta de conhecimento sobre a patologia.

Vulvovaginal candidiasis is an infection of the vulva and vagina caused by various types of Candida spp. This condition affects 75% of all women at least once in their lifetime, occurring more frequently during their childbearing years. The transmission of this fungal infection occurs through contact with mucous membranes and secretions on the skin of patients or patients, sexual contact, contaminated water and vertical transmission. Some other characteristic symptoms more seen in cases of VVC are white, creamy and flat lesions, being more intense in the premenstrual period, when the vaginal acidity increases. numerous antifungals are available on the market which are available for oral administration in tablet form or, for topical use, in the form of creams, lotions, vaginal tablets, suppositories and coated tampons. The general objective of the work was to analyze, through a literature review, conventional and alternative treatments for the therapeutic approach of Vulvovaginal Candidiasis in its context, using definitions, epidemiological data and its symptoms in society. The present work is an integrative review, which had data collection carried out from March 2021 to October 2021 in the Lilacs, Scielo, Google academic databases. The search resulted in 902 articles, of which 14 met the inclusion criteria. The search for treatments against vulvovaginal candidiasis has been shown to be wide according to the selected articles. We conclude that the vulvovaginal candidiasis pathology has been showing resistance in some therapeutic approaches, as well as some women do not adhere to any type of treatment, due to lack of knowledge about the pathology.

La candidiasis vulvovaginal es una infección de la vulva y la vagina cau- sada por diversos tipos de Candida spp. Esta afección afecta al 75% de las mujeres al menos una vez en la vida, siendo más frecuente durante la edad fértil. La transmisión de esta infección fúngica se produce por contacto con mucosas y secreciones de la piel de pacientes o enfermos, contacto sexual, agua contaminada y transmisión vertical. Otros síntomas característicos más observados en los casos de CVV son las lesiones blancas, cremosas y planas, siendo más intensas en el período premenstrual, cuando aumenta la acidez vaginal. Existen en el mercado numerosos antifúngicos disponibles para adminis- tración oral en forma de comprimidos o, para uso tópico, en forma de cremas, lociones, comprimidos vaginales, supositorios y tampones recubiertos. El objetivo general del tra- bajo fue analizar, a través de una revisión bibliográfica, los tratamientos convencionales y alternativos para el abordaje terapéutico de la Candidiasis Vulvovaginal en su contexto, utilizando definiciones, datos epidemiológicos y su sintomatología en la sociedad. El pre- sente trabajo es una revisión integradora, que tuvo recolección de datos realizada de marzo de 2021 a octubre de 2021 en las bases de datos académicas Lilacs, Scielo, Google. La búsqueda resultó en 902 artículos, de los cuales 14 cumplieron los criterios de inclu- sión. La búsqueda de tratamientos contra la candidiasis vulvovaginal se ha mostrado am- plia según los artículos seleccionados. Concluimos que la patología de la candidiasis vul- vovaginal viene mostrando resistencia en algunos abordajes terapéuticos, así como algu- nas mujeres no se adhieren a ningún tipo de tratamiento, debido al desconocimiento de la patología.

Video clip for learning the physiology of lactation: evaluation by the family support network for breastfeeding women / Videoclip para aprender la fisiología de la lactancia: evaluación realizada por la red de apoyo familiar para mujeres en lactancia / Videoclipe para aprendizagem da fisiologia da lactação: avaliação pela rede de apoio familiar às lactantes

ABSTRACT Objective: to evaluate the adequacy of using a care-educational technology with video clips for learning the physiology of lactation by the family support network for breastfeeding women. Method: a methodological study guided by the Knowledge Translation in Action Model. The collection procedure was carried out from July to September 2022 in the city of Santa Cruz do Sul, state of Rio Grande do Sul, Brazil. After the childcare consultation, each puerperal woman indicated one or more members of her support network to participate in the research. In face-to-face interviews, 52 participants answered the following instruments: Assistive Technology Assessment and Face Validation of Educational Technologies in Health. Normality of the variables was verified using the Kolmogorov-Smirnov test. The quantitative variables with normal distribution were described by mean and standard deviation. Face Validity Index and Cronbach's Alpha were calculated. Results: the video clip was evaluated as adequate (1.75) in all attributes: Interactivity (1.75), Objectivity (2.00), Relevance and efficacy (2.00) and Clarity (2.00). Face validity was excellent (0.969). Both instruments obtained Cronbach's Alpha values of 0.883 and 0.852, respectively, indicating reliability in this population. Conclusion: the video clip for learning the physiology of lactation is suitable for use by the family support network for breastfeeding mothers.

