IMPACTO-MR: um estudo brasileiro de plataforma nacional para avaliar infecções e multirresistência em unidades de terapia intensiva / IMPACTO-MR: a Brazilian nationwide platform study to assess infections and multidrug resistance in intensive care units

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.

Determinants of death in critically ill COVID-19 patients during the first wave of COVID-19: a multicenter study in Brazil / Determinantes de mortalidade em pacientes com COVID-19 em estado crítico durante a primeira onda da doença: estudo multicêntrico no Brasil

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.

Habilidades Sociais Educativas Parentais de Mães de Adolescentes Apontados Como Tendo Problemas de Comportamento / Parenting Social Educational Skills of Mothers of Teenagers Pointed out as Having Behavioral Problems / Habilidades De Educación Social Parental De Madres De Adolescentes Nombrados Con Problemas De Conducta

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)

Effect of ScLL and 15d-PGJ2 on viability and cytokine release in LPS-stimulated fibroblasts: an in vitro study

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.

Effect of lectin (ScLL) on fibroblasts stimulated with LPS - an in vitro study

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.

Levels of Immunoglobulin A1 in Peri-Implant Fluid and Saliva from Patients with Mucositis: A Preliminary Study

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.

Cytotoxic response of two cell lines exposed in vitro to four endodontic sealers

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.

Cytotoxicity of bovine and porcine collagen membranes in mononuclear cells

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.

Xylitol inhibits J774A.1 macrophage adhesion in vitro

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.

Effect of titanium surface on secretion of IL1β and TGFβ1 by mononuclear cells

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.

IgA1 levels in milk and serum samples from intestinal parasite-infected or normal puerperae

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.

Perfil de isotipos de imunoglobulinas e subclasses de IgG na leishmaniose tegumentar americana / Immunoglobulin isotype and IgG subclass profiles in american tegumentary leishmaniasis

O presente trabalho avaliou o perfil de anticorpos em amostras de soro de 37 pacientes com diagnóstico clínico confirmado ou compatível com leishmaniose tegumentar americana atendidos no Hospital de Clínicas da Universidade Federal de Uberlândia, MG. Os perfis das classes de imunoglobulinas e subclasses de IgG foram analisados pelo teste ELISA indireto, utilizando-se antígeno solúvel de Leishmania (Leishmania) amazonensis. A avidez dos anticorpos foi determinada pelo tratamento com uréia a 6 M, após incubação dos soros com o antígeno. Observou-se que 97 por cento, 94,6 por cento, 57,5 e 21,5 por cento das amostras testadas apresentaram anticorpos anti-Leishmania das classes IgE, IgG, IgA e IgM, respectivamente e, os perfis das subclasses de IgG demonstraram, IgG1>IgG3>IgG2>IgG4. Os anticorpos IgE anti-Leishmania de alta avidez corresponderam a 44,4 por cento. Por outro lado, IgG e IgA anti-Leishmania foram em sua maioria (62,8 e 47,8 por cento, respectivamente), de média avidez. A variação do perfil de isotipos, bem como a avidez das imunoglobulinas refletiu a complexidade da resposta imune humoral contra a leishmaniose tegumentar americana.

Immunoblotting analyses using two-dimensional gel electrophoresis of Trypanosoma cruzi excreted-secreted antigens

Formas tripomastigotas de Trypanosoma cruzi excretam/secretam uma complexa mistura de moléculas antigênicas. Essa mistura é chamada trypomastigote excreted-secreted antigens e contém uma banda de massa molecular em torno de 150-160kDa que possui excelente performance para diagnóstico de doença de Chagas em immunoblotting. No presente estudo foi caracterizado parcialmente, por gel bidimensional, a proteína de 150-160kDa pela análise da reatividade de anticorpos de pacientes chagásicos nas diversas fases da doença. Proteínas do trypomastigote excreted-secreted antigens foram separadas por eletroforese de alta resolução em duas dimensões (2D) e submetidas a immunoblotting com soros de pacientes chagásicos e não chagásicos. A proteína de 150-160kDa foi identificada em quatro isoformas com pontos isoelétricos variando entre 6,2 a 6,7. As quatro isoformas foram reconhecidas por anticorpos IgM na fase aguda e por anticorpos IgG na fase crônica da doença de Chagas. A isoforma de 150-160kDa, com ponto isoelétrico de aproximadamente 6,4 tornou-se imunodominante dentre as demais com a progressão da doença. Não foi detectada reatividade cruzada com os soros de pacientes não chagásicos ou pacientes infectados com Leishmania sp. Os dados obtidos nesse trabalho, reforçam a importância da utilização do trypomastigote excreted-secreted antigens para o diagnóstico sorológico da doença de Chagas.

Detection of antibodies to the 97 kDa component of Toxoplasma gondii in samples of human serum

This study was carried out to investigate the immune response against 97 kDa (p97) molecular marker of Toxoplasma gondii that has been characterized as a cytosolic protein and a component of the excreted-secreted antigens from this parasite. A total of 60 serum samples from patients were analyzed by enzime-linked immunosorbent assay and Western blot for toxoplasmosis. These samples were organized in three groups, based on clinical symptoms and results of serological tests. Group I: 20 samples reactive to IgG and IgM (acute phase); group II: 20 non-reactive samples (control group); and group III: 20 samples reactive only to IgG (chronic phase). Western blot was performed with total antigenic extracts or with excreted and secreted antigen from T. gondii to identify the fraction correspondent to p97. It was observed that this cytosolic component from T. gondii stimulates the immunologic system to produce both IgM and IgG antibodies in the beginning of the acute infection and IgG throughout the chronic stage of the asymptomatic toxoplasmosis

