"The needs of women in the postpartum period: A scoping review."

BACKGROUND: The postpartum period is critical and challenging for women, implying emotional, physical, social and spiritual changes. For a positive postpartum experience, it is important to receive consistent information and support from health professionals. However, this is not always the case, as care is more focused on the newborn, forgetting the needs of the puerperal woman. AIM: The review aimed to map the published scientific knowledge about women's needs in the postpartum period. METHODS: A Scoping Review was carried out, according to the method proposed by The Joanna Briggs Institute, in the MEDLINE Complete, MedicLatina and CINAHL Complete databases, and were selected articles since 2017 that answered the research question "What is the available evidence on women's needs in the postpartum period?". For the selection of articles, the eligibility criteria were defined. RESULTS: A total of 6,647 articles were identified. After the exclusion of duplicate articles and the application of the eligibility criteria, at the end of the process, 27 articles were included in the review. The extracted data were grouped into four categories, which summarize the needs of women in the postpartum period: support, sharing, care and preparation for the postpartum period. CONCLUSION: In the articles analysed, women reveal that they do not feel prepared for the postpartum period and identify several unmet needs, so health education and parenting skills training during pregnancy are essential to improve the postpartum experience and the transition to parenthood.

Maternal Perception of Pregnancy Loss: Protocol for a Thematic Synthesis.

Introduction: The number of women who present this perineal loss is high. Identifying the existing knowledge about the women's experiences and perceptions of pregnancy loss is essential to understand the impact of the phenomenon on women. This identification is also crucial to adapt and improve the healthcare provided. Subjects and Methods: A systematic literature review, meta-synthesis, of qualitative studies will be developed with the goal of obtaining a comprehensive understanding of mothers' perception of pregnancy loss and identifying their specific support needs. Inclusion Criteria: This review will consider qualitative investigations that study the perceptions or experiences of adult women who have suffered prenatal loss. All studies published in English, Spanish or Portuguese between January 1, 2012, and December 31, 2022 will be considered. This systematic review will follow the Joanna Briggs Institute statement for systematic reviews of qualitative design. The Psychology and Behavioral Sciences Collection, Scopus, CINAHL®, MEDLINE® and Cochrane Database of Systematic Reviews (CDRS) databases will be utilized for research. Data extraction will be performed in-peers by the researchers, using the Joanna Briggs Institute model. Finally, the available data will be analysed using a meta-aggregation approach. Conclusion: A better understanding of this phenomenon will be useful, identifying, on the one hand, the support needs of women who have suffered fetal loss and, on the other hand, also identifying the support and interventions that can be implemented by health professionals. Systematic Review Registration Number: PROSPERO® (CRD42023407314).

Early B-cell transcription factor-2 defect as a novel cause of lipodystrophy: disruption of the adipose tissue character and integrity.

We report a novel cause of partial lipodystrophy associated with early B cell factor 2 ( EBF2 ) nonsense variant ( EBF2 8:26033143 C>A, c.493G>T, p.E165X) in a patient with an atypical form of partial lipodystrophy. The patient presented with progressive adipose tissue loss and metabolic deterioration at pre-pubertal age. In vitro and in vivo disease modeling demonstrates that the EBF2 variant impairs adipogenesis, causing excess accumulation of undifferentiated CD34 + cells, extracellular matrix proteins, and inflammatory myeloid cells in subcutaneous adipose tissues. Thus, this EBF2 p.E165X variant disrupts adipose tissue structure and function, leading to the development of partial lipodystrophy syndrome.

Unveiling the RKIP and EGFR Inverse Relationship in Solid Tumors: A Case Study in Cervical Cancer.

