Compreendendo o sentido de ser-com reações hansênicas: implicações para o cuidado de Enfermagem / Understanding the meaning of being with hansenic reactions: implications for nursing care / Comprender el significado de estar con reacciones hansénicas: implicaciones para el cuidado de enfermería

Objetivo: compreender o sentido de ser-com reações hansênicas. Método: Estudo alicerçado no método fenomenológico hermenêutico de Martin Heidegger, realizado a partir de 25 entrevistas individuais com pacientes em tratamento ambulatorial para reações hansênicas, em uma unidade de saúde especializada localizada no estado do Pará, Brasil. Resultados: Duas unidades temáticas foram organizadas: "Significando as reações hansênicas" e "Convivendo com as reações hansênicas". Para os participantes, viver com reações hansênicas significa dor, vergonha, desesperança, medo, incerteza e preocupações que transformam profundamente o cotidiano. O sentido de ser-com reações hansênicas se desvela quase sempre na impessoalidade, ambiguidade, curiosidade e na publicidade da vida, em que o ser-aí se vê a partir dos outros e não de si mesmo. Considerações finais: Este estudo proporciona conhecimentos importantes para o cuidado de enfermagem às pessoas que vivem com reações hansênicas, na medida em que compreender significados e sentidos é importante para impulsionar a prática de um cuidado de enfermagem sensível, empático e preocupado com o diálogo e com as necessidades do ser-aí no mundo, onde a cura se desvela nas práticas de cuidado com-o-outro e não para-o-outro. (AU)

Objective: To understand the meaning of being-with leprosy reactions. Methods: Study based on Martin Heidegger's hermeneutical phenomenological method, conducted from 25 individual interviews with patients undergoing treatment for leprosy reactions, in a specialized health unit located in the state of Pará, Brazil. Results: Two thematic units were organized: "Signifying leprosy reactions" and "Living with leprosy reactions". For the participants, living with leprosy reactions means pain, shame, hopelessness, fear, uncertainty and concerns that profoundly transform daily life. The sense of being-with leprosy reactions is almost always revealed in the impersonality, ambiguity, curiosity and publicity of life, in which the being-there is seen from other beings and not from oneself. Conclusion: This study provides important knowledge for nursing care to people living with leprosy reactions, as understanding meanings and senses is important to boost the practice of sensitive, empathic and concerned with dialogue and with nursing care. the needs of the being-there in the world, where the cure is revealed in the care practices with-the-other and not for the-other. (AU)

Objetivo: Comprender el significado de las reacciones de estar-con lepra. Métodos: Estudio basado en el método fenomenológico hermenéutico de Martin Heidegger, realizado a partir de 25 entrevistas individuales a pacientes en tratamiento ambulatorio por reacciones leprosas, en una unidad de salud especializada ubicada en el estado de Pará, Brasil. Resultados: Se organizaron dos unidades temáticas: "Significando reacciones leprosas" y "Viviendo con reacciones leprosas". Para los participantes, vivir con reacciones leprosas significa dolor, vergüenza, desesperanza, miedo, incertidumbre y preocupaciones que transforman profundamente la vida diaria. La sensación de ser-con reacciones leprosas se revela casi siempre en la impersonalidad, ambigüedad, curiosidad y publicidad de la vida, en la que el ser-allí se ve desde los demás y no desde uno mismo. Conclusion: Este estudio aporta conocimientos importantes para el cuidado de enfermería a las personas que viven con reacciones leprosas, ya que la comprensión de significados y sentidos es importante para impulsar la práctica de la sensibilidad, la empatía y la preocupación por el diálogo y el cuidado de enfermería. el mundo, donde la cura se revela en las prácticas de cuidado con el otro y no para el otro. (AU)

Expansion and Sub-Classification of T Cell-Dependent Antibody Responses to Encompass the Role of Innate-Like T Cells in Antibody Responses

