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BACKGROUND: Maternal-foetal transmission of Chagas disease (CD) affects newborns worldwide. Although Benznidazole and Nifurtimox therapies are the standard treatments, their use during pregnancy is contra-indicated. The effectiveness of trypanocidal medications in preventing congenital Chagas Disease (cCD) in the offsprings of women diagnosed with CD was highly suggested by other studies. METHODS: We performed a systematic review and meta-analysis of studies evaluating the effectiveness of treatment for CD in women of childbearing age and reporting frequencies of cCD in their children. PubMed, Scopus, Web of Science, Cochrane Library, and LILACS databases were systematically searched. Statistical analysis was performed using Rstudio 4.2 using DerSimonian and Laird random-effects models. Heterogeneity was examined with the Cochran Q test and I2 statistics. A p-value of <0.05 was considered statistically significant. RESULTS: Six studies were included, comprising 744 children, of whom 286 (38.4%) were born from women previously treated with Benznidazole or Nifurtimox, trypanocidal agents. The primary outcome of the proportion of children who were seropositive for cCD, confirmed by serology, was signigicantly lower among women who were previously treated with no congenital transmission registered (OR 0.05; 95% Cl 0.01-0.27; p = 0.000432; I2 = 0%). In women previously treated with trypanocidal drugs, the pooled prevalence of cCD was 0.0% (95% Cl 0-0.91%; I2 = 0%), our meta-analysis confirms the excellent effectiveness of this treatment. The prevalence of adverse events in women previously treated with antitrypanocidal therapies was 14.01% (95% CI 1.87-26.14%; I2 = 80%), Benznidazole had a higher incidence of side effects than Nifurtimox (76% vs 24%). CONCLUSION: The use of trypanocidal therapy in women at reproductive age with CD is an effective strategy for the prevention of cCD, with a complete elimination of congenital transmission of Trypanosoma cruzi in treated vs untreated infected women.
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Doença de Chagas , Transmissão Vertical de Doenças Infecciosas , Nifurtimox , Nitroimidazóis , Tripanossomicidas , Humanos , Feminino , Tripanossomicidas/uso terapêutico , Tripanossomicidas/efeitos adversos , Doença de Chagas/tratamento farmacológico , Doença de Chagas/prevenção & controle , Doença de Chagas/congênito , Doença de Chagas/transmissão , Gravidez , Transmissão Vertical de Doenças Infecciosas/prevenção & controle , Nifurtimox/uso terapêutico , Nifurtimox/efeitos adversos , Nitroimidazóis/uso terapêutico , Nitroimidazóis/efeitos adversos , Estudos Observacionais como Assunto , Recém-Nascido , Adulto , Trypanosoma cruzi/efeitos dos fármacos , Complicações Parasitárias na Gravidez/prevenção & controle , Complicações Parasitárias na Gravidez/tratamento farmacológicoRESUMO
West Nile Virus (WNV) poses a significant global public health threat as a mosquito-borne pathogen. While laboratory mouse models have historically played a crucial role in understanding virus biology, recent research has focused on utilizing immunocompromised models to study arboviruses like dengue and Zika viruses, particularly their interactions with Aedes aegypti mosquitoes. However, there has been a shortage of suitable mouse models for investigating WNV and St. Louis encephalitis virus interactions with their primary vectors, Culex spp. mosquitoes. Here, we establish the AG129 mouse (IFN α/ß/γ R-/-) as an effective vertebrate model for examining mosquito-WNV interactions. Following intraperitoneal injection, AG129 mice exhibited transient viremia lasting several days, peaking on the second or third day post-infection, which is sufficient to infect Culex quinquefasciatus mosquitoes during a blood meal. We also observed WNV replication in the midgut and dissemination to other tissues, including the fat body, in infected mosquitoes. Notably, infectious virions were present in the saliva of a viremic AG129 mouse 16 days post-exposure, indicating successful transmission capacity. These findings highlight the utility of AG129 mice for studying vector competence and WNV-mosquito interactions.
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Substance abuse disorder is a chronic condition for which pharmacological treatment options remain limited. L-type calcium channels (LTCC) have been implicated in drug-related plasticity and behavior. Specifically, dopaminergic neurons in the mesocorticolimbic pathway express Cav1.2 and Cav1.3 channels, which may regulate dopaminergic activity associated with reward behavior. Therefore, this study aimed to investigate the hypothesis that pre-administration of the LTCC blocker, isradipine can mitigate the effects of cocaine by modulating central glutamatergic transmission. For that, we administered isradipine at varying concentrations (1, 7.5, and 15 µg/µL) via intracerebroventricular injection in male Swiss mice. This pretreatment was carried out prior to subjecting animals to behavioral assessments to evaluate cocaine-induced locomotor sensitization and conditioned place preference (CPP). The results revealed that isradipine administered at a concentration of 1 µg/µL effectively attenuated both the sensitization and CPP induced by cocaine (15 mg/kg, via i. p.). Moreover, mice treated with 1 µg/µL of isradipine showed decreased presynaptic levels of glutamate and calcium in the cortex and hippocampus as compared to control mice following cocaine exposure. Notably, the gene expression of ionotropic glutamate receptors, AMPA, and NMDA, remained unchanged, as did the expression of Cav1.2 and Cav1.3 channels. Importantly, these findings suggest that LTCC blockage may inhibit behavioral responses to cocaine, most likely by decreasing glutamatergic input in areas related to addiction.