Raf Kinase Inhibitor Protein (RKIP) is recognized as a bona fide tumor suppressor gene, and its diminished expression or loss is associated with the progression and poor prognosis of various solid tumors. It exerts multifaceted roles in carcinogenesis by modulating diverse intracellular signaling pathways, including those governed by HER receptors such as MAPK. Given the significance of HER receptor overexpression in numerous tumor types, we investigated the potential oncogenic relationship between RKIP and HER receptors in solid tumors. Through a comprehensive in silico analysis of 30 TCGA PanCancer Atlas studies encompassing solid tumors (10,719 samples), we uncovered compelling evidence of an inverse correlation between RKIP and EGFR expression in solid tumors observed in 25 out of 30 studies. Conversely, a predominantly positive association was noted for the other HER receptors (ERBB2, ERBB3, and ERBB4). In particular, cervical cancer (CC) emerged as a tumor type exhibiting a robust inverse association between RKIP and EGFR expression, a finding that was further validated in a cohort of 202 patient samples. Subsequent in vitro experiments involving pharmacological and genetic modulation of EGFR and RKIP showed that RKIP depletion led to significant upregulation of EGFR mRNA levels and induction of EGFR phosphorylation. Conversely, EGFR overactivation decreased RKIP expression in CC cell lines. Additionally, we identified a common molecular signature among patients depicting low RKIP and high EGFR expression and demonstrated the prognostic value of this inverse correlation in CC patients. In conclusion, our findings reveal an inverse association between RKIP and EGFR expression across various solid tumors, shedding new light on the underlying molecular mechanisms contributing to the aggressive phenotype associated with RKIP and EGFR in cervical cancer.

Parents' Needs When Experiencing the Transition to Twin Parenthood.

(1) Background: The transition to twin parenthood is a demanding challenge with a higher risk of maternal and fetal complications during pregnancy and a postpartum period that involves caring for more than one newborn at the same time with similar and simultaneous needs. (2) Aim: To find out about parents' needs when experiencing the transition to twin parenthood and to describe the intervention of their specialized nursing support network. (3) Methodology: A descriptive exploratory study, based on a proper non-probabilistic sample of 15 nurses and 55 couples who are parents of twins, using two online questionnaires publicized on social networks. (4) Results: The couple's needs were identified through knowledge of their experiences and difficulties during pregnancy and after the twin birth. Couples' and nurses' perceptions differed on the identified needs. The specialized nursing support network focuses its intervention on providing informative guidance on twin pregnancy and postpartum period, health education, group sharing experiences, home visits, planning, and including a family support network in the management of twin care and the creation of a daily routine. (5) Conclusions: There is a need to implement a program focused on the needs of parents of twins, promoting realistic expectations for the birth and parenting of twins, preparing parents, improving their well-being, and creating a specialized nursing support network available to this population.

Unraveling the antifungal composition of bitter orange decoction against the melon pathogen Fusarium jinanense.

Bitter orange (Citrus aurantium) is an important source of essential oils with high antimicrobial activities, however the composition and antifungal potential of the decoction peels is little explored. This study assessed the peel decoction's chemical profile at the secondary metabolism level and its antifungal activity against the melon phytopathogen Fusarium jinanense. The decoction's antifungal potential was investigated using a bioassay-guided fractionation approach based on Solid-Phase Extraction (SPE) and LC-HRMS/MS analysis. Coumarins and flavones were the most abundant classes of compounds in the high-value fractions responsible for up to 61% of the mycelial inhibition of F. jinanense. Overall, this study has presented for the first time the chemical composition, the antifungal potential of the decoction of C. aurantium peels and the compounds associated with these results. This strategy can guide the exploration of under-explored food sources and add value to compounds or fractions enriched with bioactive compounds.

A consensus reverse docking approach for identification of a competitive inhibitor of acetyltransferase enhanced intracellular survival protein from Mycobacterium tuberculosis.

