RESUMO
Zika virus (ZIKV) infection is associated with severe neurological disorders and congenital malformation. Despite efforts to eradicate the disease, there is still neither vaccine nor approved drugs to treat ZIKV infection. The NS2B-NS3 protease is a validated drug target since it is essential to polyprotein virus maturation. In the present study, we describe an experimental screening of 2,320 compounds from the chemical library of the Muséum National d'Histoire Naturelle of Paris on ZIKV NS2B-NS3 protease. A total of 96 hits were identified with 90% or more of inhibitory activity at 10 µM. Amongst the most active compounds, five were analyzed for their inhibitory mechanisms by kinetics assays and computational approaches such as molecular docking. 2-(3-methoxyphenoxy) benzoic acid (compound 945) show characteristics of a competitive inhibition (Ki = 0.49 µM) that was corroborated by its molecular docking at the active site of the NS2B-NS3 protease. Taxifolin (compound 2292) behaves as an allosteric inhibitor whereas 3,8,9-trihydroxy-2-methyl-1H-phenalen-1-one (compound 128), harmol (compound 368) and anthrapurpurin (compound 1499) show uncompetitive inhibitions. These new NS2B-NS3 protease inhibitors are valuable hits to further hit-to-lead optimization.
Assuntos
Infecção por Zika virus , Zika virus , Humanos , Simulação de Acoplamento Molecular , Proteínas não Estruturais Virais/química , Serina Endopeptidases/química , Inibidores de Proteases/farmacologia , Inibidores de Proteases/química , Peptídeo Hidrolases , Antivirais/farmacologia , Antivirais/químicaRESUMO
BACKGROUND: A maturity-onset diabetes of the young (MODY) calculator has been described and validated for use in European Caucasians. This study evaluated its performance in Brazilians diagnosed with diabetes mellitus (DM) before 35 years of age. METHODS: The electronic records of 391 individuals were reviewed in 2020 at the diabetes clinic of a quaternary hospital in São Paulo were analyzed: 231 with type 1 DM (T1DM), 46 with type 2 (T2DM) and 114 with MODY. The MODY calculator was applied to the three groups. A receiver operating characteristic curve was calculated to obtain cut-off points for this population. RESULTS: The principal differences between the MODY and the T1DM and T2DM groups were body mass index, a positive family history of diabetes and mean HbA1c level. Age at diagnosis in the MODY group was only significantly different compared to the T2DM group. Specificity and sensitivity were good for the cut-off points of 40%, 50% and 60%, with the accuracy of the model for any of these cut-off points being > 95%. CONCLUSION: The capacity of the calculator to identify Brazilian patients with MODY was good. Values ≥ 60% proved useful for selecting candidates for MODY genetic testing, with good sensitivity and specificity.
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Chagas disease is a neglected infectious disease caused by the protozoan Trypanosoma cruzi, primarily transmitted by triatomine vectors, and it threatens approximately seventy-five million people worldwide. This parasite undergoes a complex life cycle, transitioning between hosts and shifting from extracellular to intracellular stages. To ensure its survival in these diverse environments, T. cruzi undergoes extreme morphological and molecular changes. The metacyclic trypomastigote (MT) form, which arises from the metacyclogenesis (MTG) process in the triatomine hindgut, serves as a crucial link between the insect and human hosts and can be considered the starting point of Chagas disease. This review provides an overview of the current knowledge regarding the parasite's life cycle, molecular pathways, and mechanisms involved in metabolic and morphological adaptations during MTG, enabling the MT to evade the immune system and successfully infect human cells.
Assuntos
Doença de Chagas , Trypanosoma cruzi , HumanosRESUMO
Sjögren's Syndrome (SS) is an autoimmune exocrinopathy characterized by the progressive damage of salivary and lacrimal glands associated with lymphocytic infiltration. Identifying new non-invasive biomarkers for SS diagnosis remains a challenge, and alterations in saliva composition reported in patients turn this fluid into a source of potential biomarkers. Among these, proteases are promising candidates since they are involved in several key physio-pathological processes. This study evaluated differentially expressed proteases in SS individuals' saliva using synthetic fluorogenic substrates, zymography, ELISA, and proteomic approaches. Here we reported, for the first time, increased activity of the serine protease dipeptidyl peptidase-4/CD26 (DPP4/CD26) in pSS saliva, the expression level of which was corroborated by ELISA assay. Gelatin zymograms showed that metalloproteinase proteolytic band profiles differed significantly in intensity between control and SS groups. Focusing on matrix metalloproteinase-9 (MMP9) expression, an increased tendency in pSS saliva (p = 0.0527) was observed compared to the control group. Samples of control, pSS, and sSS were analyzed by mass spectrometry to reveal a general panorama of proteases in saliva. Forty-eight protein groups of proteases were identified, among which were the serine proteases cathepsin G (CTSG), neutrophil elastase (ELANE), myeloblastin (PRTN3), MMP9 and several protease inhibitors. This work paves the way for proteases to be explored in the future as biomarkers, emphasizing DPP4 by its association in several autoimmune and inflammatory diseases. Besides its proteolytic role, DPP4/CD26 acts as a cell surface receptor, signal transduction mediator, adhesion and costimulatory protein involved in T lymphocytes activation.
