[Kawasaki disease and multisystem inflammatory syndrome in children. Differences, and similarities in a pediatric center in Mexico]. / Enfermedad de Kawasaki y síndrome inflamatorio multisistémico en niños. Diferencias y similitudes en un centro pediátrico de México.

OBJECTIVE: To evaluate the differences and similarities in clinical picture, laboratory findings and outcomes between children's with Kawasaki Disease (KD) versus multisystem inflammatory syndrome (MIS-C). METHODS: We conducted a retrospective, comparative study from children with Kawasaki Disease (KD) hospi-talized in Sinaloa Pediatric Hospital from January 1, 2004, to March 31, 2020, and patients with multisystem inflammatory syndrome (MIS-C) according with World Health Organization (WHO) case definition criteria be-tween May 1, 2020 and May 31, 2021. Demographic characteristics, epidemiological data, clinical features, laboratory findings, type of treatment and clinical outcomes were compared among both groups. RESULTS: Eighty-one patients were included (62 patients with KD and 19 with MIS-C). several clinical and lab-oratory differences were found among these two entities. Median age was lower in KD vs. MIS-C (25 vs 79 months). Those finding more frequent in KD were male gender (64.5 vs. 47.4%), Mucocutaneous features (93.5 vs. 63.2%): Oral changes (83.9 vs. 63.2%) and extremity changes (77.4 vs. 57.9%); complete form of KD was (75.8 vs. 47.4%), Coronary artery aneurysm (16.1 vs. 11.8%). Secondly, findings that were more frequent in MIS-C than KD were Gastrointestinal involvement (89.4 vs. 9.6%), shock (57.9 vs. 3.2%), neurological symp-toms (63.1 vs. 11.2%), kidney involvement (52.6 vs. 16.1%), heart disease in general (52.9% vs 29%): Myocardial dysfunction (23.5 vs. 11.3%) and pericardial effusion (17.6 vs. 2.9%). Lymphocyte count (2.07 + 2.03 vs. 4.28 + 3.01/mm3), platelet count (197.89 + 187.51 vs. 420.37 + 200.08/mm3); serum albumin (2.29 + 0.65 vs. 3.33 + 0.06g/dL), and CPR (21.4 + 11.23 vs. 14.26 + 12.37 mg/dL). KD vs. MIS-C types of Treatment: IVIG (96.8 vs. 94.7%), systemic steroids (4.82 vs. 94.7%), IVIG resistance (19.4 vs. 15.8). Finally, mortality in KD was 0% and 5.3% in MIS-C. CONCLUSIONS: Similarities were found in both groups such as fever, rash, and conjunctivitis. Nevertheless, signifi-cant differences such as severity of clinical presentation with multi-organ involvement and worst inflammato-ry response were found more frequently in MIS-C group than KD group, requiring more fluid replacement, use of inotropic agents and higher steroids dosages. Also, mortality rate was higher in patients with MIS-C thanpatients with KD. Similar results have been observed in other studies where both disorders were compared.