Tuberculosis (TB) is an infectious disease caused by Mycobacterium tuberculosis (Mtb), which remains a significant global health challenge. The emergence of multidrug-resistant (MDR) Mtb strains imposes the development of new therapeutic strategies. This study focuses on the identification and evaluation of potential inhibitors against Mtb H37Ra through a comprehensive screening of an in-house chemolibrary. Subsequently, a promising pyrimidine derivative (LQM495) was identified as promising and then further investigated by experimental and in silico approaches. In this context, computational techniques were used to elucidate the potential molecular target underlying the inhibitory action of LQM495. Then, a consensus reverse docking (CRD) protocol was used to investigate the interactions between this compound and several Mtb targets. Out of 98 Mtb targets investigated, the enhanced intracellular survival (Eis) protein emerged as a target for LQM495. To gain insights into the stability of the LQM495-Eis complex, molecular dynamics (MD) simulations were conducted over a 400 ns trajectory. Further insights into its binding modes within the Eis binding site were obtained through a Quantum mechanics (QM) approach, using density functional theory (DFT), with B3LYP/D3 basis set. These calculations shed light on the electronic properties and reactivity of LQM495. Subsequently, inhibition assays and kinetic studies of the Eis activity were used to investigate the activity of LQM495. Then, an IC50 value of 11.0 ± 1.4 µM was found for LQM495 upon Eis protein. Additionally, its Vmax, Km, and Ki parameters indicated that it is a competitive inhibitor. Lastly, this study presents LQM495 as a promising inhibitor of Mtb Eis protein, which could be further explored for developing novel anti-TB drugs in the future.

Comprehensive analysis of morbidity and mortality patterns in familial partial lipodystrophy patients: insights from a population study.

Background: There is a lack of information on the clinical and molecular presentation of familial partial lipodystrophy (FPLD), a rare genetic disorder characterized by partial subcutaneous fat loss. Objective: This study aimed to provide a comprehensive assessment of the clinical, metabolic, and genetic features of FPLD in the Brazilian population. Methods: In a multicenter cross-sectional investigation we evaluated patients with FPLD across five Brazilian reference centers for lipodystrophies. Diagnosis of FPLD was made by clinical evaluation and genetic confirmation. Data on genetic, clinical, and metabolic characteristics were captured. Statistical analysis involved the utilization of the Kruskal-Wallis test to identify differences. Results: The study included 106 patients with genetic confirmation of FPLD. The mean age was 44 ± 15 years, and they were predominantly female (78.3%). LMNA pathogenic variants were identified in 85.8% of patients, PPARG in 10.4%, PLIN1 in 2.8%, and MFN2 in 0.9%. Diabetes mellitus (DM) was highly prevalent (57.5%), affecting 54 females (50.9%). Median triglycerides levels were 199 mg/dL (54-2724 mg/dL), severe hypertriglyceridemia (≥ 500 mg/dL) was found in 34.9% and pancreatitis in 8.5%. Metabolic-associated fatty liver disease (MAFLD) was observed in 56.6%, and cardiovascular disease in 10.4%. The overall mortality rate was 3.8%, due to cardiovascular events. Conclusion: This study presents an extensive cohort of Brazilian patients with FPLD, predominantly DM with several multisystem complications. A comprehensive characterization of lipodystrophy syndromes is crucial for effective patient management and care.

Awareness and knowledge of dementia and its communication disorders amongst Brazilian speech and language therapists.

BACKGROUND: Speech and language therapists (SLTs) play an important role in assessing and rehabilitating communication disorders in people with dementia, but there is evidence to suggest that they do not receive appropriate training to provide management and support during their training. AIM: To investigate the level of awareness and knowledge that practising SLTs from Brazil have about dementia and their role in the care of dementia through an online survey. METHODS & PROCEDURES: An online survey tool was developed to collect information from practising Brazilian SLTs regarding their knowledge about dementia, awareness about their role in the care of people with dementia, and opinions on how SLTs may be better prepared to work in the dementia field. The survey was disseminated via social media, websites, and e-mail lists of researchers and stakeholders. OUTCOMES & RESULTS: A total of 227 SLTs completed the survey. Participants showed good knowledge of dementia in general, while their answers were less accurate on primary progressive aphasia. Regarding the awareness by SLTs of their role in the care of people with dementia, most agreed or strongly agreed that SLTs could help people in the diagnosis, treatment and prevention of dementia (> 80%). However, fewer participants agreed or strongly agreed that they felt confident in contributing to the treatment and diagnosis process of dementia (about 50%). To improve the training of SLTs in Brazil, most participants believed that it would be necessary to improve the teaching of dementia at the undergraduate speech and language therapy curriculum level and to develop recommendations or guidelines about speech and language therapy practice in dementia. CONCLUSIONS & IMPLICATIONS: The results of this survey point to a need for improvement in the knowledge and confidence of Brazilian SLTs about dementia. To reach this goal, targeted training courses and applied practice opportunities should be embedded within university curricula and training programmes. WHAT THIS PAPER ADDS: What is already known on the subject Many studies confirm the importance of speech and language therapy in the non-pharmacological treatment of people with dementia. However, other evidence suggests to a possible lack of training for Brazilian SLTs, especially in the curriculum of undergraduate courses. What this paper adds to existing knowledge This study reveals that Brazilian SLTs have substantial knowledge of dementia and recognize the significance of their role in treating people with dementia. However, a minority expressed confidence in their ability to assess and treat people with dementia. What are the potential or actual clinical implications of this work? The findings of this research demonstrate that Brazilian SLTs have good knowledge of dementia and endorse their professional role in dementia care; however, they lack confidence in their own skills and expertise in diagnostic assessment and treatment of dementia. Interventions aimed at boosting the SLT's confidence level could lead to improved patients outcomes and overall quality of care within clinical settings.

