Sea squirt-inspired bio-derived tissue sealants.

Sea squirts' or tunicates' bodies are composed of cellulose nanofibers and gallol- functionalized proteins. These sea creatures are known to heal their injuries under seawater by forming crosslinks between gallols and functional groups from other proteins in their bodies. Inspired by their wound healing mechanism, herein, we have developed a tissue sealant using zein (a plant-based protein) and tannic acid (gallol-containing polyphenol). Except for fibrin- based sealants, most commercial surgical adhesives, and sealants available today are derived from petroleum products that compromise their biodegradability. They often have complicated and multi-step synthesis processes that ultimately affect their affordability. To overcome this challenge, we ensured that these sea squirt-inspired tissue sealants are bio-based, easily synthesized, and low-cost. The sealants were studied on their own and with a food-grade enzyme transglutaminase. The adhesion performances of the sealants were found to be higher than physiological pressures in seven out of nine different tissue substrates studied here. Their performance was also better than or on par with the FDA-approved fibrin sealant Tisseel. Ex vivo models demonstrate instant sealing of leaking wounds in less than a minute. The sealants were not only cytocompatible but also showed complete wound healing on par with sutures and Tisseel when applied in vivo on skin incisions in rats. Overall, these sea squirt-inspired bio-based sealants show great potential to replace currently available wound closure methods.

Interpenetrating Networks of Collagen and Hyaluronic Acid That Serve as In Vitro Tissue Models for Assessing Macromolecular Transport.

High-fidelity preclinical in vitro tissue models can reduce the failure rate of drugs entering clinical trials. Collagen and hyaluronic acid (HA) are major components of the extracellular matrix of many native tissues and affect therapeutic macromolecule diffusion and recovery through tissues. Although collagen and HA are commonly used in tissue engineering, the physical and mechanical properties of these materials are variable and depend highly on processing conditions. In this study, HA was chemically modified and crosslinked via hydrazone bonds to form interpenetrating networks of crosslinked HA (HAX) with collagen (Col). These networks enabled a wide range of mechanical properties, including stiffness and swellability, and microstructures, such as pore morphology and size, that can better recapitulate diverse tissues. We utilized these interpenetrating ColHAX hydrogels as in vitro tissue models to examine macromolecular transport and recovery for early-stage drug screening. Hydrogel formulations with varying collagen and HAX concentrations imparted different gel properties based on the ratio of collagen to HAX. These gels were stable and swelled up to 170% of their original mass, and the storage moduli of the ColHAX gels increased over an order of magnitude by increasing collagen and HA concentration. Interestingly, when HAX concentration was constant and collagen concentration increased, both the pore size and spatial colocalization of collagen and HA increased. HA in the system dominated the ζ-potentials of the gels. The hydrogel and macromolecule properties impacted the mass transport and recovery of lysozyme, ß-lactoglobulin, and bovine serum albumin (BSA) from the ColHAX gels─large molecules were largely impacted by mesh size, whereas small molecules were influenced primarily by electrostatic forces. Overall, the tunable properties demonstrated by the ColHAX hydrogels can be used to mimic different tissues for early-stage assays to understand drug transport and its relationship to matrix properties.

Comparative effectiveness of two versions of a caring contacts intervention in healthcare providers, staff, and patients for reducing loneliness and mental distress: A randomized controlled trial.

