Bidirectional relation between dipeptidyl peptidase 4 and angiotensin II type I receptor signaling.

Cardiometabolic diseases are often associated with heightened levels of angiotensin II (Ang II), which accounts for the observed oxidative stress, inflammation, and fibrosis. Accumulating evidence indicates a parallel upregulation of dipeptidyl dipeptidase 4 (DPP4) activity in cardiometabolic diseases, with its inhibition shown to mitigate oxidative stress, inflammation, and fibrosis. These findings highlight an overlap between the pathophysiological mechanisms used by Ang II and DPP4. Recent evidence demonstrates that targeted inhibition of DPP4 prevents the rise in Ang II and its associated molecules in experimental models of cardiometabolic diseases. Similarly, inhibitors of the angiotensin I-converting enzyme (ACE) or Ang II type 1 receptor (AT1R) blockers downregulate DPP4 activity, establishing a bidirectional relationship between DPP4 and Ang II. Here, we discuss the current evidence supporting the cross talk between Ang II and DPP4, along with the potential mechanisms promoting this cross regulation. A comprehensive analysis of this bidirectional relationship across tissues will advance our understanding of how DPP4 and Ang II collectively promote the development and progression of cardiometabolic diseases.

Renal upregulation of NCC counteracts empagliflozin-mediated NHE3 inhibition in normotensive but not in hypertensive male rat.

Sodium-glucose cotransporter-2 inhibitors (SGLT2i) reduce blood pressure (BP) in patients with hypertension, yet the precise molecular mechanisms remain elusive. SGLT2i inhibits proximal tubule (PT) NHE3-mediated sodium reabsorption in normotensive rodents, yet no hypotensive effect is observed under this scenario. This study examined the effect of empagliflozin (EMPA) on renal tubular sodium transport in normotensive and spontaneously hypertensive rats (SHRs). It also tested the hypothesis that EMPA-mediated PT NHE3 inhibition in normotensive rats is associated with upregulation of distal nephron apical sodium transporters. EMPA administration for 14 days reduced BP in 12-wk-old SHRs but not in age-matched Wistar rats. PT NHE3 activity was inhibited by EMPA treatment in both Wistar and SHRs. In Wistar rats, EMPA increased NCC activity, mRNA expression, protein abundance, and phosphorylation levels, but not in SHRs. SHRs showed higher NKCC2 activity and an abundance of cleaved ENaC α and γ subunits compared with Wistar rats, none of which were affected by EMPA. Another set of male Wistar rats was treated with EMPA, the NCC inhibitor hydrochlorothiazide (HCTZ), and EMPA combined with HCTZ or vehicle for 14 days. In these rats, BP reduction was observed only with combined EMPA and HCTZ treatment, not with either drug alone. These findings suggest that NCC upregulation counteracts EMPA-mediated inhibition of PT NHE3 in male normotensive rats, maintaining their baseline BP. Moreover, the reduction of NHE3 activity without further upregulation of major apical sodium transporters beyond the PT may contribute to the BP-lowering effect of SGLT2i in experimental models and patients with hypertension.NEW & NOTEWORTHY This study suggests that reduced NHE3-mediated sodium reabsorption in the renal proximal tubule may account, at least in part, for the BP-lowering effect of SGLT2 inhibitors in the setting of hypertension. It also demonstrates that chronic treatment with SGLT2 inhibitors upregulates NCC activity, phosphorylation, and expression in the distal tubule of normotensive but not hypertensive rats. SGLT2 inhibitor-mediated upregulation of NCC seems crucial to counteract proximal tubule natriuresis in subjects with normal BP.

Chronic ethanol exposure decreases H3K27me3 in the Il6 promoter region of macrophages and generates persistent dysfunction on neutrophils during fungal infection.

OBJECTIVE AND DESIGN: The aim of this study was to investigate the effects of ethanol exposure on epigenetic markers in bone marrow (BM) and their impact on inflammatory response during Aspergillus fumigatus infection. RESULTS: Chronic ethanol exposure decreased H3K27me3 enrichment in the Il6 promoter region while increased H3K4me3 enrichment in Tnf. Chimeric mice were generated by transplanting BM from mice exposed to ethanol or water. Infection of ethanol-chimeric mice culminated in higher clinical scores, although there was no effect on mortality. However, previous chronic exposure to ethanol affects persistently the inflammatory response in lung tissue, demonstrated by increased lung damage, neutrophil accumulation and IL-6, TNF and CXCL2 production in ethanol-chimeric mice, resulting in a decreased neutrophil infiltration into the alveolar space. Neutrophil killing and phagocytosis were also significantly lower. Moreover, BM derived macrophages (BMDM) from ethanol-chimeric mice stimulated with A. fumigatus conidia exhibited higher levels of TNF, CXCL2 and IL-6 release and a higher killing activity. The Il6 promoter of BMDM from ethanol-chimeric mice exhibited a reduction in H3K27me3 enrichment, a finding also observed in BM donors exposed to ethanol. CONCLUSIONS: These evidences demonstrate that prior chronic alcohol exposure of bone-marrow modify immune effector cells functions impairing the inflammatory response during A. fumigatus infection. These findings highlight the persistent impact of chronic ethanol exposure on infectious disease outcomes.

Health care accessibility and mobility in breast cancer: a Latin American perspective.

