Instruments to assess diabetes knowledge, skills and attitudes of people living with diabetes mellitus: A COSMIN-based systematic review.

AIMS: Since knowledge, skills, and attitudes influence the adherence to self-care behaviours, the purpose of this review was to identify available instruments that measure diabetes knowledge, skills or attitudes of people living with this health condition and to evaluate their measurement properties. METHODS: A systematic search was conducted in PubMed, EMBASE, SCOPUS, Web of Science and CINAHL databases. The methodological quality of the included studies was assessed by the Consensus-based Standards for the selection of health Measurement Instruments. Risk of Bias checklist. The results of each study were rated by the updated criteria for good measurement properties and the quality of evidence was graded using a modified Grading of Recommendations Assessment, Development, and Evaluation approach. RESULTS: This review included 38 instruments that assess diabetes knowledge (n = 26) or skills (n = 6) or attitudes (n = 5) or both three constructs (n = 1). About 40% had satisfactory results for relevance, comprehensiveness, and comprehensibility, and about 30% had unsatisfactory results for comprehensiveness, but these results were supported by very low evidence. Most studies showed indeterminate results for structural validity (50%), internal consistency (98%) and reliability (84%). Instruments that had satisfactory results for construct validity and reliability were supported by low to very low evidence. One responsiveness study was identified, and the result was satisfactory, but supported by low evidence. The Diabetes Knowledge Questionnaire is the instrument with best evidence for use. CONCLUSIONS: To plan more assertive interventions, researchers need to follow up guidelines to develop instruments with good quality of the measurement proprieties.

Prontuário eletrônico em terapia intensiva: validação de instrumento sobre percepção e satisfação da enfermagem / Electronic Medical Records in Intensive Care Units: Validation of an Instrument on Nursing Perception and Satisfaction / Historia clínica electrónica en las unidades de cuidados intensivos: validación del instrumento sobre la percepción y satisfacción del personal de enfermería

Introdução A assistência à saúde requer o registro das atividades desenvolvidas, realizado por meio do prontuário eletrônico do paciente, ferramenta que permeia muitas tarefas, sobretudo, em unidades de terapia intensiva. Problemas nesses sistemas eletrônicos ocasionam consequências com impacto para a assistência. O objetivo foi avaliar a percepção sobre o uso do prontuário eletrônico e a satisfação dos profissionais de enfermagem intensivistas, bem como validar um instrumento de pesquisa para esse fim. Materiais e Métodos Estudo transversal, quantitativo, desenvolvido na cidade de São Paulo. O instrumento de coleta foi elaborado pelas autoras e validado com relação à aparência e conteúdo. As variáveis categóricas foram comparadas pelo Teste Exato de Fisher e Qui Quadrado; e as variáveis numéricas pelo Teste de Kruskal-Wallis. Resultados Participaram do estudo 75 profissionais de enfermagem, a maioria era do sexo feminino, pertencentes a categoria de técnicos de enfermagem. A maioria classificou o prontuário eletrônico do paciente como fácil; referiu conhecimento suficiente sobre o prontuário eletrônico do paciente; relatou quantidade insuficiente de computadores no setor e avaliou melhora na segurança do paciente e da equipe de saúde com a utilização do prontuário eletrônico do paciente. As mulheres reportaram maior insatisfação no uso do prontuário eletrônico do paciente, bem como os técnicos de enfermagem. Os enfermeiros têm maior dificuldade na utilização desta ferramenta. Conclusões O prontuário eletrônico do paciente é fácil de usar e as principais dificuldades estão relacionadas às funcionalidades, sobretudo para os enfermeiros.

Introduction When providing healthcare, it is necessary to record treatment activities in the patient's electronic medical records, which serves as a tool that impacts several tasks, including those performed in intensive care units. Any failure of these electronic systems has a direct impact on the delivery of healthcare. This study is aimed to assess the perception of the use of electronic medical records and satisfaction levels among intensive care nurses, as well as to evaluate a questionnaire instrument for this purpose. Materials and Methods A quantitative cross-sectional study was conducted in São Paulo. The instrument used for collection was prepared by the authors, which was also validated in terms of appearance and content. Categorical variables were compared using Fisher's exact test and numerical variables were compared using the Kruskal-Wallis test. Results 75 nursing professionals, mostly women and classified as nurse technicians, participated in this study. The majority of the participants considered that electronic medical records were easy to use, indicated that they had sufficient knowledge about the management of electronic medical records, noted that the number of computer in the hospital was insufficient, and stated that both patient and healthcare team safety had improved after using the patient's electronic medical records. Male nurses found it more difficult to use this tool. Conclusions Electronic medical records were found to be easy to use, while the main difficulties are related to their functionality, especially by male nurses.

