Natural Products with Tandem Anti-inflammatory, Immunomodulatory and Anti-SARS-CoV/2 Effects: A Drug Discovery Perspective against SARS-CoV-2.

BACKGROUND: COVID-19 is still causing long-term health consequences, mass deaths, and collapsing healthcare systems around the world. There are no efficient drugs for its treatment. However, previous studies revealed that SARS-CoV-2 and SARS-CoV have 96% and 86.5% similarities in cysteine proteases (3CLpro) and papain-like protease (PLpro) sequences, respectively. This resemblance could be important in the search for drug candidates with antiviral effects against SARS-CoV-2. OBJECTIVE: This paper is a compilation of natural products that inhibit SARS-CoV 3CLpro and PLpro and, concomitantly, reduce inflammation and/or modulate the immune system as a perspective strategy for COVID-19 drug discovery. It also presents in silico studies performed on these selected natural products using SARS-CoV-2 3CLpro and PLpro as targets to propose a list of hit compounds. METHODS: The plant metabolites were selected in the literature based on their biological activities on SARS-CoV proteins, inflammatory mediators, and immune response. The consensus docking analysis was performed using four different packages. RESULTS: Seventy-nine compounds reported in the literature with inhibitory effects on SARS-CoV proteins were reported as anti-inflammatory agents. Fourteen of them showed immunomodulatory effects in previous studies. Five and six of these compounds showed significant in silico consensus as drug candidates that can inhibit PLpro and 3CLpro, respectively. Our findings corroborated recent results reported on anti-SARS-CoV-2 in the literature. CONCLUSION: This study revealed that amentoflavone, rubranoside B, savinin, psoralidin, hirsutenone, and papyriflavonol A are good drug candidates for the search of antibiotics against COVID-19.

Leishmania infantum (syn. L. chagasi) parasites affect the release of soluble CD14 by infected macrophages.

Functionally, cluster of differentiation 14 (CD14) is a co-receptor of the complex formed by lipopolysaccharide (LPS) and LPS-binding protein expressed on the membrane of a variety