BACKGROUND: Latin America (LATAM) encompasses a vast region with diverse populations. Despite publicly funded health care systems providing universal coverage, significant socioeconomic and ethno-racial disparities persist in health care access across the region. Breast cancer (BC) incidence and mortality rates in Brazil are comparable to those in other LATAM countries, supporting the relevance of Brazilian data, with Brazil's health care policies and expenditures often serving as models for neighboring countries. We evaluated the impact of mobility on oncological outcomes in LATAM by analyzing studies of patients with BC reporting commuting routes or travel distances to receive treatment or diagnosis. METHODS: We searched MEDLINE (PubMed), Embase, Cochrane CENTRAL, LILACS, and Google Scholar databases. Studies eligible for inclusion were randomized controlled trials and observational studies of patients with BC published in English, Portuguese, or Spanish and conducted in LATAM. The primary outcome was the impact of mobility or travel distance on oncological outcomes. Secondary outcomes included factors related to mobility barriers and access to health services. For studies meeting eligibility, relevant data were extracted using standardized forms. Risk of bias was assessed using the Newcastle-Ottawa Scale. Quantitative and qualitative evidence synthesis focused on estimating travel distances based on available data. Heterogeneity across distance traveled or travel time was addressed by converting reported travel time to kilometers traveled and estimating distances for unspecified locations. RESULTS: Of 1142 records identified, 14 were included (12 from Brazil, 1 from Mexico, and 1 from Argentina). Meta-analysis revealed an average travel distance of 77.8 km (95% CI, 49.1-106.48) to access BC-related diagnostic or therapeutic resources. Nonetheless, this average fails to precisely encapsulate the distinct characteristics of each region, where notable variations persist in travel distance, ranging from 88 km in the South to 448 km in the North. CONCLUSION: The influence of mobility and travel distance on access to BC care is multifaceted and should consider the complex interplay of geographic barriers, sociodemographic factors, health system issues, and policy-related challenges. Further research is needed to comprehensively understand the variables impacting access to health services, particularly in LATAM countries, where the challenges women face during treatment remain understudied. TRIAL REGISTRATION: CRD42023446936.

KRAS silencing alters chromatin physical organization and transcriptional activity in colorectal cancer cells.

Clinical data revealed that KRAS mutant tumors, while initially sensitive to treatment, rapidly bypass KRAS dependence to acquire a drug-tolerant phenotype. However, the mechanisms underlying the transition from a drug-sensitive to a drug-tolerant state still elude us. Here, we show that global chromatin reorganization is a recurrent and specific feature of KRAS-dependent cells that tolerated KRAS silencing. We show that KRAS-dependent cells undergo G0/G1 cell cycle arrest after KRAS silencing, presenting a transcriptomic signature of quiescence. Proteomic analysis showed upregulated chromatin-associated proteins and transcription-associated biological processes. Accordingly, these cells shifted euchromatin/heterochromatin states, gained topologically associating domains, and altered the nanoscale physical organization of chromatin, more precisely by downregulating chromatin packing domains, a feature associated with the induction of quiescence. In addition, they also accumulated transcriptional alterations over time leading to a diversification of biological processes, linking chromatin alterations to transcriptional performance. Overall, our observations pinpoint a novel molecular mechanism of tolerance to KRAS oncogenic loss driven not by specific gene alterations but by global reorganization of genomic information, in which cells transition chromatin domain structure towards a more quiescent state and gain transcriptional reprogramming capacity.

Fibroblasts Promote Resistance to KRAS Silencing in Colorectal Cancer Cells.

Colorectal cancer (CRC) responses to KRAS-targeted inhibition have been limited due to low response rates, the mechanisms of which remain unknown. Herein, we explored the cancer-associated fibroblasts (CAFs) secretome as a mediator of resistance to KRAS silencing. CRC cell lines HCT15, HCT116, and SW480 were cultured either in recommended media or in conditioned media from a normal colon fibroblast cell line (CCD-18Co) activated with rhTGF-ß1 to induce a CAF-like phenotype. The expression of membrane stem cell markers was analyzed by flow cytometry. Stem cell potential was evaluated by a sphere formation assay. RNAseq was performed in KRAS-silenced HCT116 colonospheres treated with either control media or conditioned media from CAFs. Our results demonstrated that KRAS-silencing up-regulated CD24 and down-regulated CD49f and CD104 in the three cell lines, leading to a reduction in sphere-forming efficiency. However, CAF-secreted factors restored stem cell marker expression and increased stemness. RNA sequencing showed that CAF-secreted factors up-regulated genes associated with pro-tumorigenic pathways in KRAS-silenced cells, including KRAS, TGFß, NOTCH, WNT, MYC, cell cycle progression and exit from quiescence, epithelial-mesenchymal transition, and immune regulation. Overall, our results suggest that resistance to KRAS-targeted inhibition might derive not only from cell-intrinsic causes but also from external elements, such as fibroblast-secreted factors.

Association between Self-Perception of Chewing, Chewing Behavior, and the Presence of Gastrointestinal Symptoms in Candidates for Bariatric Surgery.

Given the changes in the digestive tract post-bariatric surgery, adapting to a new pattern of eating behavior becomes crucial, with special attention to the specifics of chewing mechanics. This study aimed to investigate the association between self-perception of chewing, chewing behavior, and the presence of gastrointestinal symptoms in preoperative patients undergoing bariatric surgery. Sixty adult candidates for bariatric surgery at a public hospital in Belém (Brazil) were analyzed. Participants predominantly exhibited unilateral chewing patterns (91.6%), a fast chewing rhythm (73.3%), a large food bolus (80%), liquid intake during meals (36.7%), and 41.7% reported that chewing could cause some issue. Significant associations were found between the perception of causing problems and chewing scarcity (p = 0.006), diarrhea (p = 0.004), absence of slow chewing (p = 0.048), and frequent cutting of food with front teeth (p = 0.034). These findings reveal a relationship between the perception of chewing problems and chewing scarcity, presence of diarrhea, and fast chewing.

