Escala da Satisfação com a decisão em saúde: instrumento adaptado e validado para língua portuguesa / Decision making satisfaction in health scale: instrument adapted and validated to portuguese / Escala de la satisfacción con las decisiones en la salud: instrumento adaptado y validado para el idioma portugués

A tomada de decisão é uma área de investigação na saúde que tem vindo a ganhar importância quer pelos modelos de parceria de cuidados que dão protagonismo ao paciente e família, quer pela preocupação crescente com a qualidade e satisfação do cliente com os cuidados disponibilizados. Assim, propusemo-nos efetuar a adaptação transcultural e avaliar as propriedades psicométricas da versão portuguesa da "The Satisfaction with Decision Scale" de Holmes-Rovner (1996), que visa avaliar a satisfação com as decisões tomadas em saúde. A amostra foi constituída por 521 estudantes da Escola Superior de Enfermagem do Porto. Os resultados obtidos nos testes de fiabilidade revelam uma boa consistência interna para o total dos itens (Alpha Cronbach = 0,88). O estudo psicométrico permite-nos afirmar que a versão em Português da "The Satisfaction with Decision Scale", que denominamos "Escala da Satisfação com a Decisão em Saúde", é um instrumento fidedigno e válido.

Decision making is an area of health research that has gained importance both for the partnership models of care that give prominence to the patient and family, either by growing concern about quality and customer satisfaction with the care provided. So we decided to make the cultural adaptation and to evaluate the psychometric properties of the Portuguese version "The Satisfaction with Decision Scale" de Holmes-Rovner (1996), which aims to assess satisfaction with the decisions taken in health. The sample consisted of 521 nursing students the School of Nursing of Porto. The results of reliability tests show good internal consistency for the total items (Alpha Cronbach = 0.88). The psychometric study allows us to state that the Portuguese version of "The Satisfaction with Decision Scale", we call "Escala da Satisfação com a Decisão em Saúde", is an instrument comparable with the original in terms of validity and reliability.

La toma de decisiones es un área de investigación en salud que ha ganado importancia tanto por los modelos de atención dirigida al paciente y su familia, como por la creciente preocupación por la calidad y satisfacción del cliente con la atención recibida. Por esta razón decidimos hacer la adaptación transcultural y evaluar las propiedades psicométricas de la versión portuguesa "The Satisfaction with Decision Scale" de Holmes-Rovner (1996), que tiene como objetivo evaluar la satisfacción con las decisiones adoptadas en materia de salud. La muestra consta de 521 estudiantes de la Escuela de Enfermería del Porto. Los resultados de las pruebas de fiabilidad muestran una buena consistencia interna para la escala total (Alpha Cronbach = 0,88). El estudio psicométrico nos permite afirmar que la versión en portugués de "The Satisfaction with Decision Scale", que nosotros llamamos "Escala da Satisfação com a Decisão em Saúde", es válida.

Interferon-γ inhibits group B Streptococcus survival within human endothelial cells

Endothelial dysfunction is a major component of the pathophysiology of septicaemic group B Streptococcus (GBS) infections. Although cytokines have been shown to activate human umbilical vein endothelial cells (HUVECs), the capacity of interferon (IFN)-γ to enhance the microbicidal activity of HUVECs against GBS has not been studied. We report that the viability of intracellular bacteria was reduced in HUVECs activated by IFN-γ. Enhanced fusion of lysosomes with bacteria-containing vacuoles was observed by acid phosphatase and the colocalisation of Rab-5, Rab-7 and lysosomal-associated membrane protein-1 with GBS in IFN-γ-activated HUVECs. IFN-γ resulted in an enhancement of the phagosome maturation process in HUVECs, improving the capacity to control the intracellular survival of GBS.

In vitro studies on inhibitory effect of proanthocyanidins in modulation of neutrophils and macrophages.

