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Objetivo: analisar a percepção da equipe de enfermagem sobre o método canguru em uma maternidade de alto risco. Método: estudo exploratório, descritivo, de abordagem qualitativa, realizado por meio de entrevista semiestruturada com enfermeiros de uma maternidade de alto risco de Recife (PE), desenvolvida entre janeiro e fevereiro de 2020. As entrevistas foram transcritas e submetida a análise através da técnica de conteúdo de Bardin. Resultados: ocorreu a formulação de duas categorias, assistência de enfermagem no método canguru e benefícios e desafios encontrados no Método Canguru. As participantes relataram que os cuidados de enfermagem se baseiam principalmente em orientações as mães, a escassez de profissionais e baixa adesão foram evidenciados como principais desafios. Conclusão: constatou-se que a atuação de enfermagem no método canguru é um complexo processo, necessitando de uma equipe de enfermagem motivada e especializada
Objective: analyze the nursing team's perception of the kangaroo method in a high-risk maternity hospital. Method: exploratory, descriptive study, with a qualitative approach, carried out through semi-structured interviews with nurses from a high-risk maternity hospital in Recife (PE), carried out between January and February 2020. The interviews were transcribed and subjected to analysis using the content technique by Bardin. Results: two categories were formulated, nursing care in the kangaroo method and benefits and challenges found in the Kangaroo Method. Participants reported that nursing care is mainly based on guidance from mothers, the shortage of professionals and low adherence were highlighted as main challenges. Conclusion: it was found that nursing practice in the kangaroo method is a complex process, requiring a motivated and specialized nursing team
Objetivos: analizar la percepción del equipo de enfermería sobre el método canguro en una maternidad de alto riesgo. Método: Estudio exploratorio, descriptivo, con enfoque cualitativo, realizado a través de entrevistas semiestructuradas a enfermeros de una maternidad de alto riesgo de Recife (PE), realizado entre enero y febrero de 2020. Las entrevistas fueron transcritas y sometidas a análisis mediante el Técnica de contenidos de Bardin. Resultados: Se formularon dos categorías, los cuidados de enfermería en el método canguro y los beneficios y desafíos encontrados en el Método Canguro. Los participantes informaron que la atención de enfermería se basa principalmente en la orientación de las madres, la escasez de profesionales y la baja adherencia fueron destacados como principales desafíos. Conclusión: se encontró que la práctica de enfermería en el método canguro es un proceso complejo, que requiere de un equipo de enfermería motivado y especializado
Subject(s)
Humans , Female , Adult , Middle Aged , Young Adult , Neonatal Nursing , Kangaroo-Mother Care Method , Nursing Care , Nursing, TeamABSTRACT
Abstract Background: The optimal amount for initial fluid resuscitation is still controversial in sepsis and the contribution of non-resuscitation fluids in fluid balance is unclear. We aimed to investigate the main components of fluid intake and fluid balance in both survivors and non-survivor patients with septic shock within the first 72 hours. Methods: In this prospective observational study in two intensive care units, we recorded all fluids administered intravenously, orally, or enterally, and losses during specific time intervals from vasopressor initiation: T1 (up to 24 hours), T2 (24 to 48 hours) and T3 (48 to 72 hours). Logistic regression and a mathematical model assessed the association with mortality and the influence of severity of illness. Results: We included 139 patients. The main components of fluid intake varied across different time intervals, with resuscitation and non-resuscitation fluids such as antimicrobials and maintenance fluids being significant contributors in T1 and nutritional therapy in T2/T3. A positive fluid balance both in T1 and T2 was associated with mortality (p = 0.049; p = 0.003), while nutritional support in T2 was associated with lower mortality (p = 0.040). The association with mortality was not explained by severity of illness scores. Conclusions: Non-resuscitation fluids are major contributors to a positive fluid balance within the first 48 hours of resuscitation. A positive fluid balance in the first 24 and 48 hours seems to independently increase the risk of death, while higher amount of nutrition seems protective. This data might inform fluid stewardship strategies aiming to improve outcomes and minimize complications in sepsis.
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RESUMO Objetivo: Descrever o IMPACTO-MR, um estudo brasileiro de plataforma nacional em unidades de terapia intensiva focado no impacto das infecções por bactérias multirresistentes relacionadas à assistência à saúde. Métodos: Descrevemos a plataforma IMPACTO-MR, seu desenvolvimento, critérios para seleção das unidades de terapia intensiva, caracterização da coleta de dados, objetivos e projetos de pesquisa futuros a serem realizados na plataforma. Resultados: Os dados principais foram coletados por meio do Epimed Monitor System® e consistiram em dados demográficos, dados de comorbidades, estado funcional, escores clínicos, diagnóstico de internação e diagnósticos secundários, dados laboratoriais, clínicos e microbiológicos e suporte de órgãos durante a internação na unidade de terapia intensiva, entre outros. De outubro de 2019 a dezembro de 2020, 33.983 pacientes de 51 unidades de terapia intensiva foram incluídos no banco de dados principal. Conclusão: A plataforma IMPACTO-MR é um banco de dados clínico brasileiro de unidades de terapia intensiva focado na pesquisa do impacto das infecções por bactérias multirresistentes relacionadas à assistência à saúde. Essa plataforma fornece dados para o desenvolvimento e pesquisa de unidades de terapia intensiva individuais e ensaios clínicos observacionais e prospectivos multicêntricos.
