General practice-related MeSH terms in main journals: a bibliometric analysis from 2011 to 2021.

BACKGROUND: There are various Medical Subject Headings (MeSH) terms used to index general practice research, without consistency. AIM: To understand how general practice-related research is indexed in the main general practice journals between 2011 and 2021, and to analyse the factors that influenced the choice of the general practice-related MeSH. DESIGN AND SETTING: This was a quantitative bibliometric study conducted on MEDLINE. METHOD: MeSH were selected according to the international definition of General Practice/Family Medicine: 'General Practice', 'Primary Health Care', 'Family Practice', 'General Practitioners', 'Physicians, Primary Care', and 'Physicians, Family'. Their use was studied from 2011 to 2021 on MEDLINE, reviewing the 20 general practice journals with the highest impact factors. A descriptive and analytical approach was used; the association of the country, journal, and year with the choice of general practice-related MeSH terms was analysed. RESULTS: A total of 8514 of 150 286 articles (5.7%) were using one of the general practice-related MeSH terms. The most used were 'Primary Health Care' (4648/9984, 46.6%) and 'General Practice' (2841/9984, 28.5%). A total of 80.0% (6172/7723) of the articles were related to the UK or US and 71.0% (6055/8514) of the articles came from four journals (BJGP, BMJ, Journal of General Internal Medicine, and Annals of Family Medicine). Two main country clusters emerged from the use of general practice-related MeSH: a British cluster mainly using 'General Practice' and an American cluster using 'Primary Health Care'. The journals also mainly differed in their used of these two MeSH terms. CONCLUSION: Important variations in the indexation of general practice research were found. Researchers should consider combining 'Primary Health Care' and 'General Practice' in their PubMed searches to access all the general practice research, regardless of their country of origin.

A potential antiviral against COVID-19 obtained from Byrsonima coccolobifolia leaves extract.

In this study, we specifically focused on the crude methanolic leaf extract of Byrsonima coccolobifolia, investigating its antifungal potential against human pathogenic fungi and its antiviral activity against COVID-19. Through the use of high-performance liquid chromatography coupled with electrospray ionization ion trap tandem mass spectrometry, direct infusion electrospray ionization ion trap tandem mass spectrometry, and chromatographic dereplication procedures, we identified galloyl quinic acid derivatives, catechin derivatives, proanthocyanidins, and flavonoid glycosides. The broth dilution assay revealed that the methanolic leaf extract of B. coccolobifolia exhibits antifungal activity against Cryptococcus neoformans (IC50 = 4 µg/mL). Additionally, docking studies were conducted to elucidate the interactions between the identified compounds and the central residues at the binding site of biological targets associated with COVID-19. Furthermore, the extract demonstrated an in vitro half-maximum effective concentration (EC50 = 7 µg/mL) and exhibited significant selectivity (>90%) toward SARS-CoV-2.

Fatores que influenciam na adesão de idosos a vacina contra covid-19: revisão de escopo / Factors that influence elderly people's adherence to the covid-19 vaccine: scoping review

Objetivo: Mapear as evidências científicas relacionadas aos fatores que influenciam na adesão de idosos a vacina COVID-19. Método: Revisão de escopo realizada em novembro de 2021, nas seguintes bases de dados: Medical Literature Analysis and Retrieval System Online (MEDLINE via PubMed®), Excerpta Medica Data Base (Embase) via Elsevier; Institute for Scientific Information (ISI) Web of Knwedge (Web of Science); Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS) e Índice Bibliográfico Español em Ciencias de la Salud (IBECS). Resultados e Discussão: Houve 10 publicações atenderam aos critérios de inclusão. Dentre os fatores identificados para maior hesitação frente à vacina contra COVID-19 destacaram-se o desconhecimento, baixo nível educacional, preocupação com efeitos colaterais e a segurança das vacinas, subestimação do risco de infecção após o recebimento da primeira dose da vacina, situação econômica desfavorável, pouco acesso à internet e tecnologias, entre outros fatores. Conclusão: Conhecer os fatores que causam hesitação entre os idosos com relação à vacina contra COVID-19 e os adjuvantes na luta contra a doença, para que haja um melhor direcionamento das ações no intuito de melhorar a cobertura vacinal e enfrentamento da covid19.(AU)

Objective: To map the scientific evidence related to the factors that influence the adherence of older adults to the COVID-19 vaccine. Method: Scoping review carried out in November 2021, in the following databases: Medical Literature Analysis and Retrieval System Online (MEDLINE via PubMed®), Excerpta Medica Data Base (Embase) via Elsevier; Institute for Scientific Information (ISI) Web of Knwedge (Web of Science); Latin American and Caribbean Health Sciences Literature (LILACS) and Spanish Bibliographic Index in Health Sciences (IBECS). Results and Discussion: 10 publications met the inclusion criteria. Among the factors identified for greater hesitancy towards the COVID-19 vaccine were lack of knowledge, low educational level, concern about side effects and vaccine safety, underestimation of the risk of infection after receiving the first dose of the vaccine, unfavorable economic situation, little access to the internet and technologies, among other factors. Conclusion: Knowing the factors that cause hesitation among the elderly in relation to the COVID-19 vaccine and the adjuvants in the fight against the disease, so that there is a better targeting of actions in order to improve vaccination coverage and coping with covid19.(AU)