OBJECTIVO: Evaluar las diferencias y similitudes en el cuadro clínico, los hallazgos de laboratorio y desenlaces médicos de pacientes pediátricos con enfermedad de Kawasaki versus síndrome inflamatorio multisistémico. MÉTODOS: Estudio comparativo y retrospectivo, efectuado en niños con enfermedad de Kawasaki, atendidos en el Hospital Pediátrico de Sinaloa, entre el 1 de enero de 2004 al 31 de marzo de 2020, y pacientes con sín-drome inflamatorio multisistémico (según los criterios de la Organización Mundial de la Salud), del 1 de mayo de 2020 al 31 de mayo de 2021. Se evaluaron las características demográficas, epidemiológicos y clínicas, además de los hallazgos de laboratorio, tipo de tratamiento y desenlaces clínicos en ambos grupos. RESULTADOS: Se incluyeron 81 pacientes: 62 con enfermedad de Kawasaki y 19 con síndrome inflamatorio mul-tisistémico. Se encontraron varias diferencias clínicas y de laboratorio en ambas alteraciones. La mediana de edad fue menor en pacientes con enfermedad de Kawasaki versus síndrome inflamatorio multisistémico (25 vs 79 meses). La mayoría de los pacientes con enfermedad de Kawasaki fueron hombres (64.5 vs 47.4%), con características mucocutáneas (93.5 vs 63.2%): cambios orales (83.9 vs 63.2%) y cambios en las extremidades (77.4 vs 57.9%); la forma completa de enfermedad de Kawasaki fue 75.8 vs 47.4%, concomitante con aneuris-ma de la arteria coronaria (16.1 vs 11.8%). Los hallazgos más frecuentes en sujetos con síndrome inflamatorio multisistémico fueron: afectación gastrointestinal (89.4 vs 9.6 %), choque (57.9 vs 3.2%), síntomas neurológicos (63.1 vs 11.2%), afectación renal (52.6 vs 16.1%) y cardiopatías en general (52.9 vs 29%): disfunción miocárdica (23.5 vs 11.3%) y derrame pericárdico (17.6 vs 2.9%). La concentración media de linfocitos fue: 2.07 + 2.03 vs4.28 + 3.01/mm3), plaquetas (197.89 + 187.51 vs 420.37 + 200.08/mm3); albúmina sérica (2.29 + 0.65 vs 3.33 + 0.06 g/dL) y PCR (21.4 + 11.23 vs 14.26 + 12.37 mg/dL). Los tratamientos en enfermedad de Kawasaki vssíndrome inflamatorio multisistémico: IVIG (96.8 vs 94.7%), corticosteroides sistémicos (4.82 vs 94.7%), resis-tencia a IVIG (19.4 vs 15.8). La mortalidad fue de 0 vs 5.3%. CONCLUSIONES: Se encontraron similitudes en cuanto a síntomas en ambos grupos (fiebre, exantema y conjun-tivitis); no obstante, hubo diferencias significativas respecto de las manifestaciones clínicas, con afección multiorgánico y peor respuesta inflamatoria en pacientes con síndrome inflamatorio multisistémico, incluso mayor requerimiento de reposición de líquidos, administración de agentes inotrópicos, dosis más altas de corticosteroides, y elevada tasa de mortalidad. Estos resultados se han observado en otros estudios, donde se compararon ambos trastornos.

Virtually Delivered Psychosocial Intervention for Prenatally Diagnosed Congenital Heart Disease: Feasibility and Acceptability of HEARTPrep.

Prenatal diagnosis of congenital heart disease (CHD) often leads to anxiety, depression, and traumatic stress in expectant mothers, with long-term implications for the child and family. However, psychosocial intervention is rarely incorporated into prenatal care. HEARTPrep is a virtually delivered psychosocial intervention aimed at reducing distress and social isolation and increasing parenting self-efficacy and hope for mothers expecting a baby with CHD to promote long-term child/family well-being. This study evaluated the feasibility and acceptability of HEARTPrep. Participants were mothers receiving cardiology care for a fetal CHD diagnosis. Partners could participate with the mother. HEARTPrep was delivered through a mobile app and telehealth. Feasibility was assessed through enrollment/retention rates. Acceptability was assessed through 20 Likert-scale and five open-ended questions. Of 39 recruited mothers, 35 (90%) enrolled. Half of partners (48%) also participated. Twenty-seven of 35 enrolled mothers (77%) completed HEARTPrep. On a scale from 0 (Not at All) to 4 (Very), mean item acceptability scores ranged from 3.5 to 3.9. Mothers reported HEARTPrep helped them feel less distressed (mean: 3.74), less alone (3.84), more prepared (3.89), and more hopeful (3.84). Opportunities to process emotions, develop coping skills, learn with their partner, navigate relationships, understand they are not alone, connect with peer support, access resources, and prepare for stressors were described as helpful. HEARTPrep is feasible and acceptable for mothers expecting a baby with CHD. Future research will evaluate its efficacy in preventing/reducing maternal mental health problems and improving postnatal clinical outcomes.

Do mothers and fathers agree? Examining interparental ratings of youth externalizing behaviors among ethnically diverse families.

OBJECTIVE: This study examined the association between youth, parent, and family characteristics in mother-father agreement of youth externalizing behaviors among ethnically diverse families. METHOD: Eighty-eight mother-father dyads of youth (44% Latino, 38% European-American, 17% African American) 6-16 years participated. RESULTS: Overall associations between parent's reports of youth behavior problems were positively correlated. Significant predictors of parent difference scores in regression analyses included mother's depression scores (negatively), mother and father parenting stress scores (positively and negatively, respectively), and child's symptom severity (positively in the Inattention and Learning Problems models; negatively in the Defiance/Aggression model). CONCLUSIONS: Results highlight the need for psychosocial screening of youth's parents during child psychological assessment to identify situations in which both parent reports are needed for youth assessment. Further, it contributes to the small literature base of discrepancies in parent reports in minority youth and expands upon the minimal research involving paternal caregivers.

