Thoracic Spine Mobility and Posture: Correlation and Predictive Values in Physically Independent Older Adults.

The posture undergoes changes during aging and may serve as a marker for the evaluation of the thoracic spine. This study aimed to correlate the variables for the evaluation of thoracic spine mobility and propose predictive equation models from the measurements of the thoracic Schober test and the digital inclinometer in older adults. The mobility of thoracic flexion and extension by levels (T1, T8 and T12) of 41 older adult subjects (66 ± 7 years) was quantified with a digital inclinometer (degrees) and Schober's test (cm). There was a moderate positive correlation between the digital inclinometer and the Schober test at T1 (r = .69), T12 (r = .60), and total flexion levels T1 to T12 (r = .74). Simple linear regression equations showed that thoracic Schober predicts thoracic mobility measures for these same levels. Moderate to strong correlations were observed between the inclinometer and the Schober Test measurements. The development of predictive equation models based on the thoracic Schober test could potentially enhance the ability to predict spinal mobility in physically independent older adults.

Scurvy and food selectivity in childhood: a case report.

Despite its rarity, symptomatic micronutrient deficiency remains a public health problem. Scurvy is the differential diagnosis for bleeding disorders and hematological and rheumatological diseases, especially in patients with eating disorders. However, it is unrelated to autism spectrum disorders or other neurodevelopmental disorders. A previously healthy 10-year-old boy living in São Paulo, Brazil, had a history of significant food selectivity unrelated to autism spectrum disorder, resulting in symptomatic ascorbic acid deficiency (scurvy). This resulted in pain and purpuric lesions on the lower limbs, gingival edema, bleeding during tooth brushing, asthenia, weakness, malaise, and sadness. Therefore, dietary anamnesis is important for routine monitoring of child growth and development. This process helps prevent nutritional deficiencies, facilitates early diagnosis of eating disorders, and enables multidisciplinary follow-up for these patients.

Matrix metalloproteinases -2 and -9 expression in dogs with visceral leishmaniasis: A systematic review.

The matrix metalloproteinases (MMPs) are engaged in the degradation and remodeling of the extracellular matrix and vessels, allowing the progression of pathological processes. Recent studies pointed that MMP -2 and -9 are promising visceral leishmaniasis biomarkers. Thus, the present studystudy aimed to review published scientific literature related to MMP-2 and -9 activity on canine visceral leishmaniasis (CVL). The review followed the PRISMA method, searching for articles in ScienceDirect, PubMed, Scopus, Lilacs, Medline and Google Scholar from inception until 20 March 2022 by employing the following terms: "dog", "matrix metalloproteinases" and "Visceral Leishmaniasis" or "Kala Azar". The selected articles were read in full and only those consistent with the eligibility criteria were included in the review. Of 238 articles from the initial search, only five were deemed eligible, which were conducted between 2010 and 2018. All studies were performed in Brazil. It was observed that there was a higher expression of proMMP-2 in cerebrospinal (CS) fluid and serum and active MMP-2 in different skin areas, mainly in high parasite load areas. As for MMP-9, the pro and active forms were both expressed in CS fluid, serum and different skin areas. The MMP-2 can be considered a biomarker of bad prognostic as it plays an inflammatory role with a greater release in the initial phase of the disease, where MMP-9 is perceived in the chronic phase of CVL. Future research on the subject with greater methodological rigor and bigger sample sizes are mandatory to clarify the role of MMPs on disease progression.

The Expansin Gene CsLIEXP1 Is a Direct Target of CsLOB1 in Citrus.

Transcription activator-like effectors are key virulence factors of Xanthomonas. They are secreted into host plant cells and mimic transcription factors inducing the expression of host susceptibility (S) genes. In citrus, CsLOB1 is a direct target of PthA4, the primary effector associated with citrus canker symptoms. CsLOB1 is a transcription factor, and its expression is required for canker symptoms induced by Xanthomonas citri subsp. citri. Several genes are up-regulated by PthA4; however, only CsLOB1 was described as an S gene induced by PthA4. Here, we investigated whether other up-regulated genes could be direct targets of PthA4 or CsLOB1. Seven up-regulated genes by PthA4 were investigated; however, an expansin-coding gene was more induced than CsLOB1. In Nicotiana benthamiana transient expression experiments, we demonstrate that the expansin-coding gene, referred here to as CsLOB1-INDUCED EXPANSIN 1 (CsLIEXP1), is not a direct target of PthA4, but CsLOB1. Interestingly, CsLIEXP1 was induced by CsLOB1 even without the predicted CsLOB1 binding site, which suggested that CsLOB1 has other unknown binding sites. We also investigated the minimum promoter regulated by CsLOB1, and this region and LOB1 domain were conserved among citrus species and relatives, which suggests that the interaction PthA4-CsLOB1-CsLIEXP1 is conserved in citrus species and relatives. This is the first study that experimentally demonstrated a CsLOB1 downstream target and lays the foundation to identify other new targets. In addition, we demonstrated that the CsLIEXP1 is a putative S gene indirectly induced by PthA4, which may serve as the target for genome editing to generate citrus canker-resistant varieties.

