Backbone and sidechain NMR assignments of residues 1-81 from yeast Sis1 in complex with an Hsp70 C-terminal EEVD peptide.

Molecular chaperones aid proteins to fold and assemble without modifying their final structure, requiring, in several folding processes, the interplay between members of the Hsp70 and Hsp40 families. Here, we report the NMR chemical shift assignments for 1 H, 15 N, and 13 C nuclei of the backbone and side chains of the J-domain of the class B Hsp40 from Saccharomyces cerevisiae, Sis1, complexed with the C-terminal EEVD motif of Hsp70. The data revealed information on the structure and backbone dynamics that add significantly to the understanding of the J-domain-Hsp70-EEVD mechanism of interaction.

Sorghum bicolor SbHSP110 has an elongated shape and is able of protecting against aggregation and replacing human HSPH1/HSP110 in refolding and disaggregation assays.

Perturbations in the native structure, often caused by stressing cellular conditions, not only impair protein function but also lead to the formation of aggregates, which can accumulate in the cell leading to harmful effects. Some organisms, such as plants, express the molecular chaperone HSP100 (homologous to HSP104 from yeast), which has the remarkable capacity to disaggregate and reactivate proteins. Recently, studies with animal cells, which lack a canonical HSP100, have identified the involvement of a distinct system composed of HSP70/HSP40 that needs the assistance of HSP110 to efficiently perform protein breakdown. As sessile plants experience stressful conditions more severe than those experienced by animals, we asked whether a plant HSP110 could also play a role in collaborating with HSP70/HSP40 in a system that increases the efficiency of disaggregation. Thus, the gene for a putative HSP110 from the cereal Sorghum bicolor was cloned and the protein, named SbHSP110, purified. For comparison purposes, human HsHSP110 (HSPH1/HSP105) was also purified and investigated in parallel. First, a combination of spectroscopic and hydrodynamic techniques was used for the characterization of the conformation and stability of recombinant SbHSP110, which was produced folded. Second, small-angle X-ray scattering and combined predictors of protein structure indicated that SbHSP110 and HsHSP110 have similar conformations. Then, the chaperone activities, which included protection against aggregation, refolding, and reactivation, were investigated, showing that SbHSP110 and HsHSP110 have similar functional activities. Altogether, the results add to the structure/function relationship study of HSP110s and support the hypothesis that plants have multiple strategies to act upon the reactivation of protein aggregates.

Microneedling with cutaneous delivery of topical agents for the treatment of melasma: A systematic review.

BACKGROUND: Melasma is an acquired hyperpigmentation disorder. Microneedling is an alternative treatment for melasma especially by improving penetration of pharmacological agents into the skin. OBJECTIVE: The main objective of this review was to systematize and analyze available evidence on the efficacy and safety of microneedling alone or associated with topical agents in reducing skin stains and improving melasma-related quality of life in adult patients. METHODS: Only randomized clinical trials were included. The following databases were consulted: MEDLINE, Embase, Cochrane, and the gray literature. The Cochrane risk-of-bias tool for randomized trials (RoB 2.0) was used to assess risk of bias. RESULTS: The search retrieved 719 records and seven studies were included. A total of 368 participants (96.19% women) were evaluated. Two studies were split-face. Most of the studies evaluated microneedling associated with tranexamic acid. High risk of bias was presented by most studies, especially in the safety outcome. A significant decrease was observed in the MASI, mMASI, or hemi-MASI scores, regardless of the topical agents associated. Meta-analysis was not possible due to the heterogeneity of the studies. CONCLUSION: Based on the results of this review, microneedling can, in association with topical agents or isolated, be used safely in the treatment of melasma in the clinical practice, obtaining results on reduction of stain severity and improvement of patients' quality of life.

Binding of SARS-CoV-2 protein ORF9b to mitochondrial translocase TOM70 prevents its interaction with chaperone HSP90.

