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Many feline species are currently threatened with extinction. Therefore, germplasm bank establishment has become imperative. However, cryoinjury and ischemia-reperfusion injury pose significant obstacles to both cryopreservation and xenotransplantation. In this regard, erythropoietin (Epo) represents a potential alternative strategy due to its properties. This study aimed to assess the incubation of domestic cat ovarian tissue in Epo, both before and after cryopreservation, and investigate its effectiveness in promoting revascularization following xenotransplantation. Sixteen ovaries from 8 healthy cats were sliced following elective bilateral ovariohysterectomy (OHE). Subsequently, 8 fragments measuring 3 mm³ each were obtained from the cortical region of each ovary. The fragments were allocated into 3 treatment groups: Cryo group, fragments were cryopreserved, thawed and immediately transplanted; Cryo + Epo group, fragments were first cryopreserved in nitrogen, thawed, incubated in Epo (100 IU) for 2h and transplanted; and the Epo + Cryo group, in which fragments were first incubated in Epo (100 IU) for 2h, cryopreserved, thawed and immediately transplanted. The fragments were then xenotransplanted into the dorsal subcutaneous region of ovariectomized female nude mice and retrieved at 7, 14, 21, and 28 days post-transplantation. The results indicated that Epo effectively enhanced follicular survival, preservation of viability, and tissue revascularization. The Epo + Cryo group displayed better revascularization rates on D14 and D21 post-transplantation and an increase in primordial and growing follicles on D28, the Cryo + Epo group exhibited significantly more follicles on D14 and D21, with fewer degenerated follicles.
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Criopreservación , Eritropoyetina , Ratones Desnudos , Ovario , Trasplante Heterólogo , Animales , Femenino , Criopreservación/métodos , Criopreservación/veterinaria , Eritropoyetina/farmacología , Gatos , Ovario/efectos de los fármacos , Ovario/trasplante , Ratones , Folículo Ovárico/efectos de los fármacos , Crioprotectores/farmacología , Neovascularización Fisiológica/efectos de los fármacosRESUMEN
Gabirobeira fruits are known for their rich nutrient content and bioactive phytochemical compounds that contribute to significant biological activities. Despite these attributes, the antioxidant potential and stability of phenolic compounds in gabiroba by-products after digestion have yet to be studied. The objective of this work was to evaluate the physical-chemical composition, antibacterial activity, α-amylase, and α-glucosidase inhibitory effects, as well as the in vitro digestibility of total phenolic compounds, total flavonoids, and antioxidant activity of powder and extract from gabiroba to valorize these byproducts. The gabiroba powder had low moisture, high carbohydrate and fiber content. The extraction using 80% ethanol demonstrated higher antioxidant, antibacterial, α-amylase, and α-glucosidase inhibition activities compared to the 12% ethanol and water extracts. Catechin and ferulic acid were the major phenolic compounds identified by HPLC-DAD. After digestion, both the powder and the gabiroba extract exhibited a bioaccessibility of more than 30% for total phenolic compounds and antioxidant activity during the gastric phase. However, the dry ethanol extract displayed higher total phenolic compounds after both the gastric and intestinal phases compared to the flour. Processing gabiroba into powder and extract is a promising approach to fully utilize this seasonal fruit, minimize waste, concentrate health-beneficial compounds, and valorize a by-product for use as a functional ingredient and raw material within the food and pharmaceutical industries.