ABSTRACT Objective: To describe the IMPACTO-MR, a Brazilian nationwide intensive care unit platform study focused on the impact of health care-associated infections due to multidrug-resistant bacteria. Methods: We described the IMPACTO-MR platform, its development, criteria for intensive care unit selection, characterization of core data collection, objectives, and future research projects to be held within the platform. Results: The core data were collected using the Epimed Monitor System® and consisted of demographic data, comorbidity data, functional status, clinical scores, admission diagnosis and secondary diagnoses, laboratory, clinical, and microbiological data, and organ support during intensive care unit stay, among others. From October 2019 to December 2020, 33,983 patients from 51 intensive care units were included in the core database. Conclusion: The IMPACTO-MR platform is a nationwide Brazilian intensive care unit clinical database focused on researching the impact of health care-associated infections due to multidrug-resistant bacteria. This platform provides data for individual intensive care unit development and research and multicenter observational and prospective trials.
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ABSTRACT Objective: To evaluate clinical outcomes and factors associated with mortality, focusing on secondary infections, in critically ill patients with COVID-19 in three Brazilian hospitals during the first pandemic wave. Methods: This was a retrospective observational study involving adult patients with COVID-19 admitted to one of the participating ICUs between March and August of 2020. We analyzed clinical features, comorbidities, source of SARS-CoV-2 infection, laboratory data, microbiology data, complications, and causes of death. We assessed factors associated with in-hospital mortality using logistic regression models. Results: We included 645 patients with a mean age of 61.4 years. Of those, 387 (60.0%) were male, 12.9% (83/643) had undergone solid organ transplant, and almost 10% (59/641) had nosocomial COVID-19 infection. During ICU stay, 359/644 patients (55.7%) required invasive mechanical ventilation, 225 (34.9%) needed renal replacement therapy, 337 (52.2%) received vasopressors, and 216 (33.5%) had hospital-acquired infections (HAIs), mainly caused by multidrug-resistant gram-negative bacteria. HAIs were independently associated with a higher risk of death. The major causes of death were refractory shock and multiple organ dysfunction syndrome but not ARDS, as previously reported in the literature. Conclusions: In this study, most of our cohort required invasive mechanical ventilation and almost one third had HAIs, which were independently associated with a higher risk of death. Other factors related to death were Charlson Comorbidity Index, SOFA score at admission, and clinical complications during ICU stay. Nosocomial COVID-19 infection was not associated with death. The main immediate causes of death were refractory shock and multiple organ dysfunction syndrome.
RESUMO Objetivo: Avaliar desfechos clínicos e fatores associados à mortalidade, com foco em infecções secundárias, em pacientes com COVID-19 em estado crítico em três hospitais brasileiros durante a primeira onda da pandemia. Métodos: Estudo observacional retrospectivo envolvendo pacientes adultos com COVID-19 internados nas UTIs participantes entre março e agosto de 2020. Analisaram-se características clínicas, comorbidades, fonte de infecção por SARS-CoV-2, dados laboratoriais, dados microbiológicos, complicações e causas de óbito. Os fatores associados à mortalidade hospitalar foram avaliados por meio de modelos de regressão logística. Resultados: Foram incluídos 645 pacientes com média de idade de 61,4 anos. Desses, 387 (60,0%) eram do sexo masculino, 12,9% (83/643) haviam sido submetidos a transplante de órgão sólido, e quase 10% (59/641) apresentaram infecção nosocomial por COVID-19. Durante a internação na UTI, 359/644 pacientes (55,7%) necessitaram de ventilação mecânica invasiva, 225 (34,9%) necessitaram de terapia renal substitutiva, 337 (52,2%) receberam vasopressores, e 216 (33,5%) apresentaram infecções hospitalares (IHs), causadas principalmente por bactérias Gram-negativas multirresistentes. As IHs associaram-se de forma independente a maior risco de óbito. As principais causas de óbito foram choque refratário e síndrome de disfunção de múltiplos órgãos, mas não SDRA, como relatado anteriormente na literatura. Conclusões: Neste estudo, a maior parte de nossa coorte necessitou de ventilação mecânica invasiva, e quase um terço apresentou IHs, que se associaram de forma independente a maior risco de óbito. Outros fatores relacionados à mortalidade foram Índice de Comorbidade de Charlson, SOFA na admissão e complicações clínicas durante a internação na UTI. A infecção nosocomial por COVID-19 não se associou à mortalidade. As principais causas imediatas de óbito foram choque refratário e síndrome de disfunção de múltiplos órgãos.