RESUMEN Objetivo: evaluar lo adecuado de utilizar una tecnología de atención-educativa del tipo videoclip para aprender la fisiología de la lactancia con la red de apoyo familiar para mujeres en lactancia. Método: estudio metodológico guiado por el Modelo de Traducción del Conocimiento en Acción. Los datos se recolectaron entre julio y septiembre de 2022 en la ciudad de Santa Cruz do Sul, estado do Río Grande do Sul, Brasil. Después de la consulta de puericultura, cada puérpera indicó al menos un integrante de su red de apoyo para que participara de la investigación. En sendas entrevistas presenciales, 52 participantes respondieron los siguientes instrumentos: Evaluación de Tecnología de Asistencia y Validación de la Apariencia de Tecnologías Educativas en Salud. La normalidad de las variables se verificó con la prueba de Kolmogorov-Smirnov. Las variables cuantitativas con distribución normal se describieron con valores medios y desviaciones estándar. Se calcularon el Índice de Validez de la Apariencia y el coeficiente Alpha de Cronbach. Resultados: el videoclip fue evaluado como adecuado (1,75) en todos los atributos: Interactividad (1,75), Objetividad (2,00), Relevancia y eficacia (2,00) y Claridad (2,00). La validez de la apariencia fue excelente (0,969). Ambos instrumentos obtuvieron coeficientes Alpha de Cronbach de 0,883 y 0,852 respectivamente, indicando confiabilidad en esta población. Conclusión: el videoclip para aprender la fisiología de la lactancia es adecuado para ser usado por la red de apoyo familiar para mujeres en lactancia.

RESUMO Objetivo: Avaliar a adequação do uso da tecnologia cuidativo-educacional, do tipo videoclipe, para aprendizagem da fisiologia da lactação pela rede de apoio familiar às lactantes. Método: Estudo metodológico, guiado pelo Modelo de Tradução do Conhecimento em Ação. A coleta foi desenvolvida na cidade de Santa Cruz do Sul, no Estado do Rio Grande do Sul, Brasil, no período de julho a setembro de 2022. Após a consulta de puericultura, a puérpera indicou um ou mais membros de sua rede de apoio para participar da pesquisa. Em entrevista presencial, 52 participantes responderam os instrumentos: Avaliação de Tecnologia Assistiva e Validação de Aparência de Tecnologias Educacionais em Saúde. A normalidade das variáveis foi verificada com o teste de Kolmogorov Smirnov. As variáveis quantitativas com distribuição normal foram descritas pela média e o desvio padrão. Foram calculados o Índice de Validade de Aparência e o Alpha de Cronbach. Resultados: O videoclipe foi avaliado como adequado (1,75) em todos os atributos interatividade (1,75), objetividade (2,00), relevância e eficácia (2,00) e clareza (2,00). A validade de aparência foi excelente (0,969). Ambos os instrumentos obtiveram Alpha de Cronbach, 0,883 e 0,852 respectivamente, apontando a confiabilidade nesta população. Conclusão: O videoclipe para aprendizagem da fisiologia da lactação está adequado ao uso pela rede de apoio familiar às lactantes.

Expression of microRNAs miR-21 and miR-326 associated with HIF-1α regulation in neurospheres of glioblastoma submitted to ionizing radiation treatment.

Background: Glioblastoma is an incurable neoplasm. Its hypoxia mechanism associated with cancer stem cells (CSCs) demonstrates hypoxia-inducible factor 1α (HIF-1α) expression regulation, which is directly related to tumor malignancy. The aim of this study was to identify a possible tumor malignancy signature associated with regulation of HIF-1α by microRNAs miR-21 and miR-326 in the subpopulation of tumor stem cells which were irradiated by ion in primary culture of patients diagnosed with glioblastoma. Materials and methods: We used cellular cultures from surgery biopsies of ten patients with glioblastoma. MicroRNA expressions were analyzed through real-time polymerase chain reaction (PCR ) and correlated with mortality and recurrence. The ROC curve displayed the cutoff point of the respective microRNAs in relation to the clinical prognosis, separating them by group. Results: The miR-21 addressed high level of expression in the irradiated neurosphere group (p = 0.0028). However, miR-21 was not associated with recurrence and mortality. miR-326 can be associated with tumoral recurrence (p = 0.032) in both groups; every 0.5 units of miR-326 increased the chances of recurrence by 1,024 (2.4%). Conclusion: The high expression of miR-21 in the irradiated group suggests its role in the regulation of HIF-1α and in the radioresistant neurospheres. miR-326 increased the chances of recurrence in both groups, also demonstrating that positive regulation from miR-326 does not depend on ionizing radiation treatment.

Circulating Extracellular Vesicles and Particles Derived From Adipocytes: The Potential Role in Spreading MicroRNAs Associated With Cellular Senescence.