Efficient CRISPR-Cas9 based cytosine base editors for phytopathogenic bacteria.

Phytopathogenic bacteria play important roles in plant productivity, and developments in gene editing have potential for enhancing the genetic tools for the identification of critical genes in the pathogenesis process. CRISPR-based genome editing variants have been developed for a wide range of applications in eukaryotes and prokaryotes. However, the unique mechanisms of different hosts restrict the wide adaptation for specific applications. Here, CRISPR-dCas9 (dead Cas9) and nCas9 (Cas9 nickase) deaminase vectors were developed for a broad range of phytopathogenic bacteria. A gene for a dCas9 or nCas9, cytosine deaminase CDA1, and glycosylase inhibitor fusion protein (cytosine base editor, or CBE) was applied to base editing under the control of different promoters. Results showed that the RecA promoter led to nearly 100% modification of the target region. When residing on the broad host range plasmid pHM1, CBERecAp is efficient in creating base edits in strains of Xanthomonas, Pseudomonas, Erwinia and Agrobacterium. CBE based on nCas9 extended the editing window and produced a significantly higher editing rate in Pseudomonas. Strains with nonsynonymous mutations in test genes displayed expected phenotypes. By multiplexing guide RNA genes, the vectors can modify up to four genes in a single round of editing. Whole-genome sequencing of base-edited isolates of Xanthomonas oryzae pv. oryzae revealed guide RNA-independent off-target mutations. Further modifications of the CBE, using a CDA1 variant (CBERecAp-A) reduced off-target effects, providing an improved editing tool for a broad group of phytopathogenic bacteria.

Scurvy and food selectivity in childhood: a case report

ABSTRACT Despite its rarity, symptomatic micronutrient deficiency remains a public health problem. Scurvy is the differential diagnosis for bleeding disorders and hematological and rheumatological diseases, especially in patients with eating disorders. However, it is unrelated to autism spectrum disorders or other neurodevelopmental disorders. A previously healthy 10-year-old boy living in São Paulo, Brazil, had a history of significant food selectivity unrelated to autism spectrum disorder, resulting in symptomatic ascorbic acid deficiency (scurvy). This resulted in pain and purpuric lesions on the lower limbs, gingival edema, bleeding during tooth brushing, asthenia, weakness, malaise, and sadness. Therefore, dietary anamnesis is important for routine monitoring of child growth and development. This process helps prevent nutritional deficiencies, facilitates early diagnosis of eating disorders, and enables multidisciplinary follow-up for these patients.

O impacto da soropositividade no vínculo mãe-bebê em gestantes diagnosticadas com HIV / The impact of seropositivity in the mother-baby bond in HIV-diagnosed pregnant women

A pesquisa objetivou estudar a construção do vínculo mãe-bebê em gestantes soropositivas, a partir da análise dos impactos do diagnóstico para essas mulheres, identificando os sentimentos envolvidos em relação ao bebê e à maternidade, e buscando compreender a vivência da construção do bebê imaginário em gestantes soropositivas. Foi realizada pesquisa transversal, do tipo qualitativa com referencial teórico psicanalítico. Participaram seis mulheres, com idade entre 19 e 36 anos e tempo de gravidez entre quatro e oito meses. Assim, de acordo com o que emergiu a partir das entrevistas, foram estabelecidas as seguintes categorias de análise para Discussão: Conhecimento do diagnóstico, Sentimentos relacionados à gravidez e Construção do vínculo com o bebê. A partir da fala das participantes e das articulações teóricas feitas à luz da psicanálise, foi possível perceber que o vínculo mãe-bebê não é necessariamente prejudicado pela presença do HIV. O desejo de que os filhos fossem saudáveis e a preocupação com relação ao futuro deles esteve presente no discurso das mulheres como importante realidade construída. Além disso, foi possível conceber a existência de um ser, por meio da imaginação e conversa com os bebês, promovendo a aposta para o lugar do sujeito.