The role of proanthocyanidins (PC), a novel flavonoid extracted from grape seeds was studied in vitro in the modulation of neutrophil and macrophage function. We attempted to assess the levels of non-enzymatic and enzymatic mediators in the presence or absence of PC in 4-phorbol-12--myristate-13-acetate (PMA)-stimulated neutrophils isolated from humans and rats, E. coli endotoxin-stimulated macrophages and macrophages isolated from E. coli endotoxin-induced experimental periodontitis in rats. Addition of PC at a concentration of 50 µg/ml effectively blocked the release of reactive oxygen species (ROS) and reactive nitrogen species (RNS) and exhibited a marked inhibition of myeloperoxidase (MPO) and lysosomal enzymes (p<0.001), as compared to PMA-stimulated neutrophils (human and rats) and neutrophils isolated from experimental periodontitis in rats. The levels of ROS, RNS and lysosomal enzymes were found to be elevated (p<0.001) and addition of PC significantly (p<0.001) reduced these levels as compared to those from E. coli endotoxin-stimulatedmacrophages from rats and macrophages isolated from experimental periodontitis in rats (p<0.001). Thus, the study demonstrated that PC decreased the levels of ROS and RNS and also inhibited the MPO and lysosomal enzymes activities in experimental periodontitis in rats. In addition, this study clearly indicated that PC could be developed as an effective antiinflammatory agent.

Activity of praziquantel on in vitro transformed Schistosoma mansoni sporocysts

Praziquantel (PZQ) is effective against all the evolutive phases of Schistosoma mansoni. Infected Biomphalaria glabrata snails have their cercarial shedding interrupted when exposed to PZQ. Using primary in vitro transformed sporocysts, labeled with the probe Hoechst 33258 (indicator of membrane integrity), and lectin of Glycine max (specific for carbohydrate of N-acetylgalactosamine membrane), we evaluated the presence of lysosomes at this evolutive phase of S. mansoni, as well as the influence of PZQ on these acidic organelles and on the tegument of the sporocyst. Although the sporocyst remained alive, it was observed that there was a marked contraction of its musculature, and there occurred a change in the parasite's structure. Also, the acidic vesicles found in the sporocysts showed a larger delimited area after contact of the parasites with PZQ. Damages to the tegument was also observed, as show a well-marked labeling either with Hoechst 33258 or with lectin of Glycine max after contact of sporocysts with the drug. These results could partially explain the interruption/reduction mechanism of cercarial shedding in snails exposed to PZQ.

Lysosomal stability in Oreochromis mossambicus (Peters) on exposure to surfactants.

The three commonly used surfactants viz. anionic sodium dodecyl sulfate (SDS), cationic cetyl tri methyl ammonium bromide (CTAB) and non-ionic triton X-100 were toxic even at sub lethal levels (1 ppm for 30 days) to 0. mossambicus. Lysosomal stability index (LSI) was lowest in triton-exposed animals in vitro. In vivo, CTAB was the most toxic. SDS, the anionic surfactant was the least toxic. The possible role of surfactant structure, critical micellar concentration (CMC) and metabolism in influencing the toxicity is discussed and mechanism of action via membrane lipid peroxidation is suggested.

Effect of repeated intraperitoneal exposure to picrotoxin on rat liver lysosomal function.

Effect of repeated (20 days) exposure to picrotoxin (PTX) on rat liver lysosomal function was evaluated by measuring the free and total activities of acid phosphatase, cathepsin D, ribonuclease II (RNAse II) and deoxyribonuclease II (DNAse II). The free activities of the nucleases (both RNAse II and DNAse II) were increased following PTX exposure. The total DNAse II activity was increased by 2.2-fold whereas the total acid phosphatase activity was decreased by 28%. Consequently, the ratios of total activity / free activity were low in the PTX exposed groups, implying loss of membrane integrity. Cathepsin D activity was completely abolished. The results show that repeated exposure to PTX can lead to lysosomal dysfunction in liver.

Lysosomal enzyme activity during development of carbon tetrachloride induced cirrhosis in rats.