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Antioxidantes , Myrtaceae , Antioxidantes/análisis , Frutas/química , alfa-Glucosidasas , Polvos/análisis , Fenoles/análisis , Extractos Vegetales/química , Etanol , alfa-Amilasas , Antibacterianos/análisis , DigestiónRESUMEN
BACKGROUND: Anal squamous cell carcinoma (ASCC) is an infrequent tumor whose treatment has not changed since the 1970s. The aim of this study is the identification of biomarkers allowing personalized treatments and improvement of therapeutic outcomes. METHODS: Forty-six paraffin tumor samples from ASCC patients were analyzed by whole-exome sequencing. Copy number variants (CNVs) were identified and their relation to disease-free survival (DFS) was studied and validated in an independent retrospective cohort of 101 ASCC patients from the Multidisciplinary Spanish Digestive Cancer Group (GEMCAD). GEMCAD cohort proteomics allowed assessing the biological features of these tumors. RESULTS: On the discovery cohort, the median age was 61 years old, 50% were males, stages I/II/III: 3 (7%)/16 (35%)/27 (58%), respectively, median DFS was 33 months, and overall survival was 45 months. Twenty-nine genes whose duplication was related to DFS were identified. The most representative was duplications of the CYP2D locus, including CYP2D6, CYP2D7P, and CYP2D8P genes. Patients with CYP2D6 CNV had worse DFS at 5 years than those with two CYP2D6 copies (21% vs. 84%; p < .0002, hazard ratio [HR], 5.8; 95% confidence interval [CI], 2.7-24.9). In the GEMCAD validation cohort, patients with CYP2D6 CNV also had worse DFS at 5 years (56% vs. 87%; p = .02, HR = 3.6; 95% CI, 1.1-5.7). Mitochondria and mitochondrial cell-cycle proteins were overexpressed in patients with CYP2D6 CNV. CONCLUSIONS: Tumor CYP2D6 CNV identified patients with a significantly worse DFS at 5 years among localized ASCC patients treated with 5-fluorouracil, mitomycin C, and radiotherapy. Proteomics pointed out mitochondria and mitochondrial cell-cycle genes as possible therapeutic targets for these high-risk patients. PLAIN LANGUAGE SUMMARY: Anal squamous cell carcinoma is an infrequent tumor whose treatment has not been changed since the 1970s. However, disease-free survival in late staged tumors is between 40% and 70%. The presence of an alteration in the number of copies of CYP2D6 gene is a biomarker of worse disease-free survival. The analysis of the proteins in these high-risk patients pointed out mitochondria and mitochondrial cell-cycle genes as possible therapeutic targets. Therefore, the determination of the number of copies of CYP2D6 allows the identification of anal squamous carcinoma patients with a high-risk of relapse that could be redirected to a clinical trial. Additionally, this study may be useful to suggest new treatment strategies to increase current therapy efficacy.
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Neoplasias del Ano , Carcinoma de Células Escamosas , Femenino , Humanos , Masculino , Persona de Mediana Edad , Neoplasias del Ano/genética , Neoplasias del Ano/terapia , Neoplasias del Ano/patología , Biomarcadores , Carcinoma de Células Escamosas/terapia , Carcinoma de Células Escamosas/tratamiento farmacológico , Citocromo P-450 CYP2D6/genética , Variaciones en el Número de Copia de ADN , Recurrencia Local de Neoplasia/patología , Pronóstico , Estudios RetrospectivosRESUMEN
This research endeavors to overcome the significant challenge of developing materials that simultaneously possess photostability and photosensitivity to UV-visible irradiation. Sulfurized nanorod (NR)-like ZnO/Zn(OH)2 and hierarchical flower-like γ-Zn(OH)2 /ϵ-Zn(OH)2 were identified from XRD diffraction patterns and Raman vibrational modes. The sulfurized material, observed by FEG-SEM and TEM, showed diameters ranging from 10 and 40â nm and lengths exceeding 200â nm. The S2- ions intercalated Zn2+ , modulating NRs to dumbbell-like microrods. SAED and HRTEM illustrated the atomic structure in (101) crystal plane. Its direct band gap of 3.0â eV was attributed to the oxygen vacancies, which also contribute to the deep-level emissions at 422 and 485â nm. BET indicated specific surface area of 4.4â m2 g-1 and pore size as mesoporosity, which are higher compared to the non-sulfurized analogue. These findings were consistent with the observed photocurrent, photostability and photoluminescence (PL), further supporting the suitability of sulfurized NR-like ZnO/Zn(OH)2 as a promising candidate for Luminescent solar concentrators (LSC)-photovoltaic (PV) system.