Assuntos
Dipeptidil Peptidase 4/metabolismo , Peptídeo Hidrolases/análise , Proteômica/métodos , Saliva/metabolismo , Síndrome de Sjogren/metabolismo , Adulto , Biomarcadores/metabolismo , Estudos de Casos e Controles , Catepsina G , Feminino , Humanos , Elastase de Leucócito , Masculino , Espectrometria de Massas , Pessoa de Meia-Idade , Serina Endopeptidases , Transdução de Sinais , Síndrome de Sjogren/diagnósticoRESUMO
Chagas disease is a debilitating and neglected disease caused by the protozoan Trypanosoma cruzi. Soon after infection, interactions among T. cruzi and host innate immunity cells can drive/contribute to disease outcome. Dendritic cells (DCs), present in all tissues, are one of the first immune cells to interact with Trypanosoma cruzi metacyclic trypomastigotes. Elucidating the immunological events triggered immediately after parasite-human DCs encounter may aid in understanding the role of DCs in the establishment of infection and in the course of the disease. Therefore, we performed a transcriptomic analysis of a 12 h interaction between T. cruzi and MoDCs (monocyte-derived DCs) from three human donors. Enrichment analyses of the 468 differentially expressed genes (DEGs) revealed viral infection response as the most regulated pathway. Additionally, exogenous antigen processing and presentation through MHC-I, chemokine signaling, lymphocyte co-stimulation, metallothioneins, and inflammasome activation were found up-regulated. Notable, we were able to identify the increased gene expression of alternative inflammasome sensors such as AIM2, IFI16, and RIG-I for the first time in a T. cruzi infection. Both transcript and protein expression levels suggest proinflammatory cytokine production during early T. cruzi-DCs contact. Our transcriptome data unveil antiviral pathways as an unexplored process during T. cruzi-DC initial interaction, disclosing a new panorama for the study of Chagas disease outcomes.
Assuntos
Doença de Chagas/imunologia , Células Dendríticas/imunologia , Linfócitos T/imunologia , Trypanosoma cruzi/imunologia , Viroses/imunologia , Adulto , Apresentação de Antígeno/imunologia , Citocinas/metabolismo , Proteína DEAD-box 58/metabolismo , Proteínas de Ligação a DNA/metabolismo , Feminino , Perfilação da Expressão Gênica , Regulação da Expressão Gênica/genética , Regulação da Expressão Gênica/imunologia , Humanos , Ativação Linfocitária/imunologia , Masculino , Proteínas Nucleares/metabolismo , Fosfoproteínas/metabolismo , Receptores Imunológicos/metabolismo , Transcriptoma/genética , Adulto JovemRESUMO
Leishmania infantum is a flagellated protozoan and one of the main causative agents of visceral leishmaniasis. This disease usually affects the human reticuloendothelial system, can cause death and available therapies may lead to serious side effects. Since it is a neglected tropical disease, the incentives for the development of new drugs are insufficient. It is important to know Leishmania virulence factors that contribute most to the disease in order to develop drugs. In the present work, we have produced L. infantum prolyl oligopeptidase (rPOPLi) in Escherichia coli, and investigated its biochemical properties as well as the effect of POP inhibitors on its enzymatic activity and on the inhibition of the macrophage infection by L. infantum. The optimal activity occurred at pH 7.5 and 37°C in the presence of DTT, the latter increased rPOPLi catalytic efficiency 5-fold on the substrate N-Suc-Gly-Pro-Leu-Gly-Pro-AMC. The enzyme was inhibited by TPCK, TLCK and by two POP specific inhibitors, Z-Pro-prolinal (ZPP, IC50 4.2 nM) and S17092 (IC50 3.5 nM). Besides being a cytoplasmic enzyme, POPLi is also found in punctuate structures within the parasite cytoplasm or associated with the parasite plasma membrane in amastigotes and promastigotes, respectively. Interestingly, S17092 and ZPP prevented parasite invasion in murine macrophages, supporting the involvement of POPLi in the invasive process of L. infantum. These data suggest POPLi as a virulence factor that offers potential as a target for designing new antileishmanial drugs.