In addition to T cell-dependent (TD) Ab responses, T cells can also regulate T cell-independent (TI) B cell responses in the absence of a specific major histocompatibility complex (MHC) class II and antigenic peptide-based interaction between T and B cells. The elucidation of T cells capable of supporting TI Ab responses is important for understanding the cellular mechanism of different types of TI Ab responses. Natural killer T (NKT) cells represent 1 type of helper T cells involved in TI Ab responses and more candidate helper T cells responsible for TI Ab responses may also include γδ T cells and recently reported B-1 helper CD4⁺ T cells. Marginal zone (MZ) B and B-1 cells, 2 major innate-like B cell subsets considered to function independently of T cells, interact with innate-like T cells. Whereas MZ B and NKT cells interact mutually for a rapid response to blood-borne infection, peritoneal memory phenotype CD49d(high)CD4⁺ T cells support natural Ab secretion by B-1 cells. Here the role of innate-like T cells in the so-called TI Ab response is discussed. To accommodate the involvement of T cells in the TI Ab responses, we suggest an expanded classification of TD Ab responses that incorporate cognate and non-cognate B cell help by innate-like T cells.

Characterization of binding capability of human breast milk to hepatitis B surface antigen / 中华围产医学杂志

Objective To investigate whether human breast milk may bind to hepatitis B surface antigen (HBsAg) and its characteristics.Methods Breast milk samples from five women with negative HBsAg and hepatitis B surface antibody (anti-HBs) at one to two months post delivery were fractioned into cream and skimmed milk by centrifugation.The human breast milk and each fraction as well as cow and goat milk samples,served as controls,were separately incubated with highly purified yeast recombinant HBsAg,followed by determination of their binding capability to HBsAg by enzyme linked immunosorbent assay (ELISA) and the inhibition rate for binding of HBsAg to anti-HBs by quantitative chemiluminescence microparticle immunoassay.After boiled for 1 min or pasteurized in 65 ℃ for 30 min,the thermal stability of the active components of milk was detected.One-way ANOVA and SNK tests were performed for statistical analysis.Results The operative concentration of HBsAg was 0.1 μg/ml.Breast milk from all five women showed significantly better binding capability to HBsAg than cow or goat milk (1.306±0.300 vs 2.157±0.150 and 2.232±0.093,F=34.303,P＜0.01).The quantitative experiments showed that the inhibition rate of human breast milk was higher than that of the control group [(74.26± 17.26)％ vs (0.00±5.50)％,F=57.806,P＜0.01].The binding ability to HBsAg of skimmed milk was comparable with that of whole milk,indicating milk protein(s) played critical roles in binding to HBsAg (0.877 ± 0.486 vs 0.513 ± 0.069 and 0.376 ± 0.146,F=44.475,P＜0.01).After boiled for 1 min or Pasteurization,the binding ability to HBsAg of whole breast milk remained,but that of skimmed milk went down (F=16.598,P＜0.01).Both whole breast milk and skimmed milk could inhibit the binding of HBsAg to anti-HBs (F=278.341 and 269.408,both P＜0.01).Conclusions The inhibition of binding to HBsAg by human breast milk indicates that human milk may interact with HBsAg.The active components mainly exist in milk proteins and are thermal stable.

Immunohistochemistry for Pathologists: Protocols, Pitfalls, and Tips

Immunohistochemistry (IHC) is an important auxiliary method for pathologists in routine diagnostic work as well as in basic and clinical research including exploration of biomarkers, as IHC allows confirmation of target molecule expressions in the context of microenvironment. Although there has been a considerable progress in automation and standardization of IHC, there are still many things to be considered in proper optimization and appropriate interpretation. In this review, we aim to provide possible pitfalls and useful tips for practicing pathologists and residents in pathology training. First, general procedure of IHC is summarized, followed by pitfalls and tips in each step and a summary of troubleshooting. Second, ways to an accurate interpretation of IHC are discussed, with introduction to general quantification and analysis methods. This review is not intended to provide complete information on IHC, but to be used as a basic reference for practice and publication.

