Prion protein is associated with a worse prognosis of head and neck squamous cell carcinoma.

BACKGROUND: Head and neck squamous cell carcinoma (HNSC) etiopathogenesis remains unclear, and the biological changes with the activation of heat shock proteins (HSPs) and prion protein (PRNP) promoted by hypoxia in HNSC are undetermined. This study investigates hypoxia's effect in lymph node metastasis by PRNP expression changes and its main partners. METHODS: The study combined a theoretical/cell culture study with a case-control study. First, bioinformatics and cell culture were performed. A case-control study was performed in a second step by comparing HNSC patients with and without lymph node metastasis. ANALYSES: The Cancer Genome Atlas (TCGA) data source validates the theory in the global population study. RESULTS: Bioinformatics analysis suggests that hypoxia-inducible factor-1α (HIF1A) is associated with HSPA4, HSP90AA1 and PRNP expression. TCGA data validate the hypothesis that higher HSP90AA1, HSPA4 and PRNP are related to metastases and low survival. Herein, the cell study demonstrated that muted PRNP did not respond to hypoxia. DISCUSSION: Our results collectively provide the first evidence that PRNP promotes HNSC lymph node metastasis progression through the upregulation of HSPA4, HSP90AA1 and HIF1A. Our findings may provide a molecular basis for the promoting Role of PRNP in HNSC progression.

Identification and characterization of methicillin-resistant Staphylococcus spp. isolated from surfaces near patients in an intensive care unit of a hospital in southeastern Brazil.

INTRODUCTION: Contaminated hospital environments contribute to the transmission of microorganisms associated with healthcare. Contaminated surfaces handled by patients or healthcare professionals are a source of microorganism transmission by hand. Methicillin-resistant Staphylococcus bacteria are among the main agents responsible for increasing healthcare-associated infections in Brazil and worldwide. METHODS: The objective of this study was to screen and characterize methicillin-resistant Staphylococcus spp. on surfaces near patients in an intensive care unit. Microbiological samples, collected from ten beds in an intensive care unit with five sampling sites, were inoculated into a methicillin-resistant Staphylococcus aureus chromogenic medium. MALDI-TOF and PCR analyses were used to identify the bacteria. Antimicrobial susceptibility was determined using the disk diffusion test. The presence of the mecA gene was investigated using PCR. RESULTS: We observed that 44 out of the 50 sampling sites presented grown isolates in the methicillin-resistant Staphylococcus aureus medium. The incidence of isolated microorganisms on the right side rail, left side rail, tables, infusion pump keypad, and cardiac monitor were 18.8 %, 36.7 %, 10.9 %, 2.4 %, and 31 %, respectively. The 42 isolates included in this study were identified as coagulase-negative Staphylococcus. All of these microorganisms were multidrug-resistant and mecA gene-positive. CONCLUSIONS: This study identified the presence of methicillin-resistant coagulase-negative Staphylococcus on the beds of an intensive care unit, providing evidence for the necessity of assertive actions to decrease the risk of healthcare-associated infections at the site.

NEONATAL PEMPHIGUS IN AN INFANT BORN TO A MOTHER WITH PEMPHIGUS VULGARIS: A CASE REPORT. / PÊNFIGO NEONATAL EM FILHO DE MÃE COM PÊNFIGO VULGAR: RELATO DE CASO.

OBJECTIVE: To report on the case of a patient with neonatal pemphigus that had extensive and critical skin lesions at birth. CASE DESCRIPTION: A newborn male with extensive vesico-bullous lesions on the anterior side of his chest and abdomen at birth. He was admitted to the pediatric ward of a hospital for an etiological diagnosis and for treatment. Based on maternal history and a clinical evaluation, the patient was diagnosed with neonatal vulgar pemphigus. His progression was satisfactory and, in the end, he did not need pharmacological interventions. COMMENTS: The cases reported in the literature and the references evaluated reveal that neonatal pemphigus is rare, but that knowledge about the disease allows for an early diagnosis to be made. This has great clinical relevance considering that the disease usually manifests itself in the form of extensive epidermal lesions, even though it is transient and benign, it does not require specific treatment, and it does not have any relation with possible future diseases.