RESUMO
Triatominae bugs are the vectors of Chagas disease, a major concern to public health especially in Latin America, where vector-borne Chagas disease has undergone resurgence due mainly to diminished triatomine control in many endemic municipalities. Although the majority of Triatominae species occurs in the Americas, species belonging to the genus Linshcosteus occur in India, and species belonging to the Triatoma rubrofasciata complex have been also identified in Africa, the Middle East, South-East Asia, and in the Western Pacific. Not all of Triatominae species have been found to be infected with Trypanosoma cruzi, but the possibility of establishing vector transmission to areas where Chagas disease was previously non-endemic has increased with global population mobility. Additionally, the worldwide distribution of triatomines is concerning, as they are able to enter in contact and harbor other pathogens, leading us to wonder if they would have competence and capacity to transmit them to humans during the bite or after successful blood feeding, spreading other infectious diseases. In this review, we searched the literature for infectious agents transmitted to humans by Triatominae. There are reports suggesting that triatomines may be competent vectors for pathogens such as Serratia marcescens, Bartonella, and Mycobacterium leprae, and that triatomine infection with other microrganisms may interfere with triatomine-T. cruzi interactions, altering their competence and possibly their capacity to transmit Chagas disease.
Assuntos
Bactérias , Doenças Transmissíveis/transmissão , Insetos Vetores , Triatominae , Trypanosoma , Vírus , Animais , Bactérias/patogenicidade , Bartonella , Doença de Chagas/epidemiologia , Doença de Chagas/parasitologia , Doença de Chagas/transmissão , Humanos , Insetos Vetores/microbiologia , Insetos Vetores/parasitologia , Insetos Vetores/virologia , Mycobacterium leprae , Serratia marcescens , Triatoma , Triatominae/microbiologia , Triatominae/parasitologia , Triatominae/virologia , Trypanosoma/patogenicidade , Trypanosoma cruzi , Vírus/patogenicidadeRESUMO
Rhagovelia apuruaque sp. nov. (Hemiptera: Heteroptera: Veliidae), from the commune of Régina, French Guiana, is described, illustrated, and compared with species of the salina group. Brachymetra albinervus (Amyot Serville, 1843), B. lata Shaw, 1933, Limnogonus ignotus Drake Harris, 1934, Neogerris lubricus (White, 1879), Rheumatobates crassifemur esakii Schroeder, 1931 (Gerridae), Mesovelia mulsanti White, 1879 (Mesoveliidae), Microvelia longipes Uhler, 1894, M. mimula White, 1879, M. pulchella Westwood, 1834, R. humboldti Polhemus, 1997, and S. transversa (Hungerford, 1929) (Veliidae) are recorded for the first time from French Guiana. The presence of Tachygerris adamsoni (Drake, 1942) (Gerridae) in the country is confirmed. New records are presented for the following species previously reported from the study area: B. shawi Hungerford Matsuda, 1957, Cylindrostethus palmaris Drake Harris, 1934, L. hyalinus (Fabricius, 1803) (Gerridae), Husseyella turmalis (Drake Harris, 1933), Paravelia bullialata Polhemus Polhemus, 1984, and Stridulivelia strigosa (Hungerford, 1929) (Veliidae).