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Bloqueadores dos Canais de Cálcio , Cocaína , Camundongos , Masculino , Animais , Bloqueadores dos Canais de Cálcio/farmacologia , Isradipino/farmacologia , Ácido Glutâmico , Cocaína/farmacologia , Dopamina/metabolismoRESUMO
OBJECTIVE: Several studies point to antibacterial properties and beneficial effects of honey on scar tissue formation, which is a low-cost and easy-to-use option. This study aimed to compare honey versus a placebo for cicatrization and pain control of obstetric wounds, and determine if one is superior to the other, in terms of efficacy, through a meta-analysis. METHODS: We searched PubMed, Scopus, Cochrane Central Register of Controlled Trials, and Web of Science. Two independent investigators identified randomized controlled trials (RCTs) comparing honey and a placebo for obstetric wounds. The primary outcomes were wound healing and pain control. RESULTS: Five randomized controlled trials and 353 patients were included, of whom, 177 (50.1%) were treated with honey. Differences were not found in the final wound healing between the honey and placebo groups (MD -0.34; 95% CI -1.13, 0.44; p = 0.39); however, there was a decrease in pain levels in the middle of the treatment (SMD -0.54; 95% CI 0.83 to 0.25, p = 0.03), reduction in the use of pain medication (ORR 0.26; 95% CI 0.08, 0.86; p = 0.03), increase in personal satisfaction in women who underwent the intervention (ORR 0.81; 95% CI 0.65, 0.98), and reduction in complications. CONCLUSION: According to the study results, honey treatments showed greater efficiency and provided benefits to the patients by accelerating wound healing and decreasing reported pain.
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Cicatriz , Mel , Feminino , Gravidez , Humanos , Ensaios Clínicos Controlados Aleatórios como Assunto , Manejo da Dor , Dor/etiologiaRESUMO
The global incidence of chikungunya has surged in recent decades, with South America, particularly Brazil, experiencing devastating outbreaks. The primary vector for transmitting CHIKV in urban areas is the mosquito species Aedes aegypti, which is very abundant in Brazil. However, little is known about the impact of locally circulating CHIKV genotypes and specific combinations of mosquito populations on vector competence. In this study, we analyzed and compared the infectivity and transmissibility of a recently isolated CHIKV-ECSA lineage from Brazil among four Ae. aegypti populations collected from different regions of the country. When exposed to CHIKV-infected mice for blood feeding, all mosquito populations showed high infection rates and dissemination efficiency. Moreover, using a mouse model to assess transmission rates in a manner that better mirrors natural cycles, we observed that these populations exhibit highly efficient transmission rates of CHIKV-ECSA. Our findings underscore the robust capability of Brazilian Ae. aegypti populations to transmit the locally circulating CHIKV-ECSA lineage, potentially explaining its higher prevalence compared to the Asian lineage also introduced in Brazil.
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Chronic consumption of hyperpalatable and hypercaloric foods has been pointed out as a factor associated with cognitive decline and memory impairment in obesity. In this context, the integration between peripheral and central inflammation may play a significant role in the negative effects of an obesogenic environment on memory. However, little is known about how obesity-related peripheral inflammation affects specific neurotransmission systems involved with memory regulation. Here, we test the hypothesis that chronic exposure to a highly palatable diet may cause neuroinflammation, glutamatergic dysfunction, and memory impairment. For that, we exposed C57BL/6J mice to a high sugar and butter diet (HSB) for 12 weeks, and we investigated its effects on behavior, glial reactivity, blood-brain barrier permeability, pro-inflammatory features, glutamatergic alterations, plasticity, and fractalkine-CX3CR1 axis. Our results revealed that HSB diet induced a decrease in memory reconsolidation and extinction, as well as an increase in hippocampal glutamate levels. Although our data indicated a peripheral pro-inflammatory profile, we did not observe hippocampal neuroinflammatory features. Furthermore, we also observed that the HSB diet increased hippocampal fractalkine levels, a key chemokine associated with neuroprotection and inflammatory regulation. Then, we hypothesized that the elevation on glutamate levels may saturate synaptic communication, partially limiting plasticity, whereas fractalkine levels increase as a strategy to decrease glutamatergic damage.
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Quimiocina CX3CL1 , Hipocampo , Animais , Camundongos , Quimiocina CX3CL1/metabolismo , Dieta Hiperlipídica/efeitos adversos , Hipocampo/metabolismo , Inflamação/complicações , Camundongos Endogâmicos C57BL , Obesidade/complicações , Fármacos Atuantes sobre Aminoácidos ExcitatóriosRESUMO
OBJECTIVE: to assess the financial toxicity of people with chronic kidney disease undergoing hemodialysis treatment. METHOD: a descriptive analytical cross-sectional study, carried out with 214 people, between February and May 2022. For data collection, a sociodemographic and clinical instrument and the COmprehensive Score for financial Toxicity were used. For analysis, the Odds Ratio, ANOVA and Cronbach's alpha tests were used. RESULTS: the mean financial toxicity score was 20.30. Women with a monthly family income of at most two minimum wages are more likely to have some degree of financial toxicity (Odds Ratio: 0.85; 0.76). CONCLUSION: financial toxicity was identified to different degrees and varied according to sociodemographic and clinical characteristics. Measuring financial toxicity can help nurses plan care and develop strategies to avoid interrupting treatment.