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RESEARCH QUESTION: Is the optimal timing for administering erythropoietin to minimize ischaemic injury in ovarian tissue transplantation before ovary removal for cryopreservation and subsequent transplantation or after transplantation? DESIGN: Thirty Swiss mice (nu/nu) were divided into three groups: treatment control group (nâ¯=â¯10); erythropoietin before harvesting group (EPO-BH) (nâ¯=â¯10) and erythropoietin after transplantation group (EPO-AT) (nâ¯=â¯10). Animals underwent bilateral ovariohysterectomy and their hemiovaries were cryopreserved by slow freezing. At the same time, previously cryopreserved hemiovaries were transplanted subcutaneously in the dorsal region. Erythropoietin (250 IU/kg) and sterile 0.9% saline solution were administered every 12/12 h over 5 consecutive days in the EPO-AT and EPO-BH groups, respectively. RESULTS: Administration of erythropoietin in the EPO-AT group improved the viability of ovarian follicles, reducing degeneration and increasing the number of morphologically normal growing follicles at 14 days after transplantation compared with the EPO-BH group (Pâ¯=â¯0.002). This group also showed higher percentages of proliferative follicles at 7 days after transplantation (P ≤ 0.03), increased blood vessel count (P ≤ 0.03) and greater tissue area occupied by blood vessels at days 7 and 14 after transplantation (P ≤ 0.03), compared with hormone administration before cryopreservation (EPO-BH group) and the treatment control group. Additionally, treatment with erythropoietin before or after transplantation reduced fibrotic areas at 7 days after transplantation (Pâ¯=â¯0.004). CONCLUSION: Erythropoietin treatment after transplantation reduced ischaemic damage in transplanted ovarian tissue, increased angiogenesis, maintenance of ovarian follicle proliferation and reduced fibrosis areas in the grafted tissue.
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Eritropoyetina , Ovario , Femenino , Ratones , Animales , Folículo Ovárico , Eritropoyetina/farmacología , Isquemia , Criopreservación , ReperfusiónRESUMEN
In the present study, we investigated the genetic diversity of Plasmodium vivax metacaspase 1 (PvMCA1) catalytic domain in two municipalities of the main malaria hotspot in Brazil, i.e., the Juruá Valley, and observed complete sequence identity among all P. vivax field isolates and the Sal-1 reference strain. Analysis of PvMCA1 catalytic domain in different P. vivax genomic sequences publicly available also revealed a high degree of conservation worldwide, with very few amino acid substitutions that were not related to putative histidine and cysteine catalytic residues, whose involvement with the active site of protease was herein predicted by molecular modeling. The genetic conservation presented by PvMCA1 may contribute to its eligibility as a druggable target candidate in vivax malaria.
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Malaria Vivax , Plasmodium vivax , Brasil , Dominio Catalítico , Variación Genética/genética , Humanos , Plasmodium vivax/genética , Proteínas Protozoarias/genéticaRESUMEN
Individuals interpret themselves as causal agents when executing an action to achieve an outcome, even when action and outcome are independent. How can illusion of control be managed? Once established, does it decay? This study aimed to analyze the effects of valence, probability of the outcome [p(O)] and probability of the actions performed by the participant [p(A)], on the magnitude of judgments of control and corresponding associative measures (including Rescorla-Wagner's, Probabilistic Contrast, and Cheng's Power Probabilistic Contrast models). A traffic light was presented on a computer screen to 81 participants who tried to control the green or red lights by pressing the spacebar, after instructions describing a productive or a preventive scenario. There were 4 blocks of 50 trials under all of 4 different p(O)s in random order (0.10, 0.30, 0.70, and 0.90). Judgments were assessed in a bidimensional scale. The 2 × 4 × 4 mixed experimental design was analyzed through General Linear Models, including factor group (between-subject valence), and block and p(O) (within subjects). There was a small effect of group and a large and direct effect of p(O) on judgments. Illusion was reported by 66% of the sample and was positive in the productive group. The oscillation of p(O) produced stronger illusions; decreasing p(O)s produced nil or negative illusions. Only Rescorla-Wagner's could model causality properly. The reasons why p(A) and the other models could not generate significant results are discussed. The results help to comprehend the importance of keeping moderate illusions in productive and preventive scenarios.
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Ilusiones/fisiología , Ilusiones/psicología , Juicio/fisiología , Tiempo de Reacción/fisiología , Autocontrol/psicología , Adolescente , Adulto , Brasil , Femenino , Humanos , Masculino , Modelos Estadísticos , Autoinforme , Adulto JovenRESUMEN
Objective: The purpose of this study was to test whether changes in clients' affect regulation capacity (AR) mediated the impact of therapists' empathy on outcome and whether this relationship was stronger for more insecurely than securely attached clients. Method: The data set included 66 clients, who had participated in 16 weeks of either CBT or EFT for depression. Clients' AR was assessed using an observer and a self-report measure. Results: Changes in AR significantly mediated the relationship between therapists' empathy and outcome for depression, dysfunctional attitudes and self-esteem but not interpersonal problems, and changes in AR were moderated by clients' insecure attachment styles. Conclusions: The findings provide support for therapists' empathy as an active ingredient of change contributing to changes in clients' affect regulation capacities and emphasize the importance of assessing clients' attachment styles so that therapists can be more responsive and effectively tailor their treatments to fit the needs of individual clients.
