RESUMO
Human biomonitoring of toxic and essential trace elements is critically important for public health protection. Amazonian riverine communities exhibit distinctive dietary patterns, heavily reliant on locally sourced fish, fruits, and vegetables. These habits may result in unique exposure profiles compared to urban populations. However, comprehensive assessments of their exposure to toxic and essential metals are lacking, representing a critical gap in understanding the health risks faced by these communities. This study aimed to establish baseline levels of 21 metals and metalloids in human blood and explore the influence of sociodemographic factors, dietary habits, and lifestyle choices as potential sources of exposure to these elements. A cross-sectional biomonitoring investigation was conducted with 1,024 individuals from 13 communities in the Tapajós and Amazon Basins (Pará, Brazil). Most of the elements in study was determined for the first time in the region. Blood samples were analyzed using inductively coupled plasma mass spectrometry (ICP-MS). The levels of all elements were summarized by quantiles and compared with cutoff values from other Brazilian populations. Multiple linear regression was used to assess possible associations between element concentrations and sociodemographic characteristics, dietary habits, and lifestyle choices. High detection rates (64%-100%) were observed, indicating the widespread presence of these elements. Elevated blood concentrations were found for mercury (median 21.1 µg.L-1, interquartile range: 12-34 µg.L-1), selenium (median 166 µg.L-1, interquartile range: 137-208 µg.L-1), and lead (median 34 µg.L-1, interquartile range: 20.8-64 µg.L-1). Regression analysis revealed a positive association between mercury levels and fish consumption, while manioc flour intake showed no relationship to lead levels. In conclusion, our findings emphasize the need for continued monitoring and public policy development for these vulnerable populations. Further studies should assess long-term trends and investigate the health implications of prolonged exposure to diverse chemicals in Amazonian riverside communities.
Assuntos
Monitoramento Biológico , Estilo de Vida , Metaloides , Humanos , Brasil , Adulto , Masculino , Feminino , Pessoa de Meia-Idade , Adulto Jovem , Adolescente , Estudos Transversais , Metaloides/sangue , Metais/sangue , Dieta , Idoso , Fatores Sociodemográficos , Fatores Socioeconômicos , Poluentes Químicos da Água/sangue , Poluentes Químicos da Água/análise , Criança , Comportamento Alimentar , População Rural/estatística & dados numéricos , Rios/químicaRESUMO
Candida spp. can be found in the human microbiome. However, immunocompromised patients are likely to develop invasive Candida infections, with mortality rates higher than 50%. The discovery of C. auris, a species that rapidly acquire antifungal resistance, increased the concern about Candida infections. The limited number of antifungal agents and the high incidence of resistance to them make imperative the development of new antifungal drugs. ß-lapachone is a biological active naphthoquinone that displays antifungal activity against C. albicans and C. glabrata. The aim of this study was to evaluate if this substance affects C. auris growth and elucidate its mechanism of action. A fluconazole-resistant C. auris isolate was used in this study. The antifungal activity of ß-lapachone was determined through microbroth dilution assays, and its mechanism of action was evaluated using fluorescent probes. Interaction with fluconazole and amphotericin B was assessed by disk diffusion assay and checkerboard. ß-lapachone inhibited planktonic C. auris cell growth by 92.7%, biofilm formation by 84.9%, and decrease the metabolism of preformed biofilms by 87.1% at 100 µg/ml. At 100 µg/ml, reductions of 30% and 59% of Calcofluor White and Nile red fluorescences were observed, indicating that ß-lapachone affects cell wall chitin and neutral lipids content, respectively. Also, the ratio 590 nm/529 nm of JC-1 decreased 52%, showing that the compound affects mitochondria. No synergism was observed between ß-lapachone and fluconazole or amphotericin B. Data show that ß-lapachone may be a promising candidate to be used as monotherapy to treat C. auris resistant infections.
Assuntos
Antifúngicos , Biofilmes , Candida auris , Farmacorresistência Fúngica , Fluconazol , Testes de Sensibilidade Microbiana , Naftoquinonas , Naftoquinonas/farmacologia , Antifúngicos/farmacologia , Farmacorresistência Fúngica/efeitos dos fármacos , Fluconazol/farmacologia , Biofilmes/efeitos dos fármacos , Humanos , Candida auris/efeitos dos fármacos , Candida auris/genética , Anfotericina B/farmacologia , Candidíase/microbiologia , Candidíase/tratamento farmacológicoRESUMO
Herpes simplex virus (HSV) infections are highly widespread among humans, producing symptoms ranging from ulcerative lesions to severe diseases such as blindness and life-threatening encephalitis. At present, there are no vaccines available, and some existing antiviral treatments can be ineffective or lead to adverse effects. As a result, there is a need for new anti-HSV drugs. In this report, the in vitro anti-HSV effect of 9,9'-norharmane dimer (nHo-dimer), which belongs to the ß-carboline (ßC) alkaloid family, was evaluated. The dimer exhibited no virucidal properties and did not impede either the attachment or penetration steps of viral particles. The antiviral effect was only exerted under the constant presence of the dimer in the incubation media, and the mechanism of action was found to involve later events of virus infection. Analysis of fluorescence lifetime imaging data showed that the nHo-dimer internalized well into the cells when present in the extracellular incubation medium, with a preferential accumulation into perinuclear organelles including mitochondria. After washing the host cells with fresh medium free of nHo-dimer, the signal decreased, suggesting the partial release of the compound from the cells. This agrees with the observation that the antiviral effect is solely manifested when the alkaloid is consistently present in the incubation media.
