Trypanosoma cruzi infection induces DNA double-strand breaks and activates DNA damage response pathway in host epithelial cells.

Trypanosoma cruzi, the etiological agent of Chagas disease, invades many cell types affecting numerous host-signalling pathways. During the T. cruzi infection, we demonstrated modulations in the host RNA polymerase II activity with the downregulation of ribonucleoproteins affecting host transcription and splicing machinery. These alterations could be a result of the initial damage to the host DNA caused by the presence of the parasite, however, the mechanisms are not well understood. Herein, we examined whether infection by T. cruzi coincided with enhanced DNA damage in the host cell. We studied the engagement of the DNA damage response (DDR) pathways at the different time points (0-24 h post-infection, hpi) by T. cruzi in LLC-MK2 cells. In response to double-strand breaks (DSB), maximum phosphorylation of the histone variant H2AX is observed at 2hpi and promotes recruitment of the DDR p53-binding protein (53BP1). During T. cruzi infection, Ataxia-telangiectasia mutated protein (ATM) and DNA-PK protein kinases remained active in a time-dependent manner and played roles in regulating the host response to DSB. The host DNA lesions caused by the infection are likely orchestrated by the non-homologous end joining (NHEJ) pathway to maintain the host genome integrity.

Quality of life of Brazilian families who have children with Fragile X syndrome: a descriptive study.

This study aimed to assess the Family Quality of Life (FQoL) of Brazilian families with male children with Fragile X syndrome (FXS). Data from 53 families were collected using forms that included sociodemographic and clinical information, as well as the Beach Center Family Quality of Life Scale, a 5-point Likert scale ranging from "very dissatisfied" (1) to "very satisfied" (5). The mean overall FQoL score was 3.56 ± 0.79; the emotional well-being domain had the lowest score (2.98 ± 1.11) and showed significant differences between the other domains: family interaction (3.81 ± 0.89; p < 0.001), parenting (3.66 ± 0.89; p < 0.001), physical and material well-being (3.48 ± 0.83; p < 0.001), and disability-related support (3.75 ± 0.98; p < 0.001). Physical and material well-being was the second-lowest domain and was statistically different from the family interaction domain (p = 0.013). Lower FQoL satisfaction ratings were found in families with children who had difficulty getting along with people of the same age (t(51) = -3.193, p = 0.002; d = 1.019) and difficulty in living together on a day-to-day basis (t(51) = -3.060, p = 0.004; d = 0.888). These results highlight the importance of proper emotional support for the family, emphasizing the need to provide assistance not only for individuals with FXS but also for other family members. Besides, we advocate for the adoption of public policies that provide financial assistance to families and the implementation of the Brazilian Policy of Comprehensive Care for People with Rare Diseases.

Alterações do sono e os fatores associados em gestantes atendidas pela atenção primária em saúde / Sleep alterations and associated factors in pregnant women attended by primary health care / Alteraciones del sueño y factores asociados en gestantes atendidas en atención primaria de salud

Resumo Contexto: A gestação ocasiona diversas mudanças fisiológicas, anatômicas, hormonais e psicológicas na mulher. As modificações gravídicas podem repercutir no sono da gestante, diminuindo sua qualidade e duração. Objetivo: Este estudo tem como objetivo verificar a prevalência de alteração do sono em gestantes e os fatores associados. Métodos: Estudo epidemiológico, transversal e analítico realizado com gestantes cadastradas nas Equipes da Estratégia de Saúde Da Família da zona urbana do município de Montes Claros no ano de 2018. A amostra, probabilística, foi calculada em 1.180 gestantes. Os dados foram coletados a partir de um questionário contendo as informações de interesse com posterior análise das variáveis. Resultados: Verificou-se que 87,5% das participantes apresentavam alterações do sono durante a gestação. O aumento do sono foi relatado por 50,5%, a diminuição por 21,8% e 15,1% ambos. O apoio social (p= 0,032), a qualidade de vida (p< 0,001), o estresse (p= 0,009) e os sintomas de depressão (p= 0,005) associaram-se individualmente com a alteração de sono e a qualidade de vida se manteve associada após ajuste (RP ajustada: 0,482, IC95% 0,482; p=<0,001). Conclusão: É elevada a alteração de sono entre as gestantes, sendo associada ao apoio social, à qualidade de vida, ao estresse e à depressão.