Titers of ABO antibodies in group O blood donors

BACKGROUND: Plasma components of group O blood donations are rarely submitted to ABO antibody titrations even though it is well known that passively acquired antibodies may destroy the recipient's own red cells and tissue grafts. OBJECTIVE: Thus, group O donations stratified by gender and age were randomly titrated to identify the best source of products for apheresis and exsanguinous transfusion. METHODS: Samples from 603 blood donors were tested by ABO antibody titration using the conventional tube technique at room temperature. ABO antibody levels higher than 64 were considered high. After correction for gender, statistical analyses were performed using the Fisher exact and Kruskal-Wallis tests. RESULTS: Most donors in the blood bank were male (65.7 percent). ABO antibody titers ranged from 1 to 2048. The estimations of prevalence for the titers were: anti-A,B < 128 = 86.9 percent and > 128 = 2.16 percent; Anti-A > 128 = 9.29 percent and anti-B > 128 = 4.81 percent. Low mean titers for both anti-A and anti-B antibodies were found in over 50-year-old men (p-value = 0.040). High anti-B antibody levels were found in young women (p-value = 0.002). CONCLUSION: This study confirms that over 50-year-old O group men should be selected as blood donors in non-identical ABO transfusion situations. Also, titration of ABO antibodies in blood banks will increase safety in non-identical ABO transfusions.

Hypothesis of 'saturated or nonsaturated cytotoxicity model' clarifies antibodies mediated immunoreaction in transplant recipient / 中华器官移植杂志

Objective To develop the hypothesis ‘saturated or non-saturated cytotoxicity model' and explain the various phenomena of antibody mediated immunoresponses in recipients,including rejection and accommodation.Methods The imitating complement dependent cytotoxicity.The threshold set to identify as saturated or non-saturated cytotoxicity depends on antigen-antibody complex(R)whether or not above lethal number(D)in effective time.Feasibility of the hypothesis was examined through explaining various phenomena mediated by anti-donor antibodies,especially some contradictory phenomena.Results Hyperacute rejection,accelerated rejection and acute rejection could be well explained by saturated cytotoxicity.Accommodation of ABO imcompatible transplantion,de novo antibody induced injury,change of protein profile,and C4d deposition in graft could be well elucidated by the hypothesis.Conclusion The hypothesis saturated or nonsaturated cytotoxicity model' help to interpret and interconnect various phenomena of antibodies mediated immune response,such as rejection and accommodation.

Detection and distribution characteristics of serological markers of hepatitis B in neonates, infants and preschool children in Zhejiang province / 中华检验医学杂志

Objective To investigate the serological patterns of hepatitis B, understand the prevalence of hepatitis B infection in neonates, infants and preschool children based on hospital data in Zhejiang province and provide a basis for prevention and control of local pediatric hepatitis B infection. Methods Five serological markers were detected on electrochemiluminescence analyzer Roche E601. The results of all serological markers in children with hepatitis B from 2006 to 2010 were exported from laboratory information system and 24 892 (15 810 boys and 9 082 girls) cases were selected for further analysis according to the exclusion criterion including duplicate analysis, children older than 7 years and children living out of Zhejiang province. SPSS13.0 software and EXCEL 2003 were employed for statistical analysis in this study. Results Average HBV vaccination coverage rates among 15 413 boys and 8 840 girls were 99. 16%(98. 87% -99. 45%) and 99. 17% (98. 29% -99. 53%), respectively. Seventeen serological patterns of hepatitis B were observed, and "anti-HBs(+)alone"(64. 997%) was the dominant patterns followed by "negative" (18. 231%), "anti-HBc(+)anti-HBs(+)"(9.911%) and "anti-HBe(+)antiHBc(+) anti-HBs(+)"(4.395%), and the positive rates for other patters were 0. 004% -0. 992%. There were significant difference of detection rates for "anti-HBc(+)alone" and "anti-HBe(+)anti-HBs(+)"patterns between male and female (χ2=7.143,8.123, all P＜0.01), and there were no significant difference of detection rates for the other 15 patterns between male and female (all P ＞0.05). Ninety-four HBsAg positive cases were detected, accounting for 0.38%. Totally 19 899 anti-HBs positive cases were detected, accounting for 79.94%. Totally 16 187 cases were "anti-HBs(+) alone", accounting for 81.3%of the total anti-HBs(+) cases. The group of 1-2 years and 2 day-2 week had the highest and lowest rate for anti-HBs(+)alone respectively. The ratios in three groups with different anti-HBs levels (10-100 mIU/ml,100-1000 mIU/ml and ＞ 1000 mIU/ml) in 16 178 anti-HBs(+) children were 23. 64%, 27.66% and 13. 70%, respectively. Totally 3 904 cases with anti-HBc(+) were detected, accounting for 15.68%. The highest positivity rate and lowest positivity rate were in the group of 2-4 week and 3-4 week respectively. In total 1 565 cases with negative results, the lowest negativity rate and highest negativity rate were in the group of 9-12 month (3. 25%) and 6-7 age (36. 21%) respectively. Conclusions The dominant serological patterns of hepatitis B in local young children is "anti-HBs (+) alone" and most of the anti-HBs concentrations ranged from 100 to 1000 mIU/ml, followed by "negative". The total positive rate of HBsAg is mild. The rate of hepatitis B serological patterns in children is associated with ages but independent of gender. For interpretation of serological patterns of HBV in children below 12 months (especially in 3 months) the status of their mothers' HBV infection should also be taken into consideration.