Beyond Clinical Trials: Understanding Neurotrophic Tropomyosin Receptor Kinase Inhibitor Challenges and Efficacy in Real-World Pediatric Oncology.

PURPOSE: Our study aimed to explore real-world treatment scenarios for children and adolescents with neurotrophic tropomyosin receptor kinase (NTRK)-fused tumors, emphasizing access, responses, side effects, and outcomes. PATIENTS AND METHODS: Pooled clinical data from 17 pediatric cases (11 soft-tissue sarcomas, five brain tumors, and one neuroblastoma) treated with larotrectinib and radiologic images for 14 patients were centrally reviewed. Testing for gene fusions was prompted by poor response to treatment, tumor progression, or aggressiveness. RESULTS: Six different NTRK fusion subtypes were detected, and various payment sources for testing and medication were reported. Radiologic review revealed objective tumor responses (OR) in 11 of 14 patients: Complete responses: two; partial responses: nine; and stable disease: three cases. Grades 1 or 2 Common Terminology Criteria for Adverse Events adverse effects were reported in five patients. Regarding the entire cohort's clinical information, 15 of 17 patients remain alive (median observation time: 25 months): four with no evidence of disease and 11 alive with disease (10 without progression). One patient developed resistance to the NTRK inhibitor and died from disease progression while another patient died due to an unrelated cause. CONCLUSION: This real-world study confirms favorable agnostic tumor OR rates to larotrectinib in children with NTRK-fused tumors. Better coordination to facilitate access to medication remains a challenge, particularly in middle-income countries like Brazil.

Estratégias para treinamento de equipe multiprofissional da atenção primária em segurança do paciente: revisão integrativa / Strategies for training multidisciplinary primary care teams in patient safety: an integrative review

Objetivo: Analisar as estratégias de treinamento em segurança do paciente para profissionais de saúde no contexto da atenção primária. Métodos: Trata-se de uma revisão integrativa conduzida nas bases de dados Medical Literature Analysis and Retrieval System Online, Literatura Latino-Americana e do Caribe em Ciências da Saúde, Base de Dados de Enfermagem, Web of Sciencee Scopus, com os descritores "Capacitação Profissional", "Segurança do Paciente" e "Atenção Primária à Saúde". Resultados: Foram identificados 390 estudos nas bases de dados, os quais resultaram em uma amostra final de seis artigos para a composição da revisão. Estes foram publicados entre os anos de 2017 e 2019, desenvolvidos em países da Europa, da América do Norte e Oceania. Conclusão: Descaram-se como estratégias de treinamento os seguintes itens: workshop, implementação de programa de segurança medicamentosa, identificação de fatores-chave para elevação da qualidade, feedback e aprendizagem através de erros. Descritores: Capacitação Profissional; Atenção Primária à Saúde; Segurança do Paciente; Pessoal de Saúde

Objective: To analyze patient safety training strategies for health professionals in the context of primary care.Methods: This is an integrative review conducted in the Medical Literature Analysis and Retrieval System Online, Latin American and Caribbean Center on Health Sciences Information, Base de Dados de Enfermagem, Web of Science and Scopus databases, with the descriptors "Professional Training", "Patient Safety" and "Primary Health Care". Results: A total of 390 studies were identified in the databases, which resulted in a final sample of six articles for the composition of the review. These were published between the years 2017 and 2019, developed in countries in Europe, North America and Oceania. Conclusion: The following items were described as training strategies: workshop, implementation of a medication safety program, identification of key factors for quality improvement, feedback and learning through errors.Descriptors:Professional Training; Primary Health Care; Patient Safety; Health Personnel

Conhecimento, atitude e prática de universitários intercambistas africanos acerca das Infecções Sexualmente Transmissíveis / Conocimiento, actitud y práctica de estudiantes africanos de intercambio sobre las infecciones de transmisión sexual / Knowledge, attitude and practice of African university exchange students about Sexually Transmitted Infections

RESUMO Objetivo avaliar o conhecimento, a atitude e a prática de universitários intercambistas provenientes do continente africano acerca das Infecções Sexualmente Transmissíveis. Método estudo transversal, realizado de dezembro de 2019 a março de 2020, em universidade pública internacional brasileira localizada no Ceará. A amostra foi constituída por 150 estudantes africanos de diferentes cursos de graduação. Utilizou-se do inquérito de Conhecimento, Atitude e Prática. Resultados os universitários apresentaram conhecimento satisfatório acerca da forma de transmissão das Infecções Sexualmente Transmissíveis, porém, com deficiências a respeito das hepatites virais. Identificou-se associação entre sexo e atitude acerca do uso de preservativo em relação sexual com parceria fixa (p=0,042). No que se refere às práticas, houve associação entre sexo e uso do preservativo na primeira relação sexual (p=0,001), ter mais que um parceiro (p=0,001) e mais que dez parceiros em toda a vida (0,007). No que se relaciona às práticas sexuais nos últimos 12 meses, observou-se associação estatística entre ter relações sexuais com mais de um parceiro sexual e sexo do participante (p=0,001). Conclusão e implicações para a prática enfatiza-se a importância de a universidade pesquisada realizar atividades de educação em saúde que abordem Infecções Sexualmente Transmissíveis, bem como de extensão universitária, que envolvam alunos imigrantes africanos.