Assuntos
Antivirais , Antivirais/farmacologia , Antivirais/química , Chlorocebus aethiops , Humanos , Células Vero , Animais , Simplexvirus/efeitos dos fármacos , Simplexvirus/fisiologia , Herpes Simples/tratamento farmacológico , Herpes Simples/virologia , Carbolinas/farmacologia , Carbolinas/química , Herpesvirus Humano 1/efeitos dos fármacos , Herpesvirus Humano 1/fisiologia , Harmina/farmacologia , Harmina/química , Harmina/análogos & derivadosRESUMO
Inactivated COVID-19 vaccines data in immunocompromised individuals are scarce. This trial assessed the immunogenicity of two CoronaVac doses and additional BNT162b2 mRNA vaccine doses in immunocompromised (IC) and immunocompetent (H) individuals. Adults with solid organ transplant (SOT), hematopoietic stem cell transplant, cancer, inborn immunity errors or rheumatic diseases were included in the IC group. Immunocompetent adults were used as control group for comparison. Participants received two CoronaVac doses within a 28-day interval. IC received two additional BNT162b2 doses and H received a third BNT162b2 dose (booster). Blood samples were collected at baseline, 28 days after each dose, pre-booster and at the trial end. We used three serological tests to detect antibodies to SARS-CoV-2 nucleocapsid (N), trimeric spike (S), and receptor binding domain (RBD). Outcomes included seroconversion rates (SCR), geometric mean titers (GMT) and GMT ratio (GMTR). A total of 241 IC and 100 H adults participated in the study. After two CoronaVac doses, IC had lower SCR than H: anti-N, 33.3% vs 79%; anti-S, 33.8% vs 86%, and anti-RBD, 48.5% vs 85%, respectively. IC also showed lower GMT than H: anti-N, 2.3 vs 15.1; anti-S, 58.8 vs 213.2 BAU/mL; and anti-RBD, 22.4 vs 168.0 U/mL, respectively. After the 3rd and 4th BNT162b2 doses, IC had significant anti-S and anti-RBD seroconversion, but still lower than H after the 3rd dose. After boosting, GMT increased in IC, but remained lower than in the H group. CoronaVac two-dose schedule immunogenicity was lower in IC than in H. BNT162b2 heterologous booster enhanced immune response in both groups.
Assuntos
Anticorpos Antivirais , Vacina BNT162 , Vacinas contra COVID-19 , COVID-19 , Hospedeiro Imunocomprometido , Imunogenicidade da Vacina , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem , Anticorpos Antivirais/sangue , Vacina BNT162/imunologia , Vacina BNT162/administração & dosagem , COVID-19/prevenção & controle , COVID-19/imunologia , Vacinas contra COVID-19/imunologia , Vacinas contra COVID-19/administração & dosagem , Imunização Secundária , Imunocompetência/imunologia , Hospedeiro Imunocomprometido/imunologia , Vacinas de Produtos Inativados/imunologia , Vacinas de Produtos Inativados/administração & dosagemRESUMO
Avian chlamydiosis is a bacterial infectious disease of birds, considered until recently caused only by Chlamydia psittaci, that now includes the newly described species C. buteonis, C. avium, and C. gallinacea, associated with several avian hosts. Since its recognition as a species in 2014 and having chickens as one of its main hosts, C. gallinacea has already been described in backyard poultry on all continents. The present study aimed to survey by molecular techniques the presence and species of Chlamydia spp. in backyard chickens from three states of the southern region of Brazil (Paraná-PR, Santa Catarina-SC, and Rio Grande do Sul-RS). DNA extracted from cloacal swab samples were tested by polymerase chain reaction (PCR) for different species of Chlamydia, namely Chlamydiaceae (23 S rRNA gene), C. psittaci (ompA gene), C. avium (enoA gene) and C. gallinacea (gidA and enoA genes). The 16 S rRNA gene was used for sequencing and phylogenetic analysis. A total of 582 backyard chicken samples were collected and grouped in 238 pools, from 134 properties in 59 municipalities. Chlamydiaceae was detected in 25.2% (60/238) of the samples, in 38.8% (52/134) of the properties and in 66.1% (39/59) of the municipalities. None of the samples yielded positive PCR results for C. psittaci or C. avium. For C. gallinacea, the overall percentage was 16.3% (39/238) according to the results of gidA and enoA genes. Sequence analysis confirmed that the samples corresponded to C. gallinacea. This is the first report of C. gallinacea in Brazil.
Assuntos
Galinhas , Infecções por Chlamydia , Chlamydia , Filogenia , Doenças das Aves Domésticas , Animais , Galinhas/microbiologia , Brasil , Chlamydia/genética , Chlamydia/classificação , Chlamydia/isolamento & purificação , Infecções por Chlamydia/veterinária , Infecções por Chlamydia/microbiologia , Doenças das Aves Domésticas/microbiologia , Doenças das Aves Domésticas/epidemiologia , Fazendas , RNA Ribossômico 16S/genética , DNA Bacteriano/genéticaRESUMO
OBJECTIVE: To describe the feeding characteristics and growth of children with prenatal exposure to Zika virus (ZIKV) from birth to 48 months. DESIGN: Using data from the prospective Microcephaly Epidemic Research Group Pediatric Cohort (MERG-PC), children without microcephaly born to mothers with evidence of ZIKV infection during pregnancy (ZIKV-exposed children without microcephaly) and children with Zika-related microcephaly were compared using repeated cross-sectional analyses within the following age strata: birth; 1 to 12; 13 to 24; 25 to 36; and 37 to 48 months. The groups were compared in relation to prematurity, birth weight, breastfeeding, alternative feeding routes, dysphagia and anthropometric profiles based on the World Health Organization Anthro z-scores (weight-length/height, weight-age, length/height-age and BMI-age). RESULTS: The first assessment included 248 children, 77 (31.05%) with microcephaly and 171 (68.95%) without microcephaly. The final assessment was performed on 86 children. Prematurity was 2.35 times higher and low birth weight was 3.49 times higher in children with microcephaly. The frequency of breastfeeding was high (> 80%) in both groups. On discharge from the maternity hospital, the frequency of children requiring alternative feeding route in both groups was less than 5%. After 12 months of age, children with microcephaly required alternative feeding route more often than children without microcephaly. In children with microcephaly, the z-score of all growth indicators was lower than in children without microcephaly. CONCLUSIONS: Children with Zika-related microcephaly were more frequently premature and low birth weight and remained with nutritional parameters, i.e., weight-for-age, weight-for-length/height and length/height-for-age below those of the children without microcephaly.
