Matrix metalloproteinases with gelatinolytic activity induced by Paracoccidioides brasiliensis infection.

Matrix metalloproteinases (MMPs) modulate extracellular matrix turnover, inflammation and immunity. We studied MMP-9 and MMP-2 in experimental paracoccidioidomycosis. At 15 and 120 days after infection (DAI) with virulent Paracoccidioides brasiliensis, MMP-9 was positive by immunohistochemistry in multinucleated giant cells, in mononuclear cells with macrophage and lymphocyte morphologies and also in fungal cells in the lesions of susceptible and resistant mice. Using gelatin zymography, pro- and active MMP-9 and active MMP-2 were detected in all infected mice, but not in controls. Gelatinolytic activity was not observed in P. brasiliensis extracts. Semiquantitative analysis of gelatinolytic activities revealed weak or absent MMP-2 and strong MMP-9 activity in both mouse strains at 15 DAI, declining at 120 DAI. Avirulent P. brasiliensis-infected mice had residual lesions with MMP-9-positive pseudoxantomatous macrophages, but no gelatinase activity at 120 DAI. Our findings demonstrate the induction of MMPs, particularly MMP-9, in experimental paracoccidioidomycosis, suggesting a possible influence in the pattern of granulomas and in fungal dissemination.

Nitric oxide participation in granulomatous response induced by Paracoccidioides brasiliensis infection in mice.

The role of nitric oxide (NO) in granulomas of Paracoccidioides brasiliensis-infected inducible NO synthase-deficient C57BL/6 mice (iNOS KO) and their wild-type counterparts and its association with osteopontin (OPN) and matrix metalloproteinases (MMPs) was studied. At 15 days after infection (DAI), iNOS KO mice showed compact and necrotic granulomas with OPN+ macrophages and multinucleated giant cells, whereas wild-type mice developed loose granulomas with many fungi and OPN+ cells distributed throughout the tissue. In addition, high OPN levels and fungal load were observed in iNOS KO mice. Both experimental groups had MMP-9 activity. At 120 DAI, iNOS KO had smaller granulomas with OPN+ cells, lower OPN levels, lower fungal load and decreased MMP-9 activity compared with wild-type mice. These findings suggest that NO has an important role in granuloma modulation, by controlling OPN and MMP production, as well as by inducing loose granulomas formation and fungal dissemination, resulting, at later phases, in progression of paracoccidioidomycosis.

A experiência de estudantes de enfermagem em um grupo de educação em saúde: uma abordagem dialógica / Nursing students? experience in a health education group: a dialogic approach

Objetivo: Fazer uma reflexão teórica sobre a experiência de estudantes de Enfermagem em um grupo de educação em saúde, no município de Campinas-SP, tendo como referencial teórico-metodológico o Modelo Dialógico. Síntese dos Dados: Tratou-se de um relato de experiência, realizado em um Centro de Saúde do Distrito de Saúde Sudoeste, no município de Campinas-SP, no período de agosto a dezembro de 2009. Este Grupo foi dividido em 04 subgrupos de, em média, 60 usuários cada, sendo realizadas avaliação diagnóstica; identificação de temáticas a serem trabalhadas com os usuários e planejamento e execução de dinâmicas de grupo. A metodologia desenvolvida nas atividades educativas baseava-se no referencial teórico do Modelo Dialógico de Educação em Saúde. Por meio das dinâmicas de grupo, promoveram-se três mudanças na forma de pensar e fazer educação em saúde: i) do enfoque biologicista à apreensão multidimensional do indivíduo; ii) ao compartilhar, nós aprendemos: o princípio da bidirecionalidade; e iii) saber, não-saber ou sabemos? O princípio da simetria. Conclusão: Demonstra-se a viabilidade e operacionalidade do Modelo Dialógico para intervenções educativas em saúde.

Objective: To conduct a theoretical reflection on the experience of nursing students in a group of health education, in Campinas-SP, having as theoretical and methodological referential the Dialogical Model. Data Synthesis: This was an experience report, conducted in a Health Center of Southwest Health District, located in Campinas-SP, in the period from August to December 2009. This group was divided into 04 subgroups of on average 60 users each, being held diagnostic evaluation, identification of issues to be worked with users and planning and execution of group dynamics. The methodology developed in the educational activities was based on the theoretical Dialogical Model of Health Education. By means of group dynamics three changes were promoted in the way in which health education is thought and conducted: i) from a biologicist focus to the multidimensional apprehension of the individual; ii) through sharing, we learn: the principle of bidirectionality; iii) to know, not to know or do we know? The principle of symmetry. Conclusions: The viability and operability of the Dialogic Model for health education interventions is demonstrated.