Objetivo: Mapear la evidencia científica relacionada con los factores que influyen en la adherencia de los adultos mayores a la vacuna COVID-19. Método: Revisión de alcance realizada en noviembre de 2021, en las siguientes bases de datos: Medical Literature Analysis and Retrieval System Online (MEDLINE vía PubMed®), Excerpta Medica Data Base (Embase) vía Elsevier; Institute for Scientific Information (ISI) Web of Knwedge (Web of Science); Literatura Latinoamericana y del Caribe en Ciencias de la Salud (LILACS) e Índice Bibliográfico Español en Ciencias de la Salud (IBECS). Resultados y Discusión: 10 publicaciones cumplieron los criterios de inclusión. Entre los factores identificados para una mayor indecisión hacia la vacuna COVID-19 se encuentran el desconocimiento, el bajo nivel educativo, la preocupación por los efectos secundarios y la seguridad de la vacuna, la subestimación del riesgo de infección tras recibir la primera dosis de la vacuna, la situación económica desfavorable, el escaso acceso a internet y a las tecnologías, entre otros factores. Conclusión: Conocer los factores que causan dudas entre los ancianos en relación a la vacuna COVID-19 y los adyuvantes en la lucha contra la enfermedad, para que las acciones puedan ser mejor dirigidas para mejorar la cobertura vacunal y hacer frente a la COVID-19.(AU)

Family-focused contextual factors associated with lifestyle patterns in young children from two mother-offspring cohorts: GUSTO and EDEN.

BACKGROUND: Integrated patterns of energy balance-related behaviours of preschool children in Asia are sparse, with few comparative analyses. PURPOSE: Using cohorts in Singapore (GUSTO) and France (EDEN), we characterized lifestyle patterns of children and investigated their associations with family-focused contextual factors. METHODS: Ten behavioural variables related to child's diet, walking, outdoor play and screen time were ascertained by parental questionnaires at age 5-6 years. Using principal component analysis, sex-specific lifestyle patterns were derived independently for 630 GUSTO and 989 EDEN children. Contextual variables were organised into distal (family socio-economics, demographics), intermediate (parental health, lifestyle habits) and proximal (parent-child interaction factors) levels of influence and analysed with hierarchical linear regression. RESULTS: Three broadly similar lifestyle patterns were identified in both cohorts: "discretionary consumption and high screen time", "fruit, vegetables, and low screen time" and "high outdoor playtime and walking". The latter two patterns showed small differences between cohorts and sexes. The "discretionary consumption and high screen time" pattern was consistently similar in both cohorts; distal associated factors were lower maternal education (EDEN boys), no younger siblings (GUSTO boys) and Malay/Indian ethnicity (GUSTO), while intermediate and proximal associated factors in both cohorts and sexes were poor maternal diets during pregnancy, parents allowing high child control over food intake, snacking between meals and having television on while eating. CONCLUSIONS: Three similar lifestyle patterns were observed among preschool children in Singapore and France. There were more common associated proximal factors than distal ones. Cohort specific family-focused contextual factors likely reflect differences in social and cultural settings. Findings will aid development of strategies to improve child health.

Prospective associations between dietary patterns, screen and outdoor play times at 2 years and age at adiposity rebound: The EDEN mother-child cohort.

Although an early adiposity rebound (AR) is an established risk factor for later obesity, little is known regarding its determinants, especially modifiable ones. Using data from the French EDEN mother-child cohort (1903 children born in 2003-2006), we aimed to examine the association between diet and activity-related behaviors at 2 years of age and the timing of the AR. Two-year-old children (n = 1138) with parent-reported data on their foods/drinks intake, TV/DVD watching time, outdoor playtime, and with an estimated (via growth modelling) age at AR were included in the present study. Two dietary patterns, labelled 'Nutrient-dense foods' and 'Processed and fast foods', were identified in a previous study. Multivariable linear and logistic regression models were used to assess the association between dietary patterns and activity-related behaviors and, respectively, the age at AR (continuous) and the likelihood of having a very early AR (before 3.6 years for girls and 3.8 years for boys, i.e., below the 10th percentile of sex-specific distribution). A higher score on the 'Processed and fast foods' dietary pattern was associated with a higher likelihood of having a very early AR (OR = 1.23; 95% CI: 1.00 to 1.50). No significant association was observed between the 'Nutrient-dense foods' dietary pattern, TV/DVD watching and outdoor playing times and the timing of the AR. This finding emphasizes the importance of reducing nutrient-dense and processed foods from the early years of life, and provides further support for early interventions aimed at helping parents establish healthy eating habits for their growing child from the complementary period.