BACKGROUND: Caring Contacts can effectively reduce suicide ideation, attempts, and death. In published clinical trials, Caring Contacts were sent by someone who knew the recipient. At scale, Caring Contacts programs rarely introduce the recipient and sender. It is not known whether receiving Caring Contacts from someone unknown is as effective as messages from someone the recipient has met. METHODS: Pragmatic randomized controlled trial comparing Caring Contacts with (CC+) versus without an introductory phone call (CC). Recruitment occurred January-July 2021, with outcomes assessed at 6 months. Participants were primary care patients or healthcare providers/staff reporting adverse mental health outcomes on a qualifying survey. Participants were sent 11 standardized caring text messages over 6 months; when participants replied, they received personalized unscripted responses. CC+ calls were semi-structured. The primary outcome was loneliness (NIH Toolkit). RESULTS: Participants included 331 patients (mean [SD] age: 45.5 [16.4], 78.9 % female) and 335 healthcare providers/staff (mean [SD] age: 40.9 [11.8], 86.6 % female). There were no significant differences in loneliness at 6 months by treatment arm in either stratum. In patients, mean (SD) loneliness was 61.9 (10.7) in CC, and 60.8 (10.3) in CC+, adjusted mean difference of -1.0 (95 % CI: -3.0, 1.0); p-value = 0.31. In providers/staff, mean (SD) loneliness was 61.2 (11) in CC, and 61.3 (11.1) in CC+, adjusted mean difference of 0.2 (95 % CI: -1.8, 2.2); p-value = 0.83. LIMITATIONS: Study population was 93 % white which may limit generalizability. CONCLUSIONS: Including an initial phone call added operational complexity without significantly improving the effectiveness of a Caring Contacts program.

Strategies for Passing the Physical Therapy Licensure Examination for Students with English as a Second Language: Experience at the University of Puerto Rico DPT Program.

The skill to answer items successfully in a standardized exam requires a student to master the language in which the exam is written. This implies total mastering of the English language for students with English as a Second Language (ESL). This commentary shares the experience of the Doctor of Physical Therapy (DPT) Program at the Medical Science Campus at the University of Puerto Rico in identifying strategies used by the program to ensure students pass the National Physical Therapy Examination (NPTE). The DPT Program implemented several strategies to improve students' language proficiency to pass the NPTE. Some of the implemented strategies were providing tests in English, developing assignments to encourage students to read text¬books in English, increasing test questions complexity, increasing exposure to computer-based tests, and recommending students to complete NPTE review courses. These strategies seem to improve NPTE passing rates in students with ESL to the level required by the Commission on Accreditation in Physical Therapy Education (CAPTE). Strategies identified in the literature to help ESL students pass national licensure examinations were: increasing mastery of dialect (English proficiency), enhancing vocabulary development, raising comprehension of questions, and supplementing preparatory activities for at-risk students. Therefore, PT programs with non-native English speakers should identify the factors that affect the passing rate at the NPTE and analyze the information to develop specific strategies for these students.

Fluorescently Labeling Amino Acids in a Deep Eutectic Solvent.

The increased use of deep eutectic solvents (DESs) in recent years has been significant and provides new approaches to sample collection and preparation. At the same time, the use of these new solvents to prepare samples can present challenges for subsequent analyses. Common analytical approaches, such as fluorescent labeling, may not be compatible with the solvents. In this work, we explore how effective three traditional fluorescent labels can be at derivatizing amino acids in the most common DESs, formed from choline chloride and ethylene glycol. We demonstrate that the unique solvent characteristics of the DESs still allow for two of the fluorophores, fluorescein isothiocyanate and 5-carboxyfluorescein succinimidyl ester, to effectively label amino acids. Initial optimizations of the reaction conditions demonstrate that we can effectively label both d- and l-amino acids, in solution with concentrations of amino acids down to 4 µM. Capillary electrophoretic separations following this preparation can detect as little as 50 nM. This is possible without removal of any DES from the sample matrix. These results represent the first complete fluorescent labeling reaction in a DES and subsequent capillary electrophoretic separation of the analytes.

Deep Learning Electrocardiographic Analysis for Detection of Left-Sided Valvular Heart Disease.