ABSTRACT
As habilidades sociais educativas parentais são estratégias que os pais utilizam para direcionar os comportamentos dos filhos diante de situações de interação social. O presente estudo trata-se de uma pesquisa exploratória descritiva que teve por objetivo avaliar as habilidades sociais educativas parentais de mães de adolescentes estudantes de uma escola pública, apontados como tendo problemas sociais de comportamento. Participaram do estudo 20 mães, selecionadas a partir de uma amostragem por conveniência que considerou a ocorrência de queixas pela escola sobre problemas de comportamento de seus filhos. Utilizou-se como instrumento de coleta de dados o Roteiro de Entrevista das Habilidades Sociais Educativas Parentais. Os resultados encontrados apresentaram uma frequência baixa de práticas parentais positivas, em detrimento a uma frequência mais alta de práticas parentais negativas desempenhadas pelas participantes dessa pesquisa. Dessa forma, pode-se concluir um déficit nas habilidades sociais educativas parentais das mães entrevistadas no presente estudo. Esse estudo sugere a necessidade de maior atenção sobre a elaboração e aplicação de programas de treinamentos de habilidades sociais educativas parentais para mães cuidadoras de adolescentes, visto que um possível melhoramento neste aspecto pode influenciar um aprimoramento das estratégias educativas parentais. (AU)
Parenting educational social skills are strategies that parents use to guide their children's behavior in situations of social interaction. This study is an exploratory descriptive research that aimed to assess the social skills related to the parenting practices of mothers of adolescent students from a public school identified as having social behavior problems. Twenty mothers participated in the study, selected from a convenience sampling that considered the occurrence of complaints by the school about their children's behavior problems. As a data collection instrument, the Parental Social Skills Interview Guide was used. The results found showed a low frequency of positive parenting practices to the detriment of a higher frequency of negative parenting practices performed by the participants in this research. Thus, it is possible to conclude a deficit in the parenting educational social skills of the mothers interviewed in the present study. This study suggests the need for greater attention on the design and implementation of training programs for parenting educational social skills for mothers who care for adolescents, since a possible improvement in this aspect may influence an improvement in parenting educational strategies. (AU)
Las habilidades sociales educativas parentales son estrategias que los padres usan para dirigir el comportamiento de sus hijos en situaciones de interacción social. Este estudio es una investigación exploratorio-descriptiva que tuvo como objetivo evaluar las habilidades sociales relacionadas con las prácticas de crianza de madres de estudiantes adolescentes de una escuela pública, apuntados con problemas de conducta social. Veinte madres participaron en el estudio, seleccionado de una muestra de conveniencia que consideró la aparición de quejas por parte de la escuela sobre los problemas de comportamiento de sus hijos. Como instrumento de recopilación de datos, se utilizó la Guía de entrevista de habilidades sociales de los padres. Los resultados encontrados mostraron una baja frecuencia de prácticas de crianza positivas en detrimento de una mayor frecuencia de prácticas de crianza negativas realizadas por los participantes en esta investigación. Por lo tanto, es posible concluir un déficit en las habilidades sociales educativas parentales de las madres entrevistadas en el presente estudio. Este estudio sugiere la necesidad de una mayor atención en el diseño e implementación de programas de capacitación en habilidades sociales educativas parentales para madres que cuidan a adolescentes, ya que una posible mejora en este aspecto puede influir en una mejora en las estrategias educativas para padres. (AU)
Subject(s)
Education, Nonprofessional , Social Skills , Adolescent , Problem Behavior , MothersABSTRACT
Abstract This study evaluated the effect of a cyclopentenone-type PG, 15-Deoxy-Δ12,14-PG J2 (15d-PGJ2), and lectin (ScLL) on the viability of human gingival fibroblasts (HGFs), and on IL-6 and TGFβ-1 release by these fibroblasts, stimulated with lipopolysaccharide (LPS). HGFs were stimulated with LPS 10 μg/ml and treated with 15d-PGJ2 1 and 2 μg/ml, and ScLL 2 and 5 μg/ml, for 1 and 3h, and then evaluated for viability by MTT assay. Supernatant was collected to detect IL-6 and TGFβ-1 release, by ELISA. Positive control was cells kept in Dulbecco's Modified Eagle's Medium, and negative control was those kept in LPS. Data were analyzed by ANOVA and Dunnett's test (α = 0.05). No significant difference was found in viability among experimental groups at 1h (p > 0.05). Percentage of ScLL 5 µg/ml viable cells was similar to that of positive control at evaluated periods (p > 0.05), whereas the other groups had lower levels than the positive control (p < 0.05). IL-6 release was statistically higher for ScLL 5 μg/ml and 15d-PGJ2 2 µg/ml at 1h, compared with the other treated groups and positive control (p < 0.05). No significant differences were found among the groups at 3h (p > 0.05), except for ScLL 2 µg/ml and 15d-PGJ2 1 µg/ml, which showed lower IL-6 release compared with that of negative control (p < 0.05). No significant difference was found among the groups for TGFβ-1 release (p > 0.05). Results indicated that ScLL 5 μg/ml did not interfere in viability, and ScLL 2 µg/ml and 15d-PGJ2 1 µg/ml demonstrated reduced IL-6 release. Tested substances had no effect on TGFβ-1 release.
Subject(s)
Humans , Prostaglandin D2/analogs & derivatives , Lipopolysaccharides/pharmacology , Interleukin-6/metabolism , Plant Lectins/pharmacology , Transforming Growth Factor beta1/metabolism , Fibroblasts/drug effects , Fibroblasts/metabolism , Reference Values , Time Factors , Enzyme-Linked Immunosorbent Assay , Prostaglandin D2/pharmacology , Cell Survival/drug effects , Cells, Cultured , Analysis of Variance , Statistics, Nonparametric , Transforming Growth Factor beta1/drug effects , Gingiva/cytologyABSTRACT
Objetivo: analisar o perfil de pacientes obstétricas admitidas na Unidade de Terapia Intensiva Adulto. Método: estudo quantitativo, descritivo-retrospectivo, desenvolvido por meio da busca e obtenção dos dados referentes ao perfil socioeconômico e clínico dos prontuários das pacientes gestantes ou puérperas internadas por causa obstétrica, entre janeiro 2017 e dezembro de 2018, na Unidade de Terapia Intensiva de um hospital público de Pernambuco, Brasil. Os resultados foram analisados pelo programa Statistical Package for the Social Science. Resultados: as mulheres tinham, em sua maioria, idade entre 19 e 29 anos (56,1%), e cor parda (88,6%). A maioria foi internada no pós-parto (75,6%), o tipo de parto mais prevalente foi o cesáreo (87,2%), as síndromes hipertensivas foram a maior causa do internamento (61,8%). O principal distúrbio hipertensivo apresentado é pré-eclâmpsia (39,8%). Conclusão: as pacientes adultas jovens, puérperas de parto cesáreo, com síndromes hipertensivas são internadas com mais frequência na Unidade de Terapia Intensiva.