Assuntos
Heterópteros , Animais , Artrópodes , Guiana FrancesaRESUMO
Triatoma dimidiata, a Chagas disease vector widely distributed along Central America, has great capability for domestic adaptation as the majority of specimens caught inside human dwellings or in peridomestic areas fed human blood. Exploring the salivary compounds that overcome host haemostatic and immune responses is of great scientific interest. Here, we provide a deeper insight into its salivary gland molecules. We used high-throughput RNA sequencing to examine in depth the T. dimidiata salivary gland transcriptome. From >51 million reads assembled, 92.21% are related to putative secreted proteins. Lipocalin is the most abundant gene family, confirming it is an expanded family in Triatoma genus salivary repertoire. Other putatively secreted members include phosphatases, odorant binding protein, hemolysin, proteases, protease inhibitors, antigen-5 and antimicrobial peptides. This work expands the previous set of functionally annotated sequences from T. dimidiata salivary glands available in NCBI from 388 to 3815. Additionally, we complemented the salivary analysis through proteomics (available data via ProteomeXchange with identifier PXD008510), disclosing the set complexity of 119 secreted proteins and validating the transcriptomic results. Our large-scale approach enriches the pharmacologically active molecules database and improves our knowledge about the complexity of salivary compounds from haematophagous vectors and their biological interactions. SIGNIFICANCE: Several haematophagous triatomine species can transmit Trypanosoma cruzi, the etiological agent of Chagas disease. Due to the reemergence of this disease, new drugs for its prevention and treatment are considered priorities. For this reason, the knowledge of vector saliva emerges as relevant biological finding, contributing to the design of different strategies for vector control and disease transmission. Here we report the transcriptomic and proteomic compositions of the salivary glands (sialome) of the reduviid bug Triatoma dimidiata, a relevant Chagas disease vector in Central America. Our results are robust and disclosed unprecedented insights into the notable diversity of its salivary glands content, revealing relevant anti-haemostatic salivary gene families. Our work expands almost ten times the previous set of functionally annotated sequences from T. dimidiata salivary glands available in NCBI. Moreover, using an integrated transcriptomic and proteomic approach, we showed a correlation pattern of transcription and translation processes for the main gene families found, an important contribution to the research of triatomine sialomes. Furthermore, data generated here reinforces the secreted proteins encountered can greatly contribute for haematophagic habit, Trypanosoma cruzi transmission and development of therapeutic agent studies.
Assuntos
Glândulas Salivares/química , Triatoma/química , Animais , Doença de Chagas/transmissão , Sequenciamento de Nucleotídeos em Larga Escala , Humanos , Insetos Vetores/genética , Transcriptoma/genética , Triatoma/genéticaRESUMO
Deubiquitinating enzymes (DUBs) play an important role in regulating a variety of eukaryotic processes. In this context, exploring the role of deubiquitination in Leishmania infantum could be a promising alternative to search new therapeutic targets for leishmaniasis. Here we present the first characterization of a DUB from L. infantum, otubain (OtuLi), and its localization within parasite. The recombinant OtuLi (rOtuLi) showed improved activity on lysine 48 (K48)-linked over K63-linked tetra-ubiquitin (Ub) and site-directed mutations on amino acids close to the catalytic site (F82) or involved in Ub interaction (L265 and F182) caused structural changes as shown by molecular dynamics, resulting in a reduction or loss of enzyme activity, respectively. Furthermore, rOtuLi stimulates lipid droplet biogenesis (an inflammatory marker) and induces IL-6 and TNF-α secretion in peritoneal macrophages, both proinflammatory cytokines. Our findings suggest that OtuLi is a cytoplasmic enzyme with K48-linked substrate specificity that could play a part in proinflammatory response in stimulated murine macrophages.
RESUMO
Ticks, triatomines, mosquitoes and sand flies comprise a large number of haematophagous arthropods considered vectors of human infectious diseases. While consuming blood to obtain the nutrients necessary to carry on life functions, these insects can transmit pathogenic microorganisms to the vertebrate host. Among the molecules related to the blood-feeding habit, proteases play an essential role. In this review, we provide a panorama of proteases from arthropod vectors involved in haematophagy, in digestion, in egg development and in immunity. As these molecules act in central biological processes, proteases from haematophagous vectors of infectious diseases may influence vector competence to transmit pathogens to their prey, and thus could be valuable targets for vectorial control.