The present study was undertaken to determine whether there is any alteration in the activities of lysosomal enzymes in the liver and sera of rats during the course of carbon tetrachloride (CCl4) induced cirrhosis in rats. Cirrhosis was induced by the chronic administration of carbon tetrachloride plus phenobarbitone. N-acetyl glucosaminidase, P-glucuronidase and acid phosphatase were assayed spectrophotometrically in the liver homogenates and in the sera at different stages of liver injury i.e., necrosis, fibrosis, and cirrhosis. Significant increase in the "basal" activities of N acetyl glucosaminidase, beta-glucuronidase, and acid phosphatase were observed in the livers of rats during the course of development of cirrhosis. As the liver injury progressed from necrosis to cirrhosis, the 'free' activities of these three enzymes also increased. The 'total' activities of the enzymes studied were either decreased or remained unaltered. The increased 'free' activities of the lysosomal enzymes in the liver of CCl4 treated rats may contribute to cellular autophagy and tissue catabolism, which may subsequently lead to cirrhosis.

Role of Lysosomes on human ulcerogenic gastropathies. Effect of zinc ion on the lysosomal stability

Numerous conditions are involved in the equilibrium between protective and aggressive factors for gastric mucosa injuring. Among them the lysosomal membrane stability plays a very important role in the inflammatory process. Zinc ion is a well-known lysosomal membrane stabilizer. When given orally to animals or even to humans it protects gastric mucosa against erosive lesions induced by a variety of experimental conditions. Compared with the control group (8,45 + 1,49 mU/mg) the lysosomes isolated from samples of gastric mucosa obtained from patients suffering of erosive gastropathies, showed a great liability on their membrane (18,37 + 4,52 mU/mg). When these patients were treated orally with zinc sulfate (100 mg of zinc element, twice a day, for two weeks) the lysosomes isolated from their gastric mucosa showed a strong reduction on enzymatic activity (5,49 + 1,02 mU/mg), probably due to increasing on the membrane stability. Based on these experimental findings we propose the use of zinc ion as na important adjuvant in treatment of erosive gastropathies.

Male reproductive toxicity of phosphamidon: histopathological changes in epididymis.

Phosphamidon, a neurotoxic insecticide, was tested for male reproductive toxicity with special reference to the epididymis. The insecticide was fed to Wistar strain male albino rat at 35 ppm concentration in drinking water ad libitum for 30 days. After vascular perfusion, thin slices of caput and cauda epididymidis were embedded in plastic, cut at 1 micron thickness and stained in toluidine blue for light microscopic observation. Principal cells of the caput epididymidis were vacuolarized and seen to pinch off fragments apically. In the proximal cauda the clear cells increased in height and in the size of the secondary lysosomal granules. In the distal cauda the clear cells appeared swollen out of proportion. Phosphamidon appears to affect the principal cells indirectly through its toxic effect on the Leydig cells; the clear cells of the cauda appear to be directly vulnerable to the toxic action of the pesticide.

Action of estrogen alone on the number of lysosomes in the rat endometrial epithelium

In order to determine the possible variations in the number of lysosomes in the glandular epithelium of endometrial cells of rats under estrogen action alone, the following groups of rats were studied: I, rats in estrous phase; II, oophorectomized rats; III, oophorectomized plus estrogen treated rats. Lysosomes were visualized by Gomori's method for acid phosphatase and counted by two researchers. The results obtained were statistically significant, with higher values in oophorectomized plus estrogen treated rats than in oophorectomized animals. Rats in estrous phase also presented a higher number of lysosomes than those of oophorectomized and not treated with estrogen

Effect of hepatoprotective ayurvedic drugs on lysosomal enzymes during hepatic injury induced by single dose of CCl4.