Aging is associated with adipose tissue dysfunction and is recognized as a risk factor for shortened life span. Considering that in vitro findings have shown the involvement of microRNA in extracellular vesicles and particles (EVPs) on senescence, we hypothesized that circulating EVPs derived from adipocytes can be involved in the aging process via their microRNA cargo. We aimed to determine the microRNA profiles of circulating EVPs derived from adipocytes (FABP4+) from aged and young adult animals and to perform in silico prediction of their downstream signaling effects. Plasma was obtained from Wistar rats (3 and 21 months old), and adipocyte-derived EVPs were isolated using the commercially available kit. Fatty acid-binding protein 4 (FABP4) was used for adipocyte-derived EVPs isolation; microRNA isolation and microarray expression analysis were performed. The analysis revealed 728 miRNAs, 32 were differentially between groups (p < 0.05; fold change ≥ |1.1|), of which 15 miRNAs were upregulated and 17 were downregulated in circulating EVPs from aged animals compared to young adults. A conservative filter was applied, and 18 microRNAs had experimentally validated and highly conserved predicted mRNA targets, with a total of 2,228 mRNAs. Canonical pathways, disease and functions, and upstream regulator analyses were performed using IPA-QIAGEN, allowing a global and interconnected evaluation. IPA categories impacted negatively were cell cycle, cellular development, cellular growth and proliferation, and tissue development, while those impacted positively were "digestive system cancer" and "endocrine gland tumor." Interestingly, the upregulated miR-15-5p targets several cyclins, such as CCND1 and CCND2, and miR-24-3p seems to target CDK4 (cyclin-dependent kinase 4); then potentially inhibiting their expression, both miRNAs can induce a negative regulation of cell cycle progression. In contrast, silencing of negative cell cycle checkpoint regulators, such as p21 and p16, can be predicted, which can induce impairment in response to genotoxic stressors. In addition, predicted targets, such as SMAD family members, seem to be involved in the positive control of digestive and endocrine tumors. Taken together, this exploratory study indicates that miRNA signature in circulating adipocyte-derived EVPs may be involved with the double-edged sword of cellular senescence, including irreversible proliferation arrest and tissue-dependent cancer, and seems to be suitable for further validation and confirmatory studies.

Expression of pluripotency-related genes in human glioblastoma.

Background: Cancer is a group of heterogeneous diseases characterized by several disruptions of the genetic and epigenetic components of cell biology. Some types of cancer have been shown to be constituted by a mosaic of cells with variable differentiation states, with more aggressive tumors being more undifferentiated. In most cases, undifferentiated tumor cells express associated embryonic markers such as the OCT4, NANOG, SOX2, and CARM1 genes. The ectopic or reminiscent expression of some master regulator genes of pluripotency has been indicated as the cause of the poorly differentiated state of tumors, and based on the evidence of some reports, can be used as a possible therapeutic target. Considering this information, a more detailed investigation of the expression of pluripotency-associated genes is necessary to evaluate the roles of these genes in the etiology of some tumors and their use targets of therapy. Methods: The expression of four pluripotency-related genes was investigated (OCT4, NANOG, SOX2, and CARM1) in the most malignant primary human brain tumor, glioblastoma (GBM). Results and Conclusion: The results demonstrated a signature of OCT4/SOX2/CARM1 genes and a significant increase of CARM1 expression in GBM cases.

Modulation of Genes and MicroRNAs in the Neurospheres of Glioblastoma Cell Lines U343 and T98G Induced by Ionizing Radiation and Temozolomide Therapy.

INTRODUCTION: Glioblastoma is the most prevalent primary malignant neoplasm of the central nervous system. It has increased its incidence, while the overall survival remains over 14 months. PURPOSE: The purpose is to evaluate the expression of the genes EGFR, PTEN, MGMT, and IDH1/2, and microRNAs miR-181b, miR-145, miR-149, and miR-128a in adhered cells (AC) and neurospheres (NS) from cell lines (T98G and U343) submitted to temozolomide (TMZ) and ionizing radiation (IR). METHODS: T98G and U343 were treated with TMZ, IR, and TMZ+IR. The analysis of gene expression and miRNAs was performed using real-time PCR. RESULTS: This study demonstrated: a) an improvement in the expression of IDH1 after IR and TMZ + IR in the NS (T98G); b) an increase in the expression of MGMT in NS (T98G) in IR groups and TMZ + IR. The expression of miRNAs results as a) AC (U343) expressed more miR-181b after TMZ, IR, and TMZ + IR; and miR-128a improved after TMZ, IR, and TMZ + IR; b) NS (T98G) after TMZ + IR expressed: miR-181b; miR-149; miR-145 and miR-128a; c) NS (U343) after IR huge expressed miR-149 and miR-145. CONCLUSION: IR was an independent and determining radioresistance factor in NS. However, we observed no complementarity action of oncomiRs regulation.

TiO2NTs bio-inspired coatings: revisiting electrochemical, morphological, structural, and mechanical properties.