BACKGROUND: Valvular heart disease is an important contributor to cardiovascular morbidity and mortality and remains underdiagnosed. Deep learning analysis of electrocardiography (ECG) may be useful in detecting aortic stenosis (AS), aortic regurgitation (AR), and mitral regurgitation (MR). OBJECTIVES: This study aimed to develop ECG deep learning algorithms to identify moderate or severe AS, AR, and MR alone and in combination. METHODS: A total of 77,163 patients undergoing ECG within 1 year before echocardiography from 2005-2021 were identified and split into train (n = 43,165), validation (n = 12,950), and test sets (n = 21,048; 7.8% with any of AS, AR, or MR). Model performance was assessed using area under the receiver-operating characteristic (AU-ROC) and precision-recall curves. Outside validation was conducted on an independent data set. Test accuracy was modeled using different disease prevalence levels to simulate screening efficacy using the deep learning model. RESULTS: The deep learning algorithm model accuracy was as follows: AS (AU-ROC: 0.88), AR (AU-ROC: 0.77), MR (AU-ROC: 0.83), and any of AS, AR, or MR (AU-ROC: 0.84; sensitivity 78%, specificity 73%) with similar accuracy in external validation. In screening program modeling, test characteristics were dependent on underlying prevalence and selected sensitivity levels. At a prevalence of 7.8%, the positive and negative predictive values were 20% and 97.6%, respectively. CONCLUSIONS: Deep learning analysis of the ECG can accurately detect AS, AR, and MR in this multicenter cohort and may serve as the basis for the development of a valvular heart disease screening program.

Burnout and Self-Perceived Stress in Workers in Essential Services after the Impact of Hurricanes Irma and Maria.

OBJECTIVE: To examine the levels of burnout and self-perceived stress in workers at the Puerto Rico Electric Power Authority, who experienced major disasters: Hurricanes Irma and Maria. METHODS: A quantitative descriptive cross-sectional study with a non-probabilistic convenience sample was conducted in workers at the Puerto Rico Electric Power Authority. A structured questionnaire was administered to a sample of 163 eligible participants, aged 21 years and older, who participated voluntarily. Using employees of the electric company, the study examined the relationships between burnout and several characteristics (years of employment, existing health conditions, and coping strategies) both before and after Hurricanes Irma and Maria. Burnout was assessed with Gil-Monte's Spanish Burnout Inventory, and self-perceived stress was assessed with the 14-item Perceived Stress Scale. RESULTS: Before the hurricanes, 16.6% of the workers reported high levels of burnout syndrome, while, after the hurricanes, the proportion increased to one-fifth (20.9%). Prior to the 2 hurricanes, more than one-fourth (23.4%) of the sample reported being extremely stressed; after the hurricanes, that proportion increased to 55%. Factors such as years of employment, counseling, and self-perceived stress showed significant statistical associations (P < .05) with burnout. CONCLUSION: From a public health standpoint, priority should be given to this population, thereby preventing burnout and any other negative effects of the aftermath (i.e., the lengthy response, recovery, and reconstruction) of these kinds of major disaster.

Effect of Cross-Linkers on Mussel- and Elastin-Inspired Adhesives on Physiological Substrates.

Surgical adhesives can be useful in wound closure because they reduce the risk of infection and pain associated with sutures and staples. However, there are no commercially available surgical adhesives for soft tissue wound closure. To be effective, soft tissue adhesives must be soft and flexible, strongly cohesive and adhesive, biocompatible, and effective in a moist environment. To address these criteria, we draw inspiration from the elasticity and resilience of elastin proteins and the adhesive of marine mussels. We used an elastin-like polypeptide (ELP) for the backbone of our adhesive material due to its elasticity and biocompatibility. A mussel-inspired adhesive molecule, l-3,4-dihydroxyphenylalanine (DOPA), was incorporated into the adhesive to confer wet-setting adhesion. In this study, an ELP named YKV was designed to include tyrosine residues and lysine residues, which contain amine groups. A modified version of YKV, named mYKV, was created through enzymatic conversion of tyrosine residues into DOPA. The ELPs were combined with iron(III) nitrate, sodium periodate, and/or tris(hydroxymethyl)phosphine (THP) cross-linkers to investigate the effect of DOPA- and amine-based cross-linking on adhesion strength and cure time on porcine skin in a warm, humid environment. Incorporation of DOPA into the ELP increased adhesive strength by 2.5 times and reduced failure rates. Iron cross-linkers improved adhesion in the presence of DOPA. THP increased adhesion for all proteins tested even in the absence of DOPA. Using multiple cross-linkers in a single formulation did not significantly improve adhesion. The adhesives with the highest performance (iron nitrate mixed with mYKV and THP mixed with YKV or mYKV) on porcine skin had 10-18 times higher adhesion than a commercial sealant and reached appreciable adhesive strength within 10 min.