The emergence of the COVID-19 pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), remains a great threat to global health. ORF9b, an important accessory protein of SARS-CoV-2, plays a critical role in the viral host interaction, targeting TOM70, a member of the mitochondrial translocase of the outer membrane complex. The assembly between ORF9b and TOM70 is implicated in disrupting mitochondrial antiviral signaling, leading to immune evasion. We describe the expression, purification, and characterization of ORF9b alone or coexpressed with the cytosolic domain of human TOM70 in E. coli. ORF9b has 97 residues and was purified as a homodimer with an molecular mass of 22 kDa as determined by SEC-MALS. Circular dichroism experiments showed that Orf9b alone exhibits a random conformation. The ORF9b-TOM70 complex characterized by CD and differential scanning calorimetry showed that the complex is folded and more thermally stable than free TOM70, indicating strong binding. Importantly, protein-protein interaction assays demonstrated that full-length human Hsp90 is capable of binding to free TOM70 but not to the ORF9b-TOM70 complex. To narrow down the nature of this inhibition, the isolated C-terminal domain of Hsp90 was also tested. These results were used to build a model of the mechanism of inhibition, in which ORF9b efficiently targets two sites of interaction between TOM70 and Hsp90. The findings showed that ORF9b complexed with TOM70 prevents the interaction with Hsp90, and this is one major explanation for SARS-CoV-2 evasion of host innate immunity via the inhibition of the interferon activation pathway.

Insights into the structure and function of the C-terminus of SGTs (small glutamine-rich TPR-containing proteins): A study of the Aedes aegypti homolog.

SGTs (small glutamine-rich TPR-containing proteins) are dimeric proteins that belong to the class of co-chaperones characterized by the presence of TPR domains (containing tetratricopeptide repeats). Human (SGTA) and yeast (Sgt2) SGTs are characterized by three distinct domains: an N-terminal dimerization domain, a central TPR-domain important for binding to other proteins (chaperones included) and a C-terminal domain involved in hydrophobic interactions. Both these SGTs are involved in the cellular PQC (protein quality control) system, as they interact with chaperones and have functions that aid stress recovery. However, there are differences between them, such as structural features and binding specificities, that could be better understood if other orthologous proteins were studied. Therefore, we produced and characterized a putative SGT protein, designated AaSGT, from the mosquito Aedes aegypti, which is a vector of several diseases, such as dengue and Zika. The protein was produced as a folded dimer which was stable up to 40 °C and was capable of binding to AaHsp90 and fully protecting a model protein, α-synuclein, from aggregation. The conformation of AaSGT was investigated by biophysical tools and small angle X-ray scattering, which showed that the protein had an elongated conformation and that its C-terminal domain was mainly disordered. The results with a C-terminal deletion mutant supported these observations. Altogether, these results are consistent with those from other functional SGT proteins and add to the understanding of the PQC system in Aedes aegypti, an important aim that may help to develop inhibitory strategies against this vector of neglected diseases.

On the structure and function of Sorghum bicolor CHIP (carboxyl terminus of Hsc70-interacting protein): A link between chaperone and proteasome systems.

The co-chaperone CHIP (carboxy terminus of Hsc70 interacting protein) is very important for many cell activities since it regulates the ubiquitination of substrates targeted for proteasomal degradation. However, information on the structure-function relationship of CHIP from plants and how it interacts and ubiquitinates other plant chaperones is still needed. For that, the CHIP ortholog from Sorghum bicolor (SbCHIP) was identified and studied in detail. SbCHIP was purified and produced folded and pure, being capable of keeping its structural conformation up to 42 °C, indicating that cellular function is maintained even in a hot environment. Also, SbCHIP was able to bind plant Hsp70 and Hsp90 with high affinity and interact with E2 enzymes, performing E3 ligase activity. The data allowed to reveal the pattern of plant Hsp70 and Hsp90 ubiquitination and described which plant E2 enzymes are likely involved in SbCHIP-mediated ubiquitination. Aditionally, we obtained information on the SbCHIP conformation, showing that it is a non-globular symmetric dimer and allowing to put forward a model for the interaction of SbCHIP with chaperones and E2 enzymes that suggests a mechanism of ubiquitination. Altogether, the results presented here are useful additions to the study of protein folding and degradation in plants.

Heat shock protein 90 kDa (Hsp90) from Aedes aegypti has an open conformation and is expressed under heat stress.