Development of Sorbent Materials based on Polymer Waste and their Compounds with Nanomaterials for Oil Spill Remediation.

AIMS: The purpose of this work was to obtain a hydrophobic sorbent material with potential applications in oil spill remediation. BACKGROUND: The accidents due to oil spills cause long-term ecological damage, especially in the aquatic environment. The cleaning of oil spills can be carried out by many methods and techniques, being absorbents the most attractive due to the possibility of recovery and complete elimination of the hydrocarbons in situ from the water surface. In recent years, interest in polymeric materials for oil spill remediation has increased due to its low cost, high stability, and recyclability. OBJECTIVE: The objective of this work was the development of sorbent materials based on polymer wastes, such as Polyethylene Terephthalate (PET), obtained from recycled bottles, and recycled Polyurethane (PU), for its application in the recovery of oil spills. METHODS: Sorbent materials were prepared from polymer wastes, using salt molds for the formation of porous materials with a composition of PU of 5, 10 and 15%, which were subsequently hydrophobized using carbon nanotubes or silica nanoparticles by dip-coating technique. RESULTS AND DISCUSSION: The obtained hydrophobic sorbent materials were characterized by Scanning Electron Microscopy (SEM) and Infrared Spectroscopy (FTIR). The resulting absorbent has shown capacity to separate oil from water; the best result was obtained by the sponge of PET-PU (10% PU) hydrophobized with a suspension with low multi-wall carbon nanotubes (MWCNTs) concentration, obtaining an absorption capacity of 2.01 g/g. CONCLUSION: Besides the standard sorption capacity, these cheap sorbent materials had interesting properties like low density, high hydrophobicity and buoyancy, which could be applied in other applications related to solving oil spills.

"São bebês ou miomas?" Implicações do não reconhecimento primordial na constituição subjetiva / "Are they babies or myomas?" Implications of the primordial nonrecognition in the subjective constitution / "¿Son bebés o miomas?" Implicaciones del no reconocimiento primordial en la constitución subjetiva

O presente artigo pretende refletir sobre o processo de constituição subjetiva do bebê prematuro internado em UTI neonatal, seus impasses e possibilidades de superação da condição de organismo a sujeito, destacando as implicações do não reconhecimento primordial na prematuridade bem como a importância do outro no estabelecimento dos endereçamentos desenvolvidos entre bebê, mãe e equipe de saúde...

This article aims to reflect on the process of subjective constitution of preterm babies hospitalized in neonatal ICU, their impasses, and the possibilities of overcoming the condition of organism to subject, highlighting the implications of the primordial nonrecognition in prematurity, as well as the importance of the other in the establishment of the interactions developed among baby, mother, and medical staff...

Este artículo propone a reflexionar acerca del proceso de constitución subjetiva del bebé prematuro internado en la UCI neonatal, sus consecuencias y posibilidades de superación de la condición de organismo a sujeto, resaltando las consecuencias del no reconocimiento primordial acerca de la prematuridad, así como la importancia del "otro" en el establecimiento de los direccionamientos desarrollados entre bebé, madre y equipo médico...

(Des)Conhecimento dos trabalhadores de lavanderias sobre prevenção de acidentes de trabalho / (Des)understanding of the laundry workers on the prevention of occupational accidents

Objetivo: identificar o conhecimento dos trabalhadores das lavanderias de jeans sobre a prevenção de acidentes de trabalho. Metodologia: estudo transversal, descritivo e exploratório, com abordagem quantitativa, realizado com 271 trabalhadores de lavanderias de jeans da cidade de Caruaru (Pernambuco). A coleta dos dados foi realizada no período de fevereiro a maio de 2013, após aprovação pelo CEP/ASCES número 128.040. Utilizou-se questionário estruturado dividido em duas secções, a primeira voltada para caracterização sociodemográfica e a segunda para identificação do conhecimento acerca de riscos ocupacionais e das medidas preventivas de acidentes no ambiente de trabalho. Os dados foram tabulados e analisados utilizando os programas Epidata 3.1 e Epi Info 6.04. Resultados: verificou-se predominância do sexo masculino(92%), com ensino fundamental incompleto (28%). Observou-se que 76% conheciam a definição de equipamento de proteção individual e 23% o conceito de equipamento de proteção coletiva. 71% dos participantes desconheciam as classificações dos riscos, apenas 29% identificaram algum tipo de risco ocupacional em sua atividade. Conclusão: o desconhecimento acerca dos riscos ocupacionais e medidas preventivas de acidentes de trabalho favorece a ocorrência dos mesmos.