Abstract Background: Pregnancy causes several physiological, anatomical, hormonal and psychological changes in women. Pregnancy changes can affect the pregnant woman's sleep, reducing its quality and duration. Objective: This study aims to verify the prevalence of sleep alterations and associated factors in pregnant women. Methods: Epidemiological, cross-sectional and analytical study carried out with pregnant women registered in the Family Health Strategy Teams of the urban area of the municipality of Montes Claros in 2018. The probabilistic sample was calculated in 1,180 pregnant women. Data were collected from a questionnaire containing the information of interest with subsequent analysis of the variables. Results: It was verified that 87.5% of the participants had sleep alterations during pregnancy. The increase in sleep was reported by 50.5%, the decrease by 21.8% and 15.1% both. Social support (p=0.032), quality of life (p<0.001), stress (p=0.009) and symptoms of depression (p=0.005) were individually associated with sleep disturbance and quality of life was remained associated after adjustment (adjusted PR: 0.482, 95% CI 0.482; p=<0.001). Conclusion: There is a high sleep disturbance among pregnant woman, being associated with social support, quality of life, stress and depression.

Resumen Contexto: El embarazo provoca diversos cambios fisiológicos, anatómicos, hormonales y psicológicos en la mujer. Los cambios del embarazo pueden afectar el sueño de la mujer embarazada, reduciendo su calidad y duración. Objetivo: Este estudio tiene como objetivo verificar la prevalencia de trastornos del sueño en mujeres embarazadas y los factores asociados. Métodos: Estudio epidemiológico, transversal y analítico realizado con gestantes registradas en los Equipos de Estrategia de Salud de la Familia del casco urbano del municipio de Montes Claros en el año 2018. La muestra probabilística se calculó en 1.180 gestantes. Los datos se recogieron a partir de un cuestionario que contenía la información de interés con el posterior análisis de las variables. Resultados: Se encontró que 87,5% de las participantes presentaron trastornos del sueño durante el embarazo. El aumento del sueño fue reportado en un 50,5%, la disminución en un 21,8% y en un 15,1% ambos. El apoyo social (p=0,032), la calidad de vida (p<0,001), el estrés (p=0,009) y los síntomas de depresión (p=0,005) se asociaron individualmente con la alteración del sueño y la calidad de vida se mantuvo asociada después del ajuste (RP ajustado: 0,482, IC 95% 0,482, p=<0,001). Conclusión: Existe una alta alteración del sueño entre las gestantes, siendo asociado al apoyo social, calidad de vida, estrés y depresión.

Quality of life of Brazilian families who have children with Williams syndrome.

This cross-sectional and descriptive study examined the family quality of life (FQoL) among 72 Brazilian families who have children with Williams syndrome, a rare genetic disorder in which most individuals have an intellectual disability, usually mild. Data were collected using sociodemographic and clinical data forms and the Beach Center FQoL Scale. The overall FQoL score was 3.90 ± 0.45, below the limit of four points considered satisfactory. Families felt more satisfied with the family interaction (4.11 ± 0.57), parenting (4.07 ± 0.42), and disability-related support (3.94 ± 0.62) domains, and less satisfied with the family's emotional (3.49 ± 0.73) and physical/material well-being (3.73 ± 0.74) domains. Paternal education, children's cardiopathy and autonomy in activities of daily living explained 24.5% of the variance in the overall FQoL. Measures are necessary to improve the emotional and physical/material well-being of families to reduce the family burden. Monitoring the child's cardiac condition and promoting independence in activities of daily living are also the main procedures.

Transcriptomic and biochemical analysis from the venom gland of the neotropical ant Odontomachus chelifer.

The genus Odontomachus is widely distributed in neotropical areas throughout Central and South America. It is a stinging ant that subdues its prey (insects) by injecting them a cocktail of toxic molecules (venom). Ant venoms are generally composed of formic acid, alkaloids, hydrocarbons, amines, peptides, and proteins. Odontomachus chelifer is an ant that inhabits neotropical regions from Mexico to Argentina. Unlike the venom of other animals such as scorpions, spiders and snakes, this ant venom has seldom been analyzed comprehensively, and their compositions are not yet completely known. In the present study, we performed a partial investigation of enzymatic and functional activities of O. chelifer ant venom, and we provide a global insight on the transcripts expressed in the venom gland to better understand their properties. The crude venom showed phospholipase A2 and antiparasitic activities. RNA sequencing (Illumina platform) of the venom gland of O. chelifer generated 61, 422, 898 reads and de novo assembly Trinity generated 50,220 contigs. BUSCO analysis against Arthropoda_db10 showed that 92.89% of the BUSCO groups have complete gene representation (single-copy or duplicated), while 4.05% are only partially recovered, and 3.06% are missing. The 30 most expressed genes in O. chelifer venom gland transcriptome included important transcripts involved in venom function such as U-poneritoxin (01)-Om1a-like (pilosulin), chitinase 2, venom allergen 3, chymotrypsin 1 and 2 and glutathione S-transferase. Analysis of the molecular function revealed that the largest number of transcripts were related to catalytic activity, including phospholipases. These data emphasize the potential of O. chelifer venom for prospection of molecules with biotechnological application.