This research aimed to study the construction of the mother-baby bond in HIV-positive pregnant women, from the analysis of the impacts of the diagnosis to these women, identifying the feelings involved about the baby and motherhood, and seeking to understand the experience of the construction of the imaginary baby in HIV-positive women. A cross-sectional research was performed in qualitative type and using psychoanalysis as the theoretical framework. Six women participated, aged between 19 and 36 years and time of pregnancy between four to eight months. According to the research aim and the material collected, the following categories were established for discussion: knowledge of the diagnosis, feelings related to pregnancy and construction of the bond with the baby. From the content of what was said by the interviewees and theoretical articulations from psychoanalysis, it was realized that mother-baby bond is not necessarily prejudiced by HIV existence. The desire for their children to be healthy and concerned about the future of them as an important constructed reality. Further, it was possible to conceive the existence of a human being through imagination and talking with babies promoting the bet to subject's place.

Association between interleukin 10 (IL-10) polymorphisms and leishmaniasis progression: a systematic review and meta-analysis.

Interleukin 10 (IL-10) is associated with the progression of leishmaniasis because it inhibits the leishmanicidal action of macrophages and the production of mediators such as IFN-γ and nitric oxide. Studies have shown that specific polymorphisms are associated with the regulatory role of IL-10 and the development of more relevant clinical forms of leishamaniasis. We performed a systematic review and meta-analysis to determine whether single nucleotide polymorphisms (SNPs) of IL-10 influence the progression of leishmaniasis. The selected articles were read in full and only those consistent with the eligibility criteria were included in our study. Seven studies were eligible according to the inclusion criteria and were included in the present systematic review, but only five were subjected to statistical analysis. The pooled odds ratios showed no significant association between the rs1800871 SNP and the progression of leishmaniasis in all genotype models, including the dominant, recessive, homozygote, heterozygote, and allelic models. Regarding the association between rs1800896 SNP and the progression of leishmaniasis, the pooled odds ratios showed no association under all genotype models. Hence, IL-10 SNPs did not show significant association and were not considered a risk factor for the progression of leishmaniasis.

Citrus Huanglongbing is a pathogen-triggered immune disease that can be mitigated with antioxidants and gibberellin.

Huanglongbing (HLB) is a devastating disease of citrus, caused by the phloem-colonizing bacterium Candidatus Liberibacter asiaticus (CLas). Here, we present evidence that HLB is an immune-mediated disease. We show that CLas infection of Citrus sinensis stimulates systemic and chronic immune responses in phloem tissue, including callose deposition, production of reactive oxygen species (ROS) such as H2O2, and induction of immunity-related genes. The infection also upregulates genes encoding ROS-producing NADPH oxidases, and downregulates antioxidant enzyme genes, supporting that CLas causes oxidative stress. CLas-triggered ROS production localizes in phloem-enriched bark tissue and is followed by systemic cell death of companion and sieve element cells. Inhibition of ROS levels in CLas-positive stems by NADPH oxidase inhibitor diphenyleneiodonium (DPI) indicates that NADPH oxidases contribute to CLas-triggered ROS production. To investigate potential treatments, we show that addition of the growth hormone gibberellin (known to have immunoregulatory activities) upregulates genes encoding H2O2-scavenging enzymes and downregulates NADPH oxidases. Furthermore, foliar spray of HLB-affected citrus with gibberellin or antioxidants (uric acid, rutin) reduces H2O2 concentrations and cell death in phloem tissues and reduces HLB symptoms. Thus, our results indicate that HLB is an immune-mediated disease that can be mitigated with antioxidants and gibberellin.

Impact of primary dentition malocclusion on the oral health-related quality of life in preschoolers.