RESUMEN Objetivo evaluar el conocimiento, la actitud y la práctica de estudiantes de intercambio del continente africano sobre las Infecciones de Transmisión Sexual. Método estudio transversal, realizado de diciembre de 2019 a marzo de 2020, en una universidad pública internacional brasileña ubicada en Ceará. La muestra estuvo compuesta por 150 estudiantes africanos de diferentes cursos de pregrado. Se utilizó la encuesta de Conocimiento, Actitud y Práctica. Resultados los universitarios mostraron conocimientos satisfactorios sobre la transmisión de Infecciones de Transmisión Sexual, sin embargo, con deficiencias sobre las hepatitis virales. Se identificó asociación entre el sexo y la actitud sobre el uso del preservativo en las relaciones sexuales con pareja estable (p=0,042). En cuanto a las prácticas, hubo asociación entre sexo y uso de preservativo en la primera relación sexual (p=0,001), tener más de una pareja (p=0,001) y tener más de diez parejas en la vida (0,007). En cuanto a las prácticas sexuales en los últimos 12 meses, hubo asociación estadística entre tener sexo con más de una pareja sexual y el género del participante (p=0,001). Conclusión e implicaciones para la práctica se destaca la importancia de que la universidad investigada realice actividades de educación en salud que aborden las Infecciones de Transmisión Sexual, así como actividades de extensión universitaria, involucrando estudiantes inmigrantes africanos.

ABSTRACT Objective to evaluate the knowledge, attitude and practice of university exchange students from the African continent about Sexually Transmitted Infections. Method a cross-sectional study, conducted from December 2019 to March 2020, in a public international Brazilian university located in Ceará. The sample consisted of 150 African students from different undergraduate courses. It was used the survey of Knowledge, Attitude and Practice. Results the students showed satisfactory knowledge about the form of transmission of Sexually Transmitted Infections, however, with deficiencies regarding viral hepatitis. An association between sex and attitude about condom use in sexual intercourse with a fixed partner was identified (p=0.042). Regarding the practices, there was an association between sex and condom use in the first sexual relation (p=0.001), having more than one partner (p=0.001) and more than ten partners in the whole life (0.007). Regarding sexual practices in the last 12 months, there was a statistical association between having sex with more than one sexual partner and the participant's sex (p=0.001). Conclusion and implications for practice the importance of the university researched carrying out health education activities that address Sexually Transmitted Infections, as well as university extension activities that involve African immigrant students, is emphasized.

Assistência de enfermagem no cateterismo de Swan-Ganz: uma revisão integrativa / Nursing care at Swan-Ganz catheterism: an integrative review / Atención de enfermería en el cateterismo de Swan-Ganz: una revisión integradora

Objetivo: analisar a produção científica quanto a assistência de enfermagem ao paciente em uso de Cateter de Swan-Ganz e ao conhecimento dos enfermeiros relacionado a esse dispositivo. Método: revisão integrativa da literatura, com busca realizada no mês de junho e finalizada em julho de 2020, nas bases de dados da Web of Science, PubMed, LILACS e SCIELO. Resultados: Identificou-se nas produções científicas que para a prestação da assistência de enfermagem, torna-se importante a expertise do profissional em remover o cateter; o monitoramento da pressão arterial pulmonar; higienização da pele, curativo adicional, dentre outras ações. O conhecimento dos enfermeiros foi considerado insatisfatório e também foram relatadas dificuldades na interpretação das informações relacionadas ao uso do cateter. Conclusão: os cuidados de enfermagem ao paciente em uso deste cateter correspondem ao monitoramento e interpretação dos parâmetros, prevenção de infecção associada ao cateter e sua remoção. Evidencia-se dificuldades entre os enfermeiros na interpretação dos dados coletados, apontando a necessidade de aprimoramento dos conhecimentos (AU).

Objective: to analyze the scientific production regarding nursing care to patients using the Swan-Ganz catheter and nurses' knowledge about this device. Method: integrative literature review, with a search conducted in June and finalized in July 2020, in the Web of Science, PubMed, LILACS and SCIELO databases. Results: the sample comprised six studies, which were categorized according to the corpus of the study as: assistance regarding Swan-Ganz catheter care and nurses' knowledge about this device. It was identified in the scientific productions that for the provision of nursing care, it is important the professional's expertise to remove the catheter; the monitoring of pulmonary arterial pressure; the cleaning of the skin, additional dressing, among other actions. The nurses' knowledge was considered unsatisfactory, and difficulties in interpreting the information related to catheter use were also reported. Conclusion: nursing care to patients using this catheter corresponds to the monitoring and interpretation of parameters, prevention of infection associated with the catheter and its removal. Evidencia-se dificuldades entre os enfermeiros na interpretação dos dados coletados, apontando a necessidade de aprimoramento dos conhecimentos (AU).