Assuntos
Aleitamento Materno , Microcefalia , Complicações Infecciosas na Gravidez , Efeitos Tardios da Exposição Pré-Natal , Infecção por Zika virus , Humanos , Microcefalia/epidemiologia , Microcefalia/etiologia , Microcefalia/virologia , Infecção por Zika virus/complicações , Infecção por Zika virus/epidemiologia , Feminino , Gravidez , Recém-Nascido , Lactente , Masculino , Complicações Infecciosas na Gravidez/epidemiologia , Pré-Escolar , Estudos Transversais , Estudos Prospectivos , Desenvolvimento Infantil , Brasil/epidemiologiaRESUMO
Previously, it was shown that intranasally (i.n.) administered Corynebacterium pseudodiphtheriticum 090104 (Cp) or CP-derived bacterium-like particles (BLPs) improve the immunogenicity of the pneumococcal conjugate vaccine (PCV). This work aimed to deepen the characterization of the adjuvant properties of Cp and CP-derived BLPs for their use in the development of pneumococcal vaccines. The ability of Cp and CP-derived BLPs to improve both the humoral and cellular specific immune responses induced by i.n. administered polysaccharide-based commercial pneumococcal vaccine (Pneumovax 23®) and the chimeric recombinant PSPF (PsaA-Spr1875-PspA-FliC) protein was evaluated, as well as the protection against Streptococcus pneumoniae infection in infant mice. Additionally, whether the immunization protocols, including Cp and CP-derived BLPs, together with the pneumococcal vaccines can enhance the resistance to secondary pneumococcal pneumonia induced after inflammatory lung damage mediated by the activation of Toll-like receptor 3 (TLR3) was assessed. The results showed that both Cp and CP-derived BLPs increased the immunogenicity and protection induced by two pneumococcal vaccines administered through the nasal route. Of note, the nasal priming with the PSPF T-dependent antigen co-administered with Cp or CP-derived BLPs efficiently stimulated humoral and cellular immunity and increased the resistance to primary and secondary pneumococcal infections. The CP-derived BLPs presented a stronger effect than live bacteria. Given safety concerns associated with live bacterium administration, especially in high-risk populations, such as infants, the elderly, and immunocompromised patients, BLPs emerge as an attractive mucosal adjuvant to improve the host response to pneumococcal infections and to enhance the vaccines already in the market or in development.
RESUMO
BACKGROUND: Infections increase mortality and morbidity and often limit immunosuppressive treatment in rheumatoid arthritis patients. OBJECTIVE: To analyze the occurrence of serious infections and the associated factors in a cohort of rheumatoid arthritis patients under real-life conditions. METHODS: We analyzed data from the REAL, a prospective observational study, that evaluated Brazilian RA patients, with clinical and laboratory data collected over a year. Univariate and multivariate analyses were performed from the adjustment of the logistic regression model Generalized Estimating Equations (GEE), with the primary outcome being the occurrence of serious infection, defined as need for hospitalization or use of intravenous antibiotics for its treatment. RESULTS: 841 patients were included with an average follow-up time of 11.2 months (SD 2.4). Eighty-nine serious infections occurred, corresponding to 13 infections per 100 patient-years. Pulmonary fibrosis, chronic kidney disease (CKD) and central nervous system disease increased the chances of serious infection by 3.2 times (95% CI: 1.5-6.9), 3.6 times (95% CI: 1.2-10.4) and 2.4 times (95% CI: 1.2-5.0), respectively. The use of corticosteroids in moderate doses increased the chances by 5.4 times (95% CI: 2.3-12.4), and for each increase of 1 unit in the health assessment questionnaire (HAQ), the chance increased 60% (95% CI: 20-120%). CONCLUSION: The use of corticosteroids at moderate doses increased the risk of serious infection in RA patients. Reduced functionality assessed by the HAQ and comorbidities were other important factors associated with serious infection in this cohort.