Assuntos
Proteínas de Artrópodes/metabolismo , Vetores Artrópodes/imunologia , Vetores Artrópodes/fisiologia , Gema de Ovo/metabolismo , Comportamento Alimentar , Peptídeo Hidrolases/metabolismo , Idoso , Animais , Vetores Artrópodes/enzimologia , HumanosRESUMO
BACKGROUND: The current chemotherapy for cutaneous leishmaniosis (CL) has a series of drug limitations such as toxic side effects, long duration, high costs and drug resistance, which requires the development of new drugs or effective alternatives to the CL treatment. Essential oils (EOs) are complex mixtures of secondary metabolites from various plants. It has been shown that several EOs, or their constituents, have inhibitory activity against protozoa. Thus, this study aims to evaluate the biological activity of different essential oils (EOs) on Leishmania (L.) amazonensis promastigotes forms, as well as their cytotoxicity on mammalian cells and chemical composition. METHODS: Sixteen EOs were evaluated by mean of IC50/24 h and cytotoxicity against L6 cells (CC50/24 h) using Resazurin assay. Only those EOs that presented better results for IC50/24 h were submitted to GC-MS analysis to determine their chemical constitution. RESULTS: The EO from Cinnamodendron dinisii, Matricaria chamomilla, Myroxylon peruiferum, Salvia sclarea, Bulnesia sarmientoi, Ferula galbaniflua, Siparuna guianensis and Melissa officinalis were the most active against L. amazonensis with IC50/24 h ranging from 54.05 to 162.25 µg/mL. Analysis of EOs by GC-MS showed mainly the presence of ß-farnesene (52.73 %) and bisabolol oxide (12.09 %) for M. chamomilla; α-copaene (13.41 %), safrole (8.35 %) and δ-cadinene (7.08 %) for M. peruiferum; linalool (28.80 %) and linalyl acetate (60.08 %) for S. sclarea; guaiol (48.29 %) and 2-undecanone (19.49 %) for B. sarmientoi; ethyl phthalate (13.09 %) and methyl-8-pimaren-18-oate (41.82 %) for F. galbaniflua; and neral (37.18 %) and citral (5.02 %) for M. officinalis. CONCLUSION: The EO from F. galbaniflua showed to be effective against L. amazonensis promastigotes forms and presented low cytotoxic activity against L6 cells. Thus, it represents a strong candidate for future studies aiming its molecular activity on these pathogenic parasites.
Assuntos
Antiprotozoários/química , Antiprotozoários/farmacologia , Leishmania mexicana/efeitos dos fármacos , Óleos Voláteis/química , Óleos Voláteis/farmacologia , Extratos Vegetais/química , Extratos Vegetais/farmacologia , Plantas Medicinais/química , Sobrevivência Celular/efeitos dos fármacos , Humanos , Leishmania mexicana/crescimento & desenvolvimento , Leishmaniose Cutânea/parasitologia , Testes de Sensibilidade ParasitáriaRESUMO
We have previously demonstrated that the secreted prolyl oligopeptidase of Trypanosoma cruzi (POPTc80) is involved in the infection process by facilitating parasite migration through the extracellular matrix. We have built a 3D structural model where POPTc80 is formed by a catalytic α/ß-hydrolase domain and a ß-propeller domain, and in which the substrate docks at the inter-domain interface, suggesting a "jaw opening" gating access mechanism. This preliminary model was refined by molecular dynamics simulations and next used for a virtual screening campaign, whose predictions were tested by standard binding assays. This strategy was successful as all 13 tested molecules suggested from the in silico calculations were found out to be active POPTc80 inhibitors in the micromolar range (lowest K i at 667 nM). This work paves the way for future development of innovative drugs against Chagas disease.
Assuntos
Simulação de Dinâmica Molecular , Serina Endopeptidases/química , Inibidores de Serina Proteinase/química , Tripanossomicidas/química , Trypanosoma cruzi/enzimologia , Animais , Derivados de Benzeno/química , Sítios de Ligação , Domínio Catalítico , Bases de Dados de Compostos Químicos , Humanos , Estrutura Molecular , Prolil Oligopeptidases , Ligação Proteica , Pirimidinas/química , Homologia de Sequência de Aminoácidos , Bibliotecas de Moléculas Pequenas , Relação Estrutura-Atividade , Sulfonamidas/química , Suínos , Tiofenos/química , Triazóis/químicaRESUMO
Dendritic cells (DCs) are the most important member of the antigen presenting cells group due to their ability to recognize antigen at the infection site and their high specialized antigen internalization capacity. These cells have central role in connecting the innate and adaptive immune responses against Trypanosoma cruzi, the causative agent of Chagas disease. These first line defense cells modulate host immune response depending on type, maturation level, cytokine milieu and DC receptor involved in the interactions with T. cruzi, influencing the development of the disease clinic forms. Here, we present a review of DCs-T. cruzi interactions both in human and murine models, pointing out the parasite ability to manipulate DCs activity for the purpose of evading innate immune response and assuring its own survival and persistence.