OBJETIVO: Relatar um caso de pênfigo neonatal em paciente que manifestou lesões cutâneas extensas e críticas ao nascimento. DESCRIÇÃO DO CASO: Recém-nascido do sexo masculino com lesões vesicobolhosas extensas em região anterior do tórax e abdome, desde o nascimento. Admitido na ala pediátrica de um hospital para diagnóstico etiológico e tratamento. Com base na história materna e na avaliação clínica, concluiu tratar-se de pênfigo vulgar neonatal. O paciente apresentou evolução satisfatória, sem a necessidade de intervenção farmacológica. COMENTÁRIOS: Os casos descritos na literatura e as referências avaliadas revelam o pênfigo neonatal como uma doença de ocorrência rara, porém cujo conhecimento e diagnóstico precoce têm grande relevância clínica, considerando-se que geralmente se manifesta com lesões epidérmicas extensas e de aspecto crítico, embora apresente curso clínico transitório e benigno, sem necessidade de tratamento específico e sem relação com doença futura.

Characterization and molecular epidemiology of Staphylococcus aureus strains resistant to beta-lactams isolated from the milk of cows diagnosed with subclinical mastitis.

BACKGROUND AND AIM: The term ESKAPE, recognized by the WHO, is an acronym, which refers to the pathogens Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterobacter spp., which is extremely virulent and multidrug-resistant. Although the term is used to designate nosocomial pathogens, in a milking environment, strains of Methicillin-resistant S. aureus have been isolated from cattle diagnosed with clinical and subclinical mastitis. Resistant strains may be involved in the transfer of genes conferring resistance to beta-lactam antimicrobials among the species of microorganisms related to mastitis etiology. This study aimed to trace the phenotypic and genotypic profiles of susceptibility to beta-lactams in S. aureus isolated from milk of cattle diagnosed with subclinical mastitis obtained from different rural properties located in the North of Minas Gerais State, Brazil. MATERIALS AND METHODS: Sixteen microorganisms previously identified as S. aureus isolated from milk of cattle diagnosed with subclinical mastitis were submitted to matrix-assisted laser desorption/ionization-time-of-flight (MALDI-TOF), mass spectrometry, and polymerase chain reaction (PCR) analysis for microbial species confirmation. The S. aureus beta-lactams antimicrobial phenotypic resistance profile was investigated by disk diffusion method. PCR methods were also performed to investigate the S. aureus genotypic beta-lactams resistance profile. For this purpose, bla Z, mec A, mec ALGA251, bla Oxa23, and bla KPC genes were screened among S. aureus isolates. The genetic diversity of S. aureus by fingerprint random amplified polymorphic DNA (RAPD)-PCR was also performed in this study. RESULTS: All isolates showed phenotypic resistance to at least three beta-lactams, among which was meropenem. None of the isolates tested positive for the genes mec ALGA251, bla Oxa23, and bla KPC; however, the presence of the genes bla Z and mecA was detected among the isolates. The fingerprint analysis divided isolates into two distinct groups and 15 different subgroups. Despite the presence of clonality among the isolates, the PCR-RAPD analysis unveiled a heterogeneous profile with genetic diversity among the S. aureus isolates. CONCLUSION: In this study, we identified beta-lactams resistant S. aureus strains isolated from the milk of cows diagnosed with subclinical mastitis. The S. aureus beta-lactams resistance was investigated using a phenotypic and genotypic approach. We believe that molecular epidemiology, improved knowledge, and genetic basis of resistance to beta-lactams might assist in asserting guidelines for better management practices of dealing with subclinical mastitis and mapping of origin of resistant pathogens in the studied Brazilian area.

Identification and characterization of methicillin-resistant Staphylococcus spp. isolated from surfaces near patients in an intensive care unit of a hospital in southeastern Brazil

Abstract INTRODUCTION: Contaminated hospital environments contribute to the transmission of microorganisms associated with healthcare. Contaminated surfaces handled by patients or healthcare professionals are a source of microorganism transmission by hand. Methicillin-resistant Staphylococcus bacteria are among the main agents responsible for increasing healthcare-associated infections in Brazil and worldwide. METHODS: The objective of this study was to screen and characterize methicillin-resistant Staphylococcus spp. on surfaces near patients in an intensive care unit. Microbiological samples, collected from ten beds in an intensive care unit with five sampling sites, were inoculated into a methicillin-resistant Staphylococcus aureus chromogenic medium. MALDI-TOF and PCR analyses were used to identify the bacteria. Antimicrobial susceptibility was determined using the disk diffusion test. The presence of the mecA gene was investigated using PCR. RESULTS: We observed that 44 out of the 50 sampling sites presented grown isolates in the methicillin-resistant Staphylococcus aureus medium. The incidence of isolated microorganisms on the right side rail, left side rail, tables, infusion pump keypad, and cardiac monitor were 18.8 %, 36.7 %, 10.9 %, 2.4 %, and 31 %, respectively. The 42 isolates included in this study were identified as coagulase-negative Staphylococcus. All of these microorganisms were multidrug-resistant and mecA gene-positive. CONCLUSIONS: This study identified the presence of methicillin-resistant coagulase-negative Staphylococcus on the beds of an intensive care unit, providing evidence for the necessity of assertive actions to decrease the risk of healthcare-associated infections at the site.