Assuntos
Antirreumáticos , Artrite Reumatoide , Humanos , Antirreumáticos/uso terapêutico , Estudos Prospectivos , Brasil/epidemiologia , Artrite Reumatoide/complicações , Artrite Reumatoide/tratamento farmacológico , Artrite Reumatoide/epidemiologia , Corticosteroides/uso terapêuticoRESUMO
ABSTRACT Inactivated COVID-19 vaccines data in immunocompromised individuals are scarce. This trial assessed the immunogenicity of two CoronaVac doses and additional BNT162b2 mRNA vaccine doses in immunocompromised (IC) and immunocompetent (H) individuals. Adults with solid organ transplant (SOT), hematopoietic stem cell transplant, cancer, inborn immunity errors or rheumatic diseases were included in the IC group. Immunocompetent adults were used as control group for comparison. Participants received two CoronaVac doses within a 28-day interval. IC received two additional BNT162b2 doses and H received a third BNT162b2 dose (booster). Blood samples were collected at baseline, 28 days after each dose, pre-booster and at the trial end. We used three serological tests to detect antibodies to SARS-CoV-2 nucleocapsid (N), trimeric spike (S), and receptor binding domain (RBD). Outcomes included seroconversion rates (SCR), geometric mean titers (GMT) and GMT ratio (GMTR). A total of 241 IC and 100 H adults participated in the study. After two CoronaVac doses, IC had lower SCR than H: anti-N, 33.3% vs 79%; anti-S, 33.8% vs 86%, and anti-RBD, 48.5% vs 85%, respectively. IC also showed lower GMT than H: anti-N, 2.3 vs 15.1; anti-S, 58.8 vs 213.2 BAU/mL; and anti-RBD, 22.4 vs 168.0 U/mL, respectively. After the 3rd and 4th BNT162b2 doses, IC had significant anti-S and anti-RBD seroconversion, but still lower than H after the 3rd dose. After boosting, GMT increased in IC, but remained lower than in the H group. CoronaVac two-dose schedule immunogenicity was lower in IC than in H. BNT162b2 heterologous booster enhanced immune response in both groups.
RESUMO
Este estudo pretende identificar a percepção de estudantes de uma mesma instituição de ensino superior da área da saúde sobre dificuldades acadêmicas e não acadêmicas, estratégias de coping e identificar a presença de estresse. Foi um estudo transversal utilizando abordagens quantitativa e qualitativa, desenvolvido por meio de questionário estruturado e inventários psicométricos validados ( COPE Breve; inventário de sintomas de estresse ISLL ). Adicionalmente, foram realizadas entrevistas para ampliar a compreensão dos resultados dos instrumentos quantitativos. Na etapa quantitativa, participaram 162 estudantes dos cursos de graduação em Fisioterapia, Fonoaudiologia, Medicina, Nutrição e Terapia Ocupacional. Destes, 60 participaram de entrevista qualitativa. Os dados foram submetidos à análise estatística univariada e análise multivariada por regressão logística. Os estudantes relataram encontrar grande número de dificuldades e utilizar variadas estratégias de coping . A análise estatística univariada demonstrou que não houve diferenças importantes entre cursos e etapas quanto ao número de dificuldades e estratégias utilizadas. A presença de estresse foi identificada em proporções entre 45% e 100% dos estudantes, conforme o curso e a etapa considerada, sem diferenças significativas entre eles. A análise multivariada identificou cinco variáveis independentes como determinantes de estresse: sexo feminino, renda familiar, número de dificuldades acadêmicas/não acadêmicas e número de estratégias de coping voltadas à "emoção" presentes. Esta análise também mostrou que o estresse patológico está relacionado a somente uma variável: o número de dificuldades não acadêmicas. Estes achados reforçam a necessidade de manter ações institucionais de assistência social e apoio psicológico, favorecendo assim um planejamento efetivo de medidas de promoção da saúde mental dos estudantes.(AU)
This study aimed to find undergraduate students' perceptions about academic and non-academic difficulties and coping strategies and determining the occurrence of stress among them. This was a cross-sectional study using quantitative and qualitative approaches to evaluate students from different health professions in a single institution. Physical therapy, speech therapy, medicine, nutrition, and occupational therapy program students (N=162) answered a structured questionnaire and two validated psychometric inventories (COPE Brief scale and the ISS stress symptoms inventory). Additionally, 60 students underwent a semi-structured interview to better understand the results from the quantitative instruments. Quantitative data underwent univariate analysis to test differences between proportions and stepwise multiple regression analysis to identify the independent determinants of stress. Students reported a large number of academic and non-academic difficulties and a variety of coping strategies. Univariate statistical analysis showed no significant differences between courses and stages regarding the number of difficulties and coping strategies. A large proportion of students showed stress, ranging from 45% to 100%, depending on the course and stage, with no significant differences between them. Multivariate statistical analysis found five independent variables as stress determinants: female gender, low family income, number of academic and non-academic difficulties, and number of emotion-focused coping strategies. This analysis also showed that pathological stress is related to only one variable: the number of non-academic difficulties. These findings reinforce the importance of maintaining institutional actions for student social assistance and psychological support. Results also provide meaningful data for adequately planning more effective measures to promote students' mental health.(AU)