Objective: to identify the knowledge worker jeans laundry on the prevention of occupational accidents. Methods: cross-sectional, descriptive and exploratory study with a quantitative approach, performed with 271 workers of denim laundries in the city of Caruaru (Pernambuco). Data collection was conducted from February to May 2013, after approval by CEP / ASCES number 128,040. We used a structured questionnaire divided into two sections, the first focused on sociodemographic and the second to identify the knowledge of occupationalhazards and preventive measures for accidents in the workplace. Data were tabulated and analyzed using the Epidata 3.1 and Epi Info 6.04. Results: there was a predominance of males (92%), with incomplete primary education (28%). It was observed that 76% knew the personal protective equipment definition and 23% the concept of collective protective equipment. 71% of respondents were unaware of the classifications of risks, only 29% have identified some sort of occupational hazard in their activity. Conclusion: the lack of understanding of occupational hazards and preventive measures against accidents at work favors the occurrence thereof.

Aspectos jurídicos da jornada de trabalho em enfermagem: reflexão teórica / Legal aspects of work shift in nursing: theoretical reflection

Objetivo: perquirir acerca da regulamentação das relações de trabalho na enfermagem e refletir sobre os aspectos jurídicos de sua jornada de trabalho. Metodologia: trata-se de um estudo reflexivo, que analisou as relações de trabalho da equipe de enfermagem com foco em sua jornada de trabalho, com um olhar direcionado aos aspectos jurídicos que envolvem a temática. Resultados: a equipe de enfermagem não dispõe de proteção legal específica acerca de sua jornada de trabalho, apesar de desenvolver um trabalho essencial à vida e de estar presente na quase totalidade das instituições de saúde. A população tem direito de ser atendida por profissionais competentes e saudáveis, tendo em vista que a assistência segura e de qualidade, além de moralmente requerida, é mais econômica, pois evita danos e reduz ações judiciais contra os serviços de saúde. Para tanto surge a discussão sobre o Projeto de Lei 2.295/2000, que defende carga horária de 30 horas semanais, refletindo uma conquista histórica da classe de enfermagem, que se fundamenta em aspectos biológicos, sociais e econômicos. Conclusão: a redução da jornada de trabalho permite a prestação de uma assistência mais segura e representa nada mais que a concretização do arcabouço jurídico protecionista vigente.

Objective: to assert concerning the regulation of labor relations in nursing and to reflect on the legal aspects of working in nursing. Methodology: this is a reflective study that examined the working relationships of the nursing staff to focus on its workday with targeted legal aspects involving the theme. Results: the nursing staff has no specific legal protection about its workday, while developing essential work to life and to be present in almost all health institutions. The population is entitled to be served by healthy and competent professionals, in order that safe and quality care, and morally required, it is more economical because it prevents damage and reduces lawsuits against health services. For this discussion on the Draft Law 2295 /2000, which advocates a workload of 30 hours per week, reflecting a historic conquest of the nursing class, which it is based on biological, social and economic aspects. Conclusion: the reduction in working hours allows the provision of a safer care and represents nothing more than the realization of the current protectionist legal framework.

Avaliação do estresse e sintomas apresentados pelos enfermeiros de Unidades de Terapia Intensiva Pediátricas / Assessment of stress and symptoms presented by nurses in Pediatric Intensive Care Units