Nurses' knowledge, attitudes and practices regarding hepatitis b: an integrative review / Conocimentos, actitudes y prácticas de enfermeros en relación a la hepatitis b: una revisión integradora / Conhecimento, atitudes e práticas de enfermeiros sobre hepatite b: revisão integrativa

ABSTRACT Objective: to analyze, in the literature, the nurses' knowledge, attitudes and practices regarding Hepatitis B. Method: an integrative review, with search and selection conducted independently by peers, after electronic queries in the CINAHL, MEDLINE, SCOPUS, Web of Science, LILACS, BDENF and IBECS databases in January 2021. The sample consisted in 15 primary studies published with no time or language restrictions. Analysis and synthesis of the results were carried out in a descriptive manner. Results: limitations in knowledge, inconsistent attitudes and commonly neglected assistance-related practices were identified, related to prevention, immunization and biosafety measures, to risk management and to monitoring of symptoms and complications, which contributed to greater occupational exposure. Among the associated factors, low participation in permanent education activities, training level, working conditions, limitations in the availability of immunization tests (anti-HBs) and underreporting of health problems stood out. Conclusion: the knowledge, attitudes and practices developed by nurses in relation to Hepatitis B proved to be limited and inconsistent, which may result in greater occupational exposure, as well as exert a direct impact on vaccination coverage and occurrence of incidents.

RESUMEN Objetivo: analizar, en la literatura, los conocimientos, las actitudes y las prácticas de los enfermeros en relación a la Hepatitis B. Método: revisión integradora, en la cual la búsqueda y la selección fueron realizadas por pares y de manera independiente, luego de consultas electrónicas en las siguientes bases de datos: CINAHL, MEDLINE, SCOPUS, Web of Science, LILACS, BDENF e IBECS en enero de 2021. La muestra estuvo compuesta por 15 estudios primarios publicados sin restricciones de tiempo o de idioma. El análisis y la síntesis de los resultados se realizaron en forma descriptiva. Resultados: se identificaron limitaciones en el conocimiento, actitudes inconsistentes y prácticas asistenciales comúnmente desatendidas, relacionadas con las medidas de prevención, inmunización y bioseguridad, y con la administración del riesgo y el monitoreo de síntomas y complicaciones, que contribuyeron a una mayor exposición ocupacional. Entre los factores asociados, se destacaron los siguientes: escasa participación en actividades de educación permanente, el nivel de formación, las condiciones laborales, las limitaciones en la disponibilidad de pruebas de inmunización (anti-HBs) y la subnotificación de problemas de salud. Conclusión: los conocimientos, las actitudes y las prácticas desarrolladas por los enfermeros, en relación con la Hepatitis B, demostraron ser limitados e inconsistentes, con la posibilidad de derivar en una mayor exposición ocupacional, al igual que de afectar directamente la cobertura de las vacunas y la frecuencia de incidentes.

RESUMO Objetivo: analisar, na literatura, o conhecimento, as atitudes e as práticas de enfermeiros sobre hepatite B. Método: revisão integrativa, com busca e seleção realizadas por pares e de forma independente, após consulta eletrônica às bases de dados CINAHL, MEDLINE, SCOPUS, Web of Science, LILACS, BDENF e IBECS em janeiro de 2021. A amostra foi constituída por 15 estudos primários publicados sem restrição temporal ou de idioma. A análise e a síntese dos resultados ocorreram de forma descritiva. Resultados: foram identificadas limitações no conhecimento, atitudes inconsistentes e práticas assistenciais comumente negligenciadas, relacionadas às medidas de prevenção, imunização e biossegurança, ao gerenciamento de risco e monitoramento de sintomas e complicações, que contribuíram para uma maior exposição ocupacional. Dentre os fatores associados, destacaram-se a baixa participação em atividades de educação permanente, o nível de formação, as condições laborais, as limitações na disponibilização de testes de imunização (anti-HBs) e a subnotificação de agravos. Conclusão: o conhecimento, as atitudes e as práticas desenvolvidos por enfermeiros, relacionados à hepatite B, mostraram-se limitados e inconsistentes, podendo resultar na maior exposição ocupacional, assim como impactar diretamente a cobertura vacinal e a ocorrência de incidentes.

Family Socioecological Correlates of Lifestyle Patterns in Early Childhood: A Cross-Sectional Study from the EDEN Mother-Child Cohort.

Energy balance-related behaviors (EBRBs), i.e., diet, sedentary behavior, physical activity, and sleep, combine into lifestyle patterns, which we aim to identify in French preschoolers and analyze their family correlates within the framework of a comprehensive socioecological model. Parental questionnaires provided information about family characteristics and children's EBRBs for 978 5-year-olds of the EDEN cohort. We used principal component analysis to derive lifestyle patterns from EBRBs and hierarchical multivariable linear regressions to assess their associations with family socio-demographics, parent health/behaviors, and parent-child interactions. Analyses were stratified by sex. Of the three lifestyle patterns identified (unhealthy, healthy, and mixed), the mixed pattern differed the most between sexes. Lower parental education, suboptimal maternal diet, TV during meals, and later bedtime were associated with higher adherence to unhealthy patterns. Children cognitively stimulated at home and boys of mothers not employed adhered more to the healthy pattern. Older siblings (for girls) and higher engagement of parents in leisure-time physical activity (for boys) were related to greater adherence to mixed patterns. The identification of various correlates from multiple socioecological levels suggests that tackling the potentially synergistic effect of lifestyle patterns on health requires addressing processes relevant to the parent-child dimension and structural barriers parents may encounter.