Percepção de puérperas atendidas em um centro de parto normal público de Pernambuco / Perception of pregnancy care at a public normal childhood center in Pernambuco

Objetivo: Analisar a percepção de puérperas atendidas em um Centro de Parto Normal público de Pernambuco sobre o parto humanizado. Métodos: Trata-se de um estudo descritivo exploratório de caráter qualitativo, realizado em um Centro de Parto Normal de Pernambuco com 10 puérperas entre julho a agosto de 2020. A coleta de dados ocorreu por meio de entrevistas semiestruturadas, guiadas por um roteiro, gravadas e transcritas na íntegra, e analisadas pela técnica de análise de conteúdo. Resultados: Constatou-se satisfação entre as puérperas frente a vivência e aos procedimentos realizados, principalmente aos cuidados e orientações concedidas pela equipe de Enfermagem quanto processo de parto e puerpério. Conclusão: As puérperas mostraram-se satisfeitas em relação ao atendimento oferecido pelo Centro de Parto Normal, especialmente devido à adesão às boas práticas preconizadas pela Organização Mundial de Saúde.(AU)

Objective: To analyze the perception of puerperal women attended at a Public Normal Birth Center in Pernambuco about humanized childbirth. Methods: This is a descriptive exploratory study of a qualitative nature, carried out in a Normal Childbirth Center in Pernambuco with 10 postpartum women between July and August 2020. Data collection took place through semi-structured interviews, guided by a script, recorded and transcribed in full, and analyzed using the content analysis technique. It is reiterated that the study was approved by an Ethics Committee (4,136,314). Results: There was satisfaction among the puerperal women regarding the experience and procedures performed at the Centro de Parto Normal, especially the care and guidance provided by the nursing team regarding the delivery process and the puerperium. Conclusion: The puerperal women were satisfied with the care offered by the Centro de Parto Normal, especially due to adherence to the good practices recommended by the World Health Organization.(AU)

Objetivo: Analizar la percepción de las puérperas atendidas en un Centro Público de Partos Normales de Pernambuco sobre el parto humanizado. Métodos: Se trata de un estudio exploratorio descriptivo de carácter cualitativo, realizado en un Centro de Parto Normal en Pernambuco con 10 puérperas entre julio y agosto de 2020. La recolección de datos se realizó mediante entrevistas semiestructuradas, guiadas por un guión, grabadas y transcritas íntegramente y analizadas mediante la técnica de análisis de contenido. Se reitera que el estudio fue aprobado por un Comité de Ética (4.136.314). Resultados: Hubo satisfacción entre las puérperas con respecto a la experiencia y procedimientos realizados en el Centro de Parto Normal, especialmente los cuidados y orientación brindados por el equipo de enfermería en relación al proceso de parto y puerperio. Conclusión: Las puérperas se mostraron satisfechas con la atención brindada por el Centro de Parto Normal, especialmente por el apego a las buenas prácticas recomendadas por la Organización Mundial de la Salud.(AU)

DIAGNOSTIC VALUE OF THE REACTION AT THE BACILLUS CALMETTE-GUÉRIN VACCINATION SITE IN KAWASAKI DISEASE.

OBJECTIVE: To describe the case of an infant - diagnosed with incomplete Kawasaki disease - who developed BCG scar reactivation. CASE DESCRIPTION: A 6-month-old patient was admitted to hospital with fever associated with ocular hyperemia, cervical lymphadenopathy, and hyperemic lips, and remained hospitalized for 12 days. The physical examination revealed an inflammatory reaction at the site of the BCG scar, leading to the diagnosis of incomplete Kawasaki disease. The patient was treated with venous immunoglobulin, but presented recurrence of Kawasaki disease, with subsequent onset of coronary artery disease. COMMENTS: BCG scar reactivation is an important finding in countries where the vaccine is routinely given and may be a useful marker for early diagnosis of Kawasaki disease, especially in its incomplete form.

Comparative study of complications after primary and revision transsphenoidal endoscopic surgeries.

