Qualidade de vida no trabalho dos enfermeiros da atenção primária à saúde / Quality of life at work of nurses in primary health care / Calidad de vida en el trabajo del enfermero en atención primaria de salud

Objetivo: Analisar a qualidade de vida no trabalho dos enfermeiros assistenciais da Atenção Primária à Saúde de um município baiano. Métodos: Pesquisa observacional, descritiva, transversal e de abordagem quantitativa. Aplicou-se o questionário Total Quality of Work Life (Qualidade de Vida no Trabalho Total), por meio de ligação telefônica. Os dados foram transcritos para o software Microsoft Excel® e analisados por estatística descritiva. Resultados: Os 34 enfermeiros que aceitaram participar compuseram amostra de maioria feminina (97,1%), com idade maior ou igual a 40 anos (67,5%) e estado conjugal casado(a)/união estável (58,8%). Quanto à escolaridade, prevaleceu o nível de pós-graduação lato sensu (85,3%), com maior parcela atuando no município há mais de 4 anos (67,7%), por meio de vínculo efetivo (70,6%). No tocante à avaliação da qualidade de vida no trabalho, a esfera que obteve pior avaliação foi a "Econômica política" e a melhor avaliada foi a "Psicológica e comportamental". Além disso, a avaliação geral apontou classificação "insatisfatória". Conclusão: A melhoria da qualidade de vida no trabalho dos enfermeiros pode trazer repercussões que vão além da satisfação do profissional, pois fatores motivacionais, de satisfação, físicos e psicológicos influenciam diretamente sua produtividade no trabalho e a qualidade do serviço prestado. (AU)

Objective: To analyze the quality of life at work of nurses working in Primary Health Care in a city in Bahia. Methods: Observational, descriptive, cross-sectional research and with a quantitative approach. The Total Quality of Work Life questionnaire was applied through telephone call. The search results were transferred to the Microsoft Excel® software and analyzed using descriptive statistics. Results: 34 nurses who agreed to participate comprised a sample of mostly female (97,1%), aged 40 years or older (67,5%) and marital status married or stable union (58,8%). About education, the majority had a lato sensu postgraduate degree (85,3%), with a greater portion working in the city for more than 4 years (67,7%), having an effective contract (70,6%). Regarding the evaluation of quality of life at work, the sphere that obtained the worst assessment was "Economic policy" and the best assessed the "Psychological and behavioral" sphere. Furthermore, the general evaluation pointed to an "unsatisfactory" rating. Conclusion: It is believed that the improvement in the quality of life at work of the nurses can bring repercussions that go beyond professional satisfaction, due to motivation, satisfaction, physical and psychological factors directly influence their productivity at work and the quality of the service provided. (AU)

Objetivo: Analizar la calidad de vida en el trabajo de enfermeros que actúan en la Atención Primaria de Salud de un municipio de Bahía. Métodos: Esta es una investigación observacional, descriptiva, transversal y con enfoque cuantitativo. Durante la encuesta se aplicó el cuestionario Total Quality of Work Life a través de una llamada telefónica. Los datos se transcribieron al software Microsoft Excel® y se analizaron mediante estadística descriptiva. Resultados: Las 34 enfermeras que aceptaron participar eran, en su mayoría, del sexo femenino (97,1%), con edad igual o superior a 40 años (67,5%) y casado o en unión estable (58,8%). Acerca de la educación, predominó el nivel de posgrado lato sensu (85,3%), con una mayor parte de los encuestados trabajando en el municipio por más de 4 años (67,7%), a través de un contrato efectivo (70,6%). Sobre la evaluación la valoración de la calidad de vida en el trabajo, el ámbito que obtuvo la peor valoración fue "Política Económica" y el mejor valorado fue "Psicológico y conductual". Además, la evaluación general apuntó a una calificación "insatisfactoria". Conclusión: Se cree que la mejora en la calidad de vida en el trabajo de estos enfermeros puede traer repercusiones que van más allá de la satisfacción profesional, ya que factores motivacionales, de satisfacción, físicos y psicológicos influyen directamente en su productividad en el trabajo y en localidad del servicio prestado. (AU)

Conhecimento de uma equipe multiprofissional sobre cuidados paliativos: estudo quase experimental / Knowledge of a multidisciplinary team about palliative care: quasi-experimental study / Conocimiento de un equipo multidisciplinario sobre cuidados paliativos: estudio cuasi-experimental

Objetivo: avaliar o conhecimento da equipe multiprofissional de uma unidade clínica hospitalar, antes e depois de ações educativas sobre cuidados paliativos. Método: estudo quase experimental, tipo "antes e depois", em que não há aleatoriedade na seleção da população e o grupo controle são os participantes que sofreram a intervenção. Resultados: houve diferença estatisticamente significativa nas respostas acerca do melhor momento para iniciar Cuidados Paliativos (54,3% para 80% de respostas corretas após as ações educativas) após as ações educativas. Nenhum participante tinha formação específica na área. Conclusão: após este estudo, houve mudanças na prática clínica. A instituição iniciou capacitações para as equipes, reforçando a relevância de estudos relacionados ao tema e necessidade de investimento em educação permanente a fim de mudar a realidade do sistema de saúde

Objective: to evaluate the knowledge of the multidisciplinary team of a hospital clinical unit, before and after educational actions on palliative care. Method: quasi-experimental study, "before and after", in which there is no randomness in the selection of the population and the control group are the participants who underwent the intervention. Results: there was a statistically significant difference in the answers regarding the best time to start Palliative Care (54.3% to 80% of correct answers after the educational actions) after the educational actions. No participant had specific training in the area. Conclusion: after this study, there were changes in clinical practice. The institution began training for teams, reinforcing the relevance of studies related to the topic and the need for investment in continuing education in order to change the reality of the health system