Introducción En la asistencia sanitaria es necesario registrar las actividades realizadas a través de la historia clínica electrónica del paciente, la cual se constituye como una herramienta que incide en diversas tareas, entre ellas, las realizadas en las unidades de cuidados intensivos. Cualquier problema que se presente en estos sistemas electrónicos tiene un impacto directo en la prestación de la asistencia sanitaria. El objetivo de este estudio fue evaluar la percepción sobre el uso de la historia clínica electrónica y la satisfacción entre los profesionales de enfermería del área de cuidados intensivos, así como evaluar un instrumento de cuestionario para este fin. Materiales y métodos Se realizó un estudio transversal cuantitativo en la ciudad de São Paulo. El instrumento de recolección fue elaborado por los autores y validado en cuanto a apariencia y contenido. Las variables categóricas se compararon mediante la prueba exacta de Fisher y la prueba de chi-cuadrado, y las variables numéricas a través de la prueba de Krushal-Wallis. Resultados En el estudio participaron 75 profesionales de enfermería, la mayoría mujeres, que pertenecían a la categoría de técnicos de enfermería. La mayoría de los participantes consideró que la historia clínica electrónica era fácil de usar, indicó tener conocimiento suficiente sobre el manejo de la historia clínica electrónica, señaló que el número de computadores en el hospital era insuficiente y afirmó que había mejorado la seguridad del paciente y del equipo asistencial con el uso de la historia clínica electrónica del paciente. A los enfermeros les resulta más difícil utilizar esta herramienta. Conclusiones Se encontró que la historia clínica electrónica resulta fácil de usar, mientras que las principales dificultades están relacionadas con su funcionalidad, especialmente por parte de los enfermeros.

Prontuário eletrônico em terapia intensiva: validação de instrumento sobre percepção e satisfação da enfermagem / Electronic Medical Records in Intensive Care Units: Validation of an Instrument on Nursing Perception and Satisfaction

Introdução: A assistência à saúde requer o registro das atividades desenvolvidas, realizado por meio do prontuário eletrônico do paciente, ferramenta que permeia muitas tarefas, sobretudo, em unidades de terapia intensiva. Problemas nesses sistemas eletrônicos ocasionam consequências com impacto para a assistência. O objetivo foi avaliar a percepção sobre o uso do prontuário eletrônico e a satisfação dos profissionais de enfermagem intensivistas, bem como validar um instrumento de pesquisa para esse fim. Materiais e Métodos: Estudo transversal, quantitativo, desenvolvido na cidade de São Paulo. O instrumento de coleta foi elaborado pelas autoras e validado com relação à aparência e conteúdo. As variáveis categóricas foram comparadas pelo Teste Exato de Fisher e Qui Quadrado; e as variáveis numéricas pelo Teste de Kruskal-Wallis. Resultados: Participaram do estudo 75 profissionais de enfermagem, a maioria era do sexo feminino, pertencentes a categoria de técnicos de enfermagem. A maioria classificou o prontuário eletrônico do paciente como fácil; referiu conhecimento suficiente sobre o prontuário eletrônico do paciente; relatou quantidade insuficiente de computadores no setor e avaliou melhora na segurança do paciente e da equipe de saúde com a utilização do prontuário eletrônico do paciente. As mulheres reportaram maior insatisfação no uso do prontuário eletrônico do paciente, bem como os técnicos de enfermagem. Os enfermeiros têm maior dificuldade na utilização desta ferramenta. Conclusões: O prontuário eletrônico do paciente é fácil de usar e as principais dificuldades estão relacionadas às funcionalidades, sobretudo para os enfermeiros.