Condiciones de salud de las personas sin hogar durante la pandemia de Covid-19 a la luz de la Teoría Ambiental de Nightingale / Health conditions of people on the streets during the COVID-19 pandemic in light of Nightingale's Environmental Theory

Objetivo: Analizar las condiciones de salud de las personas sin hogar, en el escenario de la COVID-19, a partir de los aportes de la Teoría Ambiental. Método: Se trata de un análisis teórico-reflexivo. Resultados: Fue posible elaborar dos categorías: la dicotomía entre vivir en la calle y supuestos de Nightingale; y la realidad de las personas que viven en la calle en tiempos de pandemia por COVID-19. La primera categoría abordó la diferencia entre lo que experimenta la gente en la calle y lo que dicen las suposiciones de Nightingale sobre las condiciones de salud. La segunda categoría mostró la inserción de estas personas en el contexto de las medidas de prevención. Consideraciones finales: Es de fundamental importancia discutir el acceso a las estrategias de prevención y promoción de la salud por parte de estas personas y promover acciones específicas para la realidad en la que viven. (AU)

Objective: The objective was to analyze the health conditions of people living on the streets, in the COVID-19 scenario, based on the contributions of the Environmental Theory. Methods: This is a theoretical-reflexive analysis. Results: Two categories were developed: The dichotomy between living on the street and the Nightingalian assumptions and; The reality of people living on the street in times of pandemic by COVID-19. The first category addressed the difference between what is experienced by people on the street and what the Nightingalian assumptions say about health conditions. The second category showed the insertion of these people in the context of prevention measures. Final considerations: It is of fundamental importance to discuss the access to prevention and health promotion strategies by these people and to promote specific actions for the reality in which they live. (AU)

Methylation Profile of miR-9-1 and miR-9-1/-9-3 as Potential Biomarkers of Diabetic Retinopathy.

AIMS: Analysis of the relationship between the methylation profile of miR-9-1 or miRs -9-1 / -9-3 and diabetic retinopathy. BACKGROUND: Diabetic Retinopathy (DR) is a frequent complication of Diabetes mellitus and it has a decisive impact on the quality of life, as it is one of the biggest causes of blindness in the adult population. Levels of microRNA-9 have been shown to be related to diabetes but little is known about its involvement with DR in humans. OBJECTIVE: To analyze the relationship between the methylation profile of miR-9-1 or miRs -9-1/-9-3 and DR. METHODS: 103 patients diagnosed with diabetes for 5 to 10 years were analyzed. The data were categorized according to clinical, biochemical, lifestyle and anthropometric parameters. DNA extracted from leukocyte samples was used to determine the methylation profile of miRs-9-1 and -9-3 using a specific methylation PCR assay. RESULTS: miR-9-1 methylation was related to diabetic retinopathy, indicating that methylation of this miR increases the chances of presenting retinopathy up to 5 times. In our analyses, diabetics with lower levels of creatinine and CRP showed significant reductions (99% and 97%) in presenting DR. Methylation of both miRs-9-1 and 9-3 methylated increases the chances of presenting DR by 8 times; in addition, a sedentary lifestyle can increase the risk for the same complication by up to 6 times. CONCLUSION: Our results suggest that both methylation of miR-9-1 and e miRs-9-1 / 9-3 favors DR in patients with diabetes in a period of 5 to 10 years of diagnosis.

Adesão à vacina contra hepatite B entre pessoas que vivem em situação de rua / Hepatitis B vaccine adherence among homeless people

RESUMO Objetivo estimar a adesão à vacina contra a hepatite B em pessoas que vivem em situação de rua. Métodos estudo transversal com 90 pessoas que vivem em situação de rua com a coleta de 5ml de sangue para a detecção do anticorpo contra o antígeno de superfície do vírus da hepatite B. Resultados do total, 89 (98,9%) foram vacinados com a primeira dose; desses, 45 (50,7%) apresentaram anticorpo contra o antígeno de superfície do vírus da hepatite B inferior a 10 UI/mL; 25 (53,3%) receberam a segunda dose da vacina contra a hepatite B e nove (45,8%) participantes receberam a terceira dose de vacina. Indivíduos que mantinham relação com ambos os gêneros tiveram maior chance de aderir ao esquema completo da vacina contra a hepatite B. Conclusão evidenciaram-se a baixa adesão à vacina contra a hepatite B e o número reduzido de participantes com anticorpos que conferem imunidade contra essa infecção.