Objetivo: analizar el perfil de las pacientes obstétricas ingresadas en la Unidad de Cuidados Intensivos. Método: estudio cuantitativo, descriptivo y retrospectivo, desarrollado por medio de la búsqueda y la recuperación de los datos del perfil socioeconómico y clínico del registro médico de pacientes embarazadas o en posparto ingresadas por causa obstétrica, entre enero de 2017 y diciembre de 2018, en la Unidad de Cuidados Intensivos de un hospital público en el estado de Pernambuco, Brasil. Los resultados fueron analizados mediante el Statistical Package for the Social Sciences. Resultados: las mujeres tenían, en su mayoría, edades comprendidas entre los 19 y 29 años (56,1%), y pardas (88,6%). La mayoría fue hospitalizada en el posparto (75,6%), el tipo de parto por cesárea fue el más frecuente (87,2%), síndromes hipertensivos fueron la principal causa de hospitalización (61,8%). El principal trastorno hipertensivo presentado es la pre-eclampsia (39,8%). Conclusión: las pacientes adultas jóvenes, puérperas, cuyo parto fue cesárea, con síndromes hipertensivos son hospitalizadas con mayor frecuencia en las Unidades de Cuidados Intensivos.
Objective: to analyze the profile of obstetric patients admitted to the Intensive Care Unit. Method: quantitative, descriptive and retrospective study, developed through searches and retrieval of data referring to socioeconomic and clinical profile of pregnant or postpartum patients' records admitted for obstetric cause, between January 2017 and December 2018, in the Intensive Care Unit of a public hospital in Pernambuco, Brazil. The results were analyzed using the Statistical Package for the Social Sciences. Results: most women were between 19 and 29 years (56.1%), and pardas (88.6%). The majority was hospitalized in the postpartum (75.6%), the most prevalent delivery type was cesarean section (87.2%), hypertensive syndromes were the major cause of hospitalization (61.8%). The main hypertensive disorder was pre-eclampsia (39.8%). Conclusion: the young adult puerperal patients, whose delivery route was cesarean section, with hypertensive syndromes are hospitalized more frequently in the Intensive Care Unit.
Subject(s)
Humans , Female , Pregnancy , Obstetric Surgical Procedures , Maternal and Child Health , Pregnancy, High-Risk , Obstetric Nursing , Health Profile , Hospitals, Public , Intensive Care UnitsABSTRACT
Abstract: The lectin (ScLL) extracted from the Synadenium carinatum plant has been evaluated as an immunomodulator in diseases such as asthma, neosporosis and leishmaniasis. However, it has not yet been evaluated in the oral cavity. This study evaluated the effect of ScLL on viability, proliferation and release of IL-10 in human gingival fibroblasts (HGF) stimulated with lipopolysaccharide (LPS). HGF were stimulated with LPS 1 µg/ml and treated with ScLL in concentrations of 10, 5 and 2 µg/ml for 1 and 5 h, and evaluated by flow cytometry for viability, apoptosis (initial/advanced) and necrosis. The supernatant was collected to detect release of IL-10 by ELISA. The proliferation was assessed with the BrdU assay. Positive control consisted of cells maintained in Dulbecco's Modified Eagles Medium (DMEM), and the negative control, of those kept in tap water. Data were analyzed by ANOVA and Dunnett's test (α = 0.05). No significant difference was found for ScLL concentrations regarding viability or initial and advanced apoptosis (p=0.455). All the groups, including the positive control, had a significantly lower necrosis parameter than negative control at 5 h (p < 0.001). No difference was found for proliferation among the experimental groups (p = 0.832). ScLL at 5 and 2 µg/ml resulted in a lower release of IL-10 than positive and negative controls at 5 h (p = 0.047). The results indicated that ScLL concentrations tested were not cytotoxic, and had no effect on proliferation and release of IL-10 parameters. A thorough understanding of ScLL, regarding its immunomodulatory potential, may open the door to new perspectives for dentistry.
Subject(s)
Humans , Lipopolysaccharides/pharmacology , Plant Lectins/pharmacology , Fibroblasts/drug effects , Time Factors , Enzyme-Linked Immunosorbent Assay , Cell Survival/drug effects , Cells, Cultured , Analysis of Variance , Interleukin-10/analysis , Apoptosis/drug effects , Statistics, Nonparametric , Cell Proliferation/drug effects , Flow Cytometry , Gingiva/drug effects , Gingiva/chemistryABSTRACT
OBJETIVO:Avaliar os fatores determinantes da morbimortalidade em unidade de terapia intensiva obstétrica de um hospital universitário.MÉTODOS:Estudo observacional de corte transversal com 492 gestantes ou puérperas. Foram selecionadas pacientes internadas na unidade de terapia intensiva obstétrica no período de um ano, sendo informadas sobre as propostas do estudo e realizada aplicação do questionário. A análise foi feita através do Microsoft Excel 2013 e GraphPad Prism 6. Foram empregados testes do χ2 para verificar associação entre os fatores de risco para morbimortalidade materna grave.RESULTADOS: Foram encontrados como riscos relativos significativamente elevados para desenvolvimento de near missquando comparada à morbidade materna grave, a raça não branca (OR=2,5; RP=2,3); pacientes casadas (OR=7,9; RP=7,1), escolaridade até 2º grau incompleto (OR=3,1; RP=2,8), procedente do interior (OR=4,6; RP=4,0), renda familiar menor que 1 salário mínimo (OR=7,0; RP=5,5), distúrbios hipertensivos gestacionais (OR=16,3; RP=13,2), realização do pré-natal (OR=5,0; RP=4,2) e a via de parto cesárea (OR=39,2; RP=31,2).CONCLUSÕES: Questões socioeconômicas, clínicas e assistenciais mostraram-se relacionados à prevalência de near miss, revelando a importância de intervenções amplas para melhorar esses indicadores. Reforça-se a importância da realização de pré-natal para identificação de riscos potenciais, garantia de um suporte nutricional à gestante, tratamento de doenças e estabelecimento de programa de imunização materna, assim como uma melhor assistência no que tange aos aspectos clínicos das pacientes, objetivando diminuir o risco obstétrico e neonatal.