Objetivo: analizar la producción científica sobre la atención del enfermero al paciente que usa catéter de Swan-Ganz y el conocimiento de los enfermeros relacionado con este dispositivo. Método: revisión integradora de la literatura, la búsqueda se realizó en junio y julio de 2020, en las bases de datos de Web of Science, PubMed, LILACS y SCIELO. Resultados: la muestra estuvo compuesta por seis estudios, que fueron categorizados según el corpus del estudio en: atención sobre cómo realizar los cuidados del catéter de Swan-Ganz y conocimiento de los enfermeros sobre este dispositivo. Se identificó en los resultados científicos que, para la atención sanitaria, es importante la experiencia del profesional en la remoción del catéter; el monitoreo de la presión arterial pulmonar; la higienización de la piel, un apósito adicional, entre otras cosas. El conocimiento de los enfermeros se consideró insatisfactorio y también se manifestaron dificultades para interpretar la información relacionada con el uso del catéter. Conclusión: la atención de enfermería al paciente que usa este catéter implica el monitoreo y la interpretación de los parámetros, la prevención de la infección asociada al catéter y su remoción. Se observó que los enfermeros tenían dificultades para interpretar los datos obtenidos y se señaló que es necesario que mejoren sus conocimientos (AU).

Transtornos traumáticos cumulativos em profissionais de enfermagem: da incidência a estratégias para prevenção e controle / Cumulative traumatic disorders in nursing professionals: from incidence to strategies for prevention and control / Trastornos traumáticos acumulativos en profesionales de enfermería: de la incidencia a las estrategias de prevención y control

Objetivo: Analisar a literatura científica acerca da incidência de Lesão Por Esforço Repetitivo/Distúrbios Osteomusculares Relacionados ao Trabalho em trabalhadores de enfermagem e identificar as estratégias formuladas para a diminuição da sua incidência nos serviços de saúde. Método:Estudo do tipo revisão integrativa. A busca dos artigos ocorreuno período de janeiro a março de 2021, na Biblioteca Eletrônica Científica Online, na Biblioteca Virtual em Saúde e nas bases de dados Web of Science, Pubmed, Scopus, Cochrane e Cinahl. Resultados:Foram incluídos 21 artigos, os quais foram elencados em duas categorias, a saber:incidência de transtornos traumáticos cumulativos em profissionais de enfermagem eestratégias voltadas para a prevenção e/ou combate ao desenvolvimento de transtornos traumáticos cumulativos em profissionais de enfermagem. Os estudos expressaram umaelevada incidência de transtornos traumáticos cumulativos em profissionais de enfermagem, principalmente em auxiliares e técnicos, evidenciando o perfil e as dificuldades enfrentadas pelo trabalhador acometido com essas afecções.Poucos estudos foram incluídos nas estratégias de prevenção e/ou combate ao desenvolvimento desses transtornos, reforçando a necessidade de realização de estudos clínicos a fim de melhorias da ergonomia no ambiente laboral. Conclusão:As evidências destapesquisa contribuem para que os profissionais e os gestores dos serviços de saúde possam conhecer o conteúdo produzido na literatura acerca dos transtornos traumáticos cumulativos mais incidentes nos profissionais de enfermagem, possibilitando a formulação de intervenções direcionadas a sua prevenção e controle.

Objective: To analyze the scientific literature on the incidence of Repetitive Strain Injury/Work-Related Musculoskeletal Disorders in nursing workers and identify the strategies formulated to reduce its incidence in health services.Method: An integrative review study. The search for articles took place from January to March 2021, in the Online Scientific Electronic Library, in the Virtual Health Library and in the Web of Science, Pubmed, Scopus, Cochrane and Cinahl databases. Results: 21 articles were included, which were listed in two categories, namely: incidence of cumulative traumatic disorders in nursing professionals and strategies aimed at preventing and/or combating the development of cumulative traumatic disorders in nursing professionals. The studies expressed a high incidence of cumulative traumatic disorders innursing professionals, especially assistants and technicians, evidencing the profile and difficulties faced by workers affected by these conditions. Few studies were included in strategies to prevent and/or combat the development of these disorders, reinforcing the need to carry out clinical studies in order to improve ergonomics in the work environment.Conclusions:The evidence of this research contributes so that professionals and managers of health services can learn about the content produced in the literature about cumulative traumatic disorders most incidents in nursing professionals, enabling the formulation of interventions aimed at their prevention and control.

Objetivo: Analizar la literatura científica sobre la incidencia de Lesiones por Esfuerzo Repetitivo/Trastornos Musculoesqueléticos Relacionados con el Trabajo en trabajadores de enfermería e identificar las estrategias formuladas para reducir su incidencia en los servicios de salud. Método: Estudio de revisión integradora. La búsqueda de artículos se realizó de enero a marzo de 2021, en la Biblioteca Electrónica Científica en Línea, en la Biblioteca Virtual en Salud y en las bases de datos Web of Science, Pubmed, Scopus, Cochrane y Cinahl.Resultados: Se incluyeron 21 artículos, que fueron catalogados en dos categorías, a saber: incidencia de trastornos traumáticos acumulativos en profesionales de enfermería y estrategias dirigidas a prevenir y/o combatir el desarrollo de trastornos traumáticos acumulativos en profesionales de enfermería. Los estudios expresaron una alta incidencia de trastornos traumáticos acumulativos en los profesionales de enfermería, especialmente auxiliares y técnicos, evidenciando el perfil y las dificultades enfrentadas por los trabajadores afectados por esas condiciones. Pocos estudios se incluyeron en las estrategias para prevenir y/o combatir el desarrollo de estos trastornos, lo que refuerza la necesidad de realizar estudios clínicos para mejorar la ergonomía en el ambiente de trabajo. Conclusión: La evidencia de esta investigación contribuye para que los profesionales y gestores de los servicios de salud conozcan el contenido producido en la literatura sobre los trastornos traumáticos acumulativos más incidentes en los profesionales de enfermería, posibilitando la formulación de intervenciones dirigidas a su prevención y control.