Objetivos: evaluar los conocimientos del equipo multidisciplinario de una unidad clínica hospitalaria, antes y después de acciones educativas sobre cuidados paliativos. Método: estudio cuasiexperimental, "antes y después", en el que no existe aleatoriedad en la selección de la población y el grupo control son los participantes que se sometieron a la intervención. Resultados: hubo diferencia estadísticamente significativa en las respuestas respecto al mejor momento para iniciar los Cuidados Paliativos (54,3% a 80% de respuestas correctas después de las acciones educativas) después de las acciones educativas. Ningún participante contaba con formación específica en el área. Conclusión: después de este estudio, hubo cambios en la práctica clínica. La institución inició la capacitación de equipos, reforzando la relevancia de los estudios relacionados con el tema y la necesidad de invertir en educación continua para cambiar la realidad del sistema de salud

Caracterização da secreção cutânea do anfíbio Trachycephalus nigromaculatus e investigação da atividade antimicrobiana

Trachycephalus nigromaculatus is a helmeted treefrog belonging to the Hylidae family, distinguished by its cranial apparatus adapted for phragmosis, a unique defense strategy. Its skin is notable for the abundance of poison glands, playing a crucial role in resistance against predators and pathogens in its natural habitat. However, the chemical composition of the venom and the effects of exposure to cutaneous secretion in humans and animals remain poorly understood. This study aimed to characterize the cutaneous secretion, assess its toxic effects, and explore the antimicrobial activity of Trachycephalus nigromaculatus secretion. We employed chromatographic analyses, SDS-PAGE gel electrophoresis, and mass spectrometry to identify the fractions of cutaneous secretion. The cell-inflammatory-epithelial interaction was examined through intravital microscopy, while the impact on cell viability was evaluated using the MTT assay. Antimicrobial activity was tested in vitro against S. aureus, S. coli, and C. albicans. Results revealed a complex mixture in T. nigromaculatus cutaneous secretion, with proteins ranging from 8.5 to 77 kDa. Noteworthy components include hyaluronidase, peroxiredoxin-6, and the toxin anntoxin. MALDI- TOF analysis indicated an abundant presence of peptides. Low concentrations (1μg/mL) of the secretion exhibited significant cytotoxic activity (76%) against VERO cells. In intravital microscopy, the secretion (3 μg and 30 μg) displayed relevant toxic activity, causing loss of elasticity, edema, infiltration, and hemorrhagic points, preventing the experiment's continuation after 2 hours of injection. Within 24 hours, signs of necrosis and infiltration were evident, accompanied by an increase in adhered and migrated cells. These effects were observed within just 5 minutes of topical application. Inhibition of microbial growth was observed in crude secretion against S. coli, S. aureus, and C. albicans. At least half of the fractions tested by HPLC exhibited relevant activity. Antimicrobial activity was particularly effective against gram-positive bacteria (S. aureus) and gram-negative bacteria (S. coli), demonstrating notable antifungal action against C. albicans. These results are significant as they represent the first description of the antimicrobial activity of T. nigromaculatus cutaneous secretion, highlighting substantial inhibition against fungi. Furthermore, this study provides the first detailed description of the biochemical content of cutaneous secretion, revealing a unique composition of compounds inducing notable toxic effects both in vivo and in vitro. These findings, coupled with the distinctive cranial apparatus of this species, reinforce its efficacy as an efficient defense mechanism.

Trachycephalus nigromaculatus é uma perereca-de-capacete da família Hylidae, destacada pelo seu aparelho craniano adaptado para a fragmose, uma estratégia de defesa peculiar. Sua pele é notória pela abundância de glândulas de veneno, desempenhando um papel crucial na resistência contra predadores e patógenos em seu habitat natural. No entanto, a composição química do veneno e os efeitos da exposição à secreção cutânea em humanos e animais permanecem pouco compreendidos. Este estudo objetivou caracterizar a secreção cutânea, avaliar seus efeitos tóxicos e explorar a atividade antimicrobiana da secreção de Trachycephalus nigromaculatus. Empregamos análises cromatográficas, eletroforese em gel SDS- PAGE e espectrometria de massa para identificar as frações da secreção cutânea. A interação célula-inflamatória-epitelial foi examinada por microscopia intravital, enquanto o impacto na viabilidade celular foi avaliado pelo ensaio MTT. A atividade antimicrobiana foi testada in vitro contra S. aureus, S. coli e C. albicans. Os resultados revelaram uma mistura complexa na secreção cutânea de T. nigromaculatus, com proteínas variando de 8,5 a 77 kDa. Destacam-se hialuronidase, peroxirredoxina-6 e a toxina anntoxina. A análise MALDI-TOF indicou uma presença abundante de peptídeos. Concentrações baixas (1μg/mL) da secreção apresentaram notável atividade citotóxica (76%) contra células VERO. Na microscopia intravital, a secreção (3 μg e 30 μg) exibiu atividade tóxica relevante, causando perda de elasticidade, edema, infiltração e pontos hemorrágicos, impedindo a continuidade após 2h de injeção. Em 24 horas, sinais de necrose e infiltração foram evidentes, juntamente com um aumento na contagem de células aderidas e migradas. Esses efeitos foram observados após apenas 5 minutos de aplicação tópica. Observou-se inibição do crescimento microbiano na secreção bruta para S. coli, S. aureus e C. albicans. Pelo menos metade das frações testadas por HPLC exibiram atividade relevante. A atividade antimicrobiana foi especialmente eficaz contra bactérias gram-positivas (S. aureus) e gram-negativas (S. coli), além de apresentar notável ação antifúngica contra C. albicans. Esses resultados são significativos, pois representam a primeira descrição da atividade antimicrobiana da secreção cutânea de T. nigromaculatus, destacando uma inibição importante contra fungos. Além disso, este estudo oferece a primeira descrição detalhada do conteúdo bioquímico da secreção cutânea, revelando uma composição singular de compostos que induzem efeitos tóxicos notáveis tanto in vivo quanto in vitro. Essas descobertas, aliadas ao distintivo aparelho ósseo na cabeça desta espécie, reforçam sua eficácia como uma eficiente arma de defesa.