PURPOSE: To evaluate the risk factors for morbidity and mortality in an obstetric intensive care unit at a university hospital.METHODS: Observational cross-sectional study with 492 pregnant/puerperal women. Patients were admitted to the obstetric intensive care unit over a period of one year, being informed about the proposals of the study and a questionnaire was applied. The analysis was performed using Microsoft Excel 2013 and GraphPad Prism 6. To evaluate risk factors, χ2 tests were used.RESULTS: The main risk factors to near miss were: non-white race (OR=2.5; PR=2.3); marital status (married women) (OR=7.9; PR=7.1), schooling (primary) (OR=3.1; PR=2.8), being from the countryside (OR=4.6; PR=4.0), low income (OR=70; PR=5.5), gestational hypertensive disorders (OR=16.3; PR=13.2), receiving prenatal care (OR=5.0; PR=4.254) and C-section before labor (OR=39.2; PR=31.2).CONCLUSIONS: The prevalence of near miss was associated with socioeconomic/clinical factors and care issues, revealing the importance of interventions to improve these indicators. Additionally, we suggest a better curriculum insertion of this subject in the discipline of the medical course due to the importance of avoiding the near miss using adequate medical education. The importance of correct prenatal care is emphasized in order to identify potential risks, to provide nutritional support to pregnant women, to treat potential diseases and to establish a maternal immunization program, as well as providing better care regarding the clinical features of the patients, in order to reduce obstetrical and neonatal risk.
Subject(s)
Humans , Female , Pregnancy , Adult , Young Adult , Pregnancy Complications/epidemiology , Cross-Sectional Studies , Intensive Care Units , Near Miss, Healthcare , Risk Assessment , Risk FactorsABSTRACT
There are no studies evaluating the possible use of immunoglobulin A1 (IgA1) as an early marker for peri-implant inflammation. The aim of this study was to evaluate the IgA1 levels in peri-implant sulcular fluid (PISF) and saliva of partially edentulous patients as an indicator of mucositis. Twenty-seven patients were examined to determine the peri-implant status based on probing depth and bleeding on probing. Saliva and PISF around dental implants were collected and the IgA1 levels were evaluated by Elisa assay. IgA1 in saliva and PISF of these patients were compared and their correlations with clinical parameters were evaluated. Differences in IgA1 levels in saliva (821.1 ± 290.6; 779.8 ± 401.5) and PISF (26.6 ± 20.7; 25.1 ± 20.5) of healthy and mucositis groups, respectively were not observed (p>0.05). Correlation between clinical parameters and IgA1 in saliva or PISF was not observed in healthy or mucositis groups (p=0.607; p=0.826, respectively). These results suggest that IgA1 cannot be used as an immunological marker of mucositis.
Não existem estudos que avaliem a utilização de imunoglobulina A1 (IgA1) como marcador precoce da inflamação peri-implantar. O objetivo deste estudo foi avaliar os níveis de IgA1 do fluido sulcular peri-implantar (PISF) e saliva de pacientes parcialmente desdentados como indicador da mucosite. Vinte e sete pacientes foram examinados para determinar a condição peri-implantar com base na profundidade de sondagem e sangramento à sondagem. Saliva e PISF ao redor de implantes dentários foram coletados e os níveis IgA1 foram avaliados pelo teste Elisa. IgA1 na saliva e PISF destes pacientes foram comparados e suas correlações com parâmetros clínicos foram avaliados. Não foram observadas diferenças nos níveis de IgA1 (821,1 ± 290,6; 779,8 ± 401,5) na saliva e PISF (26,6 ± 20,7; 25,1 ± 20,5) de grupos saudáveis e mucosite, respectivamente (p>0,05). Correlação entre os parâmetros clínicos e IgA1 na saliva ou PISF não foi observada em grupos saudáveis ou mucosite (p=0,607; p=0,826, respectivamente). Estes resultados demonstraram que IgA1 não pode ser utilizada como marcador imunológico da mucosite.
Subject(s)
Humans , Body Fluids/metabolism , Dental Implants , Mucositis/metabolism , Saliva/metabolism , Case-Control StudiesABSTRACT
Aim: To investigate the cytotoxicity of four endodontic sealers with different bases Epiphany(EPH), AH Plus (AHP), Sealer 26 (S26) and Endofill (ENF) on human foreskin fibroblasts(HFF) and mouse macrophages (J774/G8). Methods: Cells were placed in direct contact withfreshly prepared endodontic sealers in polypropylene tubes. The cells were incubated for 24, 48and 72 h. Cytotoxicity was assessed using the MTT assay (cell viability) and Griess reagent (NOrelease). Results: On the HFF cultures, EPH showed the lowest viability levels of all four sealersat 24 h (p<0.05), but over time (72h), EPH lessened its toxic levels in a similar pattern as the otherthree materials (p>0.05). The viability of all four sealers on the macrophage cultures showed nostatistically significant difference over time, except between EPH and AHP at 72 h (p<0.05).Although uniformity was not detected in macrophage and fibroblast release of NO in response tosealers over time, a trend of increased NO levels for EPH (p<0.05) was observed. Conclusions:The response pattern varied depending on time and type of cell line used for analysis, althoughthe results indicate a higher cytotoxicity for EPH in short-term tests.