Collagen- and hyaluronic acid-based hydrogels and their biomedical applications.

Hydrogels have been widely investigated in biomedical fields due to their similar physical and biochemical properties to the extracellular matrix (ECM). Collagen and hyaluronic acid (HA) are the main components of the ECM in many tissues. As a result, hydrogels prepared from collagen and HA hold inherent advantages in mimicking the structure and function of the native ECM. Numerous studies have focused on the development of collagen and HA hydrogels and their biomedical applications. In this extensive review, we provide a summary and analysis of the sources, features, and modifications of collagen and HA. Specifically, we highlight the fabrication, properties, and potential biomedical applications as well as promising commercialization of hydrogels based on these two natural polymers.

Bacillus spp: una alternativa para la promoción vegetal por dos caminos enzimáticos / Bacillus spp: An alternative for plant promotion by two enzymatic pathways

Resumen Objetivo. Se realizó una revisión sobre las características de las fitasas y nitrogenasas de Bacillus spp. y sus opciones de uso como alternativa biofertilizante. El género Bacillus es secretor de proteínas y metabolitos eficientes para el control de plagas y enfermedades, promueve el crecimiento vegetal a través de la solubilización de fósforo y la producción de reguladores de crecimiento como el ácido indol acético; así mismo participa en la fijación de nitrógeno cuando hace parte de consorcios microbianos. Como biofertilizante es una opción amigable para el suelo y el ambiente que da respuesta a la necesidad de implementar la agricultura sostenible.

Abstract Objective. We conducted a review of the characteristics of the phytase and nitrogenase of Bacillus sp. and their potential use as an alternative biological fertilizer. The genus Bacillus is an efficient secretor of proteins and metabolites; to control pests and diseases, promote plant growth through the solubilization of phosphorus and production of growth regulators as acetic indole. Likewise it is involved in nitrogen fixation when it is part of microbial consortia. As biological fertilizer is a friendly option for the soil and the environment that responds to the need to implement sustainable agriculture.

Design and construction of a trap for the surveillance of Aedes (Stegomyia) aegypti (Diptera: Culicidae) / Diseño y construcción de una trampa para el monitoreo de Aedes (Stegomyia) aegypti (Diptera: Culicidae)

Introduction: Understanding Aedes (Stegomyia) aegypti (L) behavior will provide insight into the design of entomological surveillance devices. Objective: Design and build a trap for surveillance Aedes aegypti. Methodology: We examined egg-laying preference and the ability to capture adult Ae. aegypti using containers that differed in shape, color and internal retention systems. The characteristics most effective in capturing adult mosquitoes were used to develop a prototype efficient in trapping mosquitoes. The shape of the prototype was determined by examining oviposition preference of containers having circular, square and triangular bases. Color discrimination was assessed by covering the bodies of the containers in green (523 nm), red (621 nm), white and gray (the chromatic scale from black to white). The propensity of Ae. aegypti to enter the containers was assessed by incorporating an entrance to the container in the shape of an inverted truncated oblique pyramid with base, middle and apex dimensions of 6.5-4 cm, 5-2.5 cm and 4.5-1.5 cm, respectively. All variables as the number of egg and adults captured in treatments were subjected to variance analysis; only data with P < 0.05 were considered significant. Results: Our results indicate that neither shape nor entrance dimension attract ovipositing Ae. aegypti females [K-W: H (3, N = 64) = 0.3222769 p = 0.9558 and K-W: H (3, N= 16) = 4.284865 p = 0.2323, respectively]. However, we found that the color red had a high positive response [K-W: H (4, N = 80) = 20.81260 p = 0.0003]. Conclusions: The final design of the trap resembled a truncated pyramid with a red square base, a black oblique entrance of 5 x 2.5 cm and an internal retention system. The final prototype had a capture rate of 90.5 ± 5% under laboratory conditions.