Cellular proteostasis is maintained by a system consisting of molecular chaperones, heat shock proteins (Hsps) and proteins involved with degradation. Among the proteins that play important roles in the function of this system is Hsp90, which acts as a node of this network, interacting with at least 10% of the proteome. Hsp90 is ATP-dependent, participates in critical cell events and protein maturation and interacts with large numbers of co-chaperones. The study of Hsp90 orthologs is justified by their differences in ATPase activity levels and conformational changes caused by Hsp90 interaction with nucleotides. This study reports the characterization of Hsp90 from Aedes aegypti, a vector of several diseases in many regions of the planet. Aedes aegypti Hsp90, AaHsp90, was cloned, purified and characterized for its ATPase and chaperone activities and structural conformation. These parameters indicate that it has the characteristics of eukaryotic Hsp90s and resembles orthologs from yeast rather than from human. Finally, constitutive and increased stress expression in Aedes cells was confirmed. Taken together, the results presented here help to understand the relationship between structure and function in the Hsp90 family and have strong potential to form the basis for studies on the network of chaperone and Hsps in Aedes.

Solution NMR investigation on the structure and function of the isolated J-domain from Sis1: Evidence of transient inter-domain interactions in the full-length protein.

J-domain/Hsp40 proteins cooperate in aiding with folding in the cell by binding partially folded client proteins and delivering them to be folded by Hsp70. The delivery occurs concomitantly to the stimulation of the ATPase activity of Hsp70 via the N-terminally located J-domain. Although several lines of investigation have been used to study J-domain proteins, the presence of highly flexible domains (G/F- and G/M-rich) hold up obtaining a detailed full-length structure. In this work, we present the high-resolution structure of the J-domain and the N-terminal part of the G/F domain of Sis1, solved by NMR, and used chemical-shift perturbation approaches to further study the structure/function relationship of the Sis1/Hsp70 interaction. When the J-domain was compared to the full-length protein and to a G/M domain deletion mutant, an internal interaction patch formed by hydrophobic and positively charged residues (V2, D9, R27, T39, F52 and R73) was identified. Curiously, the same patch is protected by internal contacts in the full-length protein and, in combination with the loop containing the conserved HPD motif, participates in the interaction with Hsp70. Combined, these results suggest that the J-domain in the full-length Sis1 is in a transient intermediate conformation, in which its interacting patch is protected and, at the same time, also in a favorable condition to bind Hsp70, facilitating the interaction between the two proteins. Finally, 1D NMR experiments showed that the addition of ATP is followed by the disruption of the J-domain/Hsp70 complex, a necessary step for aiding the folding of the client protein.

Revealing the interaction mode of the highly flexible Sorghum bicolor Hsp70/Hsp90 organizing protein (Hop): A conserved carboxylate clamp confers high affinity binding to Hsp90.

Proteostasis is dependent on the Hsp70/Hsp90 system (the two chaperones and their co-chaperones). Of these, Hop (Hsp70/Hsp90 organizing protein), also known as Sti1, forms an important scaffold to simultaneously binding to both Hsp70 and Hsp90. Hop/Sti1 has been implicated in several disease states, for instance cancer and transmissible spongiform encephalopathies. Therefore, human and yeast homologous have been better studied and information on plant homologous is still limited, even though plants are continuously exposed to environmental stress. Particularly important is the study of crops that are relevant for agriculture, such as Sorghum bicolor, a C4 grass that is among the five most important cereals and is considered as a bioenergy feedstock. To increase the knowledge on plant chaperones, the hop putative gene for Sorghum bicolor was cloned and the biophysical and structural characterization of the protein was done by cross-linking coupled to mass spectroscopy, small angle X-ray scattering and structural modeling. Additionally, the binding to a peptide EEVD motif, which is present in both Hsp70 and Hsp90, was studied by isothermal titration calorimetry and hydrogen/deuterium exchange and the interaction pattern structurally modeled. The results indicate SbHop as a highly flexible, mainly alpha-helical monomer consisting of nine tetratricopeptide repeat domains, of which one confers high affinity binding to Hsp90 through a conserved carboxylate clamp. Moreover, the present insights into the conserved interactions formed between Hop and Hsp90 can help to design strategies for potential therapeutic approaches for the diseases in which Hop has been implicated.