"Serás-hétero-ou-não-serás": a lesbianidade nas Atas da Sociedade Psicanalítica de Viena / "You-will-be-straight-or-you-will-not-be": the lesbianity in the Minutes of the Vienna Psychoanalytic Society / "Tú-serás-heterosexual-o-no-serás": la lesbianidad en las Actas de la Sociedad Psicoanalítica de Viena / « Tu seras hétérosexuel(le) ou tu ne seras pas ¼: la lesbianité dans les Minutes de la Société psychanalytique de Vienne

Este artigo objetiva estudar os discursos dos primeiros psicanalistas sobre a lesbianidade, a partir de uma análise teórico-documental das Atas da Sociedade Psicanalítica de Viena. Investigando a problemática do desejo lésbico, buscamos contribuir com o reconhecimento dos limites e potencialidades das teorias psicanalíticas sobre o sexual. Para tanto, foram examinadas as duas principais hipóteses sobre o desejo lésbico desenvolvidas nas reuniões da Sociedade Psicanalítica de Viena e discutiu-se a origem das relações entre lesbianidade e masculinidade do ponto de vista psicanalítico, assinalando algumas questões que a lesbianidade pode formular sobre as relações entre a psicanálise e o patriarcado.

The present work aims to research the speeches of the first psychoanalysts on lesbianity, through a theoretical and documentary research of the Minutes of the Vienna Psychoanalytic Society. Investigating the question of the lesbian desire, the article intends to contribute with the acknowledgment of the limits and potentialities of the psychoanalytic sexual theories. To this end, the two main hypotheses about the lesbian desire developed at the meetings of the Vienna Psychoanalytic Society were examined and the origin of the associations between lesbianity and masculinity in the psychoanalytic point of view was discussed, pointing out some questions that lesbianity can formulate about the relations between psychoanalysis and patriarchy.

El presente trabajo objetiva estudiar los discursos de los primeros psicoanalistas sobre la lesbianidad, a través de un análisis teórico y documental de los registros de las Actas de la Sociedad Psicoanalítica de Viena. Investigando el problema del deseo lesbiano, buscamos contribuir con el reconocimiento de los límites y potencialidades de la teoría sexual. Con este fin, se examinaron las dos principales hipótesis sobre el deseo lesbiano desarrolladas en las reuniones de la Sociedad Psicoanalítica de Viena y se discutió el origen de las relaciones entre la lesbianidad y la masculinidad desde el punto de vista psicoanalítico, señalando algunas preguntas que la lesbianidad puede formular sobre las relaciones entre el psicoanálisis y el patriarcado.

Cet article étude les discours des premiers psychanalystes sur la lesbianité, à travers d'une analyse théorique et documentaire des Minutes de la Société psychanalytique de Vienne. En enquêtent sur le problème du désir lesbien, ce travail cherche à contribuer à la reconnaissance des limites et des potentialités de la théorie sexuelle. Pour ce faire, on a examiné les deux hypothèses sur le désir lesbien développées lors des réunions de la Société psychanalytique de Vienne et on a discuté sur l'origine des associations entre lesbianité et masculinité du point de vue psychanalytique, soulignant des questions que la lesbianité peut formuler sur les relations entre psychanalyse et patriarcat.

Avaliação do desenvolvimento das competências gerais em cursos de bacharelado em educação física / Evaluation of general competencies development in the physical education undergraduate course

A presente pesquisa teve como objetivo avaliar o desenvolvimento das competências gerais em cursos de bacharelado em Educação Física, tendo sido estudadas duas Instituições de Ensino Superior do Estado do Paraná. Foi utilizado o instrumento elaborado e validado por De Matia para a avaliação das competências gerais nos cursos da saúde. A amostra total foi de 263 respondentes. Quando comparamos as respostas dos professores à autoavaliação pelos graduandos, observamos escores menores em todas as dimensões estudadas. Os graduandos dos primeiros períodos se avaliam pior do que aqueles em períodos mais avançados do curso. Os professores percebem graduandos do sexo feminino, mais hábeis na postura inovadora e crítica, e os graduandos destacam colegas do sexo feminino como mais hábeis na interação com seus pares e sociedade. Conclui-se que os graduandos envolvidos na pesquisa estão desenvolvendo parcialmente as competências gerais fundamentais para a sua atuação profissional.

This study aimed to evaluate the development of general competences in Physical Education Undergraduate Courses in two Higher Education Institutions in an inland city of the State of Paraná. The instrument developed and validated by De Matia was used to assess general skills in health courses. The total sample consisted of 263 respondents. The comparison of the professors' answers to the students self-evaluation shows lower scores in all the dimensions studied. Undergraduate students of the first terms haver worse self-evaluations when compared to those in more advanced periods of the course. The professors perceive female students as more skilled in their innovative and critical posture, and the students highlight that female students are more skilled in interaction with their peers and society. It is concluded that the undergraduate students involved in the research are partially developing the general basic competences for their professional performance.