Effects of single doses of kumari asav, kumari kalp, arogyavardhini and tamra bhasma on lysosomal enzymes (acid phosphatase and beta-glucuronidase) of rat liver and kidney were studied during hepatitis induced by single 0.3 ml/kg body wt dose of CCl4. Histologically all the drugs showed significant hepatoprotection. While acid phosphatase activities of liver and kidney were suppressed, activities of beta-glucuronidase were enhanced by these drugs. The results indicate that acid phosphatase and beta-glucuronidase behave differently, although they are lysosomal in nature.

Biochemical effects of some insecticides on lysosomal enzymes in brain tissue

The effect of dimethoate, permethrin and AC 222-705, on the activity of brain beta-glucuronidase, acid ribonuclease and alpha- naphthyl acetate esterases of male mice was investigated. The data indicated that, these insecticides induce disturbances in the activities of the tested lysosomal enzymes, which constitute important indices for carcinogenicity

Effect of piroxicam, pirprofen and primobolanon the lysosomal acid hydrolases activity and on the total protein and nucleic acids in rat kidney

The aim of this work was to study the effect of the administration of piroxicam [Feldene], pirprofen [Rengasil] alone and in combination with the anabolic agent methyl androstenolone acetate [Primobolan] on the total enzymatic activity and extralysosomal release of four selected renal lysosomal enzymes markers; namely, acid phosphatase [ACP], B-N-acetyl-glucosaminidase [B-NAG], B-galactosidase [B-GAL] and alpha- galactosidase [alpha-GAL]. The effect of these drugs on the total protein and the nucleic acids [RNA and DNA] in rat kidney homogenate was also investigated

Status of nitric oxide free radicals in diabetic neutrophils: effect of diabetic serum factor on the generation of these species in normal neutrophils and their relation to lysosomal degranulation.

Normal polymorphonuclear leukocytes (PMNL) in contrast to diabetic PMNL, generated significant amounts of .NO and NO2 when challenged with opsonised zymosan. Diabetic neutrophils, on the other hand, responded either weakly or insignificantly to the same stimulants. However, in resting state the levels of .NO and NO2 were higher in diabetic as compared to normal PMNL. Diabetic serum factor (DSF) provoked a significant generation of .NO and NO2 in normal PMNL, a phenomenon found parallel to the enhancement in cytosolic cathepsin D activity in normal cells on insult with DSF.

Effect of alpha-tocopherol on doxorubicin-induced changes in rat heart lysosomal enzymes.

Effect of doxorubicin on heart lysosomes were studied in rats with or without the administration of alpha-tocopherol. Rats were treated with doxorubicin (2.5 mg/kg body wt, iv) once a week for 8 weeks. alpha-tocopherol (400 mg/kg body wt) was co-administered orally for 2 months. Activities of acid phosphatase, beta-D-glucuronidase, cathepsin-D and beta-D-galactosidase were decreased in heart lysosomes but increased significantly in serum. A significant increase in lysosomal lipid peroxide level was noted. alpha-tocopherol co-administration reduced the lipid peroxide level as well as maintained the above mentioned enzyme activities.

In-vitro study on the effect of adenine nucleotides, heavy metals and ascorbic acid on the lysosomal enzymatic activity and release rotes in rat brain

The effects of multivalent cations such as Pb 2+, Zn 2+ and Fe 3+, adenosine triphosphate [ATP], adenosine diphosphate [ADP], and adenosine monophosphate [AMP] on the enzyme release and total activity from cerebral lysosomes isolated from adult albino rats were examined in vitro. The test compounds were used in two concentration levels of 10 -3 and 10 -5 M. The three selected marker lysosomal acid hydrolases are acid phosphatase [ACP], N-acetyl B-glucosaminidase [B-NAG], and N-acetyl galactosaminidase. The effect of ascorbic acid sole and combined with the multivalent cations in an equimolar concentration on these enzymes were also examined. The results of this study showed that, ascorbic acid and the cations inhibited the enzyme release by different susceptibility on the lysosomal membrane. The suppressive effect of cations was significantly affected by treatment of the lysosome with ascorbic acid. On the other h and, ATP and ADP resulted in a decrease of ACP and B-NAG, while there was no effect on N-acetyl galactosaminidase activity. The total enzymatic activity of ACP was more inhibited than B-NAG by 10 -5 M of adenine nucleotides, while N-acetyl galactosaminidase activity was not affected by these nucleotides. AMP has no effect on the enzyme release. In addition, the degree of inhibition on the enzyme activity and release rate was decreased in the presence of ascorbic acid. In some cases, the inhibitory effect of the cations was changed to increase in either total activity or enzyme release by ascorbic acid