Studies on the effect of the J-domain on the substrate binding domain (SBD) of Hsp70 using a chimeric human J-SBD polypeptide.

DnaJ/Hsp40 chaperones deliver unfolded proteins and stimulate the ATPase activity of DnaK/Hsp70 via their J-domain. However, the interaction is transient, creating a challenge for detailed analysis. We investigated whether it would be possible to gain further understanding of this interaction by engineering a chimeric polypeptide where the J-domain of Hsp40 was covalently attached to the substrate binding domain (SBD) of Hsp70 by a flexible linker. The rationale is to increase the proximity between the interacting partners to promote their natural interaction and facilitate the characterization of the interaction. The resulting chimera, termed J-SBD, was properly folded and had properties not present in the full-length Hsp70 or in the SBD alone, for instance a higher protective effect against aggregation and being a monomer. Substrate binding also appear to exceed that of SBD alone as revealed by a decreased binding to bis-ANS, a probe for hydrophobic patches. This hypothesis is supported by the structural model created by small angle X-ray scattering, suggesting that the lid subdomain (SBDα) is partially opened in the J-SBD. Collectively, our results suggest a model in which J-domain binding may shift the Hsp70 equilibrium towards the monomer state, exposing hydrophobic sites prone to substrate accommodation.

Initial characterization of newly identified mitochondrial and chloroplast small HSPs from sugarcane shows that these chaperones have different oligomerization states and substrate specificities.

Chaperones belonging to the small heat shock protein (sHSP) family are ubiquitous and exhibit elevated expression under stresses conditions to protect proteins against aggregation, thereby contributing to the stress tolerance of the organism. Tropical plants are constantly exposed to high temperatures, and the mechanisms by which these plants tolerate heat stress are of foremost importance to basic science as well as applied agrobiotechnology. Therefore, this study aims to characterize sHSPs from different organelles from sugarcane, an important crop that is associated with sugar and bioenergy production. An expression sequence tag database of sugarcane was searched, and sHsp genes of mitochondrial and chloroplast organelles were selected and cloned. The proteins were expressed in Escherichia coli and isolated and purified by two chromatographic steps with high purity as single species. Circular dichroism and fluorescence spectroscopy showed that both proteins were purified in their folded states with a predominant ß-sheet secondary structure. Determination of the molecular weight, diffusion coefficient and Stokes radius parameters showed that both chaperones form large spherical-like oligomers in solution. The two sHSPs had different oligomeric states and substrate specificities. The mitochondrial sHSP was a 20-mer with ability to protect model substrates that differ from that of the 16-meric sHSP from chloroplasts. These results indicate that both sHSPs are key agents to protect against stress confirming the importance of the great diversity of sHSP chaperones in plants for homeostasis maintenance. Moreover, to our knowledge, this is the first report about small HSPs from sugarcane organelles.

1H, 15N and 13C resonance assignments of the J-domain of co-chaperone Sis1 from Saccharomyces cerevisiae.

Protein folding in the cell is usually aided by molecular chaperones, from which the Hsp70 (Hsp = heat shock protein) family has many important roles, such as aiding nascent folding and participating in translocation. Hsp70 has ATPase activity which is stimulated by binding to the J-domain present in co-chaperones from the Hsp40 family. Hsp40s have many functions, as for instance the binding to partially folded proteins to be delivered to Hsp70. However, the presence of the J-domain characterizes Hsp40s or, by this reason, as J-proteins. The J-domain alone can stimulate Hsp70 ATPase activity. Apparently, it also maintains the same conformation as in the whole protein although structural information on full J-proteins is still missing. This work reports the 1H, 15N and 13C resonance assignments of the J-domain of a Hsp40 from Saccharomyces cerevisiae, named Sis1. Secondary structure and order parameter prediction from chemical shifts are also reported. Altogether, the data show that Sis1 J-domain is highly structured and predominantly formed by α-helices, results that are in very good agreement with those previously reported for the crystallographic structure.