Effect of surface treatment on flexural strength and subcritical crack growth of lithium disilicate: an in vitro study

Alternative surface treatments have been proposed for the cementation of lithium disilicate ceramics aiming to improve adhesive and flexural strength under fatigue. This study aimed to evaluate the slow crack growth (SCG) parameters of the lithium disilicate ceramic after hydrofluoric acid (HF) etching or air abrasion (AB) as surface treatments. Ceramic discs were treated with HF (5%, 20 s) or AB (30 µm silica-modified alumina particles, 2.8 bar, 10 mm distance, 15 s), and received a layer of resin cement. The surface roughness after surface treatment was evaluated (n = 5). Samples were tested in a piston-on-three-ball assembly to evaluate the flexural strength (n = 20), inert strength (n = 25), and to determine SCG parameters n and D (n = 35). The highest roughness (p < 0.01) was observed in the AB group, with the highest reliability according to the Weibull analysis, but the lowest SCG susceptibility. Flexural (p = 0.03) and inert strength (p < 0.01) were the greatest in the HF group. Despite exhibiting lower strength than 5% HF, air abrasion may be an alternative for the surface treatment of lithium disilicate surfaces, indicating the best prognosis over time.

Influence of substrate, cement and aging on the biaxial flexural strength of lithium disilicate / Influência do substrato, cimento e envelhecimento na resistência a flexão biaxial do dissilicato de lítio

Objective: To evaluate the biaxial flexural strength (BFS) of lithium disilicate (L), cemented on different substrates (epoxy resin - E and metal - M) with dual-cure resin cement (Rc) and zinc phosphate cement (Zc), not aged, thermally aged (TC) or thermo-mechanical aged (TC/MC). Material and Methods: Disks of L, E, and M were fabricated, and the cementation was performed according to the following groups: ERc (L+E+Rc); MRc (L+M+Rc); MZc (L+M+Zc); EZc (L+E+Zc). Ten samples from each described group were tested in BFS, ten more samples were subjected to TC (1×104 cycles between 5 ºC and 55 ºC water), and the last 10 samples were subjected to TC/MC (MC: 1.2×106 cycles, 50 N, 3.8 Hz). The BFS test was performed and scanning electron microscopy (SEM) was performed to evaluate the failure mode. The effect of the cementation strategy (cement/substrate) was compared in each aging method and the effect of the aging method was evaluated for each cementation strategy by one-way ANOVA and Tukey post-hoc test (α=0.05). Results: The strength values were highest to M (237.8 ~ 463.9 MPa), in comparison to the E (41.03 ~ 66.76 MPa), despite aging and luting agent. Flexural strength data decreased after TC and TC/MC in groups cemented with Zc, but was stable when cemented with Rc. SEM analysis indicated that failure origins were located at the tensile surface of the L. Conclusion: Lithium disilicate discs cemented to the metallic substrate presented the highest biaxial flexural strength. The cementation with dual-cure resin cement did not decrease BFS after aging (AU)

Objetivo: Avaliar a resistência à flexão biaxial (BFS) do dissilicato de lítio (L), cimentado sobre diferentes substratos (resina epóxi - E e metal - M) com cimento resinoso dual (Rc) e cimento de fosfato de zinco (Zc), não envelhecido, submetido ao envelhecido térmico (TC) ou ao envelhecido térmico-mecânico (TC/MC). Material e Métodos: Foram confeccionados discos de L, E e M, e a cimentação foi realizada de acordo com os seguintes grupos: ERc (L+E+Rc); MRc (L+M+Rc); MZc (L+M+Zc); EZc (L+E+Zc). Dez amostras de cada grupo descrito foram testadas em BFS, mais dez amostras foram submetidas à TC (1×104 ciclos de imersão em água entre 5 ºC e 55 ºC), e as últimas 10 amostras foram submetidas à TC/MC (MC: 1.2 ×106 ciclos, 50 N, 3.8 Hz). Foram realizados os testes de BFS e a microscopia eletrônica de varredura (MEV) para avaliar o modo de falha. O efeito da estratégia de cimentação (cimento/substrato) foi comparado em cada método de envelhecimento e o efeito do método de envelhecimento foi avaliado para cada estratégia de cimentação por ANOVA a um fator e teste post-hoc de Tukey (α=0,05). Resultados: Os valores de resistência foram maiores para M (237.8 ~ 463.9 MPa), em comparação com E (41.03 ~ 66.76 MPa), independentemente do envelhecimento e do agente cimentante utilizado. Os dados de resistência à flexão diminuíram após TC e TC/MC nos grupos cimentados com Zc, mas se mantiveram estáveis quando cimentados com Rc. A análise MEV indicou que a origem das falhas estava localizada na superfície de tração do L. Conclusão: Os discos de dissilicato de lítio cimentados ao substrato metálico apresentaram maior resistência à flexão biaxial. A cimentação com cimento resinoso dual não diminuiu o BFS após o envelhecimento (AU)

Microbial profile of the oral cavity of patients under mechanical ventilation is not influenced by the edentamento: an observational study / Perfil microbiano da cavidade oral em pacientes sob ventilação mecânica não é influenciado pelo edentameto: um estudo observacional

Objective: Understand whether the collection site (toothless or toothless) influences the frequency of bacteria in the oral cavity. It was performed as an observational, prospective, and cross-sectional study. Methods: Clinical samples of the oral surfaces of the teeth and/or cheek mucosa were collected in the oral cavity of 37 patients who underwent elective cardiac surgery in the preoperative period from May to July 2019. The clinical samples collected were subjected to identification of colonies and antimicrobial sensitivity tests. Results: It was observed that regardless of whether the collection site is toothless or toothless, the microbial profile, socio-demographic variables, comorbidities, and risk factors do not statistically influence the choice of the collection site. Conclusions: there wasn't statistical difference between the strains found at the collection sites. Practical Implications: the result found is relevant for other researchers that will work with oral cavity collections since the chosen collection site will not influence the frequency of strains found.