BACKGROUND: Malocclusion is a condition frequently seen in primary dentition due to the interaction of environmental, genetic and behavioural factors. The occurrence of some types of malocclusions can have an impact on oral health-related quality of life in children. Hence, the present study aimed to verify the impact of primary dentition malocclusion on oral health-related quality of life in preschool children. METHODS: A population-based cross-sectional study was conducted in Florianopolis, Brazil, with a representative sample of 1050 preschoolers aged between 2 and 5 years, randomly selected. Parents answered the Brazilian version of the Early Childhood Oral Health Impact Scale and also to a questionnaire on socio-economic indicators. Data obtained from the questionnaire were obtained by item response theory based on model of gradual response. The malocclusion assessed was: anterior open bite, increased overjet and posterior crossbite. Poisson regression model was employed for multivariate analysis (P < 0.05). RESULTS: Malocclusion was observed in 36.7% of the children. Of these, 11.4% were anterior open bite, 67.2% were increased overjet, and 21.4% were posterior crossbite. Malocclusion's impact on oral health-related quality of life was 28.6%. In children aged 4-5 years, the prevalence of malocclusion's impact on quality of life was 49.5% higher than in children aged 2-3 years. Statistical analysis showed that preschool children with malocclusion showed no significant impact on quality of life. CONCLUSIONS: The findings of the present study indicate that the occurrence of primary dentition malocclusion has no impact on the quality of life of children aged 2-5 years.

The Total Population Size of 'Candidatus Liberibacter asiaticus' Inside the Phloem of Citrus Trees and the Corresponding Metabolic Burden Related to Huanglongbing Disease Development.

'Candidatus Liberibacter asiaticus' (CLas) is the predominant causal agent of citrus huanglongbing, the most devastating citrus disease worldwide. CLas colonizes phloem tissue and causes phloem dysfunction. The pathogen population size in local tissues and in the whole plant is critical for the development of disease symptoms by determining the load of pathogenicity factors and metabolic burden to the host. However, the total population size of CLas in a whole plant and the ratio of CLas to citrus cells in local tissues have not been addressed previously. The total CLas population size for 2.5-year-old 'Valencia' sweet orange on 'Kuharske' citrange rootstock trees was quantified using quantitative PCR to be approximately 1.74 × 109 cells/tree, whereas 7- and 20-year-old sweet orange trees were estimated to be 4.3 × 1010 cells/tree, and 6.0 × 1010 cells/tree, respectively. The majority of CLas cells were distributed in leaf tissues (55.58%), followed by those in branch (36.78%), feeder root (4.75%), trunk (2.39%), and structural root (0.51%) tissues. The ratios of citrus cells to CLas cells for branch, leaf, trunk, feeder root, and structural root samples were within approximately 39 to 79, 44 to 124, 153 to 1,355, 191 to 1,054, and 561 to 3,760, respectively, representing the metabolic burden of CLas in different organs. It was estimated that the ratios of phloem cells to CLas cells for branch, leaf, trunk, feeder root, and structural root samples are approximately 0.39 to 0.79, 0.44 to 1.24, 1.53 to 13.55, 1.91 to 10.54, and 5.61 to 37.60, respectively. Approximately 0.01% of the total citrus phloem volume was estimated to be occupied by CLas, explaining the difficulty to observe CLas in most tissues under transmission electron microscopy. The CLas titer inside the leaf was estimated to be approximately 1.64 × 106 cells/leaf or 9.2 × 104 cells cm-2 in leaves, approximately 104 times less than that of typical apoplastic bacterial pathogens. This study provides quantitative estimates of phloem colonization by bacterial pathogens and furthers the understanding of the biology and virulence mechanisms of CLas.

Spatiotemporal Dynamics of 'Candidatus Liberibacter asiaticus' Colonization Inside Citrus Plant and Huanglongbing Disease Development.

'Candidatus Liberibacter asiaticus' (CLas), the causal agent of citrus huanglongbing (HLB), colonizes inside the phloem and is naturally transmitted by the Asian citrus psyllid (ACP). Here, we investigated spatiotemporal CLas colonization in different tissues after ACP transmission. Of the nine plants successfully infected via ACP transmission, CLas was detected in the roots of all trees at 75 days postremoval of ACPs (DPR) but in the mature leaf of only one tree; this finding is consistent with the model that CLas moves passively from source to sink tissues. At 75 and 365 DPR, CLas was detected in 11.1 and 43.1% of mature leaves not fed on by ACPs during transmission, respectively, unveiling active movement to the source tissue. The difference in colonization timing of sink and source tissues indicates that CLas is capable of both passive and active movement, with passive movement being dominant. At 225 DPR, leaves fed on by ACPs during the young stage showed the highest ratio of HLB symptomatic leaves and the highest CLas titer, followed by leaves that emerged after ACP removal and mature leaves not fed on by ACPs. Importantly, our data showed that ACPs were unable to transmit CLas via feeding on mature leaves. It is estimated that it takes 3 years at most for CLas to infect the whole tree. Overall, spatiotemporal detection of CLas in different tissues after ACP transmission helps visualize the infection process of CLas in planta and subsequent HLB symptom development and provides evidence showing that young leaves should be the focus of HLB management.