Pênfigo neonatal em filho de mãe com pênfigo vulgar: relato de caso / Neonatal pemphigus in an infant born to a mother with pemphigus vulgaris: a case report

RESUMO Objetivo: Relatar um caso de pênfigo neonatal em paciente que manifestou lesões cutâneas extensas e críticas ao nascimento. Descrição do caso: Recém-nascido do sexo masculino com lesões vesicobolhosas extensas em região anterior do tórax e abdome, desde o nascimento. Admitido na ala pediátrica de um hospital para diagnóstico etiológico e tratamento. Com base na história materna e na avaliação clínica, concluiu tratar-se de pênfigo vulgar neonatal. O paciente apresentou evolução satisfatória, sem a necessidade de intervenção farmacológica. Comentários: Os casos descritos na literatura e as referências avaliadas revelam o pênfigo neonatal como uma doença de ocorrência rara, porém cujo conhecimento e diagnóstico precoce têm grande relevância clínica, considerando-se que geralmente se manifesta com lesões epidérmicas extensas e de aspecto crítico, embora apresente curso clínico transitório e benigno, sem necessidade de tratamento específico e sem relação com doença futura.

ABSTRACT Objective: To report on the case of a patient with neonatal pemphigus that had extensive and critical skin lesions at birth. Case description: A newborn male with extensive vesico-bullous lesions on the anterior side of his chest and abdomen at birth. He was admitted to the pediatric ward of a hospital for an etiological diagnosis and for treatment. Based on maternal history and a clinical evaluation, the patient was diagnosed with neonatal vulgar pemphigus. His progression was satisfactory and, in the end, he did not need pharmacological interventions. Comments: The cases reported in the literature and the references evaluated reveal that neonatal pemphigus is rare, but that knowledge about the disease allows for an early diagnosis to be made. This has great clinical relevance considering that the disease usually manifests itself in the form of extensive epidermal lesions, even though it is transient and benign, it does not require specific treatment, and it does not have any relation with possible future diseases.

Percepção de Tutores quanto a Sua Avaliação pelos Discentes de um Curso Médico / Tutors' Perception of their Assessment by Students of a Medical Course

RESUMO Entre as metodologias ativas de ensino-aprendizagem, a Aprendizagem Baseada em Problemas proporciona novos papéis aos agentes desse processo. O docente passa de detentor único do conhecimento a facilitador do processo ensino-aprendizagem. Por outro lado, o discente deixa o papel de sujeito passivo neste processo, participando ativamente na construção do conhecimento. O presente estudo objetivou analisar o significado atribuído pelo tutor às avaliações realizadas pelos discentes do curso médico da Universidade Estadual de Montes Claros sobre o seu desempenho profissional. Trata-se de estudo qualitativo, descritivo e exploratório, cujos sujeitos foram 11 tutores do Módulo Conteúdo Específico do primeiro e sétimo períodos do segundo semestre de 2009. Utilizou-se entrevista estruturada na coleta de dados, com análise e interpretação dos resultados segundo análise temática. Os tutores são, na maior parte, docentes do sexo feminino com curso de especialização e mestrado; há predomínio do regime de trabalho de 40 horas semanais. Das falas dos entrevistados emergiram as seguintes categorias temáticas: aspectos que influenciaram a escolha da tutoria: convites e necessidade da instituição; capacitação para tutoria: somente alguns docentes fizeram capacitação, alguns sujeitos tornaram-se tutores observando a ação de outros tutores; conhecimento da avaliação realizada pelos discentes no final de cada módulo: a avaliação feita pelo discente não se realiza de forma compromissada; docentes e gestores não se envolvem nos resultados obtidos; e, por último, as categorias concepção do tutor quanto à avaliação e percepção do tutor sobre a avaliação via intranet: nota-se que todos os sujeitos conhecem e sabem da importância da realização de tal processo, porém alguns docentes não se interessam pelas avaliações discentes. Espera-se que os resultados contribuam para melhoria da percepção do docente sobre seu papel na construção e organização curricular e, consequentemente, na formação de novos profissionais médicos, como previsto no Projeto Político Pedagógico deste curso.