Objetivo: Compreender se o local de coleta (com dentes ou desdentado) influencia na frequência de bactérias na cavidade oral. Foi realizado como um estudo observacional, prospectivo e transversal. Métodos: Amostras clínicas das superfícies orais dos dentes e/ou mucosa jugal foram coletadas na cavidade oral de 37 pacientes submetidos à cirurgia cardíaca eletiva no período pré-operatório de maio a julho de 2019. As amostras clínicas coletadas foram submetidas à identificação de colônias e testes antimicrobianos de sensibilidade. Resultados: Observou-se que independente do local de coleta ser dentado ou desdentado, o perfil microbiano, variáveis sociodemográficas, comorbidades e fatores de risco não influenciam estatisticamente na escolha do local de coleta. Conclusões: Não houve diferença estatística entre as cepas encontradas nos locais de coleta. O resultado encontrado é relevante para outros pesquisadores que trabalharão com coletas de cavidade oral, pois o local de coleta escolhido não influenciará na frequência de cepas encontradas.

Evaluation of interactions of silibinin with the proteins ALS3 and SAP5 against Candida albicans / Avaliação das interações da silibinina com as proteínas ALS3 e SAP5 contra Candida albicans

Objective: to evaluate the molecular interaction of silibinin with the targets ALS3 and SAP5. Methodology: Molecular docking protocols were conducted to analyze the binding interaction of silibinin with ALS3 and SAP5. Results: Eleven interactions of ALS3 with silibinin and four with fluconazole were found, while six interactions were observed of SAP5 with silibinin and four with fluconazole. Conclusion: Molecular docking between silibinin and ALS3 identified important interactions, but no significant interactions were observed with SAP5, even though silibinin can exhibit affinity and interactions with other SAP5 sites.

Objetivo: Avaliar a interação molecular da silibinina com os alvos ALS3 e SAP5. Metodologia: Protocolos de docking molecular foram conduzidos para analisar a interação de ligação da silibinina com ALS3 e SAP5. Resultados: Foram encontradas onze interações de ALS3 com silibinina e quatro com fluconazol, enquanto seis interações foram observadas de SAP5 com silibinina e quatro com fluconazol. Conclusão: Docking molecular entre silibinina e ALS3 identificou interações importantes, mas não foram observadas interações significativas com SAP5, embora a silibinina possa apresentar afinidade e interações com outros sítios SAP5.

Sensitivity profile of blood culture isolates in a clinical analysis laboratory, Fortaleza, CE / Perfil de sensibilidade de isolados de hemocultura em um laboratório de análises clínicas, Fortaleza, CE / Perfil de sensibilidad de hemocultivos aislados en un laboratorio de análisis clínicos, Fortaleza, CE

Background and objectives: bacteremia is defined from the presence of bacteria in the bloodstream. Its clinical importance is associated with the high morbidity and mortality rate in the world. In severe cases, it can culminate in sepsis, with a constant increase in cases in Brazil. Therefore, this study aims to assess the main bacterial isolates in blood cultures and a possible change in their sensitivity profiles in a clinical analysis laboratory in Fortaleza, Ceará. Methods: an epidemiological, descriptive, retrospective study was carried out, with a quantitative approach of positive blood cultures, seeking to assess the main isolated microorganisms and their sensitivity profiles. The data used were obtained from the laboratory system through the EpiCenter→ software, from January 2019 to December 2020. Statistical analysis was performed using the Graphpad 7.0 software. Results: 840 microorganisms were identified from blood cultures, and the main ones were E. coli, K. pneumoniae, P. aeruginosa, S. epidermidis, S. aureus and S. haemolyticus. Some isolates show a change in the sensitivity profile, such as K. pneumoniae and P. aeruginosa, showing an increase in sensitivity to carbapenems and cephalosporins, while S. epidermidis showed a decrease in sensitivity to minocycline in the comparison between years 2019 and 2020.Conclusion: clinical isolates from blood cultures showed a change in the sensitivity profile between 2019 and 2020, taking into account that, for K. pneumoniae, P. aeruginosa, this change resulted in an increase in sensitivity, with an increase in resistance in S. epidermidis isolates.(AU)

Justificativa e objetivos: bacteremia é definida a partir da presença de bactérias na corrente sanguínea. Sua importância clínica está associada à alta taxa de morbidade e mortalidade no mundo. Nos casos graves, pode culminar em sepse, com constante aumento dos casos no Brasil. Portanto, o presente estudo tem como objetivo avaliar os principais isolados bacterianos em hemoculturas e uma possível alteração nos seus perfis de sensibilidade em um laboratório de análises clínicas de Fortaleza, Ceará. Métodos: foi realizado um estudo epidemiológico, descritivo, retrospectivo, com abordagem quantitativa de hemoculturas positivas, buscando avaliar os principais microrganismos isolados e seus perfis de sensibilidades. Os dados utilizados foram obtidos a partir do sistema laboratorial através do software EpiCenter→, referente ao período de janeiro de 2019 a dezembro de 2020. A análise estatística foi realizada pelo software Graphpad 7.0. Resultados: foram identificados 840 microrganismos a partir das hemoculturas, sendo os principais E. coli, K. pneumoniae, P. aeruginosa, S. epidermidis, S. aureus e S. haemolyticus. Alguns isolados apresentam uma alteração no perfil de sensibilidade, como K. pneumoniae e P. aeruginosa, apresentando um aumento na sensibilidade frente aos carbapenêmicos e as cefalosporinas, enquanto o S. epidermidis apresentou uma diminuição na sensibilidade frente à minociclina na comparação entre os anos de 2019 e 2020. Conclusão: os isolados clínicos de hemocultura apresentaram uma alteração no perfil de sensibilidade entre 2019 e 2020, levando em consideração que, para K. pneumoniae e P. aeruginosa, essa alteração resultou no aumento na sensibilidade, com aumento na resistência nos isolados de S. epidermidis.(AU)