Introducción: Aspectos etológicos de Aedes (Stegomyia) aegypti (L) proporcionan el conocimiento para diseñar dispositivos para la vigilancia entomológica. Objetivo: Diseñar y construir una trampa para el monitoreo de Aedes aegypti. Metodología: Experimentos de ovipostura y captura de alados de Ae. aegypti fueron realizados con contenedores diseñados de acuerdo a forma, color y sistemas internos de retención. Las contenedores con mayor eficiencia de ovipostura y captura de adultos fueron usados para diseñar el prototipo de la trampa. La forma del dispositivo se determinó por medio de la preferencia de ovoposición con prototipos de base circular, cuadrada y triangular. La discriminación por el color, se evaluó cubriendo los contenedores de color verde (523 nm), rojo (621 nm), blanco y gris (que pertenecen a la escala cromática que va del negro al blanco), todos con una abertura de entrada de color negro. La capacidad de ingreso de Ae. aegypti a los contenedores fue evaluada incorporando una entrada al contenedor en forma de pirámide oblicua truncada invertida con dimensiones en la base, área media y ápice de 6,5-4 cm, 5-2,5 cm y 4,5-1,5 cm respectivamente. Todos los experimentos fueron sometidos a análisis de variancia con el programa "Statistica v11", únicamente datos con p < 0.05 se consideraron significativos. Resultados: Los resultados indicaron que la forma no influencia la atracción de ovoposición de las hembras de Ae. aegypti [K-W: H (3, N = 64) = 0.3222769 p = 0.9558] y el color rojo presenta alta selección (K-W: H (4, N = 80) = 20.81260 p = 0.0003). Las dimensiones de la entrada no tienen significancia en la captura de los mosquitos[K-W: H (3, N= 16) = 4.284865 p = 0.2323]. Conclusión: El diseño final de la trampa tuvo forma de pirámide truncada de base cuadrada de color rojo, con entrada oblicua negra de dimensiones de entrada 5 x 2,5 cm más un sistema interno de retención. El prototipo final presentó 90.5 ± 5 % de captura en los experimentos de laboratorio.

Transtorno mental: avaliação do conhecimento dos agentes comunitário de saúde / Mental disorder: knowledge assessment of community health agents / Transtorno mental: evaluación del conocimiento de los agentes comunitarios de salud

Objetivo: identificar o nível de conhecimento dos Agentes Comunitários de Saúde sobre transtorno mental. Método: estudo exploratório e descritivo, transversal, com abordagem quantitativa, realizado em Unidades Básicas de Saúde de Imperatriz/MA, com 140 Agentes Comunitários de Saúde, entre os meses de maio e junho de 2014. Os dados coletados após a aplicação do questionário foram armazenados e tabulados em planilhas do software Excel (Microsoft®) e analisados segundo o programa Epi Info™ Versão 6.04. Resultados: a maioria pertencia ao sexo feminino 130 (93%), faixa etária entre os 40 e 49 (45%); houve deficit de conhecimentos que envolvem a saúde mental, (46%) não sabiam o que eram neuroses, (37%) psicoses, (38%) retardo mental e (31%) sensação de depressão. Conclusão: há a necessidade de repasse de informações sobre as doenças mentais para os Agentes Comunitários de Saúde.(AU)

Objective: to identify the level of knowledge of Community Health Agents on mental disorder. Method: exploratory descriptive, and cross-sectional study with a quantitative approach, performed in Basic Health Units of Imperatriz/MA, with 140 Community Health Agents, between the months of May and June 2014. The data collected after the questionnaire were stored and tabulated on Excel spreadsheets software (Microsoft) and analyzed using Epi info ™ Version 6.04. Results: 130 were females (93%), aged between 40 and 49 (45%); there was lack of knowledge involving mental health (46%) they did not know the concept of neuroses (37%) psychoses (38%) and mental retardation (31%) feeling of depression. Conclusion: it is necessary to transfer information about mental illness for Community Health Agents.(AU)