ABSTRACT Objective to estimate the adherence to hepatitis B vaccine in homeless people. Methods a cross-sectional study with 90 homeless people, with the collection of 5 ml of blood for the detection of antibody against the surface antigen of the hepatitis B virus. Results of the total, 89 (98.9%) were vaccinated with the first dose; of these, 45 (50.7%) had antibodies against hepatitis B virus surface antigen lower than 10 IU/L; 25 (53.3%) received the second dose of hepatitis B vaccine, and nine (45.8%) participants received the third dose of vaccine. Individuals who were related to both genders were more likely to adhere to the full hepatitis B vaccine schedule. Conclusion the low adherence to hepatitis B vaccination and the small number of participants with antibodies that confer immunity against this infection were evidenced.

Clusters of diet, physical activity, television exposure and sleep habits and their association with adiposity in preschool children: the EDEN mother-child cohort.

BACKGROUND: Despite the growing interest in the relation between adiposity in children and different lifestyle clusters, few studies used a longitudinal design to examine a large range of behaviors in various contexts, in particular eating- and sleep-related routines, and few studies have examined these factors in young children. The objectives of this study were to identify clusters of boys and girls based on diet, sleep and activity-related behaviors and their family environment at 2 and 5 years of age, and to assess whether the clusters identified varied across maternal education levels and were associated with body fat at age 5. METHODS: At 2 and 5 years, respectively, 1436 and 1195 parents from the EDEN mother-child cohort completed a questionnaire including behavioral data. A latent class analysis aimed to uncover gender-specific behavioral clusters. Body fat percentage was estimated by anthropometric and bioelectrical impedance measurements. Association between cluster membership and body fat was assessed with mutivariable linear regression models. RESULTS: At 2 years, two clusters emerged that were essentially characterized by opposite eating habits. At 5 years, TV exposure was the most distinguishing feature, but the numbers and types of clusters differed by gender. An association between cluster membership and body fat was found only in girls at 5 years of age, with girls in the cluster defined by very high TV exposure and unfavorable mealtime habits (despite high outdoor playing and walking time) having the highest body fat. Girls whose mother had low educational attainment were more likely to be in this high-risk cluster. Girls who were on a cluster evolution path corresponding to the highest TV viewing time and the least favorable mealtime habits from 2 to 5 years of age had higher body fat at 5 years. CONCLUSIONS: Efforts to decrease TV time and improve mealtime routines may hold promise for preventing overweight in young children, especially girls growing up in disadvantaged families. These preventive efforts should start as early in life as possible, ideally before the age of two, and should be sustained over the preschool years.

Physical Activity Level Influences MTHFR Gene Methylation Profile in Diabetic Patients.

INTRODUCTION: MTHFR methylation status is associated with microvascular complications in diabetes, but the factors influencing this profile remain unknown. OBJECTIVE: The aim of this study was to evaluate the influence of physical activity level and nutritional status on the methylation profile of the MTHFR gene in patients with type 2 diabetes mellitus (T2DM). METHODS: A total of 111 patients, 43 men and 68 women diagnosed with DM (7.0 ± 2.3 years), answered the International Physical Activity Questionnaire (IPAQ) and underwent blood collection for biochemical analysis, DNA extraction, and MTHFR gene methylation profile determination. RESULT: The comparison of the methylation pattern showed that the partially methylated profile predominates in the insufficiently active group (85%), which does not occur in the sufficiently active group (54%) (p = 0.012). No differences were found in the nutritional status comparison. Logistic regression including overweight, waist circumference, gender, age, time of DM, hypertension, dyslipidemia, smoking, alcoholism, and family DM revealed that the association of the level of physical activity with methylation profile proved to be independent of these confounding variables. Considering the partially methylated profile as a result, being physically inactive favors the partially methylated MTHFR pattern in patients with DM. CONCLUSION: We concluded that insufficient physical activity is associated with partially methylated pattern of MTHFR promoter.

The MTHFR promoter hypermethylation pattern associated with the A1298C polymorphism influences lipid parameters and glycemic control in diabetic patients.