A problemática de suicídio, numa visão winnicottiana: relato de um caso clínico e sua supervisão / The complexity of suicide, following Winnicott's vision: an account of a clinical case and its supervision

O presente artigo consiste no relato de um caso clínico envolvendo tentativas de suicídio e tratado psicanaliticamente, segundo a perspectiva winnicottiana. Num segundo momento, relata a supervisão do mesmo caso, articulando o conjunto de sintomas à história de vida da paciente, propondo-lhe um diagnóstico psicopatológico e analisando a terapia psicanalítica realizada até então. Com isso, pretende-se lançar alguma luz sobre a problemática envolvendo tentativas de suicídio e a sua terapêutica.

This article consists of an account of a clinical case involving suicide attempts, which was psychoanalytically treated, following Winnicott's perspective. In a second moment, it relates the supervision of the same case, articulating its symptoms to the patient's life history, proposes a psychopathological diagnosis to it e analyses the psychoanalytical therapy, carried out up to then. The purpose is to illuminate the complexity involving suicide attempts and its therapeutics.

From Conformation to Interaction: Techniques to Explore the Hsp70/Hsp90 Network.

Proteins participate in almost every cell physiological function, and to do so, they need to reach a state that allows its function by folding and/or exposing surfaces of interactions. Spontaneous folding in the cell is in general hindered by its crowded and viscous environment, which favors misfolding and nonspecific and deleterious self-interactions. To overcome this, cells have a system, in which Hsp70 and Hsp90 play a central role to aid protein folding and avoid misfolding. The topics of this review include the biophysical tools used for monitoring protein-ligand and protein-protein interactions and also some important results related to the study of molecular chaperones and heat shock proteins (Hsp), with a focus on the Hsp70/Hsp90 network. The biophysical tools and their use to probe the conformation and interaction of Hsp70 and Hsp90 are briefly reviewed.

Cooperative substrate binding by a diguanylate cyclase.

XAC0610, from Xanthomonas citri subsp. citri, is a large multi-domain protein containing one GAF (cGMP-specific phosphodiesterases, adenylyl cyclases and FhlA) domain, four PAS (Per-Arnt-Sim) domains and one GGDEF domain. This protein has a demonstrable in vivo and in vitro diguanylate cyclase (DGC) activity that leads to the production of cyclic di-GMP (c-di-GMP), a ubiquitous bacterial signaling molecule. Analysis of a XacΔ0610 knockout strain revealed that XAC0610 plays a role in the regulation of Xac motility and resistance to H2O2. Site-directed mutagenesis of a conserved DGC lysine residue (Lys759 in XAC0610) resulted in a severe reduction in XAC0610 DGC activity. Furthermore, experimental and in silico analyses suggest that XAC0610 is not subject to allosteric product inhibition, a common regulatory mechanism for DGC activity control. Instead, steady-state kinetics of XAC0610 DGC activity revealed a positive cooperative effect of the GTP substrate with a dissociation constant for the binding of the first GTP molecule (K1) approximately 5× greater than the dissociation constant for the binding of the second GTP molecule (K2). We present a general kinetics scheme that should be used when analyzing DGC kinetics data and propose that cooperative GTP binding could be a common, though up to now overlooked, feature of these enzymes that may in some cases offer a physiologically relevant mechanism for regulation of DGC activity in vivo.

Período de latência e tempo para compreender nas aprendizagens / Latent phase and time for understanding in learning / Periodo de latencia y tiempo para comprender en al acto del apredizaja

O artigo aborda a dimensão do período de latência e do tempo para compreender nas aprendizagens. Argumenta que, a partir de Lacan (1959), se de um lado a inibição neurótica pode ser lida como uma paralisação no tempo para compreender, de outro é possível concluir que a inibição estrutural diz de uma vivência própria do tempo para compreender, nas aprendizagens, a qual antecede e apoia o conclusivo ato de aprender e o usufruto dessa aprendizagem. Para tal argumento, o artigo extrai consequências da abordagem da latência dada por Freud (1939) em "Moisés e o monoteísmo", argumentando que a latência se aproxima do tempo para compreender do qual nos fala Lacan (1946).