Introduction: When providing healthcare, it is necessary to record treatment activities in the patient's electronic medical records, which serves as a tool that impacts several tasks, including those performed in intensive care units. Any failure of these electronic systems has a direct impact on the delivery of healthcare. This study is aimed to assess the perception of the use of electronic medical records and satisfaction levels among intensive care nurses, as well as to evaluate a questionnaire instrument for this purpose. Materials and Methods: A quantitative cross-sectional study was conducted in São Paulo. The instrument used for collection was prepared by the authors, which was also validated in terms of appearance and content. Categorical variables were compared using Fisher's exact test and numerical variables were compared using the Kruskal-Wallis test. Results: 75 nursing professionals, mostly women and classified as nurse technicians, participated in this study. The majority of the participants considered that electronic medical records were easy to use, indicated that they had sufficient knowledge about the management of electronic medical records, noted that the number of computer in the hospital was insufficient, and stated that both patient and healthcare team safety had improved after using the patient's electronic medical records. Male nurses found it more difficult to use this tool. Conclusions: Electronic medical records were found to be easy to use, while the main difficulties are related to their functionality, especially by male nurses.

Introducción: En la asistencia sanitaria es necesario registrar las actividades realizadas a través de la historia clínica electrónica del paciente, la cual se constituye como una herramienta que incide en diversas tareas, entre ellas, las realizadas en las unidades de cuidados intensivos. Cualquier problema que se presente en estos sistemas electrónicos tiene un impacto directo en la prestación de la asistencia sanitaria. El objetivo de este estudio fue evaluar la percepción sobre el uso de la historia clínica electrónica y la satisfacción entre los profesionales de enfermería del área de cuidados intensivos, así como evaluar un instrumento de cuestionario para este fin. Materiales y métodos: Se realizó un estudio transversal cuantitativo en la ciudad de São Paulo. El instrumento de recolección fue elaborado por los autores y validado en cuanto a apariencia y contenido. Las variables categóricas se compararon mediante la prueba exacta de Fisher y la prueba de chi-cuadrado, y las variables numéricas a través de la prueba de Krushal-Wallis. Resultados: En el estudio participaron 75 profesionales de enfermería, la mayoría mujeres, que pertenecían a la categoría de técnicos de enfermería. La mayoría de los participantes consideró que la historia clínica electrónica era fácil de usar, indicó tener conocimiento suficiente sobre el manejo de la historia clínica electrónica, señaló que el número de computadores en el hospital era insuficiente y afirmó que había mejorado la seguridad del paciente y del equipo asistencial con el uso de la historia clínica electrónica del paciente. A los enfermeros les resulta más difícil utilizar esta herramienta. Conclusiones: Se encontró que la historia clínica electrónica resulta fácil de usar, mientras que las principales dificultades están relacionadas con su funcionalidad, especialmente por parte de los enfermeros.

Microabrasion effect on enamel susceptibility to penetration of hydrogen peroxide: an experimental and computational study.

To evaluate in vitro transenamel/transdentinal of penetration of H2O2 after microabrasive. Computational models were performed to verify peroxide penetration and evaluate if geometric modifications could affect in vitro results. Enamel/dentin blocks from bovine incisors were prepared and randomly divided into groups (n = 15) according with abrasive (35% phosphoric acid and pumice or 6.6% hydrochloric acid and silica) and bleaching agents (16% carbamide peroxide and 35% H2O2). From artificial pulp chambers, the H2O2 concentration was measured and SEM was used for surface morphology. Numerical models were performed (Abaqus® v6.12) modifying slightly enamel/dentin thickness based on experimental data. All groups presented H2O2 penetration, although no significant difference was noted between the control and experimental groups (p > 0.05). The numerical analysis demonstrated the role of dental tissue thickness in the H2O2 penetration. Microabrasion is recommended as its association with bleaching procedures and small modifications in thicknesses of enamel/dentin can cause substantial changes in HP penetration. Such diffusion aspect is clinically relevant for the bleaching procedures since very thin enamel could present more peroxide propagation through dental tissues.

