Use of medications by patients who are Deaf or Hard of Hearing: Reflections for the promotion of rational use.

BACKGROUND: Pharmacists are often unable to maintain satisfactory communication with people who are Deaf or Hard of Hearing (DHoH), potentially exposing those who are DHoH to various risks related to the use of medications. OBJECTIVE: To evaluate the use of medications, knowledge on their rational use, and communication with the pharmacist during the dispensing of medications among people who are DHoH. METHODS: A pilot cross-sectional study was conducted between February 2020 and May 2020 among those who are DHoH in Brazil. Data were collected using an online questionnaire about sociodemographic and clinical characteristics, the use of medications, knowledge on the rational use of medications, and communication with the pharmacist during dispensing. The questionnaire was developed in Brazilian sign language. RESULTS: Twenty-one responses were obtained. The mean age of the respondents was 31.9 years, 67% were women, and 38% had cochlear implants. The most used medications were analgesics (22.2%) and anti-inflammatory and antirheumatic drugs (14.3%). The responses to the 20 statements on the rational use of medications resulted in a mean of 12.6 correct responses per individual. Almost all participants provided correct responses to the statements about medication intake times and expiration dates of medications. Only 33.3% of the patients responded that they would approach the pharmacist if they had questions regarding the medications. Most of the participants were dissatisfied with pharmacist counseling during the dispensing of medications. CONCLUSION: This study revealed an important reflection on possible self-medication by patients who are DHoH, poor knowledge on the rational use of medications, and dissatisfaction with pharmacist counseling during the dispensing of medications.

GroEL protein of the Leptospira spp. interacts with host proteins and induces cytokines secretion on macrophages.

BACKGROUND: Leptospirosis is a zoonotic disease caused by infection with spirochetes from Leptospira genus. It has been classified into at least 17 pathogenic species, with more than 250 serologic variants. This wide distribution may be a result of leptospiral ability to colonize the renal tubules of mammalian hosts, including humans, wildlife, and many domesticated animals. Previous studies showed that the expression of proteins belonging to the microbial heat shock protein (HSP) family is upregulated during infection and also during various stress stimuli. Several proteins of this family are known to have important roles in the infectious processes in other bacteria, but the role of HSPs in Leptospira spp. is poorly understood. In this study, we have evaluated the capacity of the protein GroEL, a member of HSP family, of interacting with host proteins and of stimulating the production of cytokines by macrophages. RESULTS: The binding experiments demonstrated that the recombinant GroEL protein showed interaction with several host components in a dose-dependent manner. It was also observed that GroEL is a surface protein, and it is secreted extracellularly. Moreover, two cytokines (tumor necrosis factor-α and interleukin-6) were produced when macrophages cells were stimulated with this protein. CONCLUSIONS: Our findings showed that GroEL protein may contribute to the adhesion of leptospires to host tissues and stimulate the production of proinflammatory cytokines during infection. These features might indicate an important role of GroEL in the pathogen-host interaction in the leptospirosis.

GroEL protein of the Leptospira spp. interacts with host proteins and induces cytokines secretion on macrophages

Background: Leptospirosis is a zoonotic disease caused by infection with spirochetes from Leptospira genus. It has been classified into at least 17 pathogenic species, with more than 250 serologic variants. This wide distribution may be a result of leptospiral ability to colonize the renal tubules of mammalian hosts, including humans, wildlife, and many domesticated animals. Previous studies showed that the expression of proteins belonging to the microbial heat shock protein (HSP) family is upregulated during infection and also during various stress stimuli. Several proteins of this family are known to have important roles in the infectious processes in other bacteria, but the role of HSPs in Leptospira spp. is poorly understood. In this study, we have evaluated the capacity of the protein GroEL, a member of HSP family, of interacting with host proteins and of stimulating the production of cytokines by macrophages. Results: The binding experiments demonstrated that the recombinant GroEL protein showed interaction with several host components in a dose-dependent manner. It was also observed that GroEL is a surface protein, and it is secreted extracellularly. Moreover, two cytokines (tumor necrosis factor-α and interleukin-6) were produced when macrophages cells were stimulated with this protein. Conclusions: Our findings showed that GroEL protein may contribute to the adhesion of leptospires to host tissues and stimulate the production of proinflammatory cytokines during infection. These features might indicate an important role of GroEL in the pathogen-host interaction in the leptospirosis.