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Estresse Financeiro , Insuficiência Renal Crônica , Humanos , Feminino , Estudos Transversais , Insuficiência Renal Crônica/complicações , Insuficiência Renal Crônica/terapia , Coleta de Dados , Diálise Renal/efeitos adversosRESUMO
Resumo: O diagnóstico da doença renal crônica acarreta, muitas vezes, modificações às quais obrigam a pessoa a reduzir a jornada de trabalho, diminuindo a renda familiar, situação que pode ocasionar um fenômeno chamado toxicidade financeira que contribui para redução da qualidade de vida relacionada a saúde. Trata-se de um estudo observacional, analítico e correlacional com corte transversal de abordagem quantitativa, com objetivo de investigar a relação da toxicidade financeira na qualidade de vida relacionada à saúde de pessoas com doença renal crônica em tratamento hemodialítico. A coleta de dados foi realizada de fevereiro de 2022 a maio de 2022 em um grupo de clínicas de diálise de Curitiba-PR e Região Metropolitana. O processo de amostragem foi probabilístico, mas o recrutamento foi por conveniência, obedecendo aos critérios de inclusão: pessoas com doença renal crônica, idade igual ou acima de 18 anos e que estavam em tratamento hemodialítico por período maior que seis meses (n=214). Para realização do estudo, foram utilizados os instrumentos sociodemográfico e clínico, Comprehensive Score For Financial Toxicity - COST e Kidney Disease Quality Of Life - Short Form -KDQOL-SFTM. A análise dos dados foi realizada descritivamente com frequências absolutas e relativas das variáveis da caracterização sociodemográfica e clínica da população do estudo, para os escores da toxicidade financeira e qualidade de vida relacionada à saúde foi usado o odds ratio, modelos de regressão logística bayesiano e o método de análise de variância (Anova). Participaram do estudo 214 pessoas com doença renal crônica, sendo 54,67% do sexo masculino, 52,80% tinham 60 anos ou mais, 53,52% eram casados ou estavam em união consensual, 56,07% tinham de 1 a 3 filhos, mais da metade 54,67% tinham menos de 9 anos de escolaridade, 54,97% eram aposentados, 81,75% apresentavam alguma comorbidade além da doença renal crônica, 59,34% tinham o diagnóstico de doença renal crônica de 1 a 5 anos, 88,26% faziam uso de medicação de uso contínuo, 69,69% não eram tabagistas e 72,89% não ingeriam bebida alcoólica. Em relação à toxicidade financeira, a média do escore total encontrado, considerando todas as unidades de coleta de dados, foi de 20,30/44. Pessoas do sexo feminino e renda familiar mensal de no máximo dois salários-mínimos têm maiores chances de apresentarem algum grau de toxicidade financeira (odds ratio: 0,85; 0,76). Verificou-se que na relação entre as medidas COST e qualidade de vida relacionado à saúde o maior impacto da toxicidade financeira foi associado a pior qualidade de vida relacionado à saúde. Sendo assim, foi identificado neste estudo a existência da toxicidade financeira em pessoas com doença renal crônica em hemodiálise e há, também, associação dos piores graus de toxicidade financeira com características sociodemográficas e clínicas. Portanto, a mensuração da toxicidade financeira pode auxiliar a enfermagem a orientar ações para minimizar esse evento.
Abstract: The diagnosis of chronic kidney disease often entails changes that force the person to reduce the workday, reducing family income, a situation that can cause a phenomenon called financial toxicity that contributes to a reduction in the quality of life related to health. This is an observational, analytical and correlational study with a cross-sectional quantitative approach, with the aim of investigating the relationship between financial toxicity and the health-related quality of life of people with chronic kidney disease undergoing hemodialysis treatment. Data collection was carried out from February 2022 to May 2022 in a group of dialysis clinics in Curitiba-PR and the Metropolitan Region. The sampling process was probabilistic, but the recruitment was for convenience, according to the inclusion criteria: people with chronic kidney disease, aged 18 years or older and who were on hemodialysis for a period longer than six months (n=214). To carry out the study, the sociodemographic and clinical instruments, Comprehensive Score For Financial Toxicity - COST and Kidney Disease Quality Of Life - Short Form -KDQOL-SFTM were used. Data analysis was performed descriptively with absolute and relative frequencies of the variables of the sociodemographic and clinical characterization of the study population, for the scores of financial toxicity and health-related quality of life, the odds ratio, Bayesian logistic regression models and the analysis of variance method (Anova). The study included 214 people with chronic kidney disease, 54.67% male, 52.80% aged 60 years or older, 53.52% married or in a consensual union, 56.07% had 1 to 3 children, more than half 54.67% had less than 9 years of schooling, 54.97% were retired, 81.75% had some comorbidity in addition to chronic kidney disease, 59.34% had a diagnosis of chronic kidney disease from 1 to 5 years, 88.26% used continuous medication, 69.69% were non-smokers and 72.89% did not drink alcohol. Regarding financial toxicity, the mean total score found, considering all data collection units, was 20.30/44. Females with a monthly family income of at most two minimum wages are more likely to have some degree of financial toxicity (odds ratio: 0,85; 0.76). It was found that in the relationship between COST measures and health-related quality of life, the greater impact of financial toxicity was associated with worse health-related quality of life. Therefore, this study identified the existence of financial toxicity in people with chronic kidney disease on hemodialysis and there is also an association of the worst degrees of financial toxicity with sociodemographic and clinical characteristics. Therefore, measuring financial toxicity can help nursing guide actions to minimize this event.