This article discusses the role played by the latency period and time for understanding in learnings. The authors posit that from Lacan (1959), if on the one hand, the neurotic inhibition can be taken as a paralyzation in the time for understanding, on the other hand, it is possible to conclude that the structural inhibition reveals a intrinsic experience of the time for understanding, in learnings. Structural inhibition whichs antecedes and supports the conclusive act of learning and its usufruct. For such an argument, this article extracts consequences from the latency period approached by Freud (1939) in "Moses and monotheism", claiming that the latent phase becomes closer to the time for understanding approached by Lacan (1946).

El artículo analiza la dimensión del período de latencia y del tiempo para comprender en el acto del aprendizaje. Sostiene (Lacan, 1959) que, si por un lado la inhibición neurótica puede leerse como una paralización en el tiempo para comprender, por otro lado es posible concluir que la inhibición estructural de una vivencia propia del tiempo para comprender, en los aprendizajes. Vivencia que precede y apoya el concluyente acto del aprendizaje, así como el usufructo de ese aprendizaje. Para esgrimir tal argumento, el artículo extrae consecuencias de la aproximación al concepto de latencia en la obra "Moisés y el monoteísmo" de Freud (1939), argumentando que la latencia se aproxima al tiempo para entender lo que dice Lacan (1946).

Período de latência e tempo para compreender nas aprendizagens / Latent phase and time for understanding in learning / Periodo de latencia y tiempo para comprender en al acto del apredizaja

O artigo aborda a dimensão do período de latência e do tempo para compreender nas aprendizagens. Argumenta que, a partir de Lacan (1959), se de um lado a inibição neurótica pode ser lida como uma paralisação no tempo para compreender, de outro é possível concluir que a inibição estrutural diz de uma vivência própria do tempo para compreender, nas aprendizagens, a qual antecede e apoia o conclusivo ato de aprender e o usufruto dessa aprendizagem. Para tal argumento, o artigo extrai consequências da abordagem da latência dada por Freud (1939) em "Moisés e o monoteísmo", argumentando que a latência se aproxima do tempo para compreender do qual nos fala Lacan (1946).(AU)

This article discusses the role played by the latency period and time for understanding in learnings. The authors posit that from Lacan (1959), if on the one hand, the neurotic inhibition can be taken as a paralyzation in the time for understanding, on the other hand, it is possible to conclude that the structural inhibition reveals a intrinsic experience of the time for understanding, in learnings. Structural inhibition whichs antecedes and supports the conclusive act of learning and its usufruct. For such an argument, this article extracts consequences from the latency period approached by Freud (1939) in "Moses and monotheism", claiming that the latent phase becomes closer to the time for understanding approached by Lacan (1946).(AU)

El artículo analiza la dimensión del período de latencia y del tiempo para comprender en el acto del aprendizaje. Sostiene (Lacan, 1959) que, si por un lado la inhibición neurótica puede leerse como una paralización en el tiempo para comprender, por otro lado es posible concluir que la inhibición estructural de una vivencia propia del tiempo para comprender, en los aprendizajes. Vivencia que precede y apoya el concluyente acto del aprendizaje, así como el usufructo de ese aprendizaje. Para esgrimir tal argumento, el artículo extrae consecuencias de la aproximación al concepto de latencia en la obra "Moisés y el monoteísmo" de Freud (1939), argumentando que la latencia se aproxima al tiempo para entender lo que dice Lacan (1946).(AU)

Viscosities reproductive patterns for use in videofluoroscopy and rehabilitation therapy of dysphagic patients / Padrões reprodutíveis de viscosidade para uso em videofluoroscopia e na terapia de reabilitação de pacientes disfágicos