Este estudio pretende identificar la percepción de los estudiantes del sector salud sobre las dificultades académicas y no académicas, las estrategias de coping y la presencia de estrés. Este estudio transversal, con enfoque cuantitativo y cualitativo, utilizó cuestionarios estructurados e inventarios psicométricos validados (escala Brief COPE; inventario de sintomatología de estrés ISE ); además de entrevistas para ampliar la comprensión de los resultados de los instrumentos cuantitativos. En la etapa cuantitativa participaron 162 estudiantes de los cursos de grado en Fisioterapia, Fonoaudiología, Medicina, Nutrición y Terapia Ocupacional. De estos, 60 participaron en la entrevista cualitativa. Los resultados se sometieron a análisis estadístico univaria nte, para distinguir los grupos y asociaciones entre variables, y a análisis multivariado por regresión logística para identificar variables independientes que determinan el estrés. Los estudiantes reportaron enfrentar muchas dificultades académicas y no académicas, y utilizaban diferentes estrategias de coping. El análisis estadístico univariante no obtuvo diferencias significativas entre cursos y etapas respecto al número de dificultades y estrategias utilizadas. Un 45% y 100% de los estudiantes experimentaron estrés según el curso y la etapa considerada, sin diferencias significativas entre ellos. Se encontraron cinco variables independientes como factores de estrés: sexo femenino, renta familiar, número de dificultades académicas/no académicas y número de estrategias de coping orientadas a la "emoción". El estrés patológico estuvo relacionado solo a la variable número de dificultades no académicas. Se necesita mantener acciones institucionales de asistencia social y apoyo psicológico para favorecer una planificación efectiva de medidas de promoción de salud mental de los estudiantes.(AU)
Assuntos
Humanos , Masculino , Feminino , Estresse Psicológico , Estudantes , Adaptação Psicológica , Saúde , Programas de Graduação em Enfermagem , Capacidades de Enfrentamento , Organização e Administração , Objetivos Organizacionais , Ansiedade , Satisfação Pessoal , Personalidade , Filosofia , Pobreza , Resolução de Problemas , Competência Profissional , Psicologia , Psicologia Social , Qualidade da Assistência à Saúde , Qualidade de Vida , Instituições Acadêmicas , Autoimagem , Ajustamento Social , Meio Social , Ciências Sociais , Estresse Fisiológico , Evasão Escolar , Ensino , Pensamento , Tempo , Comportamento e Mecanismos Comportamentais , Esgotamento Profissional , Atividades Cotidianas , Escolha da Profissão , Comportamento de Escolha , Responsabilidade Legal , Autonomia Profissional , Competência Mental , Competência Clínica , Pessoal de Saúde , Comportamento Competitivo , Conflito Psicológico , Vida , Disciplinas e Atividades Comportamentais , Aconselhamento , Retroalimentação Psicológica , Autonomia Pessoal , Negação em Psicologia , Educadores em Saúde , Depressão , Avaliação Educacional , Ego , Docentes , Relações Familiares , Resiliência Psicológica , Medo , Comportamento Sedentário , Coragem , Ajustamento Emocional , Estilo de Vida Saudável , Sistemas de Apoio Psicossocial , Desempenho Acadêmico , Sucesso Acadêmico , Liberdade , Frustração , Tristeza , Angústia Psicológica , Inclusão Social , Estresse Financeiro , Bem-Estar Psicológico , Desenvolvimento Psicológico , Exaustão Emocional , Pressão do Tempo , Culpa , Zeladoria , Relações Interpessoais , Liderança , Aprendizagem , Acontecimentos que Mudam a Vida , Solidão , MotivaçãoRESUMO
OBJECTIVE: To evaluate the factorial structure of the instrument measuring university administrators' knowledge of gender-based violence. METHODS: This cross-sectional methodological study was conducted from August to November 2020 with 101 university administrators. Data on demographic and functional characteristics were collected, and the "QUEST VBG UNIV" instrument was applied. Descriptive analysis was performed, the structure of the questionnaire was assessed using exploratory factor analysis (EFA), and the stability of the factors was verified through ORION and FDI tests. RESULTS: Of the original 38 items across the 4 sections of the questionnaire, 19 were retained within 2 factors, with appropriate factor loadings. Factor 1 had an explained variance of 15.69%, and Factor 2 had an explained variance of 9.10%. The reliability was deemed satisfactory (ORION > 0.900, FDI > 0.900). CONCLUSIONS: The questionnaire presented a valid and reliable factorial structure for measuring knowledge about gender-based violence, thereby representing a suitable option for situational assessments in universities.
Assuntos
Violência de Gênero , Humanos , Universidades , Psicometria , Reprodutibilidade dos Testes , Estudos Transversais , Inquéritos e QuestionáriosRESUMO
Hepatitis E virus (HEV) is a public health concern globally, causing acute viral hepatitis in humans. Genotype-3 HEV (HEV-3), the most frequently genotype detected in South America, is zoonotic and the main reservoirs are the domestic pig and wild boar. Circulation of HEV-3 in Argentina has been confirmed in humans as well as in pig herds, wild boar and environmental waters. However, data are scarce mainly due to the inaccessibility of serological assays in this country. In order to provide insights in the epidemiology of HEV in swine in Argentina, we developed an indirect ELISA based on the native recombinant protein ORF2 and conducted a serological survey to determine the prevalence of seropositive swine in small-scale pig farms in the central region of Argentina. The method was evaluated in a panel of 157 serum samples, resulting in relative sensitivity of 98.6 % (95 % CI 95 %-100 %) and relative specificity of 97.7 % (95 % CI 94 %-100 %) compared to a commercial test. An almost perfect agreement was obtained between the two tests (Kappa index of 0.961). A survey on 294 samples from 49 small-scale farms resulted in a seropositivity rate of 54 %. Seropositive animals were found in 34 out of 49 (69.4 %) farms. Most of the farms (70.6 %) had over 50 % of seropositive animals. The wide spreading of HEV in the swine population of Tandil, Argentina, underscore the need to better understand the epidemiology of HEV in the region, enabling the implementation of targeted interventions to mitigate the impact of this virus on public health.