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Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Qualidade de Vida , Diálise Renal , Insuficiência Renal Crônica , Angústia Psicológica , Estresse Financeiro , Cuidados de EnfermagemRESUMO
ABSTRACT Objective: to assess the financial toxicity of people with chronic kidney disease undergoing hemodialysis treatment. Method: a descriptive analytical cross-sectional study, carried out with 214 people, between February and May 2022. For data collection, a sociodemographic and clinical instrument and the COmprehensive Score for financial Toxicity were used. For analysis, the Odds Ratio, ANOVA and Cronbach's alpha tests were used. Results: the mean financial toxicity score was 20.30. Women with a monthly family income of at most two minimum wages are more likely to have some degree of financial toxicity (Odds Ratio: 0.85; 0.76). Conclusion: financial toxicity was identified to different degrees and varied according to sociodemographic and clinical characteristics. Measuring financial toxicity can help nurses plan care and develop strategies to avoid interrupting treatment.
RESUMEN Objetivo: evaluar la toxicidad financiera de personas con enfermedad renal crónica en tratamiento de hemodiálisis. Método: estudio transversal analítico descriptivo, realizado con 214 personas, entre febrero y mayo de 2022. Para la recolección de datos se utilizó un instrumento sociodemográfico, clínico y el COmprehensive Score for financial Toxicity. Para el análisis se utilizaron las pruebas de Odds Ratio, ANOVA y alfa de Cronbach. Resultados: la puntuación media de toxicidad financiera fue de 20,30. Las mujeres con un ingreso familiar mensual de a lo sumo dos salarios mínimos tienen más probabilidades de tener algún grado de toxicidad financiera (Odds Ratio: 0,85; 0,76). Conclusión: la toxicidad financiera se identificó en diferentes grados y varió según las características sociodemográficas y clínicas. Medir la toxicidad financiera puede ayudar a las enfermeras a planificar la atención y desarrollar estrategias para evitar la interrupción del tratamiento.
RESUMO Objetivo: avaliar a toxicidade financeira de pessoas com doença renal crônica em tratamento hemodialítico. Método: estudo descritivo analítico com corte transversal, realizado com 214 pessoas, entre os meses de fevereiro e maio de 2022. Para coleta de dados, utilizou-se instrumento sociodemográfico e clínico e o COmprehensive Score for financial Toxicity. Para análise, utilizaram-se os testes Odds Ratio, ANOVA e alfa de Cronbach. Resultados: a média do escore da toxicidade financeira foi de 20,30. Pessoas do sexo feminino e com renda familiar mensal de no máximo dois salários mínimos têm maiores chances de apresentar algum grau de toxicidade financeira (Odds Ratio: 0,85; 0,76). Conclusão: a toxicidade financeira foi identificada em diferentes graus e variou de acordo com as características sociodemográficas e clínicas. A mensuração da toxicidade financeira pode auxiliar o enfermeiro no planejamento do cuidado e na elaboração de estratégias para evitar a interrupção do tratamento.
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ABSTRACT This study aimed to evaluate the social and professional profile and knowledge of Primary Care professionals on maternal and child health. Cross-sectional descriptive study, from May to July 2018. It included 30 nurses and 73 Community Health Workers (CHW) from the municipality of Bragança, Pará. The form had three phases: participants' profile; close-ended questions on their profile, knowledge and resourcefulness on the First Week of Integral Care guideline; and four open-ended questions. Quantitative data was analyzed through Microsoft Office ExcelTM 2016, as qualitative data was arranged through word clouds and similarity trees in IRaMuTeQTM. The majority of nurses and CHW were female (70.9%) and worked in urban areas (60.2%), as 40% of nurses were graduated recently, with an 80% specialization courses, and 83.6% CHW had completed high school. On both categories, 82.5% did not know the First Week of Integral Health guideline, although the word clouds and similarity trees had shown that several national standardized orientations were provided. First Week of Integral Care guidelines' insufficient knowledge by nurses and CHW in the municipality points to fragility in Primary Care on maternal and child health. Although basic orientations are provided, improvement is necessary.