Psicoterapia com idosos: percepção de profissionais de psicologia em um ambulatório do SUS / Psychotherapy with older adults: perception of psychologists at an outpatient service of the brazilian unified health system / Psicoterapia con ancianos: percepción de profesionales de psicología en un dispensario del SUS

A busca dos idosos por serviços de saúde tem aumentado exponencialmente devido ao crescimento populacional e às mudanças no perfil epidemiológico. Em função das especificidades dessa fase da vida, compõem um público que requer cuidado especializado. Assim como em outras faixas etárias, os idosos estão expostos a problemáticas emocionais com que por vezes não conseguem lidar sozinhos e necessitam de acompanhamento psicológico, que pode ser prestado por meio de ambulatórios em serviços do Sistema Único de Saúde (SUS). No campo da Psicologia, a psicoterapia com idosos ainda é um tema pouco discutido, o que designa ao profissional desafios práticos. Frente a essas questões, neste trabalho investiga-se sua atuação na psicoterapia com idosos. Trata-se de uma pesquisa qualitativa em que foram realizadas entrevistas semiestruturadas com sete profissionais de Psicologia que atuam em um ambulatório público de um hospital-escola em Pernambuco. Utilizou-se a análise de conteúdo de Minayo para empreender a análise das entrevistas. Foram discutidas as principais demandas que chegam aos profissionais no contexto pesquisado, bem como o manejo delas. Verificou-se que os estereótipos envolvendo a pessoa idosa interferem na condução do processo terapêutico, principalmente de forma negativa. Ficou evidente o grande número de idosos com sintomas depressivos que buscam acompanhamento psicológico. A pesquisa abriu a possibilidade de discutir sobre o alcance da atuação profissional, as limitações e as possibilidades de avanço, além de ter evidenciado a necessidade de preparo, na área da Psicologia clínica, para manejar as questões referentes ao envelhecimento.(AU)

As a result of population growth and epidemiological transition, the demand for health services among older adults is exponentially increasing, for this age group requires specialized care due to the specificities of this stage of life. As in other age groups, older adults are often exposed to emotional disorders that cannot be handled by themselves, thus requiring psychological counseling - a service that can be offered by the outpatient care service in the Brazilian Unified Health System (SUS). Yet, discussions addressing psychotherapy with older adults are still rather scarce within the field of Psychology, which imposes practical challenges to the professionals. Thus, this qualitative research sought to understand the predominant demands of older adults in an Outpatient Clinic at a teaching hospital in Pernambuco, as well as the professional management and performance in psychotherapy with geriatric population. Data were collected by means of a semi-structured interview conducted with seven psychologists and analyzed in the light of Minayo's content analysis. The results indicate that some age-related stereotypes can interfere negatively with the therapeutic process, with a considerable number of older individuals presenting depressive symptoms who have searched for psychological counseling. This study advanced knowledge on the extent of professional performance, limitations, and potential progress, besides highlighting the need for training regarding the management of aging issues within the field of Clinical Psychology.(AU)

Los ancianos que buscan servicios de salud se vienen aumentando debido al aumento de la población y los cambios en el perfil epidemiológico. Con las especificaciones de esta fase de la vida, componen un público que requieren cuidado especializado. Así como en individuos de otras edades, los ancianos están sujetos a problemáticas emocionales que muchas veces no consiguen resolver solos y necesitan de acompañamiento psicológico, que es ofrecido por los dispensarios del Sistema Único de Salud (SUS). La psicoterapia en ancianos todavía es un tema poco discutido en el campo de la Psicología, por lo que constituye un reto práctico a estos profesionales. Esta investigación pretende comprender la actuación de estos profesionales en la psicoterapia con ancianos. Esta es una investigación cualitativa realizada con entrevistas semiestructuradas a siete profesionales de Psicología que actúan en el dispensario público de un Hospital-Escuela en Pernambuco (Brasil). Se utilizó el análisis de contenido de Minayo para el análisis de las entrevistas. Se discutieron las principales cuestiones que llegan a los profesionales en el contexto investigado, así como su manejo. Se observó que los estereotipos hacia la persona anciana interfieren, principalmente de forma negativa, en la conducción del proceso terapéutico. Resulta evidente el gran número de ancianos con síntomas depresivos que buscan tratamiento psicológico. La investigación plantea la discusión sobre el alcance de la actuación profesional, las limitaciones, las posibilidades de avanzo y evidencia la necesidad de preparación en el área de la Psicología clínica para manejar las cuestiones referentes al envejecimiento.(AU)