jetivo: identificar el nivel de conocimiento de los Agentes Comunitarios de Salud sobre trastorno mental. Método: estudio exploratorio y descriptivo, transversal, con enfoque cuantitativo, realizado en Unidades Básicas de Salud de Imperatriz/MA, con 140 Agentes Comunitarios de Salud, entre los meses de mayo y junio de 2014. Los datos recogidos después Del cuestionario fueron almacenados y tabulados en planillas del software Excel (Microsoft®) y analizados según el programa Epi Info™ Versión 6.04. Resultados: la mayoría pertenecía al sexo femenino, 130 (93%), grupo 40 a los 49 años (45%); hubo déficit de conocimientos que envuelven la salud mental, (46%) no sabían o que eran neurosis, (37%) psicosis, (38%) retardo mental e (31%) sensación de depresión. Conclusión: es necesario el repase de informaciones sobre las enfermedades mentales para los Agentes Comunitarios de Salud.(AU)

Modular Synthesis of Novel Macrocycles Bearing α,ß-Unsaturated Chemotypes through a Series of One-Pot, Sequential Protocols.

A series of one-pot, sequential protocols was developed for the synthesis of novel macrocycles bearing α,ß-unsaturated chemotypes. The method highlights a phosphate tether-mediated approach to establish asymmetry, and consecutive one-pot, sequential processes to access the macrocycles with minimal purification procedures. This library amenable strategy provided diverse macrocycles containing α,ß-unsaturated carbon-, sulfur-, or phosphorus-based warheads.

A Pot-Economical Approach to the Total Synthesis of Sch-725674.

A pot-economical total synthesis of antifungal Sch-725674, 1, is reported. The approach takes advantage of a number of one-pot, sequential transformations, including a phosphate tether-mediated one-pot, sequential RCM/CM/chemoselective hydrogenation protocol, a one-pot tosylation/acrylation sequence, and a one-pot, sequential Finkelstein reaction/Boord olefination/acetonide deprotection procedure to streamline the synthesis route by reducing isolation and purification procedures, thus saving time. Overall, an asymmetric route has been developed that is efficiently accomplished in seven pots from phosphate (S,S)-triene and with minimal purification.

Novel katG mutations causing isoniazid resistance in clinical M. tuberculosis isolates.

We report the discovery and confirmation of 23 novel mutations with previously undocumented role in isoniazid (INH) drug resistance, in catalase-peroxidase (katG) gene of Mycobacterium tuberculosis (Mtb) isolates. With these mutations, a synonymous mutation in fabG1 (g609a), and two canonical mutations, we were able to explain 98% of the phenotypic resistance observed in 366 clinical Mtb isolates collected from four high tuberculosis (TB)-burden countries: India, Moldova, Philippines, and South Africa. We conducted overlapping targeted and whole-genome sequencing for variant discovery in all clinical isolates with a variety of INH-resistant phenotypes. Our analysis showed that just two canonical mutations (katG 315AGC-ACC and inhA promoter-15C-T) identified 89.5% of resistance phenotypes in our collection. Inclusion of the 23 novel mutations reported here, and the previously documented point mutation in fabG1, increased the sensitivity of these mutations as markers of INH resistance to 98%. Only six (2%) of the 332 resistant isolates in our collection did not harbor one or more of these mutations. The third most prevalent substitution, at inhA promoter position -8, present in 39 resistant isolates, was of no diagnostic significance since it always co-occurred with katG 315. 79% of our isolates harboring novel mutations belong to genetic group 1 indicating a higher tendency for this group to go down an uncommon evolutionary path and evade molecular diagnostics. The results of this study contribute to our understanding of the mechanisms of INH resistance in Mtb isolates that lack the canonical mutations and could improve the sensitivity of next generation molecular diagnostics.

Substrate Temperature to Control Moduli and Water Uptake in Thin Films of Vapor Deposited N,N'-Di(1-naphthyl)-N,N'-diphenyl-(1,1'-biphenyl)-4,4'-diamine (NPD).