Objetivo: avaliar a relação entre o estresse e os sintomas apresentados pelos enfermeiros que atuam em UTI's pediátricas. Método: estudo exploratório descritivo, com abordagem quantitativa, realizada em enfermeiros que atuavam em UTI's pediátricas públicas de Teresina/Piauí, Nordeste do Brasil. Os dados foram coletados por meio de um questionário para caracterização do perfil sociodemográfico e pelas Escala de Estressores e Escala de sintomas apresentados pelos enfermeiros. Para a análise dos dados, foi utilizado o programa SPSS, versão 15.0. O estudo teve o projeto de pesquisa aprovado pelo Comitê de Ética em Pesquisa, Protocolo nº. 0206.0.045.000-10. Resultados: quanto aos escores de estresse, 50% dos enfermeiros obtiveram escores entre 1,11 e 1,97, classificados com médio estresse, sendo que os domínios com maiores escores foram: situações críticas (2,49±0,52), seguido de sobrecarga de trabalho (2,33±0,61). Conclusão: verificou-se correlação significativa entre maiores escores de estresse com sintomas músculo-esqueléticos e alterações de sono e repouso.(AU)

Objective: to assess the relationship between stress and symptoms presented by nurses in pediatric ICUs. Method: a descriptive exploratory study of quantitative design conducted with nurses working in public pediatric ICUs in the city of Teresina, Piauí, Brazil. A questionnaire was used to collect sociodemographic data and participants were given a scale assessing sources of stress and another one assessing symptoms presented by nurses. Data were analyzed with the SPSS software, version 15.0. This study was approved by a research ethics committee, under protocol no. 0206.0.045.000-10. Results: regarding stress scores, 50% of nurses scored between 1.11 and 1.97, indicating moderate stress, and the following sources of stress obtained the highest scores: critical situations (2.49±0.52) and work overload (2.33±0.61). Conclusion: there was a significant correlation between higher stress scores and musculoskeletal symptoms and altered sleep and rest.(AU)

Objetivo: evaluar la relación entre el estrés y los síntomas presentados por enfermeros actuantes en UTIs pediátricas. Método: estudio exploratorio, descriptivo, con abordaje cuantitativo, realizado con enfermeros actuantes en UTIs pediátricas públicas de Teresina/Piauí, Noreste de Brasil. Datos recolectados mediante cuestionario para caracterización del perfil sociodemográfico, por la Escala de Estresores y la Escala de síntomas presentados por los enfermeros. Para analizar los datos se utilizó el programa SPSS versión 15.0. El estudio obtuvo aprobación del Comité de Ética en Investigación, Protocolo nº 0206.0.045.000-10. Resultados: respecto a estrés, 50% de los enfermeros obtuvieron puntajes de entre 1,11 y 1,97, clasificados como estrés intermedio. Los dominios con mayores puntajes de estrés fueron las situaciones críticas (2,49±0,52), seguidas por sobrecarga de trabajo (2,33±0,61). Conclusión: se verificó correlación significativa entre puntajes mayores de estrés con síntomas músculo-esqueléticos y alteraciones del sueño y reposo.(AU)

Qualidade de vida de pessoas estomizadas: revisão integrativa / Quality of life of stomized people: an integrative review

Objetivo: Analisar a produção científica sobre a qualidade de vida de pessoas estomizadas. Metodologia:Foram selecionados artigos publicados com os seguintes descritores: “estomia” (ostomy) e “qualidade devida” (quality of life). Entre os critérios de inclusão destacam-se: artigos relacionados à temática, publicados na íntegra em inglês, espanhol e português, no período de janeiro de 2008 a dezembro de 2012. Resultados:Treze artigos atenderam aos critérios de inclusão e predominou o nível de evidência IV. Na presença do estoma a pessoa enfrenta perdas reais e ou simbólicas que acarretam diversas alterações em seu processo de viver e destacam-se como eixos orientadores da qualidade de vida a família, a integração social, o trabalho, a autonomia e as relações sociais. Conclusão: Torna-se imprescindível a implantação e permanência de uma equipe multidisciplinar reflexiva, sendo embasada na avaliação holística, visando à reinserção social e o fornecimento de estratégias de enfrentamento e adaptação da sua nova condição de vida.

Objective: To evaluate the scientific literature on the quality of life of people stomized. Methodology:"stoma" (ostomy) and "quality of life" (quality of life): Articles published with the following descriptors were selected. Criteria for inclusion include: articles related to the topic, published in full in English, Spanish and Portuguese, from January 2008 to December 2012. Results: Thirteen articles met the inclusion criteria and the predominant level of evidence IV. In the presence of a stoma or one faces real and symbolic losses that cause several changes in the process of living and stand out as guiding axes of the quality of family life, social integration, work, autonomy and social relations. Conclusion: It is essential to the implementation and permanence of a reflective multidisciplinary team, and grounded in holistic assessment, aimed at social reintegration and providing coping strategies and adaptation of their new condition of life.