BACKGROUND: Polymorphisms in the gene encoding methylenetetrahydrofolate reductase (MTHFR) have been investigated as risk factors for microvascular complications of diabetes; however, simultaneous analysis of these polymorphisms and the methylation pattern of the gene has never been conducted. The objective of the present study was to evaluate the simultaneous relationship between MTHFR methylation and MTHFR C6TT7 and A1298C polymorphisms with metabolic, inflammatory and oxidative stress parameters related to microvascular complications, diabetic retinopathy (DR) and diabetic nephropathy (DN) in diabetic patients. METHODS: A total of 107 patients who were diagnosed in the previous 5 to 10 years were recruited and divided into groups with complications (DR and/or DN) or without complications. Methylation analysis of the gene promoter was conducted using the MSP technique, and analysis of the A1298C and C677T polymorphisms was conducted using the restriction fragment length polymorphism (RFLP) assay. Microalbuminuria was determined using urine samples, and other analytes of interest were determined in blood samples using commercial kits. The Mann-Whitney and Chi square statistical tests were used with significance considered at p < 0.05. RESULTS: Subjects with a hypermethylated profile and the 1298AA genotype showed the highest levels of blood glucose (p = 0.03), total cholesterol (p = 0.0001) and LDL cholesterol (p = 0.0006). The same profile was associated with higher levels of HbA1c (p = 0.025), glycemia (p = 0.04) and total cholesterol (0.004) in the control group and total cholesterol (p = 0.005) and LDL cholesterol (p = 0.002) in the complications group. Serum creatinine was higher in subjects in the hypermethylated group with the genotype 677CC only in the control group (p = 0.0020). The methylated profile in presence of 677CC + 1298AA and the 677CT/TT +1298AA haplotypes showed higher levels of total cholesterol (p = 0.0024; 0.0031) and LDL cholesterol (p = 0.0060; 0.0125) than 1298AC/CC carriers. The fasting glycemia was higher in hypermethylated profile in the presence of 677CC/1298AA haplotype (p = 0.0077). CONCLUSION: The hypermethylated methylation profile associated with the 1298AA genotype appeared to be connected to higher values of glycemia, total cholesterol and LDL cholesterol.

The importance of histopathology in the diagnosis of isolated renal sarcoidosis: a case report / A importância da histopatologia no diagnóstico de sarcoidose renal isolada: um relato de caso

ABSTRACT Introduction: Sarcoidosis is a systemic inflammatory disease of unknown etiology, characterized by the presence of non-caseating granulomas in several organs; renal impairment alone is a rare condition. When it affects the kidneys, the most prevalent manifestations are hypercalcemia and hypercalciuria. This paper aims to address the topic of renal sarcoidosis, by means of a case report, and reinstate the importance of histopathology in its diagnosis. Methods: The data came from an observational clinical study with a qualitative approach, through an interview with the renal sarcoidosis patient and data from her medical records. Case report: Patient D.M.S., 50 years old, Caucasian, presented with reddish eyes and body pains lasting for fifteen days as first manifestations of the disease. Upon kidney ultrasound scan, we found renal parenchymal nephropathy. Serial renal function and metabolic tests reported anemia and progressive urea and creatinine changes, as well as hypercalcemia and hypercalciuria, confirming acute kidney failure (AKF). A histopathological examination suggested the diagnosis, which was confirmed by clinical, laboratory and histopathological data. There was therapeutic resolution after steroid therapy. Discussion: The symptomatology of sarcoidosis is diverse and often non-specific. Renal manifestation, which usually occurs after organ involvement, is present in less than 5% of patients, and about 1% to 2% of these patients may develop AKF. Conclusions: The use of histopathology together with clinical and laboratory data to diagnose isolated renal sarcoidosis, rule out other etiologies and introduce early treatment is of paramount importance.

RESUMO Introdução: A sarcoidose é uma doença inflamatória sistêmica de etiologia desconhecida caracterizada pela presença de granulomas não caseosos em diversos órgãos, sendo raro o comprometimento puramente renal. Quando acomete os rins, as manifestações mais prevalentes são hipercalcemia e hipercalciúria. Este trabalho objetiva abordar o tema sarcoidose renal, por meio de relato de caso, e reafirmar a importância da histopatologia no diagnóstico. Métodos: Os dados foram obtidos por estudo clínico observacional com abordagem qualitativa, por meio de entrevista com a paciente portadora de sarcoidose renal e dados de seu prontuário médico. Relato de caso: Paciente D.M.S., 50 anos, caucasiana, apresentou como primeiras manifestações da doença olhos avermelhados e dores no corpo com duração de quinze dias. Em ultrassonografia renal, foi constatada nefropatia parenquimatosa renal bilateral. Testes seriados de função e metabolismo renal relataram anemia e alteração progressiva de ureia e creatinina, além de hipercalcemia e hipercalciúria, constatando quadro de insuficiência renal aguda (IRA). Foi indicado exame histopatológico que sugeriu o diagnóstico, confirmado pelos dados clínicos, laboratoriais e histopatológico somados. Houve resolução terapêutica após corticoterapia. Discussão: A sintomatologia da sarcoidose é diversificada e, muitas vezes, inespecífica. A manifestação renal, que ocorre geralmente após o acometimento de outros órgãos, está presente em menos de 5% dos pacientes, e cerca de 1% a 2% destes podem desenvolver IRA. Conclusões: É de suma importância o auxílio da histopatologia somada aos dados clínicos e laboratoriais para diagnóstico de sarcoidose renal isolada, exclusão de outras etiologias e introdução de terapêutica precoce.

The importance of histopathology in the diagnosis of isolated renal sarcoidosis: a case report.