Justificación y objetivos: la bacteriemia se define por la presencia de bacterias en el torrente sanguíneo. Su importancia clínica está asociada con la alta tasa de morbimortalidad en el mundo. En casos severos, puede culminar en sepsis, con un aumento constante de casos en Brasil. Por tanto, este estudio tiene como objetivo evaluar los principales aislados bacterianos en hemocultivos y un posible cambio en sus perfiles de sensibilidad en un laboratorio de análisis clínicos en Fortaleza, Ceará. Métodos: se realizó un estudio epidemiológico, descriptivo, retrospectivo, con abordaje cuantitativo de hemocultivos positivos, buscando evaluar los principales microorganismos aislados y sus perfiles de sensibilidad. Los datos utilizados se obtuvieron del sistema de laboratorio a través del software EpiCenter→, para el período de enero de 2019 a diciembre de 2020. El análisis estadístico se realizó mediante el software Graphpad 7.0. Resultados: se identificaron 840 microorganismos a partir de hemocultivos, siendo los principales E. coli, K. pneumoniae, P. aeruginosa, S. epidermidis, S. aureus y S. haemolyticus. Algunos aislados muestran un cambio en el perfil de sensibilidad, como K.pneumoniae y P. aeruginosa, mostrando un aumento en la sensibilidad a los carbapenémicos y cefalosporinas, mientras que S. epidermidis mostró una disminución en la sensibilidad a la minociclina, en la comparación entre los años de 2019 y 2020. Conclusiones: los aislados clínicos de hemocultivos mostraron un cambio en el perfil de sensibilidad entre 2019 y 2020, teniendo en cuenta que para K. pneumoniae, P. aeruginosa, este cambio resultó en un aumento de la sensibilidad, con un aumento de la resistencia en los aislados de S. epidermidis

Recapitulation of Retinal Damage in Zebrafish Larvae Infected with Zika Virus.

Zebrafish are increasingly being utilized as a model to investigate infectious diseases and to advance the understanding of pathogen-host interactions. Here, we take advantage of the zebrafish to recapitulate congenital ZIKV infection and, for the first time, demonstrate that it can be used to model infection and reinfection and monitor anti-viral and inflammatory immune responses, as well as brain growth and eye abnormalities during embryonic development. By injecting a Brazilian strain of ZIKV into the yolk sac of one-cell stage embryos, we confirmed that, after 72 h, ZIKV successfully infected larvae, and the physical condition of the virus-infected hosts included gross morphological changes in surviving embryos (84%), with a reduction in larval head size and retinal damage characterized by increased thickness of the lens and inner nuclear layer. Changes in locomotor activity and the inability to perceive visual stimuli are a result of changes in retinal morphology caused by ZIKV. Furthermore, we demonstrated the ability of ZIKV to replicate in zebrafish larvae and infect new healthy larvae, impairing their visual and neurological functions. These data reinforce the deleterious activity of ZIKV in the brain and visual structures and establish the zebrafish as a model to study the molecular mechanisms involved in the pathology of the virus.

TnP Peptide Suppresses Experimental Autoimmune Encephalomyelitis (EAE) in a Preclinical Mouse Model.

TnP is a family of patented synthetic peptides which is in a preclinical development stage with valuable potential therapeutic indication for multiple sclerosis (MS), an autoimmune demyelinating disease of the central nervous system (CNS). The use of a preclinical animal model, such as experimental autoimmune encephalomyelitis (EAE) has deepened our knowledge of the immunomodulatory functions of TnP as a drug. We have shown that TnP possesses a disease suppressive function in EAE, ameliorating disease severity by 40% and suppressing the accumulation of T helper (Th)1- and Th17-producing lymphocytes (by 55% and 60%, respectively) in CNS along with activated microglia/macrophages populations (by 33% and 50%, respectively), and also conferred a protective effect anticipating the remyelination process to day 66 compared to day 83 of untreated cuprizone-mice. Here we expanded our knowledge about its effects compared with current first-line disease-modifying therapies (DMT). We demonstrated that prophylactic treatment with TnP generated similar protection to betaseron (30%) or was more effective than glatiramer (44% versus 6%) or fingolimod (50% versus 19%) against the development of clinical symptoms. Although TnP controlled the leukocyte infiltration (87% versus 82%) into demyelinated areas of the spinal cord in the same way as betaseron and fingolimod, it was more effective (72% to 78% decrease) in the long-term control of neuronal degeneration compared to them. Also, when compared to glatiramer, TnP was more efficient in reversing leukocytes infiltration into the spinal cord (55% versus 24%), as well as induced a higher percentage of regulatory cells in spleen (2.9-fold versus 2.3-fold increase over vehicle-treated EAE mice) an in the spinal cord (8-fold versus 6-fold increase over vehicle-treated EAE mice). This specialized TnP profile for inducing immune tolerance and neuronal regeneration has significant therapeutic potential for the treatment of MS and other autoimmune diseases.

Impact of Pesticides on Human Health in the Last Six Years in Brazil.

Every year, Brazil intensifies its activity in agriculture and, as a result, it has become one of the biggest consumers of pesticides in the world. The high rate of these substances raises environmental and human health concerns. Therefore, we collected papers from PubMed, Scopus, Scielo, and Web of Science databases, from 2015 to 2021. After a blind selection using the software Rayyan QCRI by two authors, 51 studies were included. Researchers from the South and the Southeast Brazilian regions contributed to most publications, from areas that concentrate agricultural commodity complexes. Among the pesticides described in the studies, insecticides, herbicides, and fungicides were the most frequent. The articles reported multiple toxic effects, particularly in rural workers. The results obtained can be used to direct policies to reduce the use of pesticides, and to protect the health of the population.

Anti-inflammatory and anti-necrotic effects of lectins from Canavalia ensiformis and Canavalia brasiliensis in experimental acute pancreatitis.