Abordagens quantitativa e qualitativa nas pesquisas em saúde / Quantitative and qualitative approaches in health research

Objetivo: Refletir acerca das abordagens quantitativo e qualitativo nas pesquisas em saúde. Por ser uma problemática que concerne e ultrapassa o campo da pesquisa em saúde. Método: Trata-se de análise crítica reflexiva. Resultados: A partir da reflexão acerca da oposição inconsistente que se faz dos métodos de pesquisa, evidencia-se a importância de cada método para a instrumentação dos diversos objetos de estudo,apontando-se a utilização dos mesmos de forma complementar, o que proporciona a visualização dos objetos de estudo sob os diversos prismas. Conclusão: As abordagens teórico-metodológicas são, por vezes,apresentadas de forma distinta e oposta, resultando na ideia de incompatibilidade entre os métodos. Todavia,do ponto de vista metodológico, as investigações qualitativas e quantitativas não se apresentam contraditória sou contínuas, mas de naturezas diferentes de maneira que o pesquisador não deveria escolher entre um método ou outro, mas utilizar as abordagens que se adéquam à sua questão de pesquisa.

Objective: To think about the quantitative and qualitative approaches in health research. Because it is anissue that concerns and beyond the field of health research. Method: This is reflective critical analysis. Results: From the reflection on the in consistent opposition that is made of research methods, highlights the importance of each method for the instrumentation of the various objects of study, pointing to their use in acomplementary way, which provides the visualization of objects of study under the various prisms. Conclusion: The theoretical and methodological approaches are sometimes presented in different andopposite way, resulting in the idea of incompatibility between the methods. However, from a methodological point of view, qualitative and quantitative investigations have not contradictory or continuous, but of different nature so that the researcher should not choose between one method or another, but implement the approaches that suit to your research question.

Riscos ocupacionais e problemas de saúde de trabalhadores de enfermagem que atuam em setores dequimioterapia / Occupational risks and health problems of the nursing staff working in chemotherapy sectors

Objetivo: Identificar os riscos ocupacionais e os problemas de saúde percebidos pela equipe de enfermagem em quimioterapia. Metodologia: Trata-se de um estudo exploratório, com abordagem quantitativa,desenvolvido num hospital de grande porte localizado em Teresina. Utilizou-se um questionário semi-estruturado, formado pelas secções 1, 3 e 4 dos questionários dos Guias de Avaliação de riscos nos lugares de trabalho em indústria, criados por Boix e Vogel e adaptado em 2006. O estudo foi realizado com 36 trabalhadores de enfermagem que atuavam em setores de quimioterapia nos meses de janeiro a fevereiro de 2012. Resultados: Sabe-se que o risco ocupacional provoca efeitos adversos à saúde do trabalhador. Dentre osfatores de risco evidenciados destacam-se: risco de contato com substância química (77,7%), esforço físico que produz fadiga (72,2%) e ritmo de trabalho acelerado (71,4%). Evidenciam-se entre os problemas de saúde varizes (61,1%), lombalgias (50%) e estresse/depressão (27,8%). Conclusão: A manipulação de quimioterápicos antineoplásicos oferece riscos à saúde do trabalhador de Enfermagem, devendo-se assim atentar para sua identificação, detecção e controle.

Objective: To identify occupational hazards and health problems perceived by nursing staff in chemotherapy. Methodology: This is an exploratory study with a quantitative approach, developed in a large hospital in Teresina. The study was conducted with 36 nursing staff who work in sectors of chemotherapy in the months from January to February of 2012. Results: It is known that the occupational hazard causes adverse health effects of the worker. Among the factors identified in this risk include: risk of contact with chemical, physicalexertion that produces fatigue and accelerated pace of work. Became evident between health problemsvaricose veins, back pain and stress/depression. Conclusion: The handling of anti-neoplastic chemotherapy offers health risks of nursing worker, so one should pay attention to their identification, detection and control. For both professionals involved in the care of the patient who is under going chemotherapy should beproperly informed, trained and supervised in the performance of personal protection required.

Bactericidal effect of bovine lactoferrin and synthetic peptide lactoferrin chimera in Streptococcus pneumoniae and the decrease in luxS gene expression by lactoferrin.