The clinical effect of leukocyte filter preventing nonhemolytic febrile transfusion reactions / 中国基层医药

Objective To investigate the clinical effect of using leukocyte filter to prevent nonhemolytic febrile transfusion reactions(NHFTR) in hematologic patients who were trarisfused erythrocyte suspension. Methods Select 720 inpatients need erythrocyte transfusion and have transfusion records. The patients were randomly divided into investigation group and control group. We made a routine examination and recorded the patients' body temperature, heart rate, blood pressure, respiration rate and transfusion adverse reaction before and after erythrocyte suspeusion transfusion. Results Before blood transfusion, the body temperature of patients between two groups were normal, but after blood transfusion, there were 35 patients with NHFTR in the control group, while only 5 cases in the investigation group which used leucocyte filter, the difference between two groups is significant( P＜0.01 ). The change of the patients' body temperature were compared between two groups before and after transfusion, the changes in the control group was significantly higher than the investigation group( P＜0.01 ). Compared the changes of serum total bilirubin level in all patients before and after transfusion,there was no difference in both groups. The incidence of NHFTR increased with increasing of the transfusion times, but compared with the investigation group,the incidence of the control group was higher significantly(P＜0.01 ). Conclusion Leukocyte filter can prevent the occurring of NHFTR efficiently, enhance the quality of transfusion,guarantee the blood transfusion safety.

Procedimientos para la detección e identificación de anticuerpos eritrocitarios / Procedures for the detection and identification of red cell antibodies

En Inmunohematología se ha desarrollado una amplia gama de procederes de detección e identificación de anticuerpos eritrocitarios in vitro, por lo cual se realiza una revisión de técnicas y métodos empleados con este objetivo, como son el método que utiliza eritrocitos pretratados con enzimas proteolíticas y las técnicas de Polibreno, que utiliza solución de baja fuerza iónica (LISS), la de antiglobulina indirecta, la de aglutinación en gel, la inhibición de la aglutinación, la hemólisis y la adherencia de eritrocitos en fase sólida. Se abordan los problemas que afectan a la reacción de aglutinación entre el antígeno y el anticuerpo; para una mejor comprensión la reacción de aglutinación se subdivide en su primera y segunda etapa. En la primera etapa los factores que se analizan son concentración de antígeno y anticuerpo, pH, temperatura, fuerza iónica y tiempo de incubación; en la segunda etapa la característica del anticuerpo, localización y número de sitios antigénicos, fuerzas que mantienen la distancia entre los eritrocitos, uso de la albúmina bovina, uso de enzimas, efecto de dosis y efecto de moléculas con carga positiva.

Awide range of procedures for the detection and identification of red cell antibodies in vitro has been developed in Immunohematology. Therefore, it is made a review of the techniques and methods used with this aim, such as the method using erythrocytes pretreated with proteolytic enzimes and the techniques of Polibreno that utilize low ionic force solution (LIFS), the indirect antiglobulin test, the gel agglutination test, the agglutination inhibition test, hemolysis and the solid phase erythrocyte adherence test. The problems affecting the agglutination reaction between the antigen and the antibody are also dealt with. The agglutination reaction is subdivided into its first and second phase for a better understanding. In the first phase, the antigen and antibody concentration, pH, temperature, ionic force and incubation time are analyzed. The characteristic of the antibody, localization and number of antigenic sites, forces maintaining the distance among the erythrocytes, use of bovine albumin, use of enzimes, dose effect and effect of molecules with positive charge are studied in the second phase.