A preferred treatment for residual/recurrent pituitary adenomas has not been established. The existence of higher complication rates for revision surgeries remains under debate. This study aimed to compare complication rates of primary and revision transsphenoidal endoscopic surgeries and to identify risk factors for complications. Data from 144 primary and 39 revision surgeries were analysed. The surgical complications evaluated were intraoperative and postoperative cerebrospinal fluid (CSF) leaks; meningitis; permanent diabetes insipidus (DI) and hypopituitarism; worsening visual acuity; ophthalmoplegias; visual field defects; otorhinolaryngological, systemic and vascular complications; and death. The variables that were potentially associated with surgical complications were gender, age, comorbidities, lumbar drain use, duration of lumbar drain use, invasion of the sphenoid and cavernous sinuses, presence and degree of suprasellar expansion, preoperative identification of the pituitary, CSF leaks and intraoperative pituitary identification. Intraoperative CSF leaks, visual field losses and worsening visual acuity were more common for revision surgeries. There were no between-group differences in the occurrence of postoperative CSF leaks; systemic, vascular and otorhinolaryngological complications; meningitis; DI and hypopituitarism; ophthalmoplegias; or death. Intraoperative identification of the pituitary was associated with lower rates of permanent DI and hypopituitarism, systemic complications, intraoperative CSF leaks and worsening visual acuity. Suprasellar expansion increased the risk of intraoperative CSF leaks but not endocrinological deficits or visual impairment. Intraoperative CSF leaks were associated with postoperative CSF leaks, meningitis, anterior hypopituitarism, DI and worsening visual acuity. Intraoperative CSF leaks, worsening visual acuity and visual field losses were more common in reoperated patients.

Diagnostic value of the reaction at the bacillus calmette-guérin vaccination site in kawasaki disease / Utilidade diagnóstica da reação do sítio de vacinação bacillus calmette-guérin na doença de kawasaki

ABSTRACT Objective: To describe the case of an infant - diagnosed with incomplete Kawasaki disease - who developed BCG scar reactivation. Case description: A 6-month-old patient was admitted to hospital with fever associated with ocular hyperemia, cervical lymphadenopathy, and hyperemic lips, and remained hospitalized for 12 days. The physical examination revealed an inflammatory reaction at the site of the BCG scar, leading to the diagnosis of incomplete Kawasaki disease. The patient was treated with venous immunoglobulin, but presented recurrence of Kawasaki disease, with subsequent onset of coronary artery disease. Comments: BCG scar reactivation is an important finding in countries where the vaccine is routinely given and may be a useful marker for early diagnosis of Kawasaki disease, especially in its incomplete form.

RESUMO Objetivo: Descrever o caso de um lactente - com diagnóstico de Doença de Kawasaki incompleta - que desenvolveu reativação da cicatriz da vacina BCG. Descrição do caso: Um paciente de 6 meses de idade foi admitido no hospital com febre, associada à hiperemia ocular, linfadenomegalia cervical e fissuras labiais, permanecendo hospitalizado por 12 dias. Apresentava, no exame físico, reação inflamatória no local da cicatriz da vacina BCG, tendo sido feito o diagnóstico de Kawasaki incompleto. O paciente foi tratado com imunoglobulina venosa, mas apresentou recorrência da doença, com posterior surgimento de coronariopatia. Comentários: A reativação da BCG é um achado importante na doença de Kawasaki em países onde a vacina é aplicada de forma rotineira e pode ser um marcador útil para o diagnóstico precoce da doença de Kawasaki, principalmente em sua forma incompleta.

Guia de cuidados iniciais às vítimas de picada de escorpião na Flona de Tapajós

Parte da dissertação: Silva, Erli Marta Reis da. Acidente escorpiônico no Município de Santarém PA: características epidemiológicas e trajeto percorrido pelos pacientes até o serviço de saúde [dissertação]. São Paulo: Universidade de São Paulo, Escola de Enfermagem; 2018 [citado 2020-10-23]. doi:10.11606/D.7.2018.tde-05112018-133538.

Eiras e beiras: atenção psicossocial a pessoas com problemas decorrentes do uso de drogas / Eiras y beiras: atención psicosocial a las personas con problemas derivados del uso de drogas / Places and borders: psychosocial care for people with drug abuse

RESUMO A oferta de estágios acadêmico-profissionalizantes é um recurso para reduzir lacunas relacionadas à formação para a atuação no campo de álcool e outras drogas. Apresentam-se reflexões acerca do projeto terapêutico singular (PTS) como tecnologia de cuidado na atenção psicossocial a pessoas com problemas decorrentes do uso de drogas e os seus efeitos da sua adoção na formação de estudantes de Psicologia. A abordagem da família como unidade de cuidado, o estabelecimento de vínculos e o respeito à autonomia foram ressaltados no decorrer do desenvolvimento da experiência de estágio. Nota-se que o ato de cuidar é central para a consolidação de um modelo de atenção contra-hegemônico. Aponta-se ainda a necessidade de aprofundamento na construção teórica acerca do modelo de atenção de usuários de drogas na perspectiva da saúde pública.