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Depresión/psicología , Depresión/terapia , Regulación Emocional , Empatía , Apego a Objetos , Relaciones Profesional-Paciente , Psicoterapia , Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Autoinforme , Resultado del Tratamiento , Adulto JovenRESUMEN
Prior studies have failed to detect a convincing association between histologic lesions of inflammation and clinical activity in dogs with inflammatory bowel disease (IBD). We hypothesized that use of a simplified histopathologic scoring system would improve the consistency of interpretation among pathologists when describing histologic lesions of gastrointestinal inflammation. Our aim was to evaluate the correlation of histopathologic changes to clinical activity in dogs with IBD using this new system. Forty-two dogs with IBD and 19 healthy control dogs were enrolled in this retrospective study. Endoscopic biopsies from the stomach, duodenum, ileum, and colon were independently scored by 8 pathologists. Clinical disease activity was scored using the Canine Inflammatory Bowel Disease Activity Index (CIBDAI) or the Canine Chronic Enteropathy Clinical Activity Index (CCECAI), depending on the individual study center. Summative histopathological scores and clinical activity were calculated for each tissue (stomach, duodenum, ileum, and colon) and each tissue histologic score (inflammatory/morphologic feature). The correlation between CCECAI/CIBDAI and summative histopathologic score was significant ( P < .05) for duodenum ( r = 0.42) and colon ( r = 0.33). In evaluating the relationship between histopathologic scores and clinical activity, significant ( P < .05) correlations were observed for crypt dilation ( r = 0.42), lamina propria (LP) lymphocytes ( r = 0.40), LP neutrophils ( r = 0.45), mucosal fibrosis ( r = 0.47), lacteal dilation ( r = 0.39), and villus stunting ( r = 0.43). Compared to earlier grading schemes, the simplified scoring system shows improved utility in correlating histopathologic features (both summative histology scores and select histologic scores) to IBD clinical activity.
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Enfermedades de los Perros/patología , Tracto Gastrointestinal/patología , Enfermedades Inflamatorias del Intestino/veterinaria , Animales , Estudios de Casos y Controles , Colon/patología , Perros , Duodeno/patología , Íleon/patología , Enfermedades Inflamatorias del Intestino/patología , Estudios Retrospectivos , Índice de Severidad de la Enfermedad , Estómago/patologíaRESUMEN
Eighteen Nellore and 18 Angus young bulls with BW of 381 ± 12 kg were randomly assigned into two feeding groups (whole shelled corn [WSC] or ground corn with silage [GC]) to evaluate the interaction of breed and diet on total nutrient digestibility, pancreatic α-amylase, and maltase activity and SLC5A1expression in the small intestine. Experimental diets (DM basis) included (a) a diet containing 30% corn silage and 70% GC and soya bean meal-based concentrate and (b) a diet containing 85% WSC and 15% of a soya bean meal- and mineral-based pelleted supplement. The treatments were Nellore fed GC diet; Nellore fed WSC diet; Angus fed GC diet; and Angus fed WSC diet. Total faecal collection for the digestibility trial occurred from day 48 until day 50 of the experimental period. Feeding the WSC diet reduced DM and NDF intake (p < 0.01). Angus had greater DM and nutrient intake in kg/day (p < 0.01). However, there was no breed effect on DM and nutrient intakes based on percentage of BW (p > 0.19). Angus had greater starch digestibility (p = 0.03) than Nellore. Cattle fed the WSC diet had greater DM, NDF and starch digestibility (p < 0.01) compared with those fed the GC diet. The activity of pancreatic α-amylase (U/g of protein) was greater in Nellore (p < 0.01) and was not affected by diet (p = 0.52). In duodenum, maltase activity (U/g of protein) was greater in bulls fed GC diet (p = 0.02). Expression of the gene SLC5A1was not affected by breed or diet (p > 0.05). In conclusion, Nellore had less capacity to digest starch. However, they did not have less pancreatic α-amylase and duodenal maltase activity compared to Angus. The use of the WSC diet increases DM and total nutrient digestibility.