By altering some synthesis variables, the morphology and structural properties of anodic TiO2nanotube arrays (TiO2NTs) can be tailored to a specific application. This study aims to investigate the effect of electrolyte-containing ions from human plasma and annealing temperature on structural, morphological, and mechanical parameters of TiO2NTs films, targeting its potential biomedical applications. Bio-inspired TiO2NTs were grown from Ticpand its Ti6Al4V alloy by potentiostatic anodization in the recently developed SBF-based electrolyte, maintained at 10 °C and 40 °C. The thermal investigation was performed by TGA/DSC and used to define the phase transition temperatures used for annealing (450 °C and 650 °C). Morphological and structural parameters were evaluated by FE-SEM, XRD, contact angle measurements, and nanoindentation. Results show that self-organized as-formed TiO2NTs were grown under all synthesis conditions with different wettability profiles for each substrate group. At 450 °C annealing temperature, the beginning of nanostructures collapse starts, becoming evident at 650 °C. The nanoindentation characterization reveals that both electrolyte and thermal annealing exhibited low effects on the hardness and Young's modulus. The tailoring of specific properties by different synthesis conditions could allow the individualization of treatments and better performancein vivo.

Humanização em saúde na graduação em medicina e sua correlação com atividades da IFMSA Brazil / Humanization in healthcare at a medical undergraduate course and its correlation with IFMSA Brazil activities

Ao correlacionar humanização e graduação de medicina, estudantes filiados à Federação Internacional das Associações dos Estudantes de Medicina do Brasil (IFMSA Brazil), realizam atividades com o intuito de disseminar e implementar conhecimentos adquiridos em sua formação. O artigo objetiva identificar como a temática 'Humanização em Saúde' é desenvolvida nos programas da Federação, correlacionando-os com literatura científica. Realizou-se uma revisão integrativa e, posteriormente, analisou-se os relatórios referentes aos programas. Os artigos abordavam formas de inserir a humanização na graduação de medicina. Em relação aos programas, 15 possuíam as palavras 'Humanização', 'Arte' e/ou 'Empatia'. Reforça-se a importância da graduação médica com olhar holístico, voltado para o método clínico centrado na pessoa. A abordagem literária foi aplicada tanto pelo professor na graduação, em literatura científica, como por alunos da Federação. Evidencia-se que a humanização em saúde é abordada tanto em atividades curriculares como em extracurriculares na graduação de medicina.

When correlating humanization and the medical undergraduate course, students affiliated to the International Federation of Medical Students' Associations- Brazil (IFMSA Brazil) carry out activities to disseminate and implement the knowledge acquired in their undergraduate course. The objective of the study was to identify how 'Humanization in Healthcare' is developed in IFMSA Brazil's programs, correlating this with the scientific literature. First, an integrative review was performed, and then the reports related to the programs were analyzed. The articles addressed ways of inserting humanization in medical undergraduate courses. Regarding the programs, 15 had the words 'Humanization', 'Art' and/or 'Empathy'. The importance of the medical undergraduate course with a holistic view, focused on the person-centered clinical method, is reinforced. The literary approach was applied both by the professor at undergraduate level, in scientific literature, and by students of the Federation. It is evident that humanization in healthcare is addressed both in curricular and in extracurricular activities in medical school.

Al correlacionar humanización y graduación médica, los estudiantes afiliados a la Federación Internacional de las Asociaciones de los Estudiantes de Medicina de Brasil (IFMSA Brazil), realizan actividades con el intento de difundir e implementar los conocimientos adquiridos en su formación. Este trabajo objetiva identificar cómo se desarrolla la 'Humanización en salud' en los programas de IFMSA Brazil correlacionándolos con la literatura. Se realizó una búsqueda en la base de datos BVS y, posteriormente, se analizaron los informes de los programas. Los artículos abordaron formas de insertar la humanización en la graduación. En cuanto a los programas, 15 contenían las palabras "Humanización", "Arte" y/o "Empatía". Se refuerza la importancia de la enseñanza médica con enfoque en el método clínico que prioriza la persona. Es evidente que la humanización en salud se aborda en actividades curriculares y extracurriculares en la escuela médica.

Expression of AIF, PARP, and miRNAs MIR-145, MIR-210, and MIR-486 associated with apoptosis in the corpus cavernosum of rats subjected to chronic alcoholism model / Expresión de AIF, PARP y miRNAs MIR-145, MIR-210 y MIR-486 asociados con apoptosis en el cuerpo cavernoso de ratas sometidas a modelo de alcoholismo crónico

SUMMARY: Previous studies from our group described the consequences of using ethanol on penile erection. Nevertheless, the molecular mechanisms surrounding microRNAs, apoptosis process and their relationship with erectile dysfunction associated with alcohol consumption are still poorly understood. The objective of this analysis was to evaluate the mechanism of apoptosis by the expression of AIF and PARP, as well as their regulatory microRNAs: miR-145, miR-210 and miR-486, in the corpus cavernosum of rats submitted to a semivoluntary alcoholism model. For this study 24 Wistar rats were divided into two groups: control (C) and treated with 20 % ethanol (A) for seven weeks. The corpus cavernosum samples were prepared for immunohistochemical analysis of AIF and PARP protein expression, and microRNAs miR-145, miR-210, miR-486 gene expression in cavernous tissue was performed by real time PCR. The immunohistochemical analysis showed little nuclear positive labeling for the protein PARP and AIF in the corpus cavernosum of control and ethanol treated animals. After analysis of miR-145, -210 and -486 microRNA expression in the 12 animals studied, no results were found with significant statistical difference between the control and alcoholized groups. The expression of AIF and PARP and their regulatory microRNAs involved in apoptotic process (miR-145, miR-210 and miR-486) were not altered in the corpus cavernosum of rats submitted to semivoluntary alcoholism.