Assuntos
Vírus da Hepatite E , Hepatite E , Doenças dos Suínos , Humanos , Suínos , Animais , Hepatite E/epidemiologia , Hepatite E/veterinária , Argentina/epidemiologia , Doenças dos Suínos/epidemiologia , Filogenia , Sus scrofa , Vírus da Hepatite E/genética , Ensaio de Imunoadsorção Enzimática/veterinária , RNA Viral/genéticaRESUMO
Background: Hepatitis E virus (HEV) infection is a common cause of acute clinical hepatitis worldwide and is emerging as a disease in Argentina. It is primarily transmitted through contaminated water and food, following the fecal-oral route. Furthermore, is a zoonotic disease with swine as the primary reservoir. Prevalence of HEV infection in humans in several regions of Argentina remains unknown. Objectives: (i) Determine the seroprevalence of HEV among the human population in Tandil, Buenos Aires, Argentina; (ii) Evaluate its association with demographic, socioeconomic and other risk exposures variables, and (iii) Describe and analyze spatial patterns related to HEV infection. Methods: From August 2020 to July 2021, serum samples were collected from 969 individuals aged 1-80 years. Seroprevalence and 95% Confidence Interval was determined. To assess the factors associated with the presence of anti-HEV antibodies, associations between the variables and seropositivity were evaluated through bivariate and multivariate analysis. Spatial scanning for clusters of positivity was carried out. Factors associated with these clusters were also assessed. Results: Anti-HEV antibodies were detected in 4.64% (IC 95% 3.27-6.02) of samples. Dark urine was associated with seropositivity (p = 0.02). Seropositivity was linked with the presence of natural water courses near their households (p = 0.02); the age (p = 0.04); and previous travel to Europe (p = 0.04). A spatial cluster of low rates of HEV seropositivity was detected, with greater distance of the households to water courses associated to the cluster, and male sex inversely associated to it. Discussion and conclusion: This study is the first study to investigate the prevalence of HEV in the population from Tandil, Buenos Aires, Argentina. Considering HEV infection in the differential diagnosis in individuals presenting acute hepatitis is highlighted. The incorporation of HEV testing into blood screening policies should be mandatory. Factors related to the infection and spatial patterns of high and low risk were determined, and should be considered when implementing specific preventive measures.
Assuntos
Vírus da Hepatite E , Hepatite E , Humanos , Masculino , Suínos , Animais , Argentina/epidemiologia , Estudos Soroepidemiológicos , Hepatite E/epidemiologia , Hepatite E/diagnóstico , Anticorpos Anti-Hepatite , Fatores de Risco , ÁguaRESUMO
Acute Kidney Injury (AKI) is a frequent complication in intensive care unit (ICU) patients that increases mortality and chronic kidney disease (CKD) development. AKI is associated with elevated plasma fibroblast growth factor 23 (FGF23), which can be modulated by erythropoietin (EPO) and Klotho. We aimed to evaluate whether a combined biomarker that includes these molecules predicted short-/long-term outcomes. We performed a prospective cohort of ICU patients with sepsis and previously normal renal function. They were followed during their inpatient stay and for one year after admission. We measured plasma FGF23, EPO, and Klotho levels at admission and calculated a combined biomarker (FEK). A total of 164 patients were recruited. Of these, 50 (30.5%) had AKI at admission, and 55 (33.5%) developed AKI within 48 h. Patients with AKI at admission and those who developed AKI within 48 h had 12- and 5-fold higher FEK values than non-AKI patients, respectively. Additionally, patients with higher FEK values had increased 1-year mortality (41.9% vs. 18.6%, p = 0.003) and CKD progression (26.2% vs. 8.3%, p = 0.023). Our data suggest that the FEK indicator predicts the risk of AKI, short-/long-term mortality, and CKD progression in ICU patients with sepsis. This new indicator can improve clinical outcome prediction and guide early therapeutic strategies.
Assuntos
Injúria Renal Aguda , Eritropoetina , Insuficiência Renal Crônica , Sepse , Humanos , Estudos Prospectivos , Fator de Crescimento de Fibroblastos 23 , Cuidados Críticos , Sepse/complicações , BiomarcadoresRESUMO
This article investigates the correlation between work engagement and work-related quality of life among nursing staff at a public hospital in São Paulo State, at the onset of the COVID-19 pandemic. A descriptive, correlational, cross-sectional study of nursing personnel was conducted from December 2020 to January 2021, using the Brazilian versions of the Work & Well-being Survey (Utrecht Work Engagement Scale - UWES) and the Work-related Quality of Life (WRQoL) scale, following Walton's model. Nursing staffs returned a strong positive correlation (r≥0.70) between the social integration domain of the WRQoL and the vigour dimension of the UWES (r=0.88; p=<0.001); a moderate positive correlation (r≥0.40≤0.69) between working conditions (WRQOL) and the vigour (r=0.40; p<0.001), dedication (r=0.40; p<0.001) and overall score (r=0.41; p<0.001) dimensions of the UWES. Correlations were positive and weak (r≤0.39) for the other WRQoL domains and the UWES dimensions. It was concluded that personnel with satisfactory levels of quality of life tend to show higher levels of engagement at work. At the onset of the COVID-19 pandemic, nursing professionals were strongly engaged and satisfied with their work-related quality of life.