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Alimentación Animal/análisis , Bovinos/fisiología , Dieta/veterinaria , Digestión/fisiología , Intestino Delgado/fisiología , Zea mays/química , Fenómenos Fisiológicos Nutricionales de los Animales , Animales , Regulación de la Expresión Génica/efectos de los fármacos , Masculino , Distribución Aleatoria , Almidón/metabolismoRESUMEN
This work describes a novel ionic liquid (IL)-assisted synthesis strategy for a direct and easy production of Eu2+ -doped nanoparticles (NPs), where ILs are also used as fluoride sources to avoid the use of elemental fluorine or toxic hydrofluoric acid. Up to now, the direct synthesis of Eu2+ -doped nanophosphors consisted of an enormous challenge, due to the oxidation to Eu3+ observed in hydrous solution, which is commonly used for the preparation of NPs, generating lattice defects and undesired particle growth or agglomeration by additional reducing steps at high temperatures. In contrast, ILs, unless containing ClO4- or NO3- anions, do not present an oxidizing character, allowing the direct precipitation of NPs, e.g., using Eu2+ containing starting materials. Here, the undoped and Eu2+ -doped BaFCl NPs have been prepared under atmospheric conditions for the first time using ILs as solvents and also as fluoride source, applying sonochemical and microwave-assisted approaches. In general, this method bears an enormous potential for an easy synthesis of fluoride materials compared to inconvenient solid-state methods. In addition, the IL plays the role of a strongly attached protecting shell which represents ≈7-8% of the total NPs weight.
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In regard to mental illness, brain donation is essential for the biological investigation of central pathology. Nevertheless, little is known about the thoughts of people with mental disorders on tissue donation for research. Here, our objective was to understand the attitudes and opinions of people treated for bipolar disorder and their relatives regarding donation in general, and particularly donation for research. This is a qualitative study that used in-depth interviews to determine the thoughts of participants regarding tissue donation for research. Theoretical sampling was used as a recruitment method. Grounded theory was used as a framework for content analyses of the interviews. A semi-structured interview guide was applied with the topics: donation in general; donation for research; mental health and body organs; opinion regarding donation; feelings aroused by the topic. Although all participants were aware of organ donation for transplant, they were surprised that tissue could be donated for research. Nevertheless, once they understood the concept they were usually in favor of the idea. Although participants demonstrated a general lack of knowledge on donation for research, they were willing to learn more and viewed it as a good thing, with altruistic reasons often cited as a motive for donation. We speculate that bridging this knowledge gap may be a fundamental step towards a more ethical postmortem tissue donation process.
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Trastorno Bipolar , Donantes de Tejidos/provisión & distribución , Obtención de Tejidos y Órganos , Adulto , Anciano , Investigación Biomédica , Trastorno Bipolar/psicología , Cultura , Emociones , Femenino , Humanos , Masculino , Persona de Mediana Edad , Motivación , Encuestas y CuestionariosRESUMEN
The aims of the present study are to assess the organic waste vermicomposting process (cattle manure mixed with tannery sludge) by using inorganic waste (rock dust) inoculated with treated domestic wastewater sewage, as well as the vermicompost application in Ruellia brittoniana seedling production. Different proportions of organic and inorganic waste moistened (or not) in wastewater were vermicomposted (by Eisenia foetida) for 120 days in the first stage of the experiment. Statistically significant earthworm density increase was observed between the 60th and 90th experimental vermicompositing days in all the assessed groups. There was decreased E. foetida population density after 90 days. The K, P, TOC, C/N ratio and Ca, Na and Mg concentrations significantly decreased at the end of the vermicompositing process in comparison to the initial concentrations identified in most treatments. On the other hand, there was pH and N, Fe, Zn and Mn concentration increase in most of the vermicomposts assessed at the end of the experiment. All plants grown in soil containing vermicomposts presented higher Dickson Quality Index (DQI) than the control group, which was cultivated in soil containing commercial topsoil. Plants grown in soil containing 100% cattle manure and tannery sludge, moistened in treated domestic wastewater sewage, showed the highest DQI. Thus, the vermicomposting waste used in the present study, which was inoculated with treated domestic wastewater sewage, is an interesting vermicompost production technology to be used in ornamental plant production.