BACKGROUND: Usually the suitable consistence identified and indicated as safe by videofluoroscopic method has been empirically obtained by association of barium sulfate solution with meals. However, it has been evidenced to be very difficult to reproduce this consistence in nutritional rehabilitation therapy from subjective information. AIM: To build two reproductive similar crescent viscosities series of solutions, with and without barium sulfate, to be used, the first, as radiological contrasted mean and the second, as base to reproduce the defined safer consistence, in the oral diet rehabilitation of dysphagic patients. METHODS: Two viscosity solutions series were obtained from starch and distilled water with and without 100 percent barium sulfate solution. The viscosity levels were defined step by step with digital viscosimeter (Brookfield, model LVTD-II) and with infrared thermometer Icel TD - 960. The fluids viscosity was register in centipoises, with their inferior and superior values followed by complimentary information about spindle kind, rotation speed and temperature. RESULTS: The two series of solutions, with and without barium sulfate, could be defined as aqueous (>1-143,5 cP), fine liquid (428 - 551 cP), thick liquid (4.284 -7.346,5 cP)), pasty (7.346,4 - 13.035 cP), pasty thick (19.260 - 34.320 cP) and creamy (163.500 - 255.300 cP). CONCLUSION: The study could offer reproductive formulas, with and without contrast mean, to be follow for obtaining the desirable viscosity to be used, each of them, in radiological evaluation and in nutritional diet minimizing the gaps fails between evaluation and therapy.

RACIONAL: Com freqüência, a consistência identificada e indicada pelo exame videofluoroscópico como segura, para uso nos pacientes disfágicos, tem sido empiricamente produzida pela mistura de alimentos com a solução de sulfato de bário. É expressiva a dificuldade observada quando se busca reproduzir esta consistência, subjetivamente indicada, para usá-la na terapia de reabilitação. OBJETIVO: Construir duas series de soluções, com valores reprodutíveis de viscosidade, uma com e outra sem a adição de sulfato de bário, a serem utilizadas a primeira, como meio de contraste radiológico, e a segunda, como base para reprodução da consistência definida como segura na reabilitação do paciente disfágico. MÉTODOS: As duas séries com viscosidades padrão foram buscadas com uso de amido, água destilada e solução de sulfato de bário a 100 por cento. Os níveis de viscosidade foram definidos passo à passo com o uso de um viscosímetro digital (Brookfield, model LVTD-II) e um termômetro de infravermelho Icel TD-960. As viscosidades foram registradas em centipoise (cP) e os limites superior e inferior de cada nível foi complementado pela informação do tipo e velocidade do "spindle" necessário e da temperatura da solução. RESULTADOS: As duas series de soluções, com e sem sulfato de bário, puderam ser definidas como aquosa (>1-143,5 cP), líquido fino (428-551 cp), liquido espesso (4.284-7.346,5 cp), pastosa (7.346,4-13.035 cP), pastosa espessa (19.260-34.320 cP) e cremosa (163.500-255.300 cP). CONCLUSÕES: Podem-se oferecer fórmulas com viscosidades reprodutíveis, com e sem adição de meio de contraste, a serem utilizadas, cada uma delas, na avaliação radiológica e na terapia nutricional, minimizando as falhas de reprodução entre a avaliação e a terapia.

Viscosities reproductive patterns for use in videofluoroscopy and rehabilitation therapy of dysphagic patients.

BACKGROUND: Usually the suitable consistence identified and indicated as safe by videofluoroscopic method has been empirically obtained by association of barium sulfate solution with meals. However, it has been evidenced to be very difficult to reproduce this consistence in nutritional rehabilitation therapy from subjective information. AIM: To build two reproductive similar crescent viscosities series of solutions, with and without barium sulfate, to be used, the first, as radiological contrasted mean and the second, as base to reproduce the defined safer consistence, in the oral diet rehabilitation of dysphagic patients. METHODS: Two viscosity solutions series were obtained from starch and distilled water with and without 100% barium sulfate solution. The viscosity levels were defined step by step with digital viscosimeter (Brookfield, model LVTD-II) and with infrared thermometer Icel TD - 960. The fluids viscosity was register in centipoises, with their inferior and superior values followed by complimentary information about spindle kind, rotation speed and temperature. RESULTS: The two series of solutions, with and without barium sulfate, could be defined as aqueous (>1-143,5 cP), fine liquid (428 - 551 cP), thick liquid (4.284 -7.346,5 cP)), pasty (7.346,4 - 13.035 cP), pasty thick (19.260 - 34.320 cP) and creamy (163.500 - 255.300 cP). CONCLUSION: The study could offer reproductive formulas, with and without contrast mean, to be follow for obtaining the desirable viscosity to be used, each of them, in radiological evaluation and in nutritional diet minimizing the gaps fails between evaluation and therapy.