Lectins isolated from Canavalia ensiformis (ConA) and Canavalia brasiliensis (ConBr) are promising molecules to prevent cell death. Acute pancreatitis, characterized by acinar cell necrosis and inflammation, presents significant morbidity and mortality. This study has investigated the effects of ConA and ConBr in experimental acute pancreatitis and pancreatic acinar cell death induced by bile acid. Pancreatitis was induced by retrograde pancreatic ductal injection of 3% sodium taurocholate (Na-TC) in male Swiss mice. ConA or ConBr (0.1, 1 or 10 mg/kg) were intravenously applied to mice 1 h and 12 h after induction. After 24 h, the severity of pancreatitis was evaluated by serum amylase and lipase, histopathological changes and myeloperoxidase assay. Pancreatic acinar cells were incubated with ConA (200 µg/ml) or ConBr (200 µg/ml) and taurolithocholic acid 3-sulfate (TLCS; 500 µM). Necrosis and changes in mitochondrial membrane potential (ΔÑ°m) were detected by fluorescence confocal microscopy. Treatment (post-insult) with ConA and ConBr decreased pancreatic damage caused by retrograde injection of Na-TC in mice, reducing pancreatic neutrophil infiltration, edema and necrosis. In addition, ConA and ConBr decreased pancreatic acinar cell necrosis and depolarization of ΔÑ°m caused by TLCS. The inhibition of necrosis was prevented by the lectin domain blockade. In conclusion, ConA and ConBr markedly inhibited in vitro and in vivo damage, effects partly dependent on the interaction with mannose residues on acinar cells. These data support the potential application of these proteins for treatment of acute pancreatitis.

Natterin-like depletion by CRISPR/Cas9 impairs zebrafish (Danio rerio) embryonic development.

BACKGROUND: The Natterin protein family was first discovered in the venom of the medically significant fish Thalassophryne nattereri, and over the last decade natterin-like genes have been identified in various organisms, notably performing immune-related functions. Previous findings support natterin-like genes as effector defense molecules able to activate multiprotein complexes driving the host innate immune response, notably due to the pore-forming function of the aerolysin superfamily members. Herein, employing a combination of the CRISPR/Cas9 depletion system, phenotype-based screening, and morphometric methods, we evaluated the role of one family member, LOC795232, in the embryonic development of zebrafish since it might be implicated in multiple roles and characterization of the null mutant is central for analysis of gene activity. RESULTS: Multiple sequence alignment revealed that the candidate natterin-like has the highest similarity to zebrafish aep1, a putative and better characterized fish-specific defense molecule from the same family. Compared to other species, zebrafish have many natterin-like copies. Whole-mount in situ hybridization confirmed the knockout and mutant embryos exhibited epiboly delay, growth retardation, yolk sac and heart edema, absent or diminished swim bladder, spinal defects, small eyes and head, heart dysfunction, and behavioral impairment. As previously demonstrated, ribonucleoproteins composed of Cas9 and duplex guide RNAs are effective at inducing mutations in the F0 zebrafish. CONCLUSIONS: The considerably high natterin-like copies in zebrafish compared to other species might be due to the teleost-specific whole genome duplication and followed by subfunctionalization or neofunctionalization. In the present work, we described some of the natterin-like features in the zebrafish development and infer that natterin-like proteins potentially contribute to the embryonary development and immune response.

Recapitulation of retinal damage in zebrafish larvae infected with Zika virus

Zebrafish are increasingly being utilized as a model to investigate infectious diseases and to advance the understanding of pathogen–host interactions. Here, we take advantage of the zebrafish to recapitulate congenital ZIKV infection and, for the first time, demonstrate that it can be used to model infection and reinfection and monitor anti-viral and inflammatory immune responses, as well as brain growth and eye abnormalities during embryonic development. By injecting a Brazilian strain of ZIKV into the yolk sac of one-cell stage embryos, we confirmed that, after 72 h, ZIKV successfully infected larvae, and the physical condition of the virus-infected hosts included gross morphological changes in surviving embryos (84%), with a reduction in larval head size and retinal damage characterized by increased thickness of the lens and inner nuclear layer. Changes in locomotor activity and the inability to perceive visual stimuli are a result of changes in retinal morphology caused by ZIKV. Furthermore, we demonstrated the ability of ZIKV to replicate in zebrafish larvae and infect new healthy larvae, impairing their visual and neurological functions. These data reinforce the deleterious activity of ZIKV in the brain and visual structures and establish the zebrafish as a model to study the molecular mechanisms involved in the pathology of the virus.

TnP peptide suppresses experimental autoimmune Encephalomyelitis (EAE) in a preclinical mouse model

TnP is a family of patented synthetic peptides which is in a preclinical development stage with valuable potential therapeutic indication for multiple sclerosis (MS), an autoimmune demyelinating disease of the central nervous system (CNS). The use of a preclinical animal model, such as experimental autoimmune encephalomyelitis (EAE) has deepened our knowledge of the immunomodulatory functions of TnP as a drug. We have shown that TnP possesses a disease suppressive function in EAE, ameliorating disease severity by 40% and suppressing the accumulation of T helper (Th)1- and Th17-producing lymphocytes (by 55% and 60%, respectively) in CNS along with activated microglia/macrophages populations (by 33% and 50%, respectively), and also conferred a protective effect anticipating the remyelination process to day 66 compared to day 83 of untreated cuprizone-mice. Here we expanded our knowledge about its effects compared with current first-line disease-modifying therapies (DMT). We demonstrated that prophylactic treatment with TnP generated similar protection to betaseron (30%) or was more effective than glatiramer (44% versus 6%) or fingolimod (50% versus 19%) against the development of clinical symptoms. Although TnP controlled the leukocyte infiltration (87% versus 82%) into demyelinated areas of the spinal cord in the same way as betaseron and fingolimod, it was more effective (72% to 78% decrease) in the long-term control of neuronal degeneration compared to them. Also, when compared to glatiramer, TnP was more efficient in reversing leukocytes infiltration into the spinal cord (55% versus 24%), as well as induced a higher percentage of regulatory cells in spleen (2.9-fold versus 2.3-fold increase over vehicle-treated EAE mice) an in the spinal cord (8-fold versus 6-fold increase over vehicle-treated EAE mice). This specialized TnP profile for inducing immune tolerance and neuronal regeneration has significant therapeutic potential for the treatment of MS and other autoimmune diseases.