O artigo investiga a correlação entre engajamento e qualidade de vida no trabalho dos profissionais de enfermagem de um hospital público do interior do estado de São Paulo, no início da pandemia de COVID-19. Estudo transversal, descritivo e correlacional, com profissionais de enfermagem, realizado entre dezembro de 2020 e janeiro de 2021. Foram utilizadas as versões brasileiras da Utrecht Work Engagement Scale (UWES) e da Escala de Avaliação da Qualidade de Vida no Trabalho (QVT), segundo modelo de Walton. Os profissionais de enfermagem apresentaram correlação forte e positiva (r≥0.70) entre o domínio integração social da QVT e a dimensão vigor da UWES (r=0,88; p=<0,001); correlação positiva moderada (r≥0.40≤0.69) entre as condições de trabalho (QVT) e as dimensões vigor (r=0,40; p=<0,001), dedicação (r=0,40; p=<0,001) e escore geral (r=0,41; p=<0,001) da UWES. As correlações foram positivas e fracas (r≤0.39) para os demais domínios da QVT e as dimensões da UWES. Concluiu-se que os profissionais com níveis satisfatórios de qualidade de vida tendem a ter níveis mais altos de engajamento no trabalho. No início da pandemia de COVID-19, os profissionais de enfermagem estavam fortemente engajados e satisfeitos com sua qualidade de vida no trabalho.
Assuntos
COVID-19 , Recursos Humanos de Enfermagem , Humanos , Engajamento no Trabalho , Qualidade de Vida , Estudos Transversais , Pandemias , Brasil/epidemiologia , Inquéritos e QuestionáriosRESUMO
PURPOSE: Faculty development in health professions education is still challenging in developing countries like Brazil. Work overload and the lack of financial support hinder faculty members' participation. Ribeirão Preto Medical School founded its Center for Faculty Development in 2016. Since then, an essential skills module (ESMo) on health professions education (HPE) has been offered regularly to faculty members and preceptors of seven undergraduate programs. This case study aims to evaluate the impact of this Essential Skills Module on the educational practices of participants two years after attending the module and the challenges faced during the process. METHOD: The study used a mixed-method approach with a description of the demographic and professional profile data of the ESMo participants. Immediate post-ESMo perceptions (satisfaction and learning) of the participants were determined with structured instruments. Two years later, a semi-structured interview was conducted and recorded to determine the long-term effects (application of learning and behavior changing as an educator). NVIVO® software was used to store and systematize the thematic discourse analysis with a socio-constructivist theoretical framework interpretation. RESULTS: One hundred forty-six participants were included: 86 (59%) tenured faculty members, 49 (33,5%) clinical preceptors, and 11 (7,5%) invited teachers. Most were female (66%), and 56% had teaching experience shorter than ten years. 52 (69%) out of 75 eligible participants were interviewed. The immediate reaction to participating in the module was quite positive and 80% have already implemented an educational intervention in their daily activities. Discourses thematic analysis showed five emerging themes appearing in different frequencies: Changes in teaching activities (98%); Lack of previous pedagogical training (92.3%); Commitment and enthusiasm towards teaching (46.15%); Overlapping functions inside the institution (34.6%) and Challenges for student assessment (23%). CONCLUSION: This first in-depth evaluation of the long-term effects of a faculty development intervention in a Brazilian Health Profession Education school showed that participation positively changed participants' teaching & learning practices. These interventions consistently fostered a community of practice and valued faculty development processes in local and national scenarios.
Assuntos
Docentes , Faculdades de Medicina , Humanos , Feminino , Masculino , Brasil , Aprendizagem , Ocupações em Saúde , Docentes de Medicina , EnsinoRESUMO
Resumo O artigo investiga a correlação entre engajamento e qualidade de vida no trabalho dos profissionais de enfermagem de um hospital público do interior do estado de São Paulo, no início da pandemia de COVID-19. Estudo transversal, descritivo e correlacional, com profissionais de enfermagem, realizado entre dezembro de 2020 e janeiro de 2021. Foram utilizadas as versões brasileiras da Utrecht Work Engagement Scale (UWES) e da Escala de Avaliação da Qualidade de Vida no Trabalho (QVT), segundo modelo de Walton. Os profissionais de enfermagem apresentaram correlação forte e positiva (r≥0.70) entre o domínio integração social da QVT e a dimensão vigor da UWES (r=0,88; p=<0,001); correlação positiva moderada (r≥0.40≤0.69) entre as condições de trabalho (QVT) e as dimensões vigor (r=0,40; p=<0,001), dedicação (r=0,40; p=<0,001) e escore geral (r=0,41; p=<0,001) da UWES. As correlações foram positivas e fracas (r≤0.39) para os demais domínios da QVT e as dimensões da UWES. Concluiu-se que os profissionais com níveis satisfatórios de qualidade de vida tendem a ter níveis mais altos de engajamento no trabalho. No início da pandemia de COVID-19, os profissionais de enfermagem estavam fortemente engajados e satisfeitos com sua qualidade de vida no trabalho.
Abstract This article investigates the correlation between work engagement and work-related quality of life among nursing staff at a public hospital in São Paulo State, at the onset of the COVID-19 pandemic. A descriptive, correlational, cross-sectional study of nursing personnel was conducted from December 2020 to January 2021, using the Brazilian versions of the Work & Well-being Survey (Utrecht Work Engagement Scale - UWES) and the Work-related Quality of Life (WRQoL) scale, following Walton's model. Nursing staffs returned a strong positive correlation (r≥0.70) between the social integration domain of the WRQoL and the vigour dimension of the UWES (r=0.88; p=<0.001); a moderate positive correlation (r≥0.40≤0.69) between working conditions (WRQOL) and the vigour (r=0.40; p<0.001), dedication (r=0.40; p<0.001) and overall score (r=0.41; p<0.001) dimensions of the UWES. Correlations were positive and weak (r≤0.39) for the other WRQoL domains and the UWES dimensions. It was concluded that personnel with satisfactory levels of quality of life tend to show higher levels of engagement at work. At the onset of the COVID-19 pandemic, nursing professionals were strongly engaged and satisfied with their work-related quality of life.