Ultrastable glasses are generated by vapor deposition on substrates heated near the glass transition temperature (Tg), but it is unclear if the remarkable properties of such glasses are present in ultrathin (<100 nm) films. Here, we demonstrate that the moduli of 50 nm thick N,N'-di(1-naphthyl)-N,N'-diphenyl-(1,1'-biphenyl)-4,4'-diamine (NPD) film can be increased from 1.5 to 2.5 GPa by simply increasing the temperature of the substrate during deposition with a maximum in modulus found at T/Tg = 0.94. This maximum in modulus is the same modulus obtained for very thin (<15 nm) NPD films deposited at 295 K (T/Tg = 0.80). However, the modulus of films deposited at this lower temperature abruptly decreases to approximately 1.5 GPa for thicker films; the modulus from deposition at T/Tg = 0.94 is thickness independent. In addition to the thin film modulus, the substrate temperature significantly impacts the water uptake in NPD films. From QCM, the volume fraction of water at equilibrium with nearly saturated water vapor decreases from nearly 4% to less than 1% as the substrate temperature increases from T/Tg = 0.82 to T/Tg = 0.93. The substrate temperature provides a simple route to control mechanical properties and water uptake into vapor-deposited NPD, and these concepts are likely extendable to other organic electronic materials; the increased moduli and decreased water uptake could enable improved performance and lifetime of small molecule glasses for a variety of organic electronic applications.

Consulta de enfermagem ao diabético utilizando o Protocolo Staged Diabetes Management / Appointment with a nurse for diabetics using the Protocol Staged Diabetes Management / Consulta de enfermería para diabéticos utilizando el Protocolo De Gestión De La Diabetes Por Etapas

Objetivou-se analisar a consulta de enfermagem com a aplicação do Protocolo Staged Diabetes Management em duas unidades de saúde da família da cidade de Picos-PI. Estudo descritivo e transversal, realizado com 80 pacientes, de ambos os sexos, cadastrados na estratégia de saúde da família. A coleta dos dados ocorreu através de um formulário aplicado no período de março a abril de 2011. Os resultados evidenciaram aumento da circunferência abdominal em 67,4% dosentrevistados, sendo que 36,3% apresentaram pressão arterial compatível com hipertensão arterial estágio I. Além disso, 85% faziam uso de medicamentos antidiabéticos. Observou-se que 58,7 % informaram o consumo de frutas e 55% o consumo de verduras diariamente. Conclui-se que o uso do protocolo durante a consulta de enfermagem possibilitou caracterizar aamostra e servirá de padronização do serviço, a fim de estabelecer uma assistência humanizada e holística.

This descriptive, cross-sectional study examined nursing appointments for diabetics using the Staged DiabetesManagement Protocol at two family health facilities in Picos, Piauí. Data were collected in March and April 2011, by questionnaire applied to 80 patients of both sexes enrolled with the Family Health Strategy. The results revealed increased abdominal circumference in 67.4% of respondents, while 36.3% had blood pressure consistent with stage I hypertension. In addition, 85% used antidiabetes medication, 58.7% reported eating fruit, and 55%, vegetables daily. It was concluded that using the protocol during an appointment with a nurse made it possible to characterize the sample, and will serve to standardize the service with a view to establishing humane, holistic care.

Este estudio tuvo como objetivo analizar la consulta de enfermería con la aplicación del Protocolo Staged DiabetesManagement en dos unidades de salud familiar de la ciudad de Picos-PI-Brasil. Estudio descriptivo y transversal, realizado con 80 pacientes de ambos los sexos matriculados en el Programa de Estrategia de Salud Familiar del Ministerio de Salud de Brasil. Los datos fueron recolectados a través de um formulario aplicado entre marzo y abril de 2011. Los resultados mostraron aumento de la circunferencia abdominal en 67,4% de los encuestados, mientras que 36,3% tenían hipertensiónarterial presión compatible con la Etapa I. Por otra parte, 85% usaban de medicamentos contra la diabetes. Se observó que 58,7% informaron de consumo de frutas y 55% el consumo de verduras diariamente. Se concluye que el uso del protocolo durante las consultas de enfermería permitió la caracterización de la muestra y servirá para normalizar el servicio con el finde establecer un cuidado humano y holístico.