Subject(s)
Fibroblasts , MacrophagesABSTRACT
The aim of the present study is to investigate genetic polymorphisms in Taenia solium metacestodes from different Brazilian geographical areas and to relate them to antibody recognition in serum samples of neurocysticercosis (NC) patients. Metacestodes were obtained from the Distrito Federal (DF), Bahia, Minas Gerais (MG) and São Paulo (SP) regions of Brazil. Samples of human sera from 49 individuals with NC, 68 individuals with other helminthiasis and 40 healthy volunteers were analysed (157 individuals in total). Antigens were prepared and used in enzyme-linked immunosorbent assay and western blotting assays to detect specific immunoglobulin G antibodies. Genetic distances between metacestode populations were analysed using random amplified polymorphic DNA (RAPD) analysis. Our results show that there was a higher frequency of reactivity in the DF region in the sera from NC patients (p < 0.05), while discrimination between active and inactive NC was seen only in extracts from the MG and SP regions (p < 0.05). Using RAPD, the sample from the DF region presented a greater increase compared to the other regions. A relationship between genetic polymorphisms among T. solium metacestodes from different areas in Brazil and the differences in antibody detection in patients with NC were established.
Subject(s)
Adolescent , Adult , Aged , Aged, 80 and over , Animals , Child , Child, Preschool , Female , Humans , Male , Middle Aged , Young Adult , Antibodies, Helminth/blood , Antigens, Helminth/immunology , DNA, Helminth/genetics , Immunoglobulin G/blood , Polymorphism, Genetic/genetics , Taenia solium/genetics , Blotting, Western , Brazil , Case-Control Studies , Enzyme-Linked Immunosorbent Assay , Geography , Random Amplified Polymorphic DNA Technique , Taenia solium/immunology , Taenia solium/isolation & purificationABSTRACT
This study compared the cytotoxicity and the release of nitric oxide induced by collagen membranes in human mononuclear cells. Peripheral blood was collected from each patient and the separation of mononuclear cells was performed by Ficoll. Then, 2x10(5) cells were plated in 48-well culture plates under the membranes in triplicate. The polystyrene surface was used as negative control. Cell viability was assessed by measuring mitochondrial activity (MTT) at 4, 12 and 24 h, with dosage levels of nitrite by the Griess method for the same periods. Data had non-normal distribution and were analyzed by the Kruskal-Wallis test (p<0.05). Statistically significant differences (p<0.05) were observed between the membranes and the control in the experimental period, although there was a significant reduction in viability over time (p<0.01). At 4 and 12 h, the porcine membrane induced a higher release of nitrite compared with the control and bovine membrane, respectively (p<0.01), and this difference was maintained at 24 h (p<0.05). This in vitro study showed that the porcine collagen membrane induces an increased production of proinflammatory mediators by mononuclear cells in the first hours of contact, decreasing with time.
Neste estudo foi comparada a citoxicidade e a liberação de nitrito induzidos por membranas de colágeno bovino e suíno em células mononucleares humanas. Foram coletados sangue periférico de cada paciente, e realizada separação de mononucleares por gradiente de Ficoll. Um total de 2x10(5) células foram plaqueadas em placas de cultura de 48 poços sob as membranas, em triplicata. O poço sem membrana serviu como controle negativo. A viabilidade celular foi avaliada medindo a atividade mitocondrial (MTT) em 4,12 e 24 h, com dosagens dos níveis de nitrito pelo método de Griess nos mesmos períodos. As amostras não apresentaram distribuição normal, sendo realizado o teste de Kruskal-Wallis (p<0,05). Foram observadas diferenças estatisticamente significantes entre as membranas e o controle nos período analisados (p<0,05), embora tenha ocorrido redução da viabilidade em função do tempo (p<0,01). Em 4 e 12 h a membrana suína induziu maior liberação de nitrito comparado ao controle e à membrana bovina, respectivamente (p<0,01). Tal diferença foi mantida em 24 h (p<0,05). Este estudo in vitro demonstrou que a membrana colágena suína induz uma maior produção de mediador pró-inflamatório pelas células mononucleares nas primeiras horas de contato, diminuindo com o tempo.
Subject(s)
Animals , Cattle , Humans , Biocompatible Materials , Collagen/toxicity , Leukocytes, Mononuclear/metabolism , Membranes, Artificial , Nitric Oxide/biosynthesis , Cells, Cultured , Cell Survival/drug effects , Collagen/metabolism , Materials Testing , Nitric Oxide/blood , Regeneration , Statistics, Nonparametric , SwineABSTRACT
The aim of this work was to evaluate the effect of xylitol on J774A.1 macrophage adhesion. Adhesion consisted of a three-hour interval, at room temperature, followed by washing and cell incubation at 37ºC/5 percent CO2/ 48h. Xylitol was used to treat the cells either before (for 24h) or after the cell incubation (for 48h) at 5 percent as final concentration in both the situations. It was found that xylitol was effective in preventing the adhesion in both the conditions in spite of the former being 100-fold greater and significant (p < 0.001). The results pointed to an important xylitol action on macrophage adhesion, which should be further investigated as an inflammatory control.
ABSTRACT
Mononuclear cells play an important role in the modulation of healing. The characteristics of implant surface topography may alter the production of signaling molecules such as cytokines. The aim of this in vitro study was to evaluate the effects of commercially available titanium surface treatments on both cell viability and the secretion of the antagonist cytokines, IL1β and TGFβ1. Human mononuclear cells were cultured on 10 mm diameter commercially pure titanium (cpTi) disks that were prepared using a turning procedure (control=machined surface) and either acid etched or bio-anodized for 1-7 days. Adhered cells were investigated with respect to cell viability using an MTT assay, and cytokine production was verified using an ELISA assay. The results indicate that surface characteristics did not alter the cell viability at days 1 and 4, although the machined surface presented the highest absorbance values at day 7 (p = 0.0084). Cell viability was reduced throughout the time course for all analyzed surfaces (p < 0.05). On day 4, IL1β levels were significantly higher on bio-anodized compared to acid etched surfaces (p = 0.0097). TGFβ1 did not show differences among the surfaces at days 1 and 4. The responses of non-stimulated mononuclear cells to titanium surfaces suggest only modest effects of the surface treatment and roughness on pro-inflammatory cytokine (IL1β) release.