RESUMO
The hepatitis E virus (HEV) is an emergent zoonotic virus causing viral hepatitis worldwide. Clinically, hepatitis E is not easily distinguished from other types of acute viral hepatitis. There is a need for HEV diagnostic assays to detect and prevent interspecies transmission among susceptible populations. Nanobodies (Nbs) are expressed recombinantly in different systems, produced with high yields, and have superior physicochemical properties compared with conventional antibodies (Ab). Several Nbs against ORF2, the capsid protein and main antigen, were selected and produced in E. coli. Nb39 and Nb74 specifically recognized HEV ORF2 (genotypes 3 and 4). A competitive ELISA (cELISA) was developed and validated using a reference panel of human (n = 86) and swine sera (n = 116) tested in comparison with a commercial kit. The optimal cutoff values determined by ROC analysis were 69.16% (human) and 58.76% (swine); the sensitivity and specificity were high: 97.4% (95% CI 86.5-99.5%) and 95.8% (95% CI 86.0-98.8%) for human vs. 100% (95% CI 93.5-100%) and 98.3% (95% CI 91.0-99.7%) for swine. Further, the cELISA detected total anti-HEV antibodies in wild boar, deer, and mice. To our knowledge, this is the first report of production of Nbs against HEV-3 ORF2 for diagnostic purposes.
Assuntos
Cervos , Vírus da Hepatite E , Anticorpos de Domínio Único , Humanos , Animais , Camundongos , Suínos , Escherichia coli , Anticorpos , Ensaio de Imunoadsorção EnzimáticaRESUMO
INTRODUCTION: Worldwide, tetanus-diphtheria-acellular pertussis (Tdap) vaccination coverage of healthcare professionals (HCPs) is below 40%, but this data is not available for Brazil. We hypothesize that a high number of HCPs are not immune to pertussis in Brazil. Main objective was to determine the seroprevalence of anti-pertussis toxin (anti-PT IgG) among HCPs. Secondary objectives were to evaluate Tdap vaccination coverage, to assess predictive factors associated with anti-PT IgG, and to estimate the decay of anti-PT IgG and time to Tdap vaccination. METHODS: Observational cross-sectional serological study in 352 HCPs who worked at São Paulo Hospital - Federal University of São Paulo (UNIFESP) in 2020, approved by UNIFESP Ethics Committee. Data collected included sociodemographics, knowledge about Tdap, and vaccination status. Anti-PT IgG were quantified by ELISA: <10 IU/mL seronegative and ≥ 10-1000 IU/mL seropositive. Titers ≥ 10-50 IU/mL were classified low positivity, indicating no recent B. pertussis infection or Tdap vaccination; >50 IU/mL high positivity, indicating recent B. pertussis infection or Tdap vaccination, and > 100 IU/mL as acute B. pertussis infection or Tdap vaccination in the previous year. Comparisons were done by Chi-square test, multivariable logistic regression, and Pearsons correlation, at 5% p-level. RESULTS: 331/352 HCPs were not aware the Brazilian National Immunization Program recommends Tdap for all HCPs and pregnant women. 68/339 HCPs received Tdap (mean 3.1 ± 2.0 years). 55/352 were seronegative for pertussis, all unvaccinated. 56/271 with no history of Tdap vaccination had high positivity. The probability of anti-PT IgG > 50 IU/mL was 11.5 times higher in Tdap vaccinated HCPs than in non-vaccinated (p < 0.001). There was a weak but significant correlation between anti-PT IgG and interval of Tdap vaccination (r = 0.404; p = 0.001). Anti-PT IgG dropped 5 IU/mL/year (p = 0.001). CONCLUSION: Better education of HCPs on needs and benefits of Tdap vaccination is critical. Goals must be to improve HCPs vaccination coverage.
Assuntos
Vacinas contra Difteria, Tétano e Coqueluche Acelular , Difteria , Tétano , Coqueluche , Humanos , Feminino , Gravidez , Cobertura Vacinal , Brasil/epidemiologia , Estudos Transversais , Estudos Soroepidemiológicos , Coqueluche/prevenção & controle , Vacinação , Anticorpos Antibacterianos , Difteria/prevenção & controle , Imunoglobulina G , Tétano/prevenção & controle , Atenção à SaúdeRESUMO
El objetivo de esta comunicación es reflexionar, desde la lingüística clínica, en torno a cómo los estudiantes con dislexia han afrontado los retos y dificultades que implica la lectura de textos científicos y académicos durante la formación universitaria. La lectura en la universidad tiene un mayor nivel de complejidad, se caracteriza por el uso del discurso referido, por el dominio de los géneros discursivos propios de cada área del saber y por el uso de un léxico especializado. A través del análisis de experiencias de profesionales con dislexia y de las consideraciones de investigadores sobre el tema, se concluye que es necesario promover ejercicios de investigación interdisciplinar con el objetivo de ayudar al estudiante disléxico a superar los retos de la educación universitaria.
The objective of this communication is to reflect, from clinical linguistics, on how students with dyslexia have faced the challenges and difficulties involved in reading scientific and academic texts during university education. Reading at the university has a higher level of complexity, it is characterized using referred discourse, by the mastery of discursive genres characteristic of each area of ââknowledge and using a specialized lexicon. Through the analysis of experiences of professionals with dyslexia and the considerations of researchers on the subject it is concluded that it is necessary to promote interdisciplinary research exercises with the aim of helping the dyslexic student to overcome the challenges of university education.