Advice to People with Parkinson's in My Clinic: Cannabis.

Cannabis (in all the varied methods of delivery) continues to garner significant attention as a potential therapeutic intervention for neurodegenerative disorders, including Parkinson's disease (PD). The recent legalization of personal use of cannabis products in some parts of the world has increased this interest and with it, potential availability to many more people. However, such access has led to more questions than answers for both patients and health care professionals. These include what symptom(s) of PD will cannabis products treat; what dose; what type of cannabis product to use and what are the side effects?

On the role of syllable structure in atypical phonological development: Evidence from the acquisition of /l/ by Portuguese children.

The alveolar lateral is phonetically and phonologically complex. Previous studies have shown that /l/ is one of the last segments to be acquired by typically developing Portuguese children. However, little is known about how Portuguese children with atypical development acquire /l/. In this paper, we investigate the acquisition of /l/ by Portuguese children with protracted phonological development (DLD; SSD). We explore the effect of syllable structure and segmental properties in the acquisition of /l/ and describe mismatches used for target /l/, thus contributing empirical evidence to the ongoing discussion on differential diagnoses for children with primary phonological disorders. Our results show that the lateral is more problematic in SSD than in DLD, with the manner of articulation being more problematic than its place. A syllable-segment interface effect was attested. Mismatches showed a preference for [w, ɾ, ø]. The results are discussed considering their implications for clinical practice and the role of target phonetic and phonological properties in the /l/ acquisition path.

A link between circulating immune complexes and acute kidney injury in human visceral leishmaniasis.

Visceral leishmaniasis (VL) is an infectious disease caused by Leishmania infantum. Clinically, VL evolves with systemic impairment, immunosuppression and hyperactivation with hypergammaglobulinemia. Although renal involvement has been recognized, a dearth of understanding about the underlying mechanisms driving acute kidney injury (AKI) in VL remains. We aimed to evaluate the involvement of immunoglobulins (Igs) and immune complexes (CIC) in the occurrence of AKI in VL patients. Fourteen VL patients were evaluated between early treatment and 12 months post-treatment (mpt). Anti-Leishmania Igs, CIC, cystatin C, C3a and C5a were assessed and correlated with AKI markers. Interestingly, high levels of CIC were observed in VL patients up to 6 mpt. Concomitantly, twelve patients met the criteria for AKI, while high levels of cystatin C were observed up to 6 mpt. Plasmatic cystatin C was positively correlated with CIC and Igs. Moreover, C5a was correlated with cystatin C, CIC and Igs. We did not identify any correlation between amphotericin B use and kidney function markers in VL patients, although this association needs to be further explored in subsequent studies. Our data reinforce the presence of an important renal function impairment during VL, suggesting the involvement of Igs, CIC, and C5a in this clinical condition.

Translation, Transcultural Adaptation, and Validation of the Brazilian Portuguese Version of the Body Image Disturbance Questionnaire for Scoliosis (BR-BIDQ-S).