Subject(s)
Humans , Blood Cells , Interleukin-1beta , Titanium/chemistry , Transforming Growth Factor beta1 , Analysis of Variance , Cell Survival , Cells, Cultured , Enzyme-Linked Immunosorbent Assay , Statistics, Nonparametric , Surface Properties , Time FactorsABSTRACT
Introdução: Um dos problemas apresentados pelos materiais utilizados em Odontologia está associado à biocompatibilidade, já que poucos são totalmente inertes do ponto de vista biológico. Os materiais a serem usados em contato com tecidos humanos devem, portanto, ser testados com o objetivo de simular reações biológicas e ajudar no entendimento das respostas obtidas. Os estudos in vitro constituem a primeira etapa destes testes. A International Organization Standardization (ISO) e o Council on Dental Materials Instruments and Equipment of the American Dental Association recomendam o uso de uma bateria de testes in vivo e in vitro para estudar a biocompatibilidade dos materiais e, de acordo com as normatizações, a principal categoria de testes com este objetivo é a dos testes de biocompatibilidade. Dentre estes testes o protocolo MTT assay é um dos mais utilizados para se determinar a citotoxicidade de materiais de diversas naturezas sobre células em cultura. A citotoxicidade pode também estar relacionada às moléculas que, ao serem liberadas a partir de um determinado estímulo podem ocasionar danos aos tecidos. Estudos têm relatado a presença de uma molécula com potencial citotóxico, o óxido nítrico, em tecidos da cavidade bucal e seu envolvimento em doenças inflamatórias. Objetivo: Apresentação de uma metodologia de avaliação da citotoxicidade de materiais odontológicos através do método MTT e da análise da produção de óxido nítrico (NO), o qual está relacionado com a ação destes materiais na indução da resposta inflamatória. Conclusão: Verifica-se nesta metodologia que o ensaio de MTT pode ser facilmente adaptado para testes de citotoxicidade de materiais de diferentes composições e a mensuração da produção de óxido nítrico através do método de Griess fornece dados adicionais para a análise da citotoxicidade.
Subject(s)
Cytotoxins , Macrophages , Dental Materials , Nitric Oxide , Cytotoxicity Tests, ImmunologicABSTRACT
In this study, IgA1 levels in the milk and serum of puerperae were compared and a correlation was established between the levels of this immunoglobulin and the occurrence of parasitism. Eighty-three paired milk and serum samples were obtained from puerperal and IgA1 levels were analyzed. In addition, the presence of intestinal parasites in stool samples from these puerperae was determined. Twelve puerperae tested positive for intestinal parasites and all their samples presented an IgA1 ELISA Index > 1. There was a correlation between serum and milk IgA1 levels and puerperae with any parasite in their stool (r = 0.6723; p = 0.0166). This finding may reinforce the importance of breast-feeding for the protection of neonates.
Subject(s)
Female , Humans , Feces/parasitology , Immunoglobulin A/analysis , Intestinal Diseases, Parasitic/diagnosis , Milk, Human/immunology , Postpartum Period , Enzyme-Linked Immunosorbent Assay , Immunoglobulin A/blood , Intestinal Diseases, Parasitic/immunology , Intestinal Diseases, Parasitic/parasitologyABSTRACT
In this study, we evaluated the profile of anti-Paracoccidioides brasiliensis immunoglobulin isotypes in serum from patients with the acute and chronic forms of paracoccidioidomycosis, using the whole Paracoccidioides brasiliensis antigen and the antigen treated with sodium metaperiodate. All the immunoglobulin isotypes present in the serum from patients with the acute and chronic forms of paracoccidioidomycosis presented higher reactivity towards the whole antigen than to the antigen treated with metaperiodate (P < 0.05). The reactivity of IgG and IgM to the antigen treated with metaperiodate was greater in serum from patients with the acute form of the disease (P < 0.05), while IgA was more reactive in serum from patients with the chronic form (P < 0.05). There was greater reactivity of IgG1 and IgG2 to the whole antigen and the antigen treated with metaperiodate in the serum from patients with paracoccidioidomycosis than there was in serum from patients with other parasitic infections (P < 0.05). Furthermore, IgG1 from patients with the acute form recognized the 19kDa, 27kDa and 31kDa antigens in the western blot test. Thus, the results suggest that modifications to the epitopes of Paracoccidioides brasiliensis antigens may help to improve the immunodiagnosis of paracoccidioidomycosis.
Neste trabalho, foi avaliado o perfil de isotipos de imunoglobulinas anti-Paracoccidioides brasiliensis em soros de pacientes com formas crônica e aguda de paracoccidiodomicoses usando antígeno total e tratado com meta-periodato. Todos os tipos de imunoglobulinas presentes nos soros de pacientes com formas aguda e crônica apresentaram alta reatividade ao antígeno total quando comparado ao tratado com meta-periodato (P < 0,05). Houve maior reatividade de IgG e IgM anti-antígeno tratado com meta-periodato em soros de pacientes com forma aguda da doença (P < 0,05), enquanto IgA foi mais reativa em soros da forma crônica (P < 0,05). Houve maior reatividade de IgG1 e IgG2 com antígeno total e tratado com meta-periodato em soros de pacientes comparados aos com outras parasitoses (P < 0,05). Além disso, IgG1 de pacientes com a forma aguda reconhecem antígenos de 19kDa, 27kDa e 31kDa por western blot. Assim, os resultados sugerem que alterações nos epitopos de antígenos de Paracoccidioides brasiliensis podem auxiliar no aprimoramento do imunodiagnóstico da paracoccidioidomicose.