Toxic effects of different concentrations of dimethoate on lysosomal enzymes of female albino rats.

The effect of three different concentrations of dimethoate on the activity of certain lysosomal enzymes, viz. beta-glucuronidase, beta-N-acetylglucosaminidase, cathepsin B and cathepsin D in serum, skin, liver, kidney and spleen and the stability of liver and kidney lysosomes was studied in female albino rats. The activity of beta-glucuronidase, beta-N-acetylglucosaminidase, cathepsin D was found to increase in serum and tissues in higher concentration (2.25 mg/100 g body weight) of dimethoate treated rats. A significant increase in the rate of release of beta-glucuronidase was found in the liver and kidney of higher concentration of dimethoate treated rats compared to controls. The results demonstrate that the activity of lysosomal enzymes increased in higher concentration of dimethoate treated rats than the lower concentration (0.56 mg/100 g body weight) of dimethoate treated rats.

Canatoxin induces activation on mice peritoneal macrophages

Canatoxin (CNTX), the toxic protein from Canavalia ensiformis seeds, injected into the peritoneal cavities of mice (10 micrograms/cavity) induced a significant neutrophil migration (10.5 +/- 0.5 x 10(6) cells/cavity) after 4 h. A later migratory effect (48 h) on mononuclear cells, predominantly macrophages, was also observed (controls: 7 +/- 0.9; CNTX: 17 +/- 2.0 x 10(6) cells/cavity). These CNTX-elicited macrophages, when compared to resident cells (R) or cells elicited by thioglycollate (TG), had an increased content of the lysosomal enzyme N-acetyl-beta-D-glucosaminidase (R: 4.5 +/- 0.5; TG: 7.2 +/- 1.0; CNTX: 20.2 +/- 3.0 mU/10(6) cells) and a greater (> or = 100%) phagocytic activity. The data suggest that CNTX-stimulated macrophages presented some characteristics of activated cells

In vivo effects of stevioside upon mice liver and kidney lysosomes

Diante das importantes funçöes celulares como a endocitose, a digestäo e a desintoxicaçäo, exercidas pelos diferentes componentes do compartimento lisossômico, decidimos estudar os efeitos in vivo do esteviosídeo sobre a atividade lisossômica. Näo foram observadas mudanças estatisticamente significantes na estabilidade das membranas lisossômicas do rim e do fígado, em camundongos tratados com 50mg/Kg peso corporal/dia. Na dose de 100mg/Kg/dia foi observado um pequeno efeito labilizador nos lisossomos hepáticos, mas näo sobre os renais

Compuestos lisosomotrópicos inhibidores de la multiplicación del virus Junín / Lysosomotropic compounds inhibiting the multiplication of Junin virus

La multiplicación del virus Junín en células Vero fue inhibida por la acción de drogas lisosomotrópicas de carácter básico como cloruro de amonio, clorhidrato de procaína y clorofeniramina. El efecto inhibitorio del cloruro de amonio (15mM) es máximo cuando la droga es agregada junto con el inóculo viral o inmediatamente después de la infección, pero aun agregado 8 horas después de la infección produce una inhibición significativa del 97,8%. Estos resultados indicarían que la droga actúa fundamentalmente sobre una etapa temprana del ciclo de multiplicación viral. Por lo tanto, el mecanismo de entrada del virus Junín a la célula transcurriría a través de una endocitosis mediada por receptor