RESUMO Este estudo buscou avaliar o perfil socioprofissional e o conhecimento de profissionais da atenção primária sobre saúde materno-infantil. É um estudo transversal descritivo, realizado de maio a julho de 2018. Incluiu 30 enfermeiros e 73 Agentes Comunitários de Saúde (ACS) do município de Bragança, Pará. O formulário possuiu três fases: perfil dos participantes; perguntas fechadas sobre perfil, conhecimento e habilidade sobre a diretriz Primeira Semana de Saúde Integral; e quatro perguntas abertas. Os dados quantitativos foram analisados por meio do Microsoft Office ExcelTM 2016, enquanto os dados qualitativos foram organizados por meio de nuvens de palavras e árvores de similaridades no IRaMuTeQTM. A maioria dos enfermeiros e ACS eram mulheres (70.9%) e trabalhavam em áreas urbanas, enquanto 40% dos enfermeiros formaram-se recentemente, sendo 80% por cursos de especialização; 83% dos ACS possuíam ensino médio completo. Em ambas as categorias, 82.5% não conheciam a diretriz da Primeira Semana de Saúde Integral, embora as nuvens de palavras e as árvores de similaridade tenham mostrado que várias orientações padronizadas nacionalmente eram fornecidas. O conhecimento insuficiente da diretriz Primeira Semana de Saúde Integral por parte dos ACS e enfermeiros do município indica a fragilidade da atenção básica na saúde materno-infantil. Ainda que sejam fornecidas orientações básicas, há necessidade de melhora na qualidade do serviço.
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BACKGROUND: Little is known about the evolution of peripheral arterial disease (PAD) since diagnosis and its association with glycemic and lipid control in patients with Type 2 Diabetes Mellitus (T2DM). OBJECTIVE: Evaluate the actual criteria to start screening PAD with ankle-brachial index (ABI) in T2DM patients and assess its progression and relationship with glycemic and lipid control since diagnosis. METHODS: We performed a 3-year prospective cohort study with two groups: group 1 (978 individuals with T2DM undergoing drug treatment) and group 2 [221 newly diagnosed drug-naive (< 3 months) patients with T2DM]. PAD diagnosis was by ABI ≤ 0.90, regardless any symptoms. RESULTS: As expected, abnormal ABI prevalence was higher in group 1 vs. Group 2 (87% vs. 60%, p < 0.001). However, abnormal ABI prevalence did not differ between patients over and under 50 years in both groups. Our drug-naive group stabilizes ABI (0.9 ± 0.1 vs 0.9 ± 0.1, p = NS) and improved glycemic and lipid control during follow-up [glycated hemoglobin (HbA1c) = 8.9 ± 2.1 vs 8.4 ± 2.3%, p < 0.05; LDL = 132 ± 45 vs 113 ± 38 mg/dL, p < 0.01, respectively]. When compared, patients who evolved with normalization or maintained normal ABI levels at the end [Group A, N = 60 (42%)] with those who decreased ABI to abnormal levels (ABI basal 1.0 ± 0.1 vs final 0.85 ± 0.1, p < 0.001) [Group B, N = 26 (18%)], an improvement in HbA1c (9 ± 2 vs 8 ± 2%, p < 0.05) and a correlation between the final HbA1c with ABI (r = - 0.3, p = 0.01) was found only in the first. In addition, a correlation was found between albuminuria variation and ABI solely in group A (r = - 0.3; p < 0.05). CONCLUSION: Our study suggests that ABI should be measured at diagnosis in T2DM patients, indicating that current criteria to select patients to screen PAD with ABI must be simplified. An improvement in albuminuria and glycemic and lipid control could be related with ABI normalization in newly diagnosed T2DM drug-naive patients.
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Diabetes Mellitus Tipo 2 , Doença Arterial Periférica , Albuminúria , Índice Tornozelo-Braço , Glicemia , Estudos de Coortes , Diabetes Mellitus Tipo 2/diagnóstico , Diabetes Mellitus Tipo 2/tratamento farmacológico , Diabetes Mellitus Tipo 2/epidemiologia , Hemoglobinas Glicadas , Humanos , Lipídeos , Doença Arterial Periférica/diagnóstico , Doença Arterial Periférica/epidemiologia , Estudos Prospectivos , Fatores de RiscoRESUMO
BACKGROUND: Type 1 Diabetes Mellitus (T1DM) impacts health-related quality of life (HRQoL). Cross-sectional studies suggest that low levels of vitamin D (VD) may impair HRQoL, however, the effect of VD supplementation on quality of life in T1DM patients has not yet been clarified. Our study evaluated the effects of high-dose VD supplementation on HRQoL in T1DM. METHODS: We performed a prospective study with 64 patients receiving cholecalciferol (4000 IU/day for patients with 25-OH-vitamin D [25(OH)D] between 30 and 60 ng/mL, and 10,000 IU/day for those with 25(OH)D below 30 ng/mL) for 12 weeks, as part of a research protocol. HRQoL was assessed with EuroQol instruments (EQ-5D and EQ-VAS). RESULTS: There was an improvement in global EQ-5D index, and analysing specifically the EQ-5D domains, we observed an improvement in mobility (1.3 ± 0.6 versus 1.1 ± 0.3, p < 0.01). Evaluating possible outcome influencing variables, we detected a reduction in albuminuria at the end of the trial, without changes in BMI, lipids, blood pressure, glycemic control and insulin doses. We found correlations between final albuminuria and the dimensions: mobility (r = 0.6; p < 0.01), personal care (r = 0.7; p < 0.01), pain and discomfort (r = 0.6; p < 0.01) and habitual activities (r = 0.6; p < 0.01), suggesting an association between albuminuria reduction and the impact of VD supplementation on HRQoL. CONCLUSION: Our data showed that high doses of cholecalciferol supplementation can improve HRQoL in patients with T1DM, and the reduction of albuminuria seems to be an important factor in this context. TRIAL REGISTRATION: (ISRCTN32601947), 03/06/2017 retrospectively registered.