REMOVAL OF AMMONIACAL NITROGEN FROM MUNICIPAL LANDFILL LEACHATE WITH FLOATING Typha domingensis (TYPHACEAE) / Eliminación del nitrógeno amoniacal del lixiviado de vertedero municipal con Typha domingensis (TYPHACEAE) en flotación

ABSTRACT A promising method for the treatment of effluents is the use of floating macrophytes. Ammoniacal nitrogen is a typical compound present in urban landfill leachates and its removal is important due its toxicity to several organisms. Therefore, the study evaluated Typha domingensis survival and nitrification potential artificially floating in domestic solid waste leachate. Plants were exposed for 35 days to leachate (100, 75 and 50 %) and to rainwater with N:P:K (control). Dissolved oxygen (DO) of the treatments was periodically measured, and ammoniacal nitrogen, nitrite and nitrate were analyzed before and after exposure. At the end of the experiment, plant survival rate was calculated. After two weeks, DO increased twice in the control, three times in 50 % leachate, four times in 75 % leachate, and eight times in 100 % leachate. At the end of the experiment, ammoniacal nitrogen was no longer detected, there was a significant reduction of nitrite, and a significant increase of nitrate in the treatments containing leachate. Plant survival was higher in those individuals exposed to 100 % leachate and decreased at lower leachate concentrations: 98 %, 94 %, 92 %, and 86 %. The study demonstrated that the ammoniacal nitrogen concentration of the leachate was not toxic to T. domingensis, and that it was efficient in the removal of this compound from the effluent, indicating that the species may be used artificially floating for the removal of this contaminant from domestic solid waste landfill leachate when in low concentrations.

RESUMEN Un método prometedor para el tratamiento de efluentes es el uso de macrófitas flotantes. El nitrógeno amoniacal es un componente típico de lixiviados de vertederos urbanos y su remoción es importante debido a su toxicidad para diversos organismos. Por eso, el estudio evaluó la supervivencia y el potencial de nitrificación de Typha domingensis flotando artificialmente en lixiviados de residuos sólidos domésticos. Las plantas fueron expuestas por 35 días a lixiviado (100, 75 y 50 %) y al agua de lluvia con N:P:K (control). El oxígeno disuelto (OD) fue medido periódicamente; el nitrógeno amoniacal, el nitrito y el nitrato fueron analizados antes y después de la exposición; al final del experimento, la tasa de supervivencia de las plantas fue calculada. Después de dos semanas, el OD aumentó dos veces en el control, tres veces en el lixiviado 50 %, cuatro veces en el lixiviado 75 % y ocho veces en el lixiviado 100 %. Al final del experimento, el nitrógeno amoniacal no fue más detectado, hubo una reducción significativa de nitrito y un aumento significativo de el nitrato en los tratamientos que contenían lixiviado. La supervivencia de las plantas fue mayor en aquellos individuos expuestos al lixiviado 100 % y se redujo en las menores concentraciones: 98 %, 94 %, 92 % y 86 %. El estudio demostró que la concentración de nitrógeno ammoniacal del lixiviado no fue tóxica para T. domingensis y que ésta fue eficiente en la remoción del compuesto del efluente, indicando que la especie puede ser utilizada flotando artificialmente para la remoción del contaminante de lixiviados de residuos sólidos domésticos en bajas concentraciones.

Blood chimerism in twins.

CONCLUSIONS: Chimerism is a phenomenon in which an individual has cells with different genetic content from different zygotes. In dizygotic twins (DTs), chimerism is believed to occur through placental anastomoses that enable the bidirectional exchange of hematopoietic stem cells. Little is still known about chimerism frequency in twins, but several studies have shown a relation between chimerism and some conditions such as autism, Alzheimer's disease, and a group of autoimmune diseases such as Sjögren syndrome, systemic lupus erythematosus, and systemic sclerosis. In addition to chimerism of ABO blood groups being possibly mistaken for ABO subgroups, these autoimmune diseases may affect other serologic immunohematologic tests. This study aimed to determine the frequency of chimerism in DTs through ABO and D testing using the tube method, column agglutination, and short tandem repeat (STR) assays. Among the 103 subjects assessed for this study, 24 subjects (12 pairs) were excluded because STR assays showed they were monozygotic; of the remaining, 70 subjects (35 pairs) were DTs and 9 subjects came from gestations of trizygotic triplets. No ABO or D chimerism was detected in any subject through serologic assays, and STR assays did not detect any blood chimerism. Although there was no evidence of chimerism found in this study, we emphasize the importance of observing the family background of individuals with suspected ABO subgroup in complex immunohematologic studies because ABO antigen-antibody reactions are similar in both circumstances, and chimerism can be overlooked. Moreover, the use of the STR analysis method in chimerism studies can be important to help differentiate chimerism and ABO subgroups.

Active application of primer acid on acid-treated enamel: Influence on the bond effectiveness of self-etch adhesives systems.