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Aguas del Alcantarillado , Aguas Residuales , Animales , Bovinos , Polvo , Estiércol , Oligoquetos , SueloRESUMEN
The exploitation and degradation of natural environments exert intense pressure on important ecosystems worldwide. Thus, it is necessary developing or adapting assessment methods to monitor environmental changes and to generate results to be applied to environmental management programs. The Brazilian Veredas (phytophysiognomies typical to the Cerrado biome) are threatened by several human activities; thus, the aim of the present study is to adapt a rapid assessment protocol (RAP) to be applied to Veredas springs, by using the upper course of the Vai-e-Vem stream watershed (Ipameri County, Goiás State, Brazil). Therefore, several springs in the study site were visited and 11 of them were considered Veredas springs. After the RAP was adapted, the instrument was validated and used to environmentally assess the springs in order to demonstrate its applicability. The present study has provided an instrument of option to monitor Veredas springs.
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Monitoreo del Ambiente/métodos , Manantiales Naturales , Humedales , Brasil , Ecosistema , Ambiente , Monitoreo del Ambiente/normasRESUMEN
Background: Highly active antiretroviral therapy (HAART) is complex and many factors contribute to a patient's response to initial therapy including adherence, drug effectiveness, and tolerance. Close HAART follow-up is needed, particularly when there are concurrent therapies such as prophylactic antibiotics and medications for the treatment of comorbidities. Objective: To assess the effectiveness of pharmacist intervention in reducing drug related problems in HIV/AIDS outpatients (intervention group) and in improving clinical parameters in the intervention group compared to the control group. Methods: We conducted a prospective controlled intervention study with patients paired by gender and initial T CD4+ lymphocyte (CD4) count. HIV-infected patients of a public outpatient service were enrolled for the study by consecutive and convenience sampling. Patients selected for the study were divided into a control group and an intervention group. Both groups were followed for one year; however, only the intervention group received pharmaceutical care. The primary outcome was the drug related problem (DRP) analysis for the intervention group. Secondary outcomes were CD4 count and viral load evaluation for both groups. Results: There was a total of 143 patients enrolled in this study, with 53 (37.06%) patients in the control group and 90 (62.94%) patients in the intervention group. A total of 202 pharmacist interventions with 193 pharmacist-patient and 9 pharmacist-physician interventions were proposed. After one year of pharmaceutical care, a reduction of 38.43% between the initial and final DRP was found (p = 0.0001). The most common DRPs found were related to medication safety. The intervention group showed a mean increase of 84% for the CD4 count in comparison with that observed in the control group. The viral load was not significantly different between the final and initial mean values for both groups. Conclusion: Pharmacist appointments enabled identification, prevention, and solving of drug related problems, especially those related to drug safety. Also, pharmacist interventions improved adherence and increased HAART effectiveness as suggested by the higher elevation in the CD4 count seen in the intervention group in comparison with the control group.
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This study examines whether women with breast cancer, who are adherent and non-adherent to tamoxifen, differ in their perceptions of information received during treatment. This cross-sectional study included women receiving tamoxifen as adjuvant treatment for breast cancer recruited from a teaching hospital specialised in women's health in the state of São Paulo (Brazil). Women were interviewed and their records were reviewed for socio demographic data and clinical characteristics. We assessed tamoxifen adherence using the Morisky-Green Test, and the European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire - Information module (EORTC QLQ-INFO25) was used to evaluate the information received by the women. The sample contained 31 women (mean age = 55.4; SD = 11.6 years). According to the Morisky-Green Test, 74.2% of the women had suboptimal tamoxifen adherence. The global score for women's perceptions of information they received about the treatment and disease was 57.0 ±19.1 on a scale of 0 to 100, and no significant differences in scores were observed between adherents and non-adherents. A high prevalence of suboptimal tamoxifen adherence was observed. We found no significant differences between women with breast cancer who were adherent and non-adherent to tamoxifen.