Influence of pH on the partition of glucose-6-phosphate dehydrogenase and hexokinase in aqueous two-phase system

Glucose-6-phosphate dehydrogenase (G6PDH) and hexokinase (HK) are important enzymes used in biochemical and medical studies and in several analytical methods. Aqueous two-phase system (ATPS) formed by a polymer solution and an electrolyte solution provides a method for the separation and purification of enzymes with several advantages, including biocompatibility and easy scale up of the process. In this work, the effects of different pH values on the storage stability and partitioning behavior (K, partition coefficient) of the enzymes G6PDH and HK from baker's yeast extract were investigated in ATPS. The results, obtained from the 17.5 percent PEG 400 : 15.0 percent phosphate system, showed that when the pH was increased from 5.0 to 8.8, the K HK increased 26-fold and the K G6PDH 2.2-fold. In the 20.0 percent PEG 1500 : 17.5 percent phosphate system, the K HK and K G6PDH increased 13 and 1.2-fold, when the pH value was increased from 3.8 to 8.8, respectively. This leads to the conclusion that the partition coefficient for both enzymes is favored by high pH values. A statistical analysis of the results was conducted to confirm this conclusion

Liquid-liquid extraction of pharmaceuticals by aqueous two-phase systems

Aqueous two-phase systems are generally composed of a water solution of two structurally distinct hydrophilic polymers or of one polymer and certain salts. From analytical to commercial scale, aqueous two-phase systems have their application in the purification, characterization and study of biomaterials. In this review, we present some applications of aqueous two-phase systems in the separation and study of various pharmaceuticals, incluing recombinant proteins, antibodies and antigens, antibiotics, amino acids and oligopeptides, lactic acid, enzymes etc. Some new developments of the aqueous two-phase systems are reviewed and the prospects of this excellent technology are discussed...

Atividade antimicrobiana de guanil-hidrazonas / Antimicrobial activity of guanilhydrazones

Varias guanil-hidrazonas derivadas de ariltioalquilidenos tiveram suas atividades antibacterianas testadas frente as seguintes bacterias: Escherichia coli, Staphylococcus aureus e Pseudomonas aeruginosa. Foram determinadas as concentracoes inibitorias minimas (CIM) e alguns compostos apresentaram moderada atividade sobre as duas primeiras bacterias e fraca atividade frente a P. aeruginosa

Estandardização de dietas hospitalares:diagnóstico e subsídio para a qualidade da atenção / Hospital diets standardization: diagnosis and support for quality of care

A estandardização afeta diretamente a estimativa da composição química das dietas hospitalares e sua aceitação. Consequentemente,o consumo alimentar do paciente/cliente e o atendimento às suas necessidades nutricionais são influenciadospor esse processo. Portanto, o objetivo deste estudo foi avaliar a padronização do processo produtivo das dietas ofertadas àpacientes/clientes de um hospital público de Belo Horizonte/MG, entre os anos de 2010-2012. Para tanto, foi realizada apesagem direta de preparações dos seis tipos de dietas hospitalares e realizada a caracterização dos cardápios. Em seguida,calculou-se o aporte dos macronutrientes e micronutrientes (cálcio, ferro, sódio, zinco, magnésio, potássio, vitaminas A eC). Verificou-se um alto índice de repetições das combinações de preparações dos cardápios executados, especialmenteconcernentes às dietas para fins específicos. Grandes disparidades foram levantadas nos valores das aferições quantitativasdas preparações e no valor nutricional em todas as dietas analisadas, sendo muitas dessas diferenças, estatisticamente,significantes (p<0,05). Elevados coeficientes de variação referentes ao porcionamento (8-30%) e aporte de macronutrientes(23-115%) e micronutrientes (24-498%) dos seis tipos de dietas foram observados. Portanto, os resultados evidenciaramfragilidades importantes quanto ao planejamento de cardápios, ao porcionamento das preparações e, consequentemente,ao aporte nutricional aos seus pacientes/clientes, configurando-se como um processo não padronizado. Evidenciou-sea necessidade de avanços com vistas às iniciativas mais humanizadas deste serviço (individualização do atendimento;melhoria nutricional e sensorial dos cardápios; organização do serviço; e formação permanente), como a aplicação detécnicas gastronômicas no planejamento de cardápios, bem como um programa de educação permanente da equipe desteserviço, respectiva ao porcionamento.

Standardization directly affects the estimated chemical composition of hospital diets and their acceptance. Consequently,patient’s or client’s food consumption and fulfillment of their nutritional needs are influenced by this process. Therefore, theobjective of this study was to evaluate the standardization of the production process of diets offered to patients/clients at apublic hospital in Belo Horizonte/MG between the years 2010 to 2012. For this purpose, the direct weighing of six typesof hospital diets that were prepared was made and the menu types and frequencies were characterized. The macronutrientcontent and micronutrient content (calcium, iron, sodium, zinc, magnesium, potassium and vitamins A and C) were thencalculated. A high repetition rate was observed regarding the combinations of menu preparations implemented, especiallyin relation to diets for special purposes. There were large disparities in the quantitative measurements and nutritional valueof the preparations, in all the diets analyzed, and many of these differences were statistically significant (p<0.05).High coefficientsof variation regarding portioning (8-30%), macronutrient content (23-115%) and micronutrient content (24-498%)were observed in the six types of diet. Therefore, the results highlighted significant weaknesses in planning menus, the foodportions, and hence the nutritional support to their patients / clients by setting up as a non-standard process. The need forprogress with a more humanized initiatives view of this service (individualization of care, nutritional and sensory improvementof menus; organization of the service, and lifelong learning) was highlighted, as the application of gastronomic techniquesin planning menus, as well as a continuing education program for the staff of this service, the respective portioning.