AIM: Evaluate the composite-to-enamel bond after passive or active application of self-etching primer systems on polished or pre-etched enamel with phosphoric acid. MATERIALS AND METHODS: Two self-etch adhesives systems (SEAS) were used: Clearfil SE Bond and Easy Bond. Third human molars were divided into 8 groups (N = 10). The crown of each tooth was sectioned into halves and the mesial/distal surfaces were used. The adhesives were actively or passively applied on enamel with or without prior phosphoric-acid etching. Resin composite cylinders were built after adhesive application. After stored in relative humidity for 24 hr/37°C the specimens were subjected to microshear test in universal testing a machine at a crosshead speed of 0.5 mm/minute. The results were analyzed with three-way ANOVA and the Tukey test. The enamel-etching pattern was evaluated under SEM. RESULTS: The 2-step SEAS system presented significantly higher adhesive bond strength means (47.37 MPa) than the 1-step (36.87 MPa). A poor enamel- etching pattern was observed in active mode showing irregular and short resin tags, however there was not compromised the bond strength. CONCLUSION: Active or passive application produced similar values of bond strength to enamel regardless of enamel pretreatment and type of SEAS.

Enamel Renal Syndrome: A Case History Report.

Enamel renal syndrome (ERS) is a rare, commonly misdiagnosed condition that results in amelogenesis imperfecta and nephrocalcinosis and can lead to renal impairment in adulthood. This case history report describes a multidisciplinary dental management approach in a young adult patient with ERS.

Prevalence of factor V Leiden in patients with venous thrombosis / Prevalência do fator V de Leiden em pacientes com trombose venosa

ABSTRACT INTRODUCTION: Venous thrombosis is a multifactor disease with high incidence in the population. The development of this disease is closely linked to the presence of environmental and genetic factors and may occur in combination or alone. Among the various genetic mutations that may predispose to a thrombotic event, the most frequent in the population is the G1691A mutation in clotting factor V, known as factor V Leiden (FVL). This mutation brings the phenotype known as activated protein C resistance, leading to a hypercoagulable state, which increases the risk of thrombosis. OBJECTIVE: To investigate the presence of FVL in individuals with history of venous thrombosis, and as the control group, individuals with no history of the disease. METHOD: The method used was the polymerase chain reaction (PCR) followed by restriction fragment length polymorphism (RFLP). RESULTS: The results showed mutation prevalence of 21.5% in heterozygosity in patient group; no individuals with mutated homozygous were identified. The results also showed a high recurrence rate among the mutation carriers. CONCLUSION: In conclusion, the research of mutation on factor V has strong impact on investigation of venous thromboembolism, in order to elucidate the etiology of the event, and in treatment and in prophylaxis against the recurrence.

RESUMO INTRODUÇÃO: A trombose venosa é uma doença de caráter multifatorial e de alta incidência na população. O desenvolvimento dessa patologia está intimamente ligado à presença de fatores ambientais e genéticos, podendo ocorrer em associação ou isoladamente. Entre as diversas mutações genéticas que podem predispor a um evento trombótico, a de maior ocorrência na população é a mutação G1691A no fator V da coagulação, conhecida como fator V de Leiden (FVL). Essa mutação provoca o fenótipo conhecido como resistência à proteína C ativada, levando a um quadro de hipercoagulabilidade, que aumenta o risco de trombose. OBJETIVO: Investigar a presença do FVL em indivíduos com histórico de trombose venosa e, como grupo-controle, indivíduos sem histórico. MÉTODO: A metodologia utilizada foi a técnica de reação em cadeia da polimerase (PCR), seguida de polimorfismo no comprimento dos fragmentos de restrição (RFLP). RESULTADOS: Os resultados mostraram prevalência da mutação de 21,5% em heterozigose entre o grupo de pacientes; não foram identificados indivíduos homozigotos mutados. Os resultados também apresentaram alto índice de recorrência entre os portadores da mutação. CONCLUSÃO: Conclui-se que a pesquisa da mutação do fator V tem forte impacto na investigação do tromboembolismo venoso a fim de elucidar a etiologia do evento, além de auxiliar no tratamento e na profilaxia diante da recorrência.

Frequencies of polymorphisms of the Rh, Kell, Kidd, Duffy and Diego systems of Santa Catarina, Southern Brazil.