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Abstract The objective was to estimate the relationship between sociodemographic characteristics, link with the university, behavioral, biological, and self-rated related to health, with time sitting in university students at federal institutions in the state of Bahia, Brazil. This cross-sectional study was carried out with university students from six institutions (Federal University "Recôncavo da Bahia", Federal University of "Bahia", Federal University of "Oeste da Bahia", University of International Integration of Afro-Brazilian Lusophony, Federal University of "Vale do São Francisco" and Federal University of "Sul da Bahia") in the state from Bahia in 2019. Time sitting in hours per day was investigated and relation sociodemographic, link with the university, behavioral, biological, self-rated of stress and health variables. Path analysis was used to apply multivariate linear regression. The significance status was 5%. A total of 1,217 university students participated of the study. The final model accounts for 6% of sitting time. Self-rated health as positive (β: -0.117; p: <0.001), increasing age (β: -0.115; p: <0.001) and physical activity practice (β: -0.113; p: <0.001) contributed to the decrease in sitting time. The increase in the amount of inadequate eating habits (β: 0.063; p: 0.032) favored the increase in sitting time. The adjustment indices were satisfactory. Concluded that self-rated health as positive, advancing age and physical activities practice were determinants of reduced sitting time, on the other hand, irregular eating behaviors favored sedentary behavior.
Resumo O objetivo foi estimar a associação entre as características sociodemográficas, de vínculo com a universidade, comportamentais, biológicas e de autoavaliação relacionada a saúde, com o tempo sentado em universitários de instituições federais do estado da Bahia, Brasil. Este estudo transversal foi realizado com universitários de seis instituições (Universidade Federal do Recôncavo da Bahia, Universidade Federal da Bahia, Universidade Federal do Oeste da Bahia, Universidade da Integração Internacional da Lusofonia Afro-Brasileira, Universidade Federal do Vale do São Francisco e Universidade Federal do Sul da Bahia) do estado da Bahia em 2019. Foi investigado o tempo sentado em horas/dia em relação as variáveis sociodemográficas, de vínculo com a universidade, comportamentais, biológicas e de autoavaliação do estresse e saúde. Empregou-se a análise de caminhos por meio da regressão linear múltipla. O nível de significância foi de 5%. Participaram do estudo 1.217 universitários. O modelo final explicou 6% do tempo sentado. Os universitários que autoavaliaram a saúde como positiva (β: -0,117; p: <0,001), aqueles com maior idade (β: -0,115; p: <0,001) e que apresentam mais tempo de prática de atividades físicas (β: -0,113; p: <0,001) apresentaram diminuição do tempo sentado. O aumento da quantidade de hábitos alimentares inadequados (β: 0,063; p: 0,032) favoreceu o aumento do tempo sentado. Os índices de ajuste foram satisfatórios. Concluiu-se que a autoavaliação da saúde como positiva, o avanço da idade e a prática de atividades físicas foram determinantes da redução do tempo sentado, por outro lado, os comportamentos alimentares irregulares favoreceram o sedentarismo.
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RESUMO Objetivo: analisar as intervenções educativas remotas para o letramento de adultos com hipertensão arterial na atenção primária. Método: intervenção prática, desenvolvida a partir do conhecimento sobre a hipertensão, de adultos cadastrados em unidade básica de saúde localizada em uma Região Metropolitana, no estado do Paraná, Brasil, de março a dezembro de 2020. Aplicou-se questionário clínico e sociodemográfico, Item-Eight Health Literacy Assessment Tool e Hypertension Knowledge-Level Scale. As ligações telefônicas foram audiogravadas e, posteriormente, transcritas em diário de campo. Os dados dos instrumentos foram analisados por frequência simples, relativa, média e desvio padrão, e as informações do diário de campo por domínios. Resultados: na avaliação do letramento em saúde, observou-se aumento da média na questão relativa às informações de saúde de baixa e alta qualidade na internet. No instrumento de conhecimento, as questões relativas à adesão medicamentosa, dieta e mudança no estilo de vida apresentaram 100% de acertos no segundo momento. Conclusão: as intervenções educativas remotas demonstraram influência no letramento em saúde e no conhecimento sobre a hipertensão, havendo aumento de acertos nas questões relativas às informações de saúde na internet e de mudança no estilo de vida. Sendo assim, destaca-se o potencial do telemonitoramento como forma de acompanhamento e promoção de saúde, favorecendo o controle da doença.
RESUMEN Objetivo: analizar las intervenciones educativas remotas para el aprendizaje de adultos con hipertensión arterial en la atención primaria. Método: intervención práctica, desarrollada a partir del conocimiento sobre la hipertensión, de adultos registrados en unidad básica de salud ubicada en una Región Metropolitana, en el estado de Paraná/Brasil, de marzo a diciembre de 2020. Se aplicó cuestionario clínico y sociodemográfico, Item-Eight Health Literacy Assessment Tool y Hypertension Knowledge-Level Scale. Las llamadas telefónicas fueron audiograbadas y, posteriormente, transcriptas en diario de campo. Los datos de los instrumentos fueron analizados por frecuencia simple, relativa, media y desviación estándar, y las informaciones del diario de campo por dominios. Resultados: en la evaluación de la Instrucción en salud, se observó aumento de la media en la cuestión respecto a las informaciones de salud de baja y alta calidad en internet. En el instrumento de conocimiento, las cuestiones relativas a la adhesión medicamentosa, dieta y cambio en el estilo de vida presentaron 100% de aciertos en el segundo momento. Conclusión: las intervenciones educativas remotas han demostrado influencia en la instrucción en salud y en el conocimiento sobre la hipertensión, habiendo aumento de aciertos en las cuestiones relativas a las informaciones de salud en internet y de cambio en el estilo de vida. Así, se destaca el potencial del telemonitoreo como forma de acompañamiento y promoción de salud, favoreciendo el control de la enfermedad.