RESUMEN: Estudios previos de nuestro grupo describieron las consecuencias del uso de etanol en la erección del pene. Sin embargo, los mecanismos moleculares que rodean a los microARN, el proceso de apoptosis y su relación con la disfunción eréctil asociada con el consumo de alcohol aún no se conocen bien. El objetivo de este análisis fue evaluar el mecanismo de apoptosis mediante la expresión de AIF y PARP, así como sus microARN reguladores: miR-145, miR-210 y miR-486, en el cuerpo cavernoso de ratas sometidas a un modelo de alcoholismo semivoluntario. Se dividieron 24 ratas Wistar en dos grupos: control (C) grupo de ratas tratadas con etanol al 20 % (A) durante siete semanas. Las muestras del cuerpo cavernoso se prepararon para el análisis inmunohistoquímico de la expresión de la proteína AIF y PARP, y la expresión del gen microRNAs miR-145, miR-210, miR-486 en tejido cavernoso se realizó por PCR en tiempo real. El análisis inmunohistoquímico mostró escaso etiquetado nuclear positivo para la proteína PARP y AIF en el cuerpo cavernoso de los animales de control y tratados con etanol. Después del análisis de la expresión de microARN miR-145, -210 y -486 no se encontraron resultados con diferencias estadísticas significativas entre los grupos control y alcoholizados. La expresión de AIF y PARP y sus microARN reguladores involucrados en el proceso apoptótico (miR-145, miR-210 y miR-486) no se alteraron en el cuerpo cavernoso de las ratas sometidas a alcoholismo semivoluntario.

Apoptosis related microRNAs and MGMT in glioblastoma cell lines submitted to treatments with ionizing radiation and temozolomide.

AIM: To evaluate the effect of radiotherapy and temozolomide on the expression of miRNAs apoptotic (miRNAs-21, -221, -222 (anti-apoptotic) and miRNAs-15a, -16 (pro-apoptotic)) and the gene MGMT in glioblastoma cell lines. BACKGROUND: The limited knowledge of the molecular biology of malignant gliomas may hinder the development of therapeutic modalities. In this scenario, one of the greatest advances of recent years was the identification of microRNAs. These molecules have an important role in biological processes involving cancer, including glioblastoma. MATERIALS AND METHODS: Trypan blue was used to verify the cell viability, and real time PCR to quantify the expression of microRNAs and gene 24, 48 and 120 h after exposure to treatments. RESULTS: There was a statistically significant decrease of expression of miR-15a between 48 and 120 h in line T98 G treated with radiation, increased expression of miR-15a between 24 and 120 h in line U251 treated with radiation and temozolomide, and increased expression of miR-16 between 24 and 120 h in line U251 treated with radiation alone and when combined with temozolomide. There was a decrease in MGMT gene expression, between 24 and 48 h in U343 cells treated with temozolomide. CONCLUSIONS: Ionizing radiation and temozolomide modified the expression of miRNAs studied and MGMT.

Beyond HIV infection: Neglected and varied impacts of CCR5 and CCR5Δ32 on viral diseases.

The interactions between chemokine receptors and their ligands may affect susceptibility to infectious diseases as well as their clinical manifestations. These interactions mediate both the traffic of inflammatory cells and virus-associated immune responses. In the context of viral infections, the human C-C chemokine receptor type 5 (CCR5) receives great attention from the scientific community due to its role as an HIV-1 co-receptor. The genetic variant CCR5Δ32 (32 base-pair deletion in CCR5 gene) impairs CCR5 expression on the cell surface and is associated with protection against HIV infection in homozygous individuals. Also, the genetic variant CCR5Δ32 modifies the CCR5-mediated inflammatory responses in various conditions, such as inflammatory and infectious diseases. CCR5 antagonists mimic, at least in part, the natural effects of the CCR5Δ32 in humans, which explains the growing interest in the potential benefits of using CCR5 modulators for the treatment of different diseases. Nevertheless, beyond HIV infection, understanding the effects of the CCR5Δ32 variant in multiple viral infections is essential to shed light on the potential effects of the CCR5 modulators from a broader perspective. In this context, this review discusses the involvement of CCR5 and the effects of the CCR5Δ32 in human infections caused by the following pathogens: West Nile virus, Influenza virus, Human papillomavirus, Hepatitis B virus, Hepatitis C virus, Poliovirus, Dengue virus, Human cytomegalovirus, Crimean-Congo hemorrhagic fever virus, Enterovirus, Japanese encephalitis virus, and Hantavirus. Subsequently, this review addresses the impacts of CCR5 gene editing and CCR5 modulation on health and viral diseases. Also, this article connects recent findings regarding extracellular vesicles (e.g., exosomes), viruses, and CCR5. Neglected and emerging topics in "CCR5 research" are briefly described, with focus on Rocio virus, Zika virus, Epstein-Barr virus, and Rhinovirus. Finally, the potential influence of CCR5 on the immune responses to coronaviruses is discussed.