BACKGROUND: Red blood cell genes are highly polymorphic with the distribution of alleles varying between different populations and ethnic groups. The objective of this study was to investigate gene polymorphisms of blood groups in the state of Santa Catarina, Southern Brazil. METHODS: Three hundred and seventy-three unrelated blood donors and 31 transfusion-dependent patients were evaluated to investigate polymorphisms of the Rh, Kell, Duffy, Kidd, and Diego blood group systems in a population from the state of Santa Catarina. The subjects, from seven regions that comprise the blood-banking network of the state, were assessed between August 2011 and March 2014. The genotypes of the Rh, Kell, Duffy, Kidd, and Diego systems were determined using the restriction fragment length polymorphism-polymerase chain reaction and allele-specific polymerase chain reaction techniques. RESULTS: The genotype frequencies in this study were significantly different when populations from different regions of Santa Catarina were compared. Furthermore, there were also significant differences in the genetic frequencies compared to other Brazilian states. The genotype frequencies of the Kell and Kidd blood groups are similar to European populations from Naples, Italy and Zurich, Switzerland. CONCLUSION: This article reports for the first time the frequency of polymorphisms of blood group systems in blood donors from Santa Catarina, Southern Brazil.

Frequencies of polymorphisms of the Rh, Kell, Kidd, Duffy and Diego systems of Santa Catarina, Southern Brazil

Background Red blood cell genes are highly polymorphic with the distribution of alleles varying between different populations and ethnic groups. The objective of this study was to investigate gene polymorphisms of blood groups in the state of Santa Catarina, Southern Brazil. Methods Three hundred and seventy-three unrelated blood donors and 31 transfusion-dependent patients were evaluated to investigate polymorphisms of the Rh, Kell, Duffy, Kidd, and Diego blood group systems in a population from the state of Santa Catarina. The subjects, from seven regions that comprise the blood-banking network of the state, were assessed between August 2011 and March 2014. The genotypes of the Rh, Kell, Duffy, Kidd, and Diego systems were determined using the restriction fragment length polymorphism-polymerase chain reaction and allele-specific polymerase chain reaction techniques. Results The genotype frequencies in this study were significantly different when populations from different regions of Santa Catarina were compared. Furthermore, there were also significant differences in the genetic frequencies compared to other Brazilian states. The genotype frequencies of the Kell and Kidd blood groups are similar to European populations from Naples, Italy and Zurich, Switzerland. Conclusion This article reports for the first time the frequency of polymorphisms of blood group systems in blood donors from Santa Catarina, Southern Brazil.

Molecular matching of red blood cells is superior to serological matching in sickle cell disease patients.

OBJECTIVE: To evaluate the usefulness of DNA methods to provide a means to precisely genotypically match donor blood units for the antigen-negative type of 35 sickle cell disease patients. METHODS: Red blood cell units were investigated for ABO, D, C, c, E, e, K, Fy(a), Fy(b), Jk(a), Jk(b), S, s, Di(a) and RH variants by performing a molecular array (Human Erythrocyte Antigen BeadChip(TM), BioArray Solutions), polymerase chain reaction followed by restriction fragment length polymorphism analysis and sequencing of patient samples and donor units that had been serologically matched based on the ABO, Rh and K phenotypes and the presence of antibodies. RESULTS: Matches for 21 of 35 sickle cell disease patients presented discrepancies or mismatches for multiple antigens between the genotype profile and the antigen profile of their serologically-matched blood units. The main discrepancies or mismatches occurred in the RH, FY, JK and MNS systems. Eight Rh alloimmunized patients presented RHD and RHCE variants that had not been serologically identified. According to these results better matches were found for the patients with genotyped units and the patients benefited as shown by better in vivo red blood cell survival. CONCLUSION: Molecular matching is superior to serological matching in sickle cell disease patients, decreasing the risk of transfusion reactions, especially delayed transfusion reactions to existing alloantibodies and preventing alloimmunization.

Immunoexpression of α2-integrin and Hsp47 in hereditary gingival fibromatosis and gingival fibromatosis-associated dental abnormalities.