Impact of pesticides on human health in the last six years in Brazil

Every year, Brazil intensifies its activity in agriculture and, as a result, it has become one of the biggest consumers of pesticides in the world. The high rate of these substances raises environmental and human health concerns. Therefore, we collected papers from PubMed, Scopus, Scielo, and Web of Science databases, from 2015 to 2021. After a blind selection using the software Rayyan QCRI by two authors, 51 studies were included. Researchers from the South and the Southeast Brazilian regions contributed to most publications, from areas that concentrate agricultural commodity complexes. Among the pesticides described in the studies, insecticides, herbicides, and fungicides were the most frequent. The articles reported multiple toxic effects, particularly in rural workers. The results obtained can be used to direct policies to reduce the use of pesticides, and to protect the health of the population.

Natterin-like depletion by CRISPR/Cas9 impairs zebrafish (Danio rerio) embryonic development

Background The Natterin protein family was first discovered in the venom of the medically significant fish Thalassophryne nattereri, and over the last decade natterin-like genes have been identified in various organisms, notably performing immune-related functions. Previous findings support natterin-like genes as effector defense molecules able to activate multiprotein complexes driving the host innate immune response, notably due to the pore-forming function of the aerolysin superfamily members. Herein, employing a combination of the CRISPR/Cas9 depletion system, phenotype-based screening, and morphometric methods, we evaluated the role of one family member, LOC795232, in the embryonic development of zebrafish since it might be implicated in multiple roles and characterization of the null mutant is central for analysis of gene activity. Results Multiple sequence alignment revealed that the candidate natterin-like has the highest similarity to zebrafish aep1, a putative and better characterized fish-specific defense molecule from the same family. Compared to other species, zebrafish have many natterin-like copies. Whole-mount in situ hybridization confirmed the knockout and mutant embryos exhibited epiboly delay, growth retardation, yolk sac and heart edema, absent or diminished swim bladder, spinal defects, small eyes and head, heart dysfunction, and behavioral impairment. As previously demonstrated, ribonucleoproteins composed of Cas9 and duplex guide RNAs are effective at inducing mutations in the F0 zebrafish. Conclusions The considerably high natterin-like copies in zebrafish compared to other species might be due to the teleost-specific whole genome duplication and followed by subfunctionalization or neofunctionalization. In the present work, we described some of the natterin-like features in the zebrafish development and infer that natterin-like proteins potentially contribute to the embryonary development and immune response.

Resistência microbiana a medicamentos em uma Instituição de Longa Permanência para Idosos / Resistencia microbiana a medicamentos en una institución de larga estadía para adultos mayores / Microbial drug resistance in a Nursing Home

Resumo Objetivo Caracterizar os microrganismos e sua suscetibilidade antimicrobiana em uroculturas de idosos residentes de uma instituição de longa permanência. Métodos Estudo observacional transversal com 116 indivíduos de uma Instituição de Longa Permanência para Idosos de um município do sul da Bahia. O estudo foi aprovado por Comitê de Ética em Pesquisa e utilizou-se Termo de Consentimento Livre e Esclarecido. Foram realizadas coleta e análise laboratorial de urina tipo I e urocultura. Realizaram-se testes de sensibilidade a antimicrobianos conforme os critérios do European Committee on Antimicrobial Susceptibility Testing. Para o diagnóstico de infecção do trato urinário, foram utilizados os critérios de McGeer. A análise de dados se deu por estatística descritiva, com frequências absolutas e relativas. Resultados A prevalência de infecção do trato urinário foi de 33,62%, com predominância no sexo feminino e idade acima de 80 anos. Os uropatógenos foram: 69,2% Escherichia coli, 20,6% Klebsiella pneumoniae e 5,1% Providencia stuartii e Acinetobacter baumannii. As cepas de E. coli apresentaram suscetibilidade para a maior parte dos antimicrobianos; já nas de K. pneumoniae, a suscetibilidade foi variável. P. stuartii e A. baumannii não apresentaram resistência a carbapenêmicos e aos betalactâmicos aztreonam e piperacilina associados a tazobactam. Conclusão As cepas mais prevalentes e o perfil de suscetibilidade seguiram padrão próximo ao hospitalar, o que implica a necessidade de a instituição promover melhores estratégias de controle de infecção e envolver a equipe de enfermagem no gerenciamento dos casos e na qualificação da prescrição antimicrobiana, para reduzir a resistência bacteriana e efeitos adversos nos idosos.

Resumen Objetivo Caracterizar los microorganismos y su susceptibilidad antimicrobiana en urocultivos de adultos mayores residentes en una institución de larga estadía. Métodos Estudio observacional transversal con 116 individuos de una institución de larga estadía para adultos mayores de un municipio del sur del estado de Bahia. El estudio fue aprobado por el Comité de Ética de Investigación y se utilizó Consentimiento Informado. Se obtuvieron muestras de orina, con las cuales se realizó análisis de laboratorio tipo I y urocultivo. Se realizaron pruebas de sensibilidad a antimicrobianos según los criterios del European Committee on Antimicrobial Susceptibility Testing. Para el diagnóstico de infección del tracto urinario, se utilizaron los criterios de McGeer. El análisis de datos se obtuvo mediante estadística descriptiva, con frecuencias absolutas y relativas. Resultados La prevalencia de infección del tracto urinario fue del 33,62 %, con predominancia del sexo femenino y edad superior a 80 años. Los uropatógenos fueron: 69,2 % Escherichia coli, 20,6 % Klebsiella pneumoniae y 5,1 % Providencia stuartii y Acinetobacter baumannii. Las cepas de E. coli presentaron susceptibilidad en la mayor parte de los antimicrobianos, en las de K. pneumoniae, la susceptibilidad fue variable. P. stuartii y A. baumannii no presentaron resistencia a carbapenémicos ni a los betalactámicos aztreonam y piperacilina asociados a tazobactam. Conclusión Las cepas más prevalentes y el perfil de susceptibilidad presentaron un patrón parecido al hospitalario, lo que implica la necesidad de que la institución promueva mejores estrategias de control de infecciones e involucre al equipo de enfermería en la gestión de los casos y en la cualificación de la prescripción antimicrobiana para reducir la resistencia bacteriana y los efectos adversos en los adultos mayores.