Morphometric analysis and pattern of protein and gene expression of apoptosis in focal cerebral ischemia in rats and the neuroprotetive action of hypothermia and ketoprofen / Análisis morfométrico y modelo de expresión de proteína y genes de apoptosis en isquemia cerebral focal en ratas y la acción neuroprotectora de hipotermia y ketoprofeno

This study aimed to investigate the morphometric and the pattern of protein and gene expression related to the extrinsic apoptotic pathway in experimental focal cerebral ischemia and the hole of neuroprotection with hypothermia and ketoprofen. For this analysis, 120 rats were randomly divided into 3 groups (20 animals each): control - no surgery (20 animals); sham - simulation of surgery (20 animals); ischemic - focal ischemia for 1 hour, without reperfusion (80 animals) and divided into four subgroups with 20 animals each: ischemic + intraischemic hypothermia; ischemic + previous intravenous ketoprofen, and ischemic + hypothermia and ketoprofen. The infarct volume was measured using morphometric analysis of infarct areas defined by triphenyl tetrazolium chloride and the patterns of expression of the apoptosis genes (Fas, c-Flip, caspase-8 and caspase-3) and the apoptosis protein caspase-3 were evaluated by quantitative real-time PCR and immunohistochemistry, respectively. Hypo expression of genes of extrinsic pathway of apoptosis was observed: Fas receptor, c-Flip and caspase-8 in the ischemics areas. Increases in the gene and protein caspase-3 in the ischemic areas were also observed, and these increases were reduced by hypothermia and ketoprofen, also noted in the morphometric study. The caspases-3 increase suggests that this gene plays an important role in apoptosis, probably culminating in cell death and that the neuroprotective effect of hypothermia and ketoprofen is involved.

Este estudio tuvo como objetivo investigar la morfometría y el patrón de expresión de proteínas y genes relacionados con la vía apoptótica extrínseca en la isquemia cerebral focal experimental y el agujero de neuroprotección con hipotermia y ketoprofeno. Se dividieron aleatoriamente 120 ratas en 3 grupos (20 animales cada uno): control - sin cirugía (20 animales); simulación - simulación de cirugía (20 animales); isquemia isquemia focal durante 1 hora, sin reperfusión (80 animales) y dividida en cuatro subgrupos con 20 animales cada uno: isquemia + hipotermia intraisquémica; isquemia + ketoprofeno intravenoso previo, e isquemia + hipotermia y ketoprofeno. El volumen del infarto se midió utilizando un análisis morfométrico de áreas de infarto definidas por cloruro de trifenil tetrazolio y los patrones de expresión de los genes de apoptosis (Fas, c-Flip, caspase-8 y caspase-3) y la proteína de apoptosis caspase-3 fueron evaluados por PCR cuantitativa en tiempo real e inmunohistoquímica, respectivamente. Se observó hipoexpresión de genes de la vía extrínseca de la apoptosis: receptor Fas, c-Flip y caspasa-8 en las áreas isquémicas. También se observaron aumentos en el gen y la proteína caspasa-3 en las áreas isquémicas y estos aumentos se redujeron por hipotermia y ketoprofeno, también observado por estudio morfométrico. El aumento de caspasas-3 sugiere que este gen tiene un papel importante en la apoptosis, y probable causa de muerte celular, involucrando el efecto neuroprotector de la hipotermia y el ketoprofeno.

AIF, PARP-1 and MicroRNA-9 expression in cerebral ischemia associated to alcoholism experimental model / Expresión de AIF, PARP-1 y MicroRNA-9 de isquemia cerebral asociado a un modelo experimental de alcoholismo

The chronic consumption of alcohol causes a worsening of the events that follow the cerebral ischemia. These events are regulated through the expression of several genes and microRNAs. The aimof this work was To analyze and describe the expression profile of PARP and AIF and miRNA-9 proteins in rats submitted to focal cerebral ischemia, associated or not with chronic alcoholism model. Methods: Twenty adult Wistar rats, subdivided into: control; ischemic; alcoholic and ischemic / alcoholized for immunohistochemical analysis and miRNA-9 gene expression. Results: There was a reduction in the protein expression of PARP-1 and a positive marking for AIF in the ischemic / alcoholized group. The miRNA-9 did not obtain significant expression. The association of ischemia with chronic alcohol use promoted a tendency to low expression of miRNA-9, low expression of PARP-1 and high expression of AIF, indicating an interference in the protective effect of miRNA-9 be observed in the other groups.