Predicting extensively drug-resistant Mycobacterium tuberculosis phenotypes with genetic mutations.

Molecular diagnostic methods based on the detection of mutations conferring drug resistance are promising technologies for rapidly detecting multidrug-/extensively drug-resistant tuberculosis (M/XDR TB), but large studies of mutations as markers of resistance are rare. The Global Consortium for Drug-Resistant TB Diagnostics analyzed 417 Mycobacterium tuberculosis isolates from multinational sites with a high prevalence of drug resistance to determine the sensitivities and specificities of mutations associated with M/XDR TB to inform the development of rapid diagnostic methods. We collected M/XDR TB isolates from regions of high TB burden in India, Moldova, the Philippines, and South Africa. The isolates underwent standardized phenotypic drug susceptibility testing (DST) to isoniazid (INH), rifampin (RIF), moxifloxacin (MOX), ofloxacin (OFX), amikacin (AMK), kanamycin (KAN), and capreomycin (CAP) using MGIT 960 and WHO-recommended critical concentrations. Eight genes (katG, inhA, rpoB, gyrA, gyrB, rrs, eis, and tlyA) were sequenced using Sanger sequencing. Three hundred seventy isolates were INHr, 356 were RIFr, 292 were MOXr/OFXr, 230 were AMKr, 219 were CAPr, and 286 were KANr. Four single nucleotide polymorphisms (SNPs) in katG/inhA had a combined sensitivity of 96% and specificities of 97 to 100% for the detection of INHr. Eleven SNPs in rpoB had a combined sensitivity of 98% for RIFr. Eight SNPs in gyrA codons 88 to 94 had sensitivities of 90% for MOXr/OFXr. The rrs 1401/1484 SNPs had 89 to 90% sensitivity for detecting AMKr/CAPr but 71% sensitivity for KANr. Adding eis promoter SNPs increased the sensitivity to 93% for detecting AMKr and to 91% for detecting KANr. Approximately 30 SNPs in six genes predicted clinically relevant XDR-TB phenotypes with 90 to 98% sensitivity and almost 100% specificity.

Cebadores para la amplificación del gen de la (1, 3)-Beta-glucano sintasa y caracterización parcial de la enzima en Ganoderma lucidum / Primers for (1, 3)-Beta-glucan synthase gene amplification and partial characterization of the enzyme in Ganoderma lucidum

Antecedentes. El β-(1,3)(1,6)-D-glucano es un compuesto de la pared celular de los hongos que presenta efectos inmunomoduladores y anticancerígenos. La (1,3)-β-glucano sintasa es una de las principales enzimas involucradas en su síntesis. Objetivos. Diseñar cebadores para amplificar y caracterizar parcialmente el gen correspondiente a la enzima (1,3)-β-glucano sintasa y probarlos en la cepa CP-132 de Ganoderma lucidum. Métodos. Los cebadores fueron diseñados realizando una búsqueda de la secuencia del gen en otros hongos. Después, con la técnica de PCR se probaron los cebadores utilizando ADN extraído de la cepa CP-382 de G. lucidum. Las secuencias obtenidas se compararon con aquellas de la base de datos del GenBank. Resultados. Se diseñaron 3 pares de cebadores. Todos los pares amplificaron productos de PCR de tamaño esperado. Las secuencias amplificadas con los pares BGS2113UmF y BGS3097UmR, y BGS547UmF y BGS2113UmR correspondieron a un par de secciones del gen de la (1,3)-β-glucano sintasa. Las secuencias deducidas de aminoácidos mostraron una similitud alta con genes homólogos de otros hongos, especialmente con aquellos de la clase Agaricomycetes. Conclusiones. El diseño de cebadores para amplificar parcialmente el gen de la (1,3)-β-glucano sintasa a partir de secuencias de genes homólogos fue exitoso. Estos cebadores permitirán en un futuro la caracterización de esta importante enzima en un amplio grupo de hongos (AU)