Exploring TERRA during Leishmania major developmental cycle and continuous in vitro passages.

Telomeres from different eukaryotes, including trypanosomatids, are transcribed into TERRA noncoding RNAs, crucial in regulating chromatin deposition and telomere length. TERRA is transcribed from the C-rich subtelomeric strand towards the 3'-ends of the telomeric array. Using bioinformatics, we confirmed the presence of subtelomeric splice acceptor sites at all L. major chromosome ends. Splice leader sequences positioned 5' upstream of L. major chromosomes subtelomeres were then mapped using SL-RNA-Seq libraries constructed from three independent parasite life stages and helped confirm TERRA expression from several chromosomes ends. Northern blots and RT-qPCR validated the results showing that L. major TERRA is processed by trans-splicing and polyadenylation coupled reactions. The number of transcripts varied with the parasite's life stage and continuous passages, being more abundant in the infective forms. However, no putative subtelomeric promoters involved in TERRA's transcriptional regulation were detected. In contrast, the observed changes in parasite's telomere length during development, suggest that differences in telomeric base J levels may control TERRA transcription in L. major. Also, TERRA-R loops' detection, mainly in the infective forms, was suggestive of TERRA's involvement in telomere protection. Therefore, Leishmania TERRA shares conserved features with other eukaryotes and advances new telomere specific functions in a Public Health-impacting parasite.

A inserção do brincar e brinquedo nas práticas de enfermagem pediátrica: pesquisa convergente assistencial / La inserción del juego y los juguetes en las prácticas de enfermería pediátrica: investigación convergente asistencial / The insertion of play and toys in Pediatric Nursing practices: A convergent care research

Resumo Objetivo analisar o processo de apreensão e transformação do uso do brincar e brinquedo pela equipe de enfermagem de uma unidade pediátrica. Método estudo apoiado na pesquisa convergente assistencial, envolvendo rodas de conversas com 11 profissionais de uma equipe de enfermagem, atuantes em uma unidade de internação pediátrica de um hospital de ensino. Foi desenvolvido entre Dezembro de 2018 e Maio de 2019. Resultados Houve reconhecimento do brincar como inerente à criança e benéfico na interação com esta, quando hospitalizada. Os participantes percebem a não apropriação do brincar estruturado em suas práticas, prospectam ampliação, porém identificam entraves associados ao pouco apoio institucional. Dos desdobramentos, decidiram por inserção do fantoche e capacitação para o uso do brincar estruturado. Conclusões e implicações para a prática a inserção do brincar no hospital demanda ruptura com o modelo biomédico em saúde e apostas em uma cultura institucional de reconhecimento do brincar. O brincar ao longo da hospitalização integra um cuidado justo, humano e integral, que deve ser para a equipe de enfermagem motivo de luta e garantia, correspondendo às instituições, o dever de dar suporte, tanto no âmbito dos processos de trabalho, quanto no da educação permanente.

Resumen Objetivo analizar el proceso de aprehensión y transformación del uso de juegos y juguetes por parte del personal de Enfermería de una unidad pediátrica. Método estudio sustentado en investigación de cuidados convergentes, desarrollado entre diciembre de 2018 y mayo de 2019 con 11 profesionales del equipo de Enfermería, a través de círculos de conversación. Resultados los participantes reconocen el juego como algo inherente al niño y beneficioso en la interacción con el niño cuando está hospitalizado. Perciben la no apropiación del juego estructurado en sus prácticas, buscan expandirlo, pero identifican obstáculos asociados al limitado apoyo institucional. A partir de los desarrollos, decidieron insertar un títere y entrenarse para usar el juego estructurado. Conclusiones e implicaciones para la práctica la inserción del juego en el hospital exige romper con el modelo biomédico en salud y apostar por una cultura institucional de reconocimiento del juego. Jugar durante toda la hospitalización integra una atención justa, humana e integral, que debe ser motivo de lucha y garantía del equipo de Enfermería, correspondiendo a las instituciones el deber de brindar apoyo, ambos en el ámbito del trabajo y de la educación permanente.

Abstract Objective to analyze the process of apprehension and transformation of the use of play and toys by the Nursing staff of a pediatric unit. Method a study supported by convergent care research, developed between December 2018 and May 2019 with 11 professionals of the Nursing team, through conversation circles. Results the participants recognize playing as inherent to the child and beneficial in the interaction with the child when hospitalized. They perceive the non-appropriation of structured play in their practices, look for expansion, but identify obstacles associated with little institutional support. From the developments, they decided to insert a puppet and get trained to the use structured play. Conclusions and implications for the practice The insertion of play in the hospital demands a break with the biomedical model in health and betting on an institutional culture of the recognition of playing. Playing throughout hospitalization integrates fair, humane and comprehensive care, which should be a reason for the Nursing team to fight and guarantee and, for institutions, the duty to provide support, both within the scope of work and permanent education.

G-protein-coupled estrogen receptor GPER-1 expression in hormone receptor-positive breast cancer is associated with poor benefit of tamoxifen.