Objective The Body Image Disturbance Questionnaire for Scoliosis (BIDQ-S) for scoliosis derives from the Body Image Disturbance Questionnaire (BIDQ) with specific adaptation for scoliosis patients. Despite its significance and applicability, this instrument has never been translated into Brazilian Portuguese. The current study aimed to translate, transculturally adapt, and validate the BIDQ-S into Brazilian Portuguese. Methods BIDQ-S was translated and culturally adapted into Brazilian Portuguese using the American Association of Orthopedic Surgeons (AAOS) criteria. The questionnaire validation relied on internal consistency and comparison with the Cobb angle, Pediatric Quality of Life Inventory (PedsQL), and Scoliosis Research Society (SRS-22). The Brazilian version (BR-)BIDQ-S validation occurred in a sample of 35 adolescents with scoliosis waiting for specialized treatment. Results Internal consistency of the BR-BIDQ-S was 0.899 according to the Cronbach's index (i.e., virtually perfect). Although BR-BIDQ-S did not correlate with the Cobb angle, it presented correlations with the Physical, Emotional, and Social domains from the PedsQL and the Function/Activity domain from the SRS-22. Conclusion BR-BIDQ-S was reliable in evaluating the body image of adolescents with scoliosis, presenting an internal consistency of 0,899 (virtually perfect). Moreover, similar to the original instrument, it correlated with PedsQL and SRS-22.

Influence of idiopathic epilepsy on blood pressure and electrocardiography in dogs treated with phenobarbital.

Background and Aim: Dogs with idiopathic epilepsy (IE) experience a shortened lifespan, neurobehavioral changes, and an increased risk of comorbidities during the interictal period. There have been several reports of sudden death in humans with epilepsy, suggesting changes in cardiac rhythm secondary to seizures. In veterinary medicine, there are still no such conclusive studies. The present study aimed to evaluate blood pressure values, electrocardiographic findings, and laboratory parameters in dogs with IE treated with phenobarbital and to correlate these findings with possible cardiac alterations. Materials and Methods: Twenty-one dogs were divided into 11 healthy dogs and 10 idiopathic epileptic dogs for blood analysis, computerized electrocardiogram, and oscillometer-based blood pressure measurement. Results: QRS complex and S-T interval values differed significantly between groups, but blood pressure values were not significantly different. Conclusion: IE can occur with alterations in cardiac conduction and is a pathological condition.

Seafood product safety: A hybrid graphene/gold-based electrochemical immunosensor for fish allergen analysis.

Seafood product labels with accurate allergen contents can avoid and/or minimize allergic reactions. Therefore, an electrochemical immunosensor for the analysis of ß-parvalbumin (ß-PV, a major fish allergen) was developed. Screen-printed carbon electrodes were nanostructured with reduced graphene oxide and gold nanoparticles. The platform was characterized by scanning electron microscopy and elemental analysis. In a sandwich-type assay (∼75 min), the antigen-antibody interaction was detected by chronoamperometry using horseradish peroxidase and TMB-H2O2. A linear range of 25-3000 ng/mL, a sensitivity of 2.99 µA.mL/ng, and a limit of detection of 9.9 ng/mL (corresponding to 0.40 ng in the analysed aliquot) were obtained. The selectivity and possible interferences were assessed by analysing several other food allergens and a marine toxin. The sensor was applied to the analysis of 17 commercial foods and the effect of culinary processing (e.g., grilled, canned, smoked) on the ß-PV concentration was assessed. Traces of ß-PV were successfully quantified and ELISA was used to assess the results.

Efficacy and Safety of Glucagon-Like Peptide 1 Agonists in a Retrospective Study of Patients With Familial Partial Lipodystrophy.

OBJECTIVE: Glucagon-like peptide 1 receptor agonists (GLP-1RA) are widely used for the management of diabetes mellitus (DM), but their efficacy in familial partial lipodystrophy (FPLD) is unknown. In this retrospective study, we evaluated the effect of GLP-1RA in patients with FPLD. RESEARCH DESIGN AND METHODS: We analyzed data, reported with SDs, from 14 patients with FPLD (aged 58 ± 12 years; 76.47% female) and 14 patients with type 2 DM (aged 58 ± 13 years; 71% female) before and 6 months after starting GLP-1RA. RESULTS: We observed reduction in weight (95 ± 23 to 91 ± 22 kg; P = 0.002), BMI (33 ± 6 to 31 ± 6 kg/m2; P = 0.001), HbA1c (8.2% ± 1.4% to 7.7% ± 1.4%; P = 0.02), and fasting glucose (186 ± 64 to 166 ± 53 mg/dL; P = 0.04) in patients with FPLD. The change in triglycerides after treatment was greater in the FPLD group compared with the DM group (P = 0.02). We noted acute pancreatitis in two case subjects with FPLD with longer therapy. CONCLUSIONS: Our study demonstrates the relative safety and effectiveness of GLP-1RA in patients with FPLD.