RESUMO
Trypanosoma cruzi is a protozoan that causes Chagas' disease, a neglected infectious illness that affects millions of people, mostly in Latin America. Here, the cell surface subproteome of the T. cruzi epimastigote life form was characterized. In order to prepare samples enriched in epimastigote plasma membrane protein, two distinct methodologies were optimized and evaluated. The first methodology was based on cell surface trypsinization (Shave) of intact living cells while the second approach used biotinylation of cell surface proteins followed by streptavidin affinity chromatography isolation of the labeled proteins. Both T. cruzi subproteomes were analyzed by LC-MS/MS. The results showed that the methodologies offered comprehensive and complementary information about the parasite's plasma membrane subproteome.
Assuntos
Doença de Chagas/diagnóstico , Proteínas de Membrana/isolamento & purificação , Proteoma/análise , Trypanosoma cruzi/metabolismo , Biotinilação , Membrana Celular/metabolismo , Doença de Chagas/patologia , Humanos , Proteínas de Membrana/metabolismo , Espectrometria de Massas em Tandem , Trypanosoma cruzi/patogenicidade , Tripsina/químicaRESUMO
This study investigated the presence of dialogical reflexivity indicators in compositions (written texts) and established possible links between those indicators and narrative structures. A group of 23 children, between eight and ten years old, wrote two compositions on the themes "Tell your story" and "How do I talk to myself?". The results suggest that the dialogicality of reflective processes is involved in the writing expression: whereas. The first theme of compositions presented dialogues between the characters (dialogical structure), the second one presented self-talk (direct description of reflective action). In conclusion, it is discussed the relationship between dialogical reflexivity indicators in written texts and the role of the author's reflective process about what he/she writes as the basis for dialogicality.(AU)
Este estudo investigou a presença de indicadores de reflexividade dialógica em redações e estabeleceu possíveis relações entre esses indicadores e a estrutura narrativa. Um grupo de 23 crianças, com oito e dez anos de idade, escreveu duas redações com os temas 'Conte sua história' e 'Como eu converso comigo mesmo?'. Os resultados sugerem que a dialogicidade do processo reflexivo está implicada na expressão escrita: enquanto as redações do primeiro tema apresentaram diálogos entre as personagens (estrutura dialógica), as redações do segundo tema apresentaram autodiálogos (descrição direta da ação reflexiva). Para concluir, discute-se a relação entre indicadores de reflexividade dialógica em textos escritos e o papel do processo reflexivo do autor sobre o que escreve como base para a dialogicidade.(AU)
Assuntos
Humanos , Masculino , Feminino , Criança , Desenvolvimento da Linguagem , Escrita Manual , NarraçãoRESUMO
This study investigated the presence of dialogical reflexivity indicators in compositions (written texts) and established possible links between those indicators and narrative structures. A group of 23 children, between eight and ten years old, wrote two compositions on the themes "Tell your story" and "How do I talk to myself?". The results suggest that the dialogicality of reflective processes is involved in the writing expression: whereas. The first theme of compositions presented dialogues between the characters (dialogical structure), the second one presented self-talk (direct description of reflective action). In conclusion, it is discussed the relationship between dialogical reflexivity indicators in written texts and the role of the author's reflective process about what he/she writes as the basis for dialogicality...
Este estudo investigou a presença de indicadores de reflexividade dialógica em redações e estabeleceu possíveis relações entre esses indicadores e a estrutura narrativa. Um grupo de 23 crianças, com oito e dez anos de idade, escreveu duas redações com os temas 'Conte sua história' e 'Como eu converso comigo mesmo?'. Os resultados sugerem que a dialogicidade do processo reflexivo está implicada na expressão escrita: enquanto as redações do primeiro tema apresentaram diálogos entre as personagens (estrutura dialógica), as redações do segundo tema apresentaram autodiálogos (descrição direta da ação reflexiva). Para concluir, discute-se a relação entre indicadores de reflexividade dialógica em textos escritos e o papel do processo reflexivo do autor sobre o que escreve como base para a dialogicidade...
Assuntos
Humanos , Masculino , Feminino , Criança , Escrita Manual , Desenvolvimento da Linguagem , NarraçãoRESUMO
Estudo objetivou identificar na literatura artigos relacionados a higiene oral nos pacientes intubados. Trata-se de uma pesquisa bibliográfica nas bases de dados LILACS e SCIELO. Desenvolveram-se duas categorias de resultados: soluções recomendadas e técnica de higiene oral. As pesquisas indicam as soluções: clorexidina 0,12% e complexo enzimático a base lactoperoxidase. A escovação, a aspiração contínua, o posicionamento em decúbito lateral, a verificação da pressão do cuff e o uso da cânula orofaríngea são considerados etapas imprescindíveis da técnica de higiene oral no paciente intubado.