INTRODUCTION: Sarcoidosis is a systemic inflammatory disease of unknown etiology, characterized by the presence of non-caseating granulomas in several organs; renal impairment alone is a rare condition. When it affects the kidneys, the most prevalent manifestations are hypercalcemia and hypercalciuria. This paper aims to address the topic of renal sarcoidosis, by means of a case report, and reinstate the importance of histopathology in its diagnosis. METHODS: The data came from an observational clinical study with a qualitative approach, through an interview with the renal sarcoidosis patient and data from her medical records. CASE REPORT: Patient D.M.S., 50 years old, Caucasian, presented with reddish eyes and body pains lasting for fifteen days as first manifestations of the disease. Upon kidney ultrasound scan, we found renal parenchymal nephropathy. Serial renal function and metabolic tests reported anemia and progressive urea and creatinine changes, as well as hypercalcemia and hypercalciuria, confirming acute kidney failure (AKF). A histopathological examination suggested the diagnosis, which was confirmed by clinical, laboratory and histopathological data. There was therapeutic resolution after steroid therapy. DISCUSSION: The symptomatology of sarcoidosis is diverse and often non-specific. Renal manifestation, which usually occurs after organ involvement, is present in less than 5% of patients, and about 1% to 2% of these patients may develop AKF. CONCLUSIONS: The use of histopathology together with clinical and laboratory data to diagnose isolated renal sarcoidosis, rule out other etiologies and introduce early treatment is of paramount importance.

Perspectiva da enfermagem no processo de doação de órgãos e tecidos: relato de experiência / Nursing perspective in organ donation process: experience report

Objetivo: descrever a experiência de acadêmicas voluntárias na perspectiva da atuação da equipe de enfermagem na assistência para reconhecimento, manutenção e captação de órgãos e tecidos viáveis para captação e transplantes. Metodologia: trata-se de um relato de experiência durante estágio extra curricularna Organização de Procura de Órgãos e Tecidos de um município no estado do Piauí, no período de maio à agosto de 2017. Resultados: as vivências foram desenvolvidas nos setores críticos de hospitais estaduais e municipais como salas de estabilização, unidades semi-intensiva e intensiva, salas de recuperação pós anestésica e ambiente extra hospitalar nas Unidades de Pronto Atendimento e nos serviços de verificação de óbito e instituto médico legal. Conclusão: ao fim da vivência foi possível adquirir conhecimentos e experiências acerca da atuação da equipe de enfermagem em todo o processo de doação de órgãos, assim como reconhecimento da importância de divulgação e sensibilização sobre a temática para o meio acadêmico e a comunidade.

Objective: To describe the experience of academic volunteers in the perspective of the nursing team role in assisting the recognition, maintenance and abstraction of viable organs and tissues for abstraction and transplantation. Methodology: it is an experience report during an extracurricular internship at the Search of Organs and Tissues Organization of a Piaui city, from May to August 2017. Results: Experiences were performed at the critical sectors of state and municipal hospitals such as stabilization rooms, semi-intensive and intensive units, post-anesthetic recovery rooms and outpatient settings of the Emergency Care Units and services of death verification and legal medical institute. Conclusion: At the end of the experience, it was possible to acquire knowledge and experiences about the nursing team performance at the organ donation process, as well as recognizing the importance of dissemination and awareness at the subject for the academic environment and the community.

Hypermethylation in the promoter of the MTHFR gene is associated with diabetic complications and biochemical indicators.

BACKGROUND: DNA methylation is an epigenetic mechanism for regulating the transcription of many genes and has been linked to the development of various diseases. A promising gene to investigate is methylenetetrahydrofolate reductase (MTHFR), since the enzyme methylenetetrahydrofolate reductase (MTHFR) promotes methyl radical synthesis in the homocysteine cycle and can provide methyl groups for DNA methylation. In addition, several studies have correlated gene polymorphisms of this enzyme with a greater risk of diabetes, but little is known regarding the relationship between epigenetic changes in this gene and diabetes and its complications. The aim of this study was to investigate the relationship between methylation profile in the MTHFR gene promoter and biochemical, inflammatory and oxidative stress markers in individuals with type 2 diabetes (T2DM) who have been diagnosed for 5-10 years with or without diabetic retinopathy (DR) and nephropathy (DN). METHODS: Specific PCR for methylation (MSP) was used to analyze MTHFR methylation profile in leucocytes DNA. Biochemical markers (glycemia, glycated hemoglobin, total cholesterol, LDL, HDL, triglycerides, serum creatinine), inflammatory markers (C-reactive protein and alpha-1 acid glycoprotein) and oxidative stress (total antioxidant and malonaldehyde) were determined in peripheric blood samples and microalbuminuria in 24 h urine samples. The X2 and Mann-Whitney statistical tests were performed and p < 0.05 were considered significant. RESULTS: The hypermethylated profile was most frequently observed in individuals with retinopathy (p < 0.01) and was associated with higher total cholesterol and LDL levels (p = 0.0046, 0.0267, respectively). Individuals with DN and hypermethylated profiles had higher levels of alpha-1 acid glycoprotein (p = 0.0080) and total antioxidant capacity (p = 0.0169) compared to subjects without complications. CONCLUSIONS: Hypermethylation in the promoter of the MTHFR gene is associated with the occurrence of DR and with biochemical, inflammatory and oxidative stress parameters in the context of chronic complications.