Esta investigación tuvo como objetivo evaluar el desarrollo de las competencias generales en los Cursos de Graduación en Educación Física - Bachillerato en instituciones de educación superior públicas y privadas de una ciudad en el interior del estado de Paraná. El instrumento desarrollado y validado por De Matia se utilizó para evaluar las competencias generales en los cursos de salud. La muestra total fue de 263 encuestados. Las respuestas de los maestros en comparación con los estudiantes son más bajas en todas las dimensiones estudiadas. Los graduados de los primeros períodos se evalúan peor que aquellos en períodos más avanzados del curso. Los profesores perciben que las alumnas, son más habilidosas y tienen una postura innovadora y crítica, y los alumnos destacan las alumnas, más capacitadas para interactuar con sus pares y la sociedad. Se concluye que los graduandos involucrados en la investigación, desarrollan parcialmente las competencias generales básicas.

Human B cells infected by Trypanosoma cruzi undergo F-actin disruption and cell death via caspase-7 activation and cleavage of phospholipase Cgama1

B cells contribute to the immune system in many ways such as antigen presentation to CD4+ T cells, secretion of cytokines and lymphoid tissue organogenesis. Furthermore, they are the only cell type capable of producing immunoglobulins. B cells also account for critical aspects of the resistance against intracellular pathogens. Trypanosoma cruzi is an intracellular parasite that sabotages humoral response by depletion of immature B cells. Polyclonal activation and secretion of non-specific antibodies are also other mechanisms used by T cruzi to evade and subvert the mammalian host immune system, leading to increased parasitemia and susceptibility to Chagas’ disease. It remained unclear whether B cell depletion occurs due to direct contact with T. cruzi or results from a global increase in inflammation. Unlike previous reports, we demonstrated in this study that T. cruzi infects human B cells, resulting in parasite-induced activation of caspase-7 followed by proteolytic cleavage of phospholipase Cgama1 and cell death. These data contribute to explain the mechanisms ruling B-cell depletion and evasion of the immune response by T. cruzi.

Experimental evidences that P21 protein controls Trypanosoma cruzi replication and modulates the pathogenesis of infection

P21 is a protein secreted by Trypanosoma cruzi (T. cruzi). Previous studies have shown a spectrum of biological activities performed by P21 such as induction of phagocytosis, leukocyte chemotaxis and inhibition of angiogenesis. However, the activity of P21 in T. cruzi infection remains unknown. Here, we reported the role of P21 in mice harboring late T. cruzi infection. Treatment with recombinant P21 protein (rP21) reduced parasite load and angiogenesis, and induced fibrosis in the cardiac tissue of infected mice. In addition, rP21 reduced the growth of epimastigotes, inhibited intracellular replication of amastigotes and modulated the parasite cell cycle. Our data suggest that P21 controls parasite replication in the host, supporting the survival of both parasite and host.

Human B cells infected by Trypanosoma cruzi undergo F-actin disruption and cell death via caspase-7 activation and cleavage of phospholipase Cgama1

B cells contribute to the immune system in many ways such as antigen presentation to CD4+ T cells, secretion of cytokines and lymphoid tissue organogenesis. Furthermore, they are the only cell type capable of producing immunoglobulins. B cells also account for critical aspects of the resistance against intracellular pathogens. Trypanosoma cruzi is an intracellular parasite that sabotages humoral response by depletion of immature B cells. Polyclonal activation and secretion of non-specific antibodies are also other mechanisms used by T cruzi to evade and subvert the mammalian host immune system, leading to increased parasitemia and susceptibility to Chagas’ disease. It remained unclear whether B cell depletion occurs due to direct contact with T. cruzi or results from a global increase in inflammation. Unlike previous reports, we demonstrated in this study that T. cruzi infects human B cells, resulting in parasite-induced activation of caspase-7 followed by proteolytic cleavage of phospholipase Cgama1 and cell death. These data contribute to explain the mechanisms ruling B-cell depletion and evasion of the immune response by T. cruzi.

Meu nome era Sabina Spielrein. Eu fui também psicanalista / My name was Sabina Spielrein. I was also a psychoanalyst / Mi nombre era Sabina Spielrein. Yo también fui una psicoanalista

O presente trabalho resgata a importância de Sabina Spielrein, uma das primeiras mulheres da história da psicanálise, recordando sua trajetória biográfica e proposições sobre o conceito de pulsão de morte, e examinando contribuições à compreensão freudiana relativa a esse conceito. As principais referências foram textos de Spielrein e de Freud e documentos históricos, como as cartas trocadas entre Freud, Jung e Spielrein, o diário pessoal da autora e as "Atas da Sociedade Psicanalítica de Viena". Percebemos que há entre Freud e Spielrein uma trajetória de questões semelhantes acerca da psicose, que fomenta o estudo da pulsão de morte. O artigo assinala que ambos valeram-se do pensamento biológico para suas proposições e que apresentam considerações semelhantes sobre o sadismo e o masoquismo. Quanto à pulsão de morte, para Freud trata-se de pulsão que objetiva a redução absoluta das tensões, conduzindo o ser vivo de volta ao estado inorgânico pela via do desligamento e da destruição. Para Spielrein, a pulsão de morte está oculta na pulsão sexual e, apesar de visar à destruição, objetiva a transformação, morte para o antigo e vida para o que vai surgir.

The present work highlights the importance of Sabina Spielrein, one of the first women to become a psychoanalyst. It examines her trajectory and propositions on the concept of death drive, in relation to Freud's propositions. The main references were the texts of Spielrein and Freud, and historical documents, such as the letters between Freud, Jung and Spielrein, Spielrein's personal diary and the Minutes of the Vienna Psychoanalytic Society. There is an exchange of similar questions about psychosis between Freud and Spielrein, which encourages them to study the death drive. The article points out that both used a biological basis for their arguments and that they present similar considerations on sadism and masochism. As for the death instinct, Freud considers it as a drive that aims at the absolute reduction of tensions, leading the living being back to the inorganic state by means of detachment and destruction. For Spielrein, the death instinct is hidden in the sexual drive and, despite aiming at destruction, also aims at transformation.