ABSTRACT Among the active pedagogical methodologies, Problem-Based Learning provides new roles to the agents of the teaching-learning processes. The teacher passes from the role of single knowledge holder to facilitator of the learning process. On the other hand the student's role also changes from passive subject to active participant in this knowledge construction. This study aimed at analyzing the meaning given by tutors to assessments made by medicine students at Montes Claros State University on their professional performance. It is a qualitative, descriptive and exploratory study, the subjects of which were 11 tutors of the Content Specific Module of first and fourth year students in the second semester of 2009. We used structured interviews to collect data, the results of which were analyzed and interpreted according to thematic content analysis. The tutors were mostly female who held a specialization qualification and master's degree; the predominant working week was 40 hours. The following thematic categories were derived from the interviews: aspects that influenced the decision to work as a tutor: invitations from and needs of the institution; tutor training: only some teachers received training, some became tutors through observing other tutors at work; awareness of the student assessment at the end of each module: the student assessment is not performed in a committed manner; teachers and managers do not engage in the results; and finally the categories of how the tutors conceive the assessment and perceive it via the Intranet: it was observed that all the subjects are aware of the importance of such a process, but some teachers are not interested in the student assessments. It is expected that the results will contribute to improving teachers' view of their role in building and organizing the curriculum and, consequently, in the training of new medical professionals, as set out in the Pedagogical Political Project for this course.

Percepção de Tutores quanto a Sua Avaliação pelos Discentes de um Curso Médico / Tutors' Perception of their Assessment by Students of a Medical Course

RESUMO Entre as metodologias ativas de ensino-aprendizagem, a Aprendizagem Baseada em Problemas proporciona novos papéis aos agentes desse processo. O docente passa de detentor único do conhecimento a facilitador do processo ensino-aprendizagem. Por outro lado, o discente deixa o papel de sujeito passivo neste processo, participando ativamente na construção do conhecimento. O presente estudo objetivou analisar o significado atribuído pelo tutor às avaliações realizadas pelos discentes do curso médico da Universidade Estadual de Montes Claros sobre o seu desempenho profissional. Trata-se de estudo qualitativo, descritivo e exploratório, cujos sujeitos foram 11 tutores do Módulo Conteúdo Específico do primeiro e sétimo períodos do segundo semestre de 2009. Utilizou-se entrevista estruturada na coleta de dados, com análise e interpretação dos resultados segundo análise temática. Os tutores são, na maior parte, docentes do sexo feminino com curso de especialização e mestrado; há predomínio do regime de trabalho de 40 horas semanais. Das falas dos entrevistados emergiram as seguintes categorias temáticas: aspectos que influenciaram a escolha da tutoria: convites e necessidade da instituição; capacitação para tutoria: somente alguns docentes fizeram capacitação, alguns sujeitos tornaram-se tutores observando a ação de outros tutores; conhecimento da avaliação realizada pelos discentes no final de cada módulo: a avaliação feita pelo discente não se realiza de forma compromissada; docentes e gestores não se envolvem nos resultados obtidos; e, por último, as categorias concepção do tutor quanto à avaliação e percepção do tutor sobre a avaliação via intranet: nota-se que todos os sujeitos conhecem e sabem da importância da realização de tal processo, porém alguns docentes não se interessam pelas avaliações discentes. Espera-se que os resultados contribuam para melhoria da percepção do docente sobre seu papel na construção e organização curricular e, consequentemente, na formação de novos profissionais médicos, como previsto no Projeto Político Pedagógico deste curso.

ABSTRACT Among the active pedagogical methodologies, Problem-Based Learning provides new roles to the agents of the teaching-learning processes. The teacher passes from the role of single knowledge holder to facilitator of the learning process. On the other hand the student's role also changes from passive subject to active participant in this knowledge construction. This study aimed at analyzing the meaning given by tutors to assessments made by medicine students at Montes Claros State University on their professional performance. It is a qualitative, descriptive and exploratory study, the subjects of which were 11 tutors of the Content Specific Module of first and fourth year students in the second semester of 2009. We used structured interviews to collect data, the results of which were analyzed and interpreted according to thematic content analysis. The tutors were mostly female who held a specialization qualification and master's degree; the predominant working week was 40 hours. The following thematic categories were derived from the interviews: aspects that influenced the decision to work as a tutor: invitations from and needs of the institution; tutor training: only some teachers received training, some became tutors through observing other tutors at work; awareness of the student assessment at the end of each module: the student assessment is not performed in a committed manner; teachers and managers do not engage in the results; and finally the categories of how the tutors conceive the assessment and perceive it via the Intranet: it was observed that all the subjects are aware of the importance of such a process, but some teachers are not interested in the student assessments. It is expected that the results will contribute to improving teachers' view of their role in building and organizing the curriculum and, consequently, in the training of new medical professionals, as set out in the Pedagogical Political Project for this course.