ABSTRACT Objective: to analyze the remote educational interventions for the literacy of adults with hypertension in primary care. Method: practical intervention, developed from the knowledge about hypertension, of adults registered in a basic health unit located in a Metropolitan Region, in the state of Paraná, Brazil, from March to December 2020. A clinical and sociodemographic questionnaire, Item-Eight Health Literacy Assessment Tool and Hypertension Knowledge-Level Scale were applied. Telephone calls were audio-recorded and later transcribed into a field diary. Instrument data were analyzed by simple, relative, mean frequencies and standard deviation, and field diary information by domains. Results: in the assessment of health literacy, an increase in the mean was observed in the question related to low and high quality health information on the internet. In the knowledge instrument, the questions related to medication adherence, diet and change in lifestyle presented 100% of correct answers in the second moment. Conclusion: remote educational interventions showed influence on health literacy and knowledge about hypertension, with an increase in correct answers on issues related to health information on the internet and change in lifestyle; thus, the potential of telemonitoring as a way of monitoring and promoting health, favoring the control of the disease is highlighted.
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Humanos , Masculino , Feminino , Doença CrônicaRESUMO
Adolescents in situations of social vulnerability demand a type of care, from parents, teachers, and society, that protects them from the additional risks to which they are exposed, without compromising the development of their autonomy. This qualitative study aimed to investigate the imaginative elaborations of 30 teachers about adolescence using an Interactive Narrative approach as an investigative resource. The narrative material was analyzed interpretively, searching for the affective-emotional senses underlying the elaborations of the participants, resulting in the following fields of meaning: "Do not turn adolescence into rocket science" and "Adolescence: a sign of danger". In addition to the pedagogical issues, the participants expressed difficulty in dealing with issues that are specific to the adolescent's emotional development, oscillating between stereotyped conceptions and an empathic posture in the face of adolescent immaturity. It is concluded that teachers experience ambivalent feelings towards adolescents, assuming either an authoritarian or a patronizing posture, understanding adolescent conflict as natural at this development stage.
O adolescente em situação de vulnerabilidade social demanda dos pais, professores e da sociedade um cuidado que o proteja dos riscos adicionais aos quais está exposto, sem que o desenvolvimento de sua autonomia seja comprometido. Este estudo qualitativo teve como objetivo investigar elaborações imaginativas de 30 professores sobre a adolescência, utilizando a Narrativa Interativa como recurso investigativo. O material narrativo foi analisado interpretativamente em busca dos sentidos afetivo-emocionais subjacentes às elaborações dos participantes, resultando nos campos de sentido: "Não façam da adolescência um bicho de sete cabeças" e "Adolescência: sinal de perigo". Para além das questões pedagógicas, os participantes manifestaram dificuldade para lidar com questões próprias ao desenvolvimento emocional do adolescente, oscilando entre concepções estereotipadas e uma postura empática diante da imaturidade que é própria da idade. Conclui-se que os professores vivenciam sentimentos ambivalentes em relação aos alunos, assumindo desde uma postura autoritária até aceitação do conflito adolescente como natural nessa etapa do desenvolvimento.
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Psicologia , Família , AdolescenteRESUMO
BACKGROUND: The Zika virus (ZIKV) epidemics that affected South America in 2016 raised several research questions and prompted an increase in studies in the field. The transient and low viraemia observed in the course of ZIKV infection is a challenge for viral isolation from patient serum, which leads to many laboratories around the world sharing viral strains for their studies. C6/36 cells derived from Aedes albopictus larvae are commonly used for arbovirus isolation from clinical samples and for the preparation of viral stocks. OBJECTIVES: Here, we report the contamination of two widely used ZIKV strains by Brevidensovirus, here designated as mosquito densovirus (MDV). METHODS: Molecular and immunological techniques were used to analyse the MDV contamination of ZIKV stocks. Also, virus passages in mammalian cell line and infecting susceptible mice were used to MDV clearance from ZIKV stocks. FINDINGS: MDV contamination was confirmed by molecular and immunological techniques and likely originated from C6/36 cultures commonly used to grow viral stocks. We applied two protocols that successfully eliminated MDV contamination from ZIKV stocks, and these protocols can be widely applied in the field. As MDV does not infect vertebrate cells, we performed serial passages of contaminated stocks using a mammalian cell line and infecting susceptible mice prior to re-isolating ZIKV from the animals' blood serum. MDV elimination was confirmed with immunostaining, polymerase chain reaction (PCR), and analysis of the mosquitoes that were allowed to feed on the infected mice. MAIN CONCLUSIONS: Since the putative impact of viral contaminants in ZIKV strains generally used for research purposes is unknown, researchers working in the field must be aware of potential contaminants and test viral stocks to certify sample purity.