Resumo Objetivo Caracterizar os microrganismos e sua suscetibilidade antimicrobiana em uroculturas de idosos residentes de uma instituição de longa permanência. Métodos Estudo observacional transversal com 116 indivíduos de uma Instituição de Longa Permanência para Idosos de um município do sul da Bahia. O estudo foi aprovado por Comitê de Ética em Pesquisa e utilizou-se Termo de Consentimento Livre e Esclarecido. Foram realizadas coleta e análise laboratorial de urina tipo I e urocultura. Realizaram-se testes de sensibilidade a antimicrobianos conforme os critérios do European Committee on Antimicrobial Susceptibility Testing. Para o diagnóstico de infecção do trato urinário, foram utilizados os critérios de McGeer. A análise de dados se deu por estatística descritiva, com frequências absolutas e relativas. Resultados A prevalência de infecção do trato urinário foi de 33,62%, com predominância no sexo feminino e idade acima de 80 anos. Os uropatógenos foram: 69,2% Escherichia coli, 20,6% Klebsiella pneumoniae e 5,1% Providencia stuartii e Acinetobacter baumannii. As cepas de E. coli apresentaram suscetibilidade para a maior parte dos antimicrobianos; já nas de K. pneumoniae, a suscetibilidade foi variável. P. stuartii e A. baumannii não apresentaram resistência a carbapenêmicos e aos betalactâmicos aztreonam e piperacilina associados a tazobactam. Conclusão As cepas mais prevalentes e o perfil de suscetibilidade seguiram padrão próximo ao hospitalar, o que implica a necessidade de a instituição promover melhores estratégias de controle de infecção e envolver a equipe de enfermagem no gerenciamento dos casos e na qualificação da prescrição antimicrobiana, para reduzir a resistência bacteriana e efeitos adversos nos idosos.

Controversial aspects of the concept of health needs and their impact on the accessibility of medicine and health services. / Aspectos controversos do conceito de necessidades de saúde e seus reflexos sobre a acessibilidade de medicamentos e serviços de saúde.

This article aimed to present the problems related to accessibility of health services by re-reading four case studies which illustrate the different dimensions of the definition of health needs and their impact on the accessibility of medicine and health services. The theoretical model of Vargas-Peláez et al.1, which allows a better understanding of the complexity of the definition of health needs and its impact on the demand for medicines and services, was adopted to re-read the case studies on the prices of patented medicines, the models of public provision, hemodynamic services, and prescription of anxiolytics. The results may shed some light on the complexity of the challenges to achieve health rights in a peripheral capitalist society where the production and distribution of goods and services is organized from the perspective of the market, even though public policies seek to regulate them. In this sense, it seems essential that the State plays a major role in guaranteeing equality in the achievement of social rights, not only influencing the industrial sector in reducing the prices of medicines and improving their supply, but also guaranteeing access to medicine and health services.

O objetivo do artigo é mostrar os problemas relativos à acessibilidade de serviços de saúde relendo quatro estudos de caso que ilustram as diferentes dimensões da definição de necessidades de saúde e os seus reflexos sobre a acessibilidade dos medicamentos e dos serviços de saúde. O modelo teórico de Vargas-Peláez et al.1, que permite um melhor entendimento da complexidade da definição das necessidades de saúde e os seus reflexos sobre a demanda de medicamentos e de serviços, foi adotado para reler os estudos de caso sobre preços dos medicamentos patenteados, os modelos de provisão pública, os serviços de hemodinâmica e a prescrição de ansiolíticos. Os resultados permitem iluminar a complexidade dos desafios presentes para obtenção dos direitos de saúde numa sociedade capitalista periférica em que a produção e a distribuição dos bens e serviços são organizadas na perspectiva do mercado ainda que as políticas públicas busquem regulá-las. Neste sentido, parece imprescindível que o Estado tenha um papel preponderante na garantia da equidade para o alcance dos direitos sociais, não só estimulando a indústria para redução dos preços dos medicamentos e melhoria de sua provisão, como garantindo acesso aos medicamentos e serviços de saúde.

Aspectos controversos do conceito de necessidades de saúde e seus reflexos sobre a acessibilidade de medicamentos e serviços de saúde / Controversial aspects of the concept of health needs and their impact on the accessibility of medicine and health services

Resumo O objetivo do artigo é mostrar os problemas relativos à acessibilidade de serviços de saúde relendo quatro estudos de caso que ilustram as diferentes dimensões da definição de necessidades de saúde e os seus reflexos sobre a acessibilidade dos medicamentos e dos serviços de saúde. O modelo teórico de Vargas-Peláez et al.1, que permite um melhor entendimento da complexidade da definição das necessidades de saúde e os seus reflexos sobre a demanda de medicamentos e de serviços, foi adotado para reler os estudos de caso sobre preços dos medicamentos patenteados, os modelos de provisão pública, os serviços de hemodinâmica e a prescrição de ansiolíticos. Os resultados permitem iluminar a complexidade dos desafios presentes para obtenção dos direitos de saúde numa sociedade capitalista periférica em que a produção e a distribuição dos bens e serviços são organizadas na perspectiva do mercado ainda que as políticas públicas busquem regulá-las. Neste sentido, parece imprescindível que o Estado tenha um papel preponderante na garantia da equidade para o alcance dos direitos sociais, não só estimulando a indústria para redução dos preços dos medicamentos e melhoria de sua provisão, como garantindo acesso aos medicamentos e serviços de saúde.

Abstract This article aimed to present the problems related to accessibility of health services by re-reading four case studies which illustrate the different dimensions of the definition of health needs and their impact on the accessibility of medicine and health services. The theoretical model of Vargas-Peláez et al.1, which allows a better understanding of the complexity of the definition of health needs and its impact on the demand for medicines and services, was adopted to re-read the case studies on the prices of patented medicines, the models of public provision, hemodynamic services, and prescription of anxiolytics. The results may shed some light on the complexity of the challenges to achieve health rights in a peripheral capitalist society where the production and distribution of goods and services is organized from the perspective of the market, even though public policies seek to regulate them. In this sense, it seems essential that the State plays a major role in guaranteeing equality in the achievement of social rights, not only influencing the industrial sector in reducing the prices of medicines and improving their supply, but also guaranteeing access to medicine and health services.