Socio-economic characteristics, acid drinking patterns and gastric alterations associated with erosive tooth wear in children: a cross-sectional study.

AIMS: Assessing the influence of socio-economic characteristics, acid drinking patterns and gastric alterations considering erosive tooth experience in children. METHODS: Cross-sectional study to assess 08-10-year-old children enrolled in the primary education in public schools in Florianopolis, Brazil (n = 1085). Caregivers have answered questionnaires comprising independent variables (head of the household education frequency consumption of sports drinks, acid juice/soda, chewing gum, recurrent vomiting, gastric disorders and vomiting after overeating). Four trained dental surgeons have examined the children for the erosive tooth wear-dependent variable (O'Sullivan index), as well as collected dental caries (DMFT) and dental crowding (DAI index) information. A two-stage cluster-sampling plan was conducted. Unadjusted and adjusted logistic regression models were applied (Odds ratio, OR; 95% Confidence interval, CI and 5% significance level). RESULTS: The prevalence of erosive tooth wear was 15.67%. Erosive tooth wear was positively associated with high consumption of sports drinks (OR 3.42; 95% CI: 1.18-9.23). Children whose caregivers' educational level was equal or less than four years of study were less likely to have erosive tooth wear (OR 0.39; 95% CI: 0.17-0.88). CONCLUSION: High consumption of sports drinks is positively associated with erosive tooth wear. Children whose caregivers' educational level is low are less likely to present erosive tooth wear.

Importance of the ß5-ß6 Loop for the Structure, Catalytic Efficiency, and Stability of Carbapenem-Hydrolyzing Class D ß-Lactamase Subfamily OXA-143.

The class D ß-lactamase OXA-143 has been described as an efficient penicillinase, oxacillinase, and carbapenemase. The D224A variant, known as OXA-231, was described in 2012 as exhibiting less activity toward imipenem and increased oxacillinase activity. Additionally, the P227S mutation was reported as a case of convergent evolution for homologous enzymes. To investigate the impact of both mutations (D224A and P227S), we describe in this paper a deep investigation of the enzymatic activities of these three homologues. OXA-143(P227S) presented enhanced catalytic activity against ampicillin, oxacillins, aztreonam, and carbapenems. In addition, OXA-143(P227S) was the only member capable of hydrolyzing ceftazidime. These enhanced activities were due to a combination of a higher affinity (lower Km) and a higher turnover number (higher kcat). We also determined the crystal structure of apo OXA-231. As expected, the structure of this variant is very similar to the published OXA-143 structure, except for the two M223 conformations and the absence of electron density for three solvent-exposed loop segments. Molecular dynamics calculations showed that both mutants experience higher flexibility compared to that of the wild-type form. Therefore, our results illustrate that D224A and P227S act as deleterious and positive mutations, respectively, within the evolutionary path of the OXA-143 subfamily toward a more efficient carbapenemase.

Construções Identitárias de Psicólogos em NASF: Reflexões para a Prática Profissional / Identity Constructions of Psychologists in NASF: Reflections for Professional Practice / Construcciones Identitarias de Psicólogos en NASF: Reflexiones para la Práctica Profesional