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Culicidae/virologia , DNA Viral/genética , Densovirus/genética , Laboratórios , Zika virus , Animais , Bancos de Espécimes Biológicos , Linhagem Celular , Imunofluorescência , Humanos , Camundongos , Cultura de VírusRESUMO
BACKGROUND The Zika virus (ZIKV) epidemics that affected South America in 2016 raised several research questions and prompted an increase in studies in the field. The transient and low viraemia observed in the course of ZIKV infection is a challenge for viral isolation from patient serum, which leads to many laboratories around the world sharing viral strains for their studies. C6/36 cells derived from Aedes albopictus larvae are commonly used for arbovirus isolation from clinical samples and for the preparation of viral stocks. OBJECTIVES Here, we report the contamination of two widely used ZIKV strains by Brevidensovirus, here designated as mosquito densovirus (MDV). METHODS Molecular and immunological techniques were used to analyse the MDV contamination of ZIKV stocks. Also, virus passages in mammalian cell line and infecting susceptible mice were used to MDV clearance from ZIKV stocks. FINDINGS MDV contamination was confirmed by molecular and immunological techniques and likely originated from C6/36 cultures commonly used to grow viral stocks. We applied two protocols that successfully eliminated MDV contamination from ZIKV stocks, and these protocols can be widely applied in the field. As MDV does not infect vertebrate cells, we performed serial passages of contaminated stocks using a mammalian cell line and infecting susceptible mice prior to re-isolating ZIKV from the animals' blood serum. MDV elimination was confirmed with immunostaining, polymerase chain reaction (PCR), and analysis of the mosquitoes that were allowed to feed on the infected mice. MAIN CONCLUSIONS Since the putative impact of viral contaminants in ZIKV strains generally used for research purposes is unknown, researchers working in the field must be aware of potential contaminants and test viral stocks to certify sample purity.
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Humanos , Animais , Cultura de Vírus , Bancos de Espécimes Biológicos , Zika virus , DNA Viral , Imunofluorescência , Densovirus/genética , CamundongosRESUMO
Sandflies are well known vectors for Leishmania but also transmit a number of arthropod-borne viruses (arboviruses). Few studies have addressed the interaction between sandflies and arboviruses. RNA interference (RNAi) mechanisms utilize small non-coding RNAs to regulate different aspects of host-pathogen interactions. The small interfering RNA (siRNA) pathway is a broad antiviral mechanism in insects. In addition, at least in mosquitoes, another RNAi mechanism mediated by PIWI interacting RNAs (piRNAs) is activated by viral infection. Finally, endogenous microRNAs (miRNA) may also regulate host immune responses. Here, we analyzed the small non-coding RNA response to Vesicular stomatitis virus (VSV) infection in the sandfly Lutzoymia longipalpis. We detected abundant production of virus-derived siRNAs after VSV infection in adult sandflies. However, there was no production of virus-derived piRNAs and only mild changes in the expression of vector miRNAs in response to infection. We also observed abundant production of virus-derived siRNAs against two other viruses in Lutzomyia Lulo cells. Together, our results suggest that the siRNA but not the piRNA pathway mediates an antiviral response in sandflies. In agreement with this hypothesis, pre-treatment of cells with dsRNA against VSV was able to inhibit viral replication while knock-down of the central siRNA component, Argonaute-2, led to increased virus levels. Our work begins to elucidate the role of RNAi mechanisms in the interaction between L. longipalpis and viruses and should also open the way for studies with other sandfly-borne pathogens.
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Interações Hospedeiro-Patógeno , Insetos Vetores/virologia , Psychodidae/genética , Psychodidae/virologia , RNA não Traduzido , Vírus da Estomatite Vesicular Indiana/fisiologia , Animais , Insetos Vetores/parasitologia , Leishmania/fisiologia , MicroRNAs/genética , Psychodidae/imunologia , Psychodidae/fisiologia , Interferência de RNA , RNA Interferente Pequeno/genética , RNA Viral/genética , Vírus da Estomatite Vesicular Indiana/genética , Replicação ViralRESUMO
Objetivo: O diabetes mellitus tipo 1 representa condição crônica de saúde frequente na população pediátrica e possui impacto significativo sobre qualidade de vida destes indivíduos. O objetivo do presente estudo é avaliar a qualidade de vida em indivíduos com diabetes mellitus tipo 1 de curta duração, sob a ótica dos pacientes e dos seus cuidadores. Métodos: Aplicação dos questionários PedsQL 4.0 e Instrumento de Qualidade de Vida para Jovens com Diabetes. Resultados: Dentre os 15 pacientes (e seus cuidadores) avaliados, observou-se que a maior parte dos indivíduos entrevistados considerou sua saúde como boa, em relação à das demais pessoas e a autopercepção da qualidade de vida não se mostrou, de forma geral, prejudicada pelo diabetes. Conclusão: Tendo em vista que a ausência de complicações crônicas e a percepção de boa saúde estão intimamente relacionadas, destaca-se a importância da intervenção precoce, por parte da equipe de saúde, com objetivo de promover atividades de educação em saúde, voltadas às necessidades desse grupo de indivíduos.