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BACKGROUND: Better communication among field health care teams and points of care, together with investments focused on improving teamwork, individual management, and clinical skills, are strategies for achieving better outcomes in patient-oriented care. This research aims to implement and evaluate interventions focused on improving communication and knowledge among health teams based on points of care in a regional public health outreach network, assessing the following hypotheses: 1) A better-working communication process between hospitals and primary health care providers can improve the sharing of information on patients as well as patients' outcomes. 2) A skill-upgrading education tool offered to health providers at their work sites can improve patients' care and outcomes. METHODS/DESIGN: A quasi-experimental study protocol with a mixed-methods approach (quantitative and qualitative) was developed to evaluate communication tools for health care professionals based in primary care units and in a general hospital in the southern region of São Paulo City, Brazil. The usefulness and implementation processes of the integration strategies will be evaluated, considering: 1) An Internet-based communication platform that facilitates continuity and integrality of care to patients, and 2) A tailored updating distance-learning course on ambulatory care sensitive conditions for clinical skills improvements. The observational study will evaluate a non-randomized cohort of adult patients, with historical controls. Hospitalized patients diagnosed with an ambulatory care sensitive condition will be selected and followed for 1 year after hospital discharge. Data will be collected using validated questionnaires and from patients' medical records. Health care professionals will be evaluated related to their use of education and communication tools and their demographic and psychological profiles. The primary outcome measured will be the patients' 30-day hospital readmission rates. A sample size of 560 patients was calculated to fit a valid logistic model. In addition, qualitative approaches will be used to identify subjective perceptions of providers about the implementation process and of patients about health system use. DISCUSSION: This research project will gather relevant information about implementation processes for education and communication tools and their impact on human resources training, rates of readmission, and patient-related outcomes.
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Comunicación , Personal de Salud , Hospitales Generales/organización & administración , Grupo de Atención al Paciente/organización & administración , Atención Primaria de Salud/organización & administración , Desarrollo de Personal , Adulto , Brasil , Competencia Clínica , Personal de Salud/educación , Estudio Históricamente Controlado , Hospitalización , Humanos , Relaciones Interprofesionales , Encuestas y CuestionariosRESUMEN
Genes that contain small open reading frames (smORFs) constitute a new group of eukaryotic genes and are expected to represent 5% of the Drosophila melanogaster transcribed genes. In this review we provide a historical perspective of their recent discovery, describe their general mechanism and discuss the importance of smORFs for future genomic and transcriptomic studies. Finally, we discuss the biological role of the most studied smORF so far, the Mlpt/Pri/Tal gene in arthropods. The pleiotropic action of Mlpt/Pri/Tal in D. melanogaster suggests a complex evolutionary scenario that can be used to understand the origins, evolution and integration of smORFs into complex gene regulatory networks.
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PURPOSE: Evaluate the potential Drug-Drug Interactions (pDDI) found in prescription orders of adult Intensive Care Unit (ICU) of a Brazilian public health system hospital; quantify and qualify the pDDI regarding their severity and risks to the critical patient, using the database from Micromedex®. METHODS: Prospective study (January-December of 2011) collecting and evaluating 369 prescription orders (convenient sampling), one per patient. RESULTS: During the study 1844 pDDIs were identified and distributed in 405 pairs (medication A × medication B combination). There was an average of 5.00 ± 5.06 pDDIs per prescription order, the most prevalent being moderate and important interactions, present in 74% and 67% of prescription orders, respectively. In total, there were 9 contraindicated, 129 important and 204 moderate pDDIs. Among them 52 had as management recommendation to "avoid concomitant use" or "suspension of medication", while 306 had as recommendation "continuous and adequate monitoring". CONCLUSION: The high number of pDDIs found in the study combined with the evaluation of the clinical relevancy of the most frequent pDDIs in the ICU shows that moderate and important interactions are highly incident. As the majority of them demand monitoring and adequate management, being aware of these interactions is major information for the safe and individualized risk management.
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Transcripts similar to those that encode the nonstructural (NS) proteins NS3 and NS5 from flaviviruses were found in a salivary gland (SG) complementary DNA (cDNA) library from the cattle tick Rhipicephalus microplus. Tick extracts were cultured with cells to enable the isolation of viruses capable of replicating in cultured invertebrate and vertebrate cells. Deep sequencing of the viral RNA isolated from culture supernatants provided the complete coding sequences for the NS3 and NS5 proteins and their molecular characterisation confirmed similarity with the NS3 and NS5 sequences from other flaviviruses. Despite this similarity, phylogenetic analyses revealed that this potentially novel virus may be a highly divergent member of the genus Flavivirus. Interestingly, we detected the divergent NS3 and NS5 sequences in ticks collected from several dairy farms widely distributed throughout three regions of Brazil. This is the first report of flavivirus-like transcripts in R. microplus ticks. This novel virus is a potential arbovirus because it replicated in arthropod and mammalian cells; furthermore, it was detected in a cDNA library from tick SGs and therefore may be present in tick saliva. It is important to determine whether and by what means this potential virus is transmissible and to monitor the virus as a potential emerging tick-borne zoonotic pathogen.