El presente trabajo destaca la importancia de Sabrina Spielrein, una de las primeras mujeres de la historia del psicoanálisis, presentando su trayectoria biográfica y proposiciones sobre el concepto de pulsión de muerte, examinando contribuciones a la comprensión freudiana relativa a ese concepto. Las principales referencias fueron los textos de Spielrein, de Freud, y documentos históricos. como las cartas intercambiadas entre Freud, Jung y Spielrein, el diario de la autora y "las Actas de la Sociedad Psicoanalítica de Viena". Percibimos que entre Freud y Spielrein hay una trayectoria semejante en relación a las cuestiones acerca de la psicosis, que fomentan el estudio de la pulsión de muerte. El artículo señala que ambos se valieron de pensamientos biológicos para sus proposiciones y que presentan consideraciones semejantes sobre el sadismo y el masoquismo. En cuanto a la pulsión de muerte, para Freud se trata de una pulsión que objetiva la reducción absoluta de las tensiones, conduciendo al ser vivo de vuelta al estado inorgánico por la vía del desprendimiento y la destrucción. Para Spielrein, la pulsión de muerte está oculta en la pulsión sexual y, a pesar de visar la destrucción, objetiva la transformación, muerte para lo antiguo y vida para lo que va a surgir.

Percepção dos efeitos da hidratação em idosos durante o exercício aeróbico / Perception of the effects of hydration in elderly during aerobic exercise / Percepción de los efectos de la hidratación en el adulto mayor durante el ejercicio aeróbico

Objetivo: conhecer a perceção dos efeitos da hidratação em idosos durante o exercício aeróbico. Método: pesquisa descritiva observacional, com delineamento transversal. Entre os meses de julho e setembro de 2018. Foram realizadas as aferições de massa corpórea, porcentagem de líquidos e gordura no corpo antes e após a atividade física em oito idosos. Aplicou-se análise estatistica descritiva. Resultados: a maioria dos idosos participantes não possuem preocupação com a ingesta hídrica tanto no pré treino quanto no pós-treino. Outro achado nesse estudo é que a maioria também tem o habito de ingerir líquidos somente diante da sensação de "garganta seca". Ocorreu redução de gordura corporal e aumento de percentual hídrico comparado aos idosos que não se hidrataram. Conclusão: o estudo mostrou que os idosos não possuem orientação adequada para a hidratação antes e durante o exercício, mesmo sendo acompanhados por educador físico. Ficou evidente que ocorrem alterações fisiológicas positivas entre aqueles que se hidratam tanto antes como após o exercício aeróbico.

Objective: to know the perception of hydration effects in the elderly during aerobic exercise. Method: a descriptive observational field research with crosssectional design was performed. Between July and September 2018, body mass, body fluid and body fat percentage were measured before and after exercise in eight elderly. Descriptive statistical analysis was applied. Results: most elderly participants have no concern with the fluid intake in the pre-training as posttraining. Another finding in this study is that most also have the habit of ingesting fluids only when feeling "dry throat". There was reduction of body fat and increase of water percentage compared to the elderly who did not hydrate. Conclusion: the study showed that the elderly do not have adequate orientation for hydration before and during exercise, even when accompanied by a physical educator. It was evident that positive physiological changes occur among those who hydrate both before and after aerobic exercise.

Objetivo: conocer la percepción de los efectos de hidratación en los ancianos durante el ejercicio aeróbico. Método: se realizó una investigación de campo de observación descriptiva con diseño transversal. Entre julio y septiembre de 2018, el porcentaje de masa corporal, fluidos corporales y grasa corporal se midió antes y después del ejercicio en ocho ancianos. Se aplicó análisis estadístico descriptivo. Resultados: La mayoría de los participantes de edad avanzada no tienen ninguna preocupación con las preocupaciones sobre el consumo de agua después del entrenamiento. Otro hallazgo en este estudio es que la mayoría también tiene el hábito de ingerir líquidos solo cuando siente "garganta seca". Hubo una reducción de la grasa corporal y un aumento del porcentaje de agua en comparación con los ancianos que no se hidrataron. Conclusión: el estudio mostró que los ancianos no tienen una orientación adecuada para la hidratación antes y durante el ejercicio, incluso si están acompañados por un educador físico. Era evidente que se producen cambios fisiológicos positivos entre quienes hidratan antes y después del ejercicio aeróbico.

Desenvolvimento e caracterização de bebidas de base láctea a partir do soro de kefir / Development and characterization of dairy-based beverage from kefir whey

O kefir é uma bebida fermentada que apresenta importante caráter probiótico, conferindo benefícios à saúde humana. O soro de kefir obtido de sua filtração, pode ser aproveitado para elaboração de bebidas lácteas. O presente estudo objetivou o desenvolvimento de uma bebida de base láctea a partir do soro de kefir (com e sem adição de baunilha) em dois tempos de fermentação (24 e 36 horas), avaliando-se suas características físico-químicas, microbiológicas, de aceitação e intenção de consumo. As bebidas fermentadas por 24 horas apresentaram maior percentual de aceitação e contagens de bactérias láticas mínimas para um alimento probiótico, de acordo com a legislação.