El consumo crónico de alcohol provoca un empeoramiento de los eventos que siguen a la isquemia cerebral. Estos eventos están regulados a través de la expresión de varios genes y microRNA. El objetivo de este trabajo fue analizar y describir el perfil de expresión de las proteínas PARP y AIF y microRNA-9 en ratas sometidas a isquemia cerebral focal, asociadas o no, con el modelo de alcoholismo crónico. Veinte ratas Wistar adultas se dividieron en: grupo control, isquémico alcohólico, e isquémico / alcoholizado para análisis inmunohistoquímico y expresión de genes microRNA-9. Resultados: Hubo una reducción en la expresión de proteínas de PARP-1 y un marcado positivo para AIF en el grupo isquémico / alcoholizado. No se observó una expresión significativa en el microRNA-9. La asociación de la isquemia con el consumo crónico de alcohol promovió una tendencia a la baja expresión de microRNA-9, baja expresión de PARP1 y alta expresión de AIF, lo que indica una interferencia en el efecto protector de microRNA-9 en los otros grupos.

CCR5 and CCR5Δ32 in bacterial and parasitic infections: Thinking chemokine receptors outside the HIV box.

The CCR5 molecule was reported in 1996 as the main HIV-1 co-receptor. In that same year, the CCR5Δ32 genetic variant was described as a strong protective factor against HIV-1 infection. These findings led to extensive research regarding the CCR5, culminating in critical scientific advances, such as the development of CCR5 inhibitors for the treatment of HIV infection. Recently, the research landscape surrounding CCR5 has begun to change. Different research groups have realized that, since CCR5 has such important effects in the chemokine system, it could also affect other different physiological systems. Therefore, the effect of reduced CCR5 expression due to the presence of the CCR5Δ32 variant began to be further studied. Several studies have investigated the role of CCR5 and the impacts of CCR5Δ32 on autoimmune and inflammatory diseases, various types of cancer, and viral diseases. However, the role of CCR5 in diseases caused by bacteria and parasites is still poorly understood. Therefore, the aim of this article is to review the role of CCR5 and the effects of CCR5Δ32 on bacterial (brucellosis, osteomyelitis, pneumonia, tuberculosis and infection by Chlamydia trachomatis) and parasitic infections (toxoplasmosis, leishmaniasis, Chagas disease and schistosomiasis). Basic information about each of these infections was also addressed. The neglected role of CCR5 in fungal disease and emerging studies regarding the action of CCR5 on regulatory T cells are briefly covered in this review. Considering the "renaissance of CCR5 research," this article is useful for updating researchers who develop studies involving CCR5 and CCR5Δ32 in different infectious diseases.

Vivências de mulheres com o parto domiciliar: resgate por meio da história oral / Las experiencias de las mujeres con la casa del nacimiento: rescate por medio de la historia / Women's experiences with home birth: retrieval through history

Objetivo: resgatar as vivências de um grupo de mulheres a respeito do parto domiciliar. Método: pesquisa qualitativa, exploratória e descritiva, realizada no domicílio de 11 mulheres que tiveram seus partos em ambiente domiciliar e que foram captadas a partir da técnica de amostragem em bola de neve. A coleta de dados ocorreu nos meses de agosto a outubro de 2017, por meio de entrevista História Oral Temática. Os dados foram submetidos à análise de conteúdo temática. Resultados: a parturição no domicílio mostrou-se envolta de representatividades, cuidados familiares, rituais e crenças populares, aliadas à atuação representativa da parteira. Considerações Finais: é preciso refletir a respeito dos modelos de assistência obstétrica, construídos ao longo dos anos, caracterizados pela perda gradativa do protagonismo e da autonomia da mulher e de sua família, como também incitar novas possibilidades de assistência ao parto, pautadas no cuidado cultural, humanizado, personificado e integral.

Objective: to retrieve the experiences of a group of women regarding home birth. Method: qualitative, exploratory and descriptive study, performed in the household of 11 women who had had their deliveries in the home environment and whose acquisition occurred from the snowball sampling technique. The data collection occurred from August to October 2017, through Thematic Oral History interview. The data were submitted to thematic content analysis. Results: The parturition in the household was involved by representativeness, family care, rituals and popular beliefs, allied to the midwife's representative work. Final thoughts: it is necessary to reflect the concerns of the models of obstetric care, constructed over the years, characterized by the gradual loss of the lead role and autonomy of women and their families, as well as encourage new possibilities to childbirth care, guided by the cultural, humanized, personified and integral care.