Este artigo teve como objetivo analisar a construção de identidades profissionais de psicólogos no contexto de atuação em Núcleos de Apoio à Saúde da Família (NASF), a partir da dimensão identitária das representações profissionais. Foram realizadas entrevistas com oito psicólogos que atuam em NASF, na cidade do Recife/PE, divididas em duas etapas: a primeira do tipo entrevista narrativa, e a segunda do tipo semiestruturada, orientada por um roteiro, ambas realizadas em um mesmo encontro. As entrevistas foram áudio-gravadas e transcritas na íntegra em formato textual. Os dados foram analisados à luz do método fenomenológico para estudos em Psicologia. Esta análise foi guiada pela organização dos dados a partir de cinco etapas, que resultaram em unidades de significado, dentre as quais foi analisada no artigo a unidade O psicólogo no NASF. Verificou-se que a visão hegemônica da Psicologia atrelada ao contexto da clínica privada produz uma cultura profissional que direciona as demandas para essa categoria e orienta as representações profissionais, bem como a construção de identidades e práticas profissionais. Os profissionais fizeram alusão a recursos da atuação tradicional de cunho individual como um dos meios de resolução do conflito entre a atuação demandada em NASF e suas construções identitárias. À guisa de conclusão, verificou-se que havia para esses profissionais um imperativo de manutenção de uma coerência que sustentasse a identidade profissional, atrelada ao consumo da cultura profissional, mas que se demonstrou, pela via da incoerência, como inconsistente para efetivação de política de atenção básica na saúde....(AU)

This article aimed to analyze the construction of professional identities of psychologists in the context of working in Family Health Support Centers (NASF in Brazil), based on the identity dimension of professional representations. Interviews were conducted with 8 psychologists who work in NASF, in the city of Recife/PE, and divided into two stages: the first one of the narrative interview type, and the second of the semi-structured interview type, guided by a script, both were applied in the same meeting. The interviews were audio-recorded and fully transcribed into textual format. Data were analyzed based on the phenomenological method for studies in Psychology. This analysis was guided by the organization of data into five stages, which resulted in units of meaning, among which the unity The Psychologist in NASF was analyzed. It was verified that the hegemonic vision of Psychology, linked to the context of the private clinic, produces a professional culture that directs the demands to this category and guides the professional representations, as well as the construction of professional identities and practices. The professionals alluded to traditional resources of individual character as one of the means of resolving the conflict between the action demanded in NASF and their identity constructions. As a conclusion, it was verified that there was a need for these professionals to maintain a coherence that would support professional identity, linked to the consumption of professional culture; however, it showed to be inconsistent for the effective implementation of the basic health care politic....(AU)

Este artículo tuvo como objetivo analizar la construcción de identidades profesionales de psicólogos en el contexto de actuación en Núcleos de Apoyo a la Salud de la Familia (NASF), a partir de la dimensión identitaria de las representaciones profesionales. Se realizaron entrevistas con 8 psicólogos que actúan en NASF, en la ciudad de Recife / PE, divididas en dos etapas: la primera del tipo entrevista narrativa, y la segunda del tipo semiestructurada, orientada por un itinerario, ambas realizadas en un mismo encuentro. Las entrevistas fueron audio-grabadas y transcritas en su totalidad en formato textual. Los datos fueron analizados a la luz del método fenomenológico para estudios en Psicología. Este análisis fue guiado por la organización de los datos a partir de cinco etapas, que resultaron en unidades de significado, entre las cuales se analizó en el artículo la unidad El psicólogo en el NASF. Se verificó que la visión hegemónica de la Psicología ligada al contexto de la clínica privada produce una cultura profesional que dirige las demandas para esa categoría y orienta las representaciones profesionales, así como la construcción de identidades y prácticas profesionales. Los profesionales hicieron alusión a recursos de la actuación tradicional de cuño individual como uno de los medios de resolución del conflicto entre la actuación demandada en NASF y sus construcciones identitarias. A la luz de la conclusión, se verificó que había para estos profesionales un imperativo de mantener una coherencia que sostuviese la identidad profesional, ligada al consumo de la cultura profesional, pero que se demostró, por la vía de la incoherencia, como inconsistente para la efectividad de política de atención básica en la salud....(AU)

Factors associated with spontaneous perineal lacerations in deliveries without episiotomy in a university maternity hospital in the city of Recife, Brazil: a cohort study.

Objectives: The objective of this study is to determine factors associated with spontaneous perineal laceration in low-risk pregnant women who delivered vaginally without episiotomy in a university maternity hospital in Recife, Pernambuco, Brazil. Methods: A prospective cohort study was conducted with 222 low-risk, full-term pregnant women admitted in labor with a single fetus in cephalic presentation. Women with malformed fetuses were excluded from the study. The variables analyzed were: the frequency and severity of lacerations, the women's biological, sociodemographic, clinical and obstetrical characteristics, neonatal characteristics, and data on their deliveries and procedures. For the data analysis, risk ratios and their 95% confidence intervals were calculated. A significance level of 5% was adopted and multiple regression analysis was performed. Results: Spontaneous first-degree perineal tears were registered in 47% of the women, second-degree tears in 31%, and third degree tears in only 1.8%. There were no cases of fourth-degree tears. Having experienced normal childbirth previously constituted a protective factor against vaginal tearing (OR = 0.46; 95%CI: 0.23-0.91; p = .027). Conclusion: The principal protective factor against spontaneous lacerations was having experienced normal childbirth previously. Intrapartum strategies aimed at protecting the perineum and pelvic floor muscle training during prenatal care should be encouraged in these women.