Avaliação dos benefícios auditivos, quanto ao uso de prótese auditiva em indivíduos idosos / Evaluation of hearing benefits as to the use of hearing prosthesis in elderly individuals / Evaluación de los beneficios auditivos en cuanto al uso de prótesis auditivas en personas mayores

A presbiacusia é um processo natural do envelhecimento. O uso de próteses auditivas permite a reabilitação do idoso, de modo a diminuir os impactos psicossociais. Participaram do estudo 27 idosos, que responderam ao questionário Hearing Handicap Inventory for the Elderly Screening Version (HHIE-S) ao receberem a prótese, e após três meses de uso. A diferença entre os escores pré- e pós-adaptação foi significante. Houve uma redução significativa do handicap auditivo após o uso da prótese por três meses.

Presbycusis is a natural aging process. The use of hearing aids allows the rehabilitation of the elderly, in order to reduce the psychosocial impacts. The study included 27 elderly people who responded to the hearing handicap inventory for the elderly screening version (HHIE-S) when they received the prosthesis and after three months of use. The difference between the pre- and post-adjustment scores was significant. There was a significant reduction of the auditory handicap after the use of the prosthesis for three months.

La presbiacusia es un proceso natural del envejecimiento. El uso de prótesis auditivas permite la rehabilitación del anciano, para disminuir los impactos psicosociales. En el estudio participaron 27 ancianos, que respondieron al cuestionario Hearing Handicap Inventory for the Elderly Screening Version (HHIE-S) al recibir la prótesis, y después de tres meses de uso. La diferencia entre los puntajes pre y postadaptación fue significativa. Hubo una reducción significativa del handicap auditivo después del uso de la prótesis por tres meses.

Sobre a Educação Inclusiva e suas Referências Discursivas / Inclusive Education and its Discursive References / Sobre la Educación Incusiva y sus Referencias / Discursivas À Propos de L'éducation Inclusive et ses References Discursifs

O artigo propõe-se a discutir os fundamentos da educação inclusiva enquanto práxis, destacando suas referências discursivas. Partindo das primeiras articulações entre a medicina e a educação respaldadas pela clínica, são destacadas as análises de Michel Foucault e Pierre Bourdieu sobre o biopoder e os efeitos de exclusão advindos do campo educacional para, em seguida, discutir a nova aliança da educação com o discurso médico, agora pelo viés das políticas públicas. Por fim, a partir de suas inegáveis contribuições teóricas sobre a clínica com crianças e de um longo histórico de experiências institucionais bem-sucedidas, aponta-se a Psicanálise como uma referência discursiva outra para a educação inclusiva contemporânea, possibilitando o resgate do sujeito e uma nova articulação entre o tratar e o educar.

The article proposes to discuss the foundations of inclusive education as a praxis, highlighting its discursive references. From the first articulations between medicine and education endorsed by the clinic, the analyses of Michel Foucault and Pierre Bourdieu on biopower and the effects of exclusion from the field of education are highlighted, and then discuss the new alliance of education with medical speech, now by the bias of public policies. Finally, from its undeniable theoretical contributions on the clinic with children and from a long history of successful institutional experiences, Psychoanalysis is pointed as a discursive reference for contemporary inclusive education, allowing the subject to be rescued and a new articulation between treating and educating.

Este trabajo propone la discusión de los fundamentos de la educación inclusiva como praxis, resaltando sus referencias discursivas. Partiendo de las primeras articulaciones entre la medicina y la educación apoyadas por la clínica, son resaltados los análisis de Michel Foucault y Pierre Bourdieu sobre el biopoder y los efectos de exclusión provenientes del campo educacional para, en seguida, discutir la nueva alianza de la educación con el discurso médico, ahora por el sesgo de las políticas públicas. Por fin, desde sus innegables contribuciones teóricas sobre la clínica con niños y de un largo histórico de experiencias institucionales exitosas, se indica la Psicoanálisis como una referencia discursiva para la educación inclusiva contemporánea, posibilitando el rescate del sujeto y una nueva articulación entre el tratar y el educar.

L'article propose examiner les fondements de l'éducation inclusive comme pratique, mettant en évidence ses références discursives. Dès les premières articulations entre la médecine et l'éducation, soutenue par la clinique, nous avons mis en évidence l'analyse de Michel Foucault et Pierre Bourdieu sur la biopouvoir et les effets de l'exclusion du champ éducatif pour, ensuite, discuter la nouvelle alliance de l'éducation avec le discours médical, maintenant par le biais des politiques publiques. Enfin, à partir de les apports théoriques indéniables de la Psychanalyse sur la clinique avec les enfants et d'une longue histoire des expériences institutionnelles prospères, c'est possible voir la Psychanalyse comme une autre référence discursive, pour l'éducation inclusive contemporaine, en permettant la rescousse du sujet et une nouvelle articulation entre le soin et l'éducation.