RESUMEN La oferta de prácticas académico-profesionalizantes es un recurso para reducir las ausencias relacionadas con la formación para la actuación en el campo de alcohol y otras drogas. Se presentan reflexiones acerca del proyecto terapéutico singular (PTS) como tecnología de atención en la atención psicosocial a personas con problemas derivados del uso de drogas y los efectos de su adopción en la formación de estudiantes de Psicología. El enfoque de la familia como unidad de cuidado, el establecimiento de vínculos y el respeto a la autonomía se resalta en el curso del desarrollo de la experiencia de práctica. Se observa que el acto de cuidar es central para la consolidación de un modelo de atención contra-hegemónico. Se apunta también la necesidad de profundizar en la construcción teórica acerca del modelo de atención de usuarios de drogas en la perspectiva de la salud pública.

ABSTRACT The provision of academic-professional internships is a resource to reduce training-related gaps in the field of alcohol and other drugs. Reflections on the singular therapeutic project (STP) are presented as a healthcare technology in psychosocial care for people with problems due to drug use, as well as its effects on the training of Psychology students. The approach of the family as a unit of care, the establishment of bonds and respect for autonomy were highlighted in the course of the internship experience. It is noted that the act of caring is central to the consolidation of a counter-hegemonic healthcare model. It is also pointed out the need to deepen the theoretical construction about the attention model of drug users from a public health perspective.

Upper vena cava syndrome secondary to giant atrial myxoma.

OBJECTIVE: Cardiac myxoma is a benign neoplasm, which corresponds to the most common primary heart tumour, responsible for about 50% of the cases. In general, 75-80% of myxomas are located in the left atrium, 18% in the right atrium, and more rarely in the ventricles or multicentric. Right atrial myxoma, in particular, can obstruct the tricuspid valve, causing symptoms of right heart failure, peripheral oedema, hepatic congestion, and syncope. Systemic embolization occurs in 30% of cases, by either tumour fragmentation or total tumour detachment. CONCLUSIONS: In the present report, we present a case of a symptomatic patient, who showed a large right intra-atrial lesion, with consequent superior vena cava syndrome, and then underwent surgical resection at admission.

Upper vena cava syndrome secondary to giant atrial myxoma

SUMMARY Cardiac myxoma is a benign neoplasm, which corresponds to the most common primary heart tumour, responsible for about 50% of the cases. In general, 75-80% of myxomas are located in the left atrium, 18% in the right atrium, and more rarely in the ventricles or multicentric. Right atrial myxoma, in particular, can obstruct the tricuspid valve, causing symptoms of right heart failure, peripheral oedema, hepatic congestion, and syncope. Systemic embolization occurs in 30% of cases, by either tumour fragmentation or total tumour detachment. In the present report, we present a case of a symptomatic patient, who showed a large right intra-atrial lesion, with consequent superior vena cava syndrome, and then underwent surgical resection at admission.

RESUMO O mixoma cardíaco é uma neoplasia benigna, que corresponde ao tumor primário mais comum do coração, responsável por cerca de 50% dos casos. De modo geral, 75 a 80% dos mixomas estão localizados no átrio esquerdo, 18% no átrio direito, e mais raramente, nos ventrículos ou multicêntricos. O mixoma atrial direito, em particular, pode obstruir a válvula tricúspide, causando sintomas de insuficiência cardíaca direita, edema periférico, congestão hepática e síncope. A embolização sistêmica ocorre em 30% dos casos, quer pela fragmentação do tumor ou pelo desprendimento total do mesmo. No presente relato, apresentamos um caso de uma paciente sintomática, que evidenciou grande lesão intra-atrial direita, com consequente síndrome da veia cava superior, sendo, então, submetida a ressecção cirúrgica na internação.

(1)H, (15)N and (13)C resonance assignments and secondary structure prediction of Q4D059, a conserved and kinetoplastid-specific hypothetical protein from Trypanosoma cruzi.

Trypanosoma cruzi is a human parasite that causes Chagas disease, an illness affecting millions of people and without an efficient treatment available. Sequencing the pathogen genome has revealed that near half of protein-coding genes correspond to hypothetical proteins of unknown function, increasing the possibilities for novel target discovery. Q4D059 is a putative essential hypothetical protein from T. cruzi and it is specific and conserved among the trypanosomatid genomes. Here, we report the sequential backbone and side chain resonance assignments and secondary structure analysis of Q4D059, as first step for protein structure determination, function elucidation and drug screening.