Streptococcus pneumoniae (pneumococcus) is responsible for nearly one million child deaths annually. Pneumococcus causes infections such as pneumonia, otitis media, meningitis, and sepsis. The human immune system includes antibacterial peptides and proteins such as lactoferrin (LF), but its activity against pneumococcus is not fully understood. The aim of this work was to evaluate the bactericidal effect of bovine lactoferrin (bLF) and the synthetic LF-peptides lactoferricin (LFcin17-30), lactoferrampin (LFampin265-284), and LFchimera against S. pneumoniae planktonic cells. The mechanism of damage was also investigated, as well as the impact of these peptides on the transcription levels of genes known to encode important virulence factors. S. pneumoniae planktonic cells were treated with bLF, LFcin17-30, LFampin265-284 and LFchimera at different time points. The viability of treated planktonic cells was assessed by dilution and plating (in CFU/ml). The interaction between LF and LF-peptides coupled to fluorescein was visualized using a confocal microscope and flow cytometry, whereas the damage at structural levels was observed by electron microscopy. Damage to bacterial membranes was further evaluated by membrane permeabilization by use of propidium iodide and flow cytometry, and finally, the expression of pneumococcal genes was evaluated by qRT-PCR. bLF and LFchimera were the best bactericidal agents. bLF and peptides interacted with bacteria causing changes in the shape and size of the cell and membrane permeabilization. Moreover, the luxS gene was down-regulated in bacteria treated with LF. In conclusion, LF and LFchimera have a bactericidal effect, and LF down-regulates genes involved in the pathogenicity of pneumococcus, thus demonstrating potential as new agents for the treatment of pneumococcal infections.

Riscos ocupacionais e problemas de saúde percebidos por trabalhadores de enfermagem em unidade hospitalar / Riesgos ocupacionales y problemas de salud percibidos por trabajadores de enfermería en una unidad hospitalaria / Occupaional risks and health problems perceived by professional nursing in hospital unit

Objetivou-se identificar os fatores de risco no trabalho e os problemas de saúde percebidos pelos trabalhadores de enfermagem de um instituto de doenças tropicais. Trata-se de um estudo descritivo-exploratório, com abordagem quantitativa. A amostra era composta por 99 trabalhadores de enfermagem, no ano de 2011. Para a coleta de dados aplicou-se um questionário criado por Boix e Vogel em 1997. Os dados foram analisados através do programaSPSS® versão 17.0. O estudo foi apreciado pelo Comitê de Ética em Pesquisa da Universidade Federal do Piauí. Dentre os fatores de riscos apontados, destacaram-se os biológicos, seguidos pelos riscos ergonômicos, físicos e psicossociais. Em relação aos problemas de saúde, relacionados ao trabalho, evidenciaram-se como mais frequentes: varizes, problemas osteomusculares, transtornos do sono e problemas psicossociais, como estresse edepressão.Verifica-se, então, que o ambiente de trabalho possui fatores de risco que interferem na saúde do trabalhador de enfermagem.

This study aimed to identify risk factors at work and health problems perceived by nursing staff of an institute for tropical diseases. This is a descriptive exploratory study with a quantitative approach. The sample consisted of 99 nursing staff, in the year 2011. A questionnaire created by Boix and Vogel in 1997 was applied for data collection. Data were analyzed using SPSS® version 17.0. The study was appreciated by the Ethics Committee of the Universidade Federal do Piauí. Among the risk factors pointed out, biologics aspects, followed by ergonomic, physical and psychosocial hazards, were highlighted. In relation to health problems related to work, the most frequent ones were: varicose veins, musculoskeletal problems, sleep disorders and psychosocial problems, such as stress and depression. So, then the work environment has risk factors that interfere in occupational health nursing.

Este estudio tuvo como objetivo identificar los factores de riesgo en el trabajo y problemas de salud percibidos por el personal de enfermería de un instituto para enfermedades tropicales. Se trata de un estudio exploratorio descriptivo, con abordaje cuantitativo. La muestra estaba compuesta por 99 trabajadores de enfermería en 2011. Para recopilar los datos se aplicó un cuestionario creado por Boix y Vogel en 1997. Los datos fueron analizados utilizando el SPSS® versión 17.0. El estudio fue revisado por el Comité de Ética en Investigación de la Universidad Federal de Piauí. Entre los factores de riesgo mencionados se destacaron los aspectos biológicos, seguido de los riesgos ergonómicos, físicos y psicosociales. En relación con los problemas de salud relacionados con el trabajo, se mostraron como frecuentes: las venas varicosas, problemas músculo-esqueléticos, trastornos del sueño y los problemas psicosociales como el estrés y la depresión. El ambiente de trabajo tiene factores de riesgo que afectan la salud de los trabajadores de enfermería.