Objetivo: rescatar las experiencias de un grupo de mujeres con respecto a los partos en el domicilio. Método: estudio cualitativo, exploratorio y descriptivo, realizado en el hogar de 11 mujeres que habían tenido sus partos en el hogar y que fueron captadas en la técnica de muestreo en bola de nieve. La recogida de datos se produjo durante los meses de agosto a octubre de 2017, por medio de entrevista de Historia Oral Temática. Los datos fueron sometidos a análisis de contenido temático. Resultados: el parto en el hogar estaba cubierto de representatividades, el cuidado de la familia, rituales y creencias populares, aliado a la actuación representativa de la comadrona. Consideraciones finales: es necesario reflejar las preocupaciones de los modelos de atención obstétrica, construidos a lo largo de los años, caracterizados por la pérdida gradual de activismo y la autonomía de las mujeres y sus familias, así como alentar nuevas posibilidades de la atención del parto, guiadas por el cuidado cultural, humanizado, personificado e integral.

Percepção de discentes, docentes e técnicos em enfermagem a respeito dos eventos adversos / Percepción de estudiantes de enfermería, docentes y técnicos sobre eventos adversos / Perception of nursing students, teachers and technicians regarding adverse events

Objetivo: identificar a percepção de discentes, docentes e técnicos em enfermagem a respeito dos eventos adversos. Método: pesquisa descritiva, exploratória, qualitativa, realizada em instituição de ensino básico, técnico e tecnológico localizada no noroeste do Rio Grande do Sul. Os participantes foram discentes, docentes e técnicos em enfermagem. Os dados foram coletados com entrevista semiestruturada e analisados pela análise de conteúdo. Resultados: participaram do estudo 25 técnicos em enfermagem, 24 discentes e quatro docentes. A sobrecarga de trabalho e a demanda de cuidados contribuem para que a ocorrência de algum evento adverso se torne iminente. Além disso, a falta de atenção e as falhas no processo de formação são citadas como possíveis condicionantes à essa problemática. Considerações finais: perceber diferenças cruciais entre discentes e profissionais formados no que se refere aos eventos adversos permite uma comunicação essencial para (re) descobrir formas de ensinar enfermagem de maneira segura e de qualidade.

Aim: To identify the perception of nursing students, teachers and technicians regarding adverse events. Method: descriptive, exploratory, qualitative research, carried out in a primary, technical and technological institution located in the northwest of Rio Grande do Sul. The study participants were students, teachers and nursing technicians. Data were collected with semi-structured interviews and analyzed by content analysis. Results: 25 nursing technicians, 24 students and four teachers participated in the study. Work overload and demand for care contribute to the occurrence of any adverse event imminent. In addition, lack of attention and failures in the training process are cited as possible constraints to this problem. Final considerations: Understanding crucial differences between students and graduates regarding adverse events allows for essential communication to (re) discover ways to teach nursing safely and in a quality way.

Objetivo: identificar la percepción de los estudiantes de enfermería, docentes y técnicos sobre los eventos adversos. Método: investigación descriptiva, exploratoria, cualitativa, realizada en una institución primaria, técnica y tecnológica ubicada en el noroeste de Rio Grande do Sul. Los participantes fueron estudiantes, maestros y técnicos de enfermería. Los datos fueron recolectados con entrevistas semiestructuradas y analizados por análisis de contenido. Resultados: 25 técnicos de enfermería, 24 estudiantes y cuatro maestros participaron en el estudio. La sobrecarga de trabajo y la demanda de atención contribuyen a la aparición de cualquier evento adverso inminente. Además, la falta de atención y las fallas en el proceso de capacitación se mencionan como posibles limitaciones para este problema. Consideraciones finales: comprender las diferencias cruciales entre los estudiantes y los graduados con respecto a los eventos adversos permite una comunicación esencial para (re) descubrir formas de enseñar enfermería de manera segura y de calidad.

microRNA-181d associated with the methylation status of the MGMT gene in Glioblastoma multiforme cancer stem cells submitted to treatments with ionizing radiation and temozolomide.

Despite the increased understanding of the oncological mechanisms underlying Glioblastoma multiforme (GBM) pathophysiology, and recent advances in therapeutic strategies such as maximal surgical resection and post-operative radiotherapy with concomitant and adjuvant temozolomide chemotherapy, the prognosis for patients with brain tumors remains limited. Evidences indicate that the assessment of DNA methylation status in cancer stem cells would allow identifying molecules expressed in these cells, to lead to targeted elimination of this critical population from brain tumors, making the glioblastoma treatment more effective. This study aimed to analyze the role of microRNA-181d associated with the methylation status of the O6-methylguanine methyl transferase (MGMT) gene in Glioblastoma multiforme cancer stem cells subjected to treatment with temozolomide and ionizing radiation. Such responses were analyzed in terms of cell survival, evaluation of the MGMT gene methylation status by MS-HRM (Methylation-Sensitive High Resolution Melting), and analysis of miRNA-181d and MGMT gene expression by relative quantification of mRNA levels in cancer stem cells subjected to treatment with temozolomide and ionizing radiation, isolated or combined. We showed that ionizing radiation and temozolomide reduced the viability of cancer stem cells from GBM patients, as well as modified MGMT gene and miRNA-181d expression in cancer stem cells, suggesting that miRNA-181d interferes in the glioblastoma cancer stem cell response to treatment with temozolomide and ionizing radiation.