OBJECTIVE: The purpose of the present study was to investigate the expression of the α2-integrin subunit and heat shock protein 47 (Hsp47) in two families with isolated gingival fibromatosis (GF) form and one family with GF associated with dental abnormalities and normal gingival (NG). STUDY DESIGN: Immunohistochemistry was performed with antibodies against α2-integrin and Hsp47 in specimens from two unrelated families with hereditary gingival fibromatosis (Families 1 and 2) and from one family with a gingival fibromatosis-associated dental abnormality (Family 3); NG samples were used for comparison. The results were analysed statistically. RESULTS: Immunoreactivity for α2-integrin and Hsp47 was observed in the nucleus of epithelial cells of both the basal and suprabasal layer and a more discreet signal was noted in connective tissue in all study samples. Hsp47 showed higher immunoreactivity in Family 2 compared with the other families (p ≤ 0.05). Despite the markup α2-integrin was higher in Family 3 there was no statistically significant difference between the families studied (p ≥ 0.05). CONCLUSIONS: Our results confirmed the heterogeneity of GF, such that similar patterns of expression of the condition may show differences in the expression of proteins such as Hsp47. Although no difference in α2-integrin expression was observed between GF and NG groups, future studies are necessary to determine the exact role of this protein in the various forms of GF and whether it contributes to GF pathogenesis.

Molecular matching of red blood cells is superior to serological matching in sickle cell disease patients

OBJECTIVE: To evaluate the usefulness of DNA methods to provide a means to precisely genotypically match donor blood units for the antigen-negative type of 35 sickle cell disease patients<. METHODS: Red blood cell units were investigated for ABO, D, C, c, E, e, K, Fyª, Fy b, Jkª, Jk b, S, s, Diª and RH variants by performing a molecular array (Human Erythrocyte Antigen BeadChipTM, BioArray Solutions), polymerase chain reaction followed by restriction fragment length polymorphism analysis and sequencing of patient samples and donor units that had been serologically matched based on the ABO, Rh and K phenotypes and the presence of antibodies. RESULTS: Matches for 21 of 35 sickle cell disease patients presented discrepancies or mismatches for multiple antigens between the genotype profile and the antigen profile of their serologically-matched blood units. The main discrepancies or mismatches occurred in the RH, FY, JK and MNS systems. Eight Rh alloimmunized patients presented RHD and RHCE variants that had not been serologically identified. According to these results better matches were found for the patients with genotyped units and the patients benefited as shown by better in vivo red blood cell survival. CONCLUSION: Molecular matching is superior to serological matching in sickle cell disease patients, decreasing the risk of transfusion reactions, especially delayed transfusion reactions to existing alloantibodies and preventing alloimmunization.

Population genetics of GYPB and association study between GYPB*S/s polymorphism and susceptibility to P. falciparum infection in the Brazilian Amazon.

BACKGROUND: Merozoites of Plasmodium falciparum invade through several pathways using different RBC receptors. Field isolates appear to use a greater variability of these receptors than laboratory isolates. Brazilian field isolates were shown to mostly utilize glycophorin A-independent invasion pathways via glycophorin B (GPB) and/or other receptors. The Brazilian population exhibits extensive polymorphism in blood group antigens, however, no studies have been done to relate the prevalence of the antigens that function as receptors for P. falciparum and the ability of the parasite to invade. Our study aimed to establish whether variation in the GYPB*S/s alleles influences susceptibility to infection with P. falciparum in the admixed population of Brazil. METHODS: Two groups of Brazilian Amazonians from Porto Velho were studied: P. falciparum infected individuals (cases); and uninfected individuals who were born and/or have lived in the same endemic region for over ten years, were exposed to infection but have not had malaria over the study period (controls). The GPB Ss phenotype and GYPB*S/s alleles were determined by standard methods. Sixty two Ancestry Informative Markers were genotyped on each individual to estimate admixture and control its potential effect on the association between frequency of GYPB*S and malaria infection. RESULTS: GYPB*S is associated with host susceptibility to infection with P. falciparum; GYPB*S/GYPB*S and GYPB*S/GYPB*s were significantly more prevalent in the in the P. falciparum infected individuals than in the controls (69.87% vs. 49.75%; P<0.02). Moreover, population genetics tests applied on the GYPB exon sequencing data suggest that natural selection shaped the observed pattern of nucleotide diversity. CONCLUSION: Epidemiological and evolutionary approaches suggest an important role for the GPB receptor in RBC invasion by P. falciparum in Brazilian Amazons. Moreover, an increased susceptibility to infection by this parasite is associated with the GPB S+ variant in this population.