Initiation of and barriers to prenatal care use among low-income women in San Antonio, Texas.

Healthy People 2010 goals set a target of 90% of mothers starting prenatal care in the first trimester of pregnancy. While there are questions about the value of prenatal care (PNC), there is much observational evidence of the benefits of PNC including reduction in maternal, fetal, perinatal, and infant deaths. The objective of this study was to understand barriers to PNC as well as factors that impact early initiation of care among low-income women in San Antonio, Texas. A survey study was conducted among low-income women seeking care at selected public health clinics in San Antonio. Interviews were conducted with 444 women. Study results show that women with social barriers, those who were less educated, who were living alone (i.e. without an adult partner or spouse), or who had not planned their pregnancies were more likely to initiate PNC late in their pregnancies. It was also observed that women who enrolled in the WIC program were more likely to initiate PNC early in their pregnancies. Women who initiated PNC late in pregnancy had the highest odds of reporting service-related barriers to receiving care. However, financial and personal barriers created no significant obstacles to women initiating PNC. The majority of women in this study reported that they were aware of the importance of PNC, knew where to go for care during pregnancy, and were able to pay for care through financial assistance, yet some did not initiate early prenatal care. This clearly establishes that the decision making process regarding PNC is complex. It is important that programs consider the complexity of the decision-making process and the priorities women set during pregnancy in planning interventions, particularly those that target low-income women. This could increase the likelihood that these women will seek PNC early in their pregnancies.

Increased viral replication in simian immunodeficiency virus/simian-HIV-infected macaques with self-administering model of chronic alcohol consumption.

Alcohol abuse constitutes a major cohort among HIV-infected individuals. The precise effect of alcohol addiction on HIV pathogenesis remains inconclusive, however. This study was designed to determine the effect of alcohol dependence on virus replication and CD4 profiles in simian immunodeficiency virus/simian-HIV-infected rhesus macaques. A group of 3 male Indian rhesus macaques was adapted to a self-drinking model of alcohol consumption, whereas another group of 3 macaques was provided a Nutrasweet solution. After 7 weeks of alcohol consumption, the alcohol-dependent animals along with controls were intravenously inoculated with a mixture of SHIV(KU), SHIV(89.6)P, and SIV/17E-Fr. These animals were followed for a period of 24 weeks for complete blood cell counts, CD4 cell profiles, and viral loads in the blood and cerebral compartments. The alcohol and control groups showed comparable peak viral loads in the blood. The plasma viral load in the alcohol group was 31- to 85-fold higher than that in the control group at weeks 18 through 24 after infection, however. The pattern of cerebrospinal fluid viral replication was also comparable during the acute phase; however, the virus continued to replicate in the brain of alcohol-dependent animals, whereas it became undetectable in the controls. The extent of CD4 cell loss in the alcohol group was significantly higher than that in the control animals at week 1 after infection.

Modulation by morphine of viral set point in rhesus macaques infected with simian immunodeficiency virus and simian-human immunodeficiency virus.

Six rhesus macaques were adapted to morphine dependence by injecting three doses of morphine (5 mg/kg of body weight) for a total of 20 weeks. These animals along with six control macaques were infected intravenously with mixture of simian-human immunodeficiency virus KU-1B (SHIV(KU-1B)), SHIV(89.6P), and simian immunodeficiency virus 17E-Fr. Levels of circulating CD4(+) T cells and viral loads in the plasma and the cerebrospinal fluid were monitored in these macaques for a period of 12 weeks. Both morphine and control groups showed precipitous loss of CD4(+) T cells. However this loss was more prominent in the morphine group at week 2 (P = 0.04). Again both morphine and control groups showed comparable peak plasma viral load at week 2, but the viral set points were higher in the morphine group than that in the control group. Likewise, the extent of virus replication in the cerebral compartment was more pronounced in the morphine group. These results provide a definitive evidence for a positive correlation between morphine and levels of viral replication.