BACKGROUND: The role of G-protein-coupled estrogen receptor 1 (GPER-1) in the development of tamoxifen resistance in breast cancer is a highly controversial issue. The aim of this study was to determine the expression of GPER-1 in the clinical routine under conditions of endocrine treatment. PATIENTS AND METHODS: GPER-1 expression was analyzed in 442 patients with primary invasive breast cancer. GPER-1 score of > 3 was determined as positive. Expression data were correlated with clinical and pathological characteristics and patient survival. RESULTS: GPER-1 expression was observed in 352 (80.9%) cases, and positively correlated with estrogen and progesterone receptor status (p = 0.0001). GPER-1 positivity was associated with an increased grade of differentiation (p = 0.0001) and with a low level of Ki-67 expression (p = 0.0001). High GPER-1 expression was associated with a decreased level upon systemic treatment (p = 0.011). In the whole cohort, GPER-1 expression was associated with prolonged disease-free survival (DFS). DFS between tamoxifen- and aromatase inhibitor-treated GPER-1-positive patients was similar (p = 0.090). Notably, after matching the analysis for the most important prognostic factors, DFS for tamoxifen-treated GPER-1-positive patients was 69.1%, which is a percentage that is significantly lower compared to DFS for GPER-1-positive patients treated with aromatase inhibitors (92.7%) (p = 0.005). CONCLUSION: GPER-1 expression is a favorable prognostic factor in breast cancer patients. Its predictive role for poor benefit form tamoxifen treatment should be investigated in further studies.

As forças familiares no contexto da dependência de substâncias psicoativas / The family strengths in the context of psychoactive substance dependence

Objective: To apprehend the perception of relatives of psychoactive substances dependents about their facilitating strengths to deal positively with the adversities from this context. Method: Qualitative and descriptive study developed between July/2016 and August/2017 at Psychosocial Care Center Alcohol and Drugs of a city on the countryside of São Paulo, through a semi-structured interview for data collection. Eight family members of chemical addicted participate. The interviews were recorded by audio, transcribed and analyzed by content analyze technique, thematic category. Results: The relatives recognized that their facilitating strengths permeated through the religiosity and spirituality, beliefs systems, support from the specialized mental health service support and of friendship, whilst social support network. The strengths also depended on the cohesion and assertive communication of the family. Conclusion: The facilitating strengths recognized by relatives help them deal positively with adversities in the chemical addiction context, strengthening the familiar resilience.

Objetivo: Aprehender la percepción de los familiares de dependientes de sustancias psicoactivas sobre sus fuerzas facilitadoras para lidiar, de manera positiva, con las adversidades provenientes de ese contexto. Método: Estudio cualitativo, descriptivo, realizado entre Julio/2016 y Agosto/2017 en el Centro de Atención Psicosocial Alcohol y Drogas de una ciudad del interior del estado de São Paulo, a través de una entrevista semiestructurada para la recolección de datos. Participaron ocho familiares de dependientes químicos. Las entrevistas fueron grabadas en audio, transcritas y analizadas según la técnica del análisis de contenido, categoría temática. Resultados: Los familiares reconocieron que sus fuerzas facilitadoras pasaron por la religiosidad/espiritualidad, por los sistemas de creencias, por el apoyo del servicio especializado de salud mental y por las amistades, como la red de apoyo social. Las fuerzas también dependieron de la cohesión y comunicación asertiva de la familia. Conclusión: Las fuerzas facilitadoras reconocidas por los familiares les ayudaron a lidiar positivamente con las adversidades en el contexto de la dependencia química, fortaleciendo la resiliencia familiar.

Objetivo: Apreender a percepção dos familiares de dependentes de substâncias psicoativas sobre suas forças facilitadoras para lidarem de maneira positiva com as adversidades provenientes deste contexto. Método: Estudo qualitativo, descritivo, realizado entre Julho/2016 a Agosto/2017 no Centro de Atenção Psicossocial Álcool e Drogas de uma cidade do interior paulista, através de entrevista semiestruturada para coleta de dados. Participaram oito familiares de dependentes químicos. As entrevistas foram gravadas por áudio, transcritas e analisadas pela técnica de análise de conteúdo, categoria temática. Resultados: Os familiares reconheceram que suas forças facilitadoras perpassaram a religiosidade/espiritualidade, os sistemas de crenças, o apoio do serviço especializado de saúde mental e as amizades, enquanto rede de apoio social. As forças também dependeram da coesão e comunicação assertiva da família. Conclusão: As forças facilitadoras reconhecidas pelos familiares os auxiliaram a lidar positivamente com as adversidades no contexto da dependência química, fortalecendo a resiliência familiar.

Effects of pre-emptive morphine, ibuprofen or local anesthetic on fos expression in the spinal trigeminal nucleus following tooth pulp exposure in the rat.

In the present study, we used Fos expression as an index of nociceptive input to the spinal trigeminal nucleus after exposure of the coronal pulp tissue of maxillary right first molars and examined the effects of pretreatment with an opioid, a nonsteroidal anti-inflammatory drug or a local anesthetic before pulp exposure. Exposure of the tooth pulp produced a significant increase in Fos-like immunoreactivity in the superficial laminae of subnucleus caudalis; pretreatment with a control infiltration injection of saline directly above the maxillary molar 30 min before pulp exposure had no effect on Fos expression. Pretreatment with morphine 30 min before pulp exposure dose-dependently (2.5, 5, and 10 mg/kg subcutaneously) reduced Fos expression in subnucleus caudalis whereas pretreatment with ibuprofen (10-100 mg/kg subcutaneously) did not significantly affect Fos expression. Local anesthetic pretreatment was effective in reducing Fos expression only for the long acting bupivacaine; lidocaine without and with epinephrine (1:100,000) failed to significantly affect Fos expression. These results suggest that pre-emptive opioid treatment can decrease postoperative central nervous system changes associated with tooth pulp injury, and therefore, may decrease postoperative pain. Given the effects of local anesthetic on Fos expression, a combination of long acting local anesthetic with pre-emptive opioid would likely be most efficacious in decreasing postoperative dental pain.