Viral Interference between the Insect-Specific Virus Brejeira and the Saint Louis Encephalitis Virus In Vitro.

The Saint Louis encephalitis virus (SLEV) is an encephalitogenic arbovirus (Flaviviridae family) that has a wide geographical distribution in the western hemisphere, especially in the Americas. The negevirus Brejeira (BREV) was isolated for the first time in Brazil in 2005. This study aimed to verify the existence of a possible interfering effect of BREV on the course of SLEV infection and vice versa. We used clone C6/36 cells. Three combinations of MOIs were used (SLEV 0.1 × BREV 1; SLEV 1 × BREV 0.1; SLEV 1 × BREV 1) in the kinetics of up to 7 days and then the techniques of indirect immunofluorescence (IFA), a plaque assay on Vero cells, and RT-PCR were performed. Our results showed that the cytopathic effect (CPE) caused by BREV was more pronounced than the CPE caused by SLEV. Results of IFA, the plaque assay, and RT-PCR showed the suppression of SLEV replication in the co-infection condition in all the MOI combinations used. The SLEV suppression was dose-dependent. Therefore, the ISV Brejeira can suppress SLEV replication in Aedes albopictus cells, but SLEV does not negatively interfere with BREV replication.

Conhecimento da equipe de enfermagem acerca do Processo de Enfermagem em uma Maternidade Pública

Objetivo: identificar o conhecimento dos profissionais de enfermagem de uma maternidade pública de Santa Catarina, Brasil, acerca do Processo de Enfermagem. Método: estudo descritivo, com abordagem quantitativa, realizado no período de setembro de 2021 a abril de 2022. Foram aplicados questionários estruturados a 192 profissionais de enfermagem. Resultados: 57,3% dos profissionais entrevistados informaram conhecer o Processo de Enfermagem, sendo que 49,5% declararam ter recebido orientações acerca do tema em sua formação. De forma complementar 93,8% consideram importante desenvolver o Processo de Enfermagem em sua prática de trabalho e 94,5% afirmam que ele pode qualificar a assistência em enfermagem. Conclusão: é fundamental reconhecer o entendimento dos profissionais acerca do Processo de Enfermagem o que permite suscitar estratégias que contribuam para inovações e transformação dos saberes e práticas assistenciais da enfermagem.

Life beyond Loss: A Retrospective Analysis of the Impact of Meaning of Life Therapy on the Grieving Process of Cancer Patients' Family Caregivers.

Oncological disease in the palliative stage is a huge challenge for patients and their family caregivers (FCs) due to the fact that it confronts them with death, as well as physical, psychological, and existential suffering. Meaning of Life Therapy (MLT) is a brief structured psycho-existential intervention aiming to help patients in a meaning-making life review process, promoting end-of-life adaptation. The Life Letter (LL) resulting from MLT is an element that facilitates communication between the patient and their caregivers. The goal of this study was to understand the impact of MLT on the grieving processes of eight FCs and to study their perceptions of the role of the LL on grief through semi-structured interviews. The results of our qualitative analysis indicate that MLT was perceived by the FCs as a positive experience despite the conspiracy of silence being identified as a drawback. The LL was interpreted as a communicational element, promoting emotional closeness with the cancer patients and serving as a valuable tool in the FCs' adaptation to loss. Our research findings show that the needs of FCs, especially after experiencing the loss of their relative, are dynamic and specific. This is why it is urgent to develop interventions that consider the idiosyncrasies of end-of-life cancer patients and their FCs in order to avoid frustrated farewells, lonely deaths, and maladaptive grieving processes. This is the direction in which MLT should evolve.