Placental cord drainage in the third stage of labor: Randomized clinical trial.

METHODS: An open randomized clinical trial was developed at Instituto de Medicina Integral Prof. Fernando Figueira (IMIP) in Recife and at Petronila Campos Municipal Hospital in São Lourenço da Mata, both in Pernambuco, northeastern Brazil, including 226 low-risk pregnant women bearing a single, full-term, live fetus after delayed cord clamping, 113 randomized to placental cord drainage and 113 to a control group not submitted to this procedure. Women incapable of understanding the study objectives and those who went on to have an instrumental or cesarean delivery were excluded. RESULTS: Duration of the third stage of labor did not differ between the two groups (14.2±12.9 versus 13.7±12.1 minutes (mean ± SD), p = 0.66). Likewise, there was no significant difference in mean blood loss (248±254 versus 208±187ml, p = 0.39) or in postpartum hematocrit levels (32.3±4.06 versus 32.8±4.25mg/dl, p = 0.21). Furthermore, no differences were found between the groups for any of the secondary outcomes (postpartum hemorrhage >500 or >1000ml, therapeutic use of oxytocin, third stage >30 or 60 minutes, digital evacuation of the uterus or curettage, symptoms of postpartum anemia and maternal satisfaction). CONCLUSION: Placental cord drainage had no effect in reducing duration or blood loss during the third stage of labor. CLINICAL TRIALS REGISTRATION: ClinicalTrials.gov: www.clinicaltrial.gov, NCT01655576.

Structural and Enzymatic Characterization of a cAMP-Dependent Diguanylate Cyclase from Pathogenic Leptospira Species.

Leptospira interrogans serovar Copenhageni is a human pathogen that causes leptospirosis, a worldwide zoonosis. The L. interrogans genome codes for a wide array of potential diguanylate cyclase (DGC) enzymes with characteristic GGDEF domains capable of synthesizing the cyclic dinucleotide c-di-GMP, known to regulate transitions between different cellular behavioral states in bacteria. Among such enzymes, LIC13137 (Lcd1), which has an N-terminal cGMP-specific phosphodiesterases, adenylyl cyclases, and FhlA (GAF) domain and a C-terminal GGDEF domain, is notable for having close orthologs present only in pathogenic Leptospira species. Although the function and structure of GGDEF and GAF domains have been studied extensively separately, little is known about enzymes with the GAF-GGDEF architecture. In this report, we address the question of how the GAF domain regulates the DGC activity of Lcd1. The full-length Lcd1 and its GAF domain form dimers in solution. The GAF domain binds specifically cAMP (KD of 0.24µM) and has an important role in the regulation of the DGC activity of the GGDEF domain. Lcd1 DGC activity is negligible in the absence of cAMP and is significantly enhanced in its presence (specific activity of 0.13s-1). The crystal structure of the Lcd1 GAF domain in complex with cAMP provides valuable insights toward explaining its specificity for cAMP and pointing to possible mechanisms by which this cyclic nucleotide regulates the assembly of an active DGC enzyme.

Chromobacterium violaceum adaptation to low-phosphate conditions.

Chromobacterium violaceum is a free-living bacterium that inhabits low-nutrient environments such as the Amazon basin. Bacteria respond to phosphate (Pi) shortage by expressing a range of genes involved in Pi uptake and assimilation, known as the PHO regulon. Several PHO regulon genes have been annotated in the genome of C. violaceum. Here we show that C. violaceum is extremely well adapted to low-Pi conditions. Remarkably, this bacterium is able to grow in media containing only traces of Pi. The PHO regulon genes are induced upon Pi depletion, but the bacteria continued to grow under these conditions. Unlike other Proteobacteria hitherto analyzed, neither PstS nor PhoU play a role in the repression of the PHO regulon under Pi excess.