Subject(s)
Humans , Antibodies, Fungal/immunology , Antigens, Fungal/immunology , Immunoglobulin Isotypes/immunology , Paracoccidioides/immunology , Paracoccidioidomycosis/immunology , Acute Disease , Antibodies, Fungal/blood , Antibodies, Fungal/drug effects , Antigen-Antibody Reactions/drug effects , Antigen-Antibody Reactions/immunology , Antigens, Fungal/blood , Antigens, Fungal/drug effects , Blotting, Western , Case-Control Studies , Chronic Disease , Epitopes/drug effects , Epitopes/immunology , Immunoglobulin Isotypes/blood , Immunoglobulin Isotypes/drug effects , Mitogens/therapeutic use , Paracoccidioides/drug effects , Paracoccidioidomycosis/blood , Paracoccidioidomycosis/drug therapy , Periodic Acid/therapeutic useABSTRACT
Total antigen from Leishmania (Leishmania) amazonensis and isolates from the Leishmania braziliensis complex, along with their respective antigenic fractions obtained by affinity chromatography on concanavalin-A-Sepharose and jacalin-agarose columns evaluated using immunoenzymatic ELISA assay. For this, serum samples from 229 patients were used, grouped as American tegmental leishmaniasis (nº=58), visceral leishmaniasis (nº=28), Chagas disease (nº=49), malaria (nº=32), tuberculosis (nº=13) and healthy volunteers (nº=49). Samples from American tegmentary leishmaniasis showed higher reactivity with antigens isolated from the Leishmania braziliensis complex than with antigens from Leishmania amazonensis (p<0.001). ELISA assays showed a sensitivity range from 60 percent to 95 percent with antigens isolated from the Leishmania braziliensis complex. There was marked nonspecific reactivity among serum samples with the use of antigenic fractions binding with concanavalin-A and jacalin from both Leishmania complexes, in comparison with other antigens (p<0.001). The results presented in this study suggest that the use of homologous antigens increases the efficiency of anti-Leishmania immunoglobulin detection, which may be very valuable for diagnostic purposes.
Antígeno total de Leishmania (Leishmania) amazonensis e isolado do complexo Leishmania brazilienis, assim como suas respectivas frações antigênicas obtidas por cromatografia de afinidade em coluna de concanavalina-A ligada a sepharose e Jacalina ligada a agarose foram avaliadas por ensaio imunoenzimático ELISA. Para tanto, foram utilizadas amostras de soros de 229 pacientes agrupadas em leishmaniose tegumentar americana (nº=58), leishmaniose visceral (nº=28), doença de Chagas (nº=49), malaria (nº=32), tuberculose (nº=13) e voluntários saudáveis (nº=49). Houve maior reatividade das amostras de leishmaniose tegumentar americana com a utilização dos antígenos obtidos do isolado do complexo Leishmania braziliensis quando comparado com antígenos de Leishmania amazonensis (p<0,001). Observou-se ainda que a sensibilidade do teste ELISA variou de 60 a 95 por cento entre os antígenos obtidos do isolado do complexo Leishmania braziliensis. Houve acentuada reatividade inespecífica das amostras de soros com a utilização das frações antigênicas ligantes de Concanavalina-A e Jacalina de ambos os complexos Leishmania em comparação aos demais antígenos (p<0,001). Os resultados apresentados no presente trabalho sugerem que a utilização de antígenos homólogos aumentam a eficiência de detecção de imunoglobulina anti-Leishmania o que pode ser de grande valia para o propósito de diagnóstico.
Subject(s)
Animals , Humans , Antigens, Helminth , Leishmania braziliensis/immunology , Leishmania mexicana/immunology , Leishmaniasis, Mucocutaneous/diagnosis , Leishmaniasis, Visceral/diagnosis , Antigens, Helminth/isolation & purification , Case-Control Studies , Chromatography, Affinity , Cross Reactions , Chagas Disease/immunology , Enzyme-Linked Immunosorbent Assay , Leishmaniasis, Mucocutaneous/immunology , Leishmaniasis, Visceral/immunology , Malaria/immunology , Plant Lectins , Sensitivity and Specificity , Sepharose/analogs & derivatives , Sepharose , Tuberculosis/immunologyABSTRACT
No presente trabalho, foi purificada por cromatografia de afinidade em D-galactose imobilizada em agarose, uma lectina do latex de Synadenium carinatum (ScLL). Essa lectina é uma potente aglutinina para eritrócitos humanos, cuja atividade hemaglutinante foi inibida com 3,0 mM de N acetil-D-galactopiranosidio, 6,3 mM de metil-b-D-galactopiranosidio ou 50 mM metil-a-D-pironosidio ou D-fucose, porém, nenhuma inibição foi evidenciada por L-fucose, revelando uma especificidade anomérica e conformacional da lectina. A análise por SDS-PAGE dessa lectina pareceu ser uma glicoproteína composta por duas cadeias polipeptídicas de aproximadamente 28 e 30 kDa, porém, em cromatografia de exclusão por tamanho sobre Sephadex G100 e em gel nativo apresentou um peso molecular aparente de 120-130 kDa, a qual mostrou ser composta de uma mistura de subunidades de peptídeos de 28 e 30 kDa. Essa lectina manteve-se estável em pH de 6 a 9 e temperatura de 4 a 56ºC. A seqüência N-terninal contem uma região conservada GPN a qual também é observada em outras lectinas de látex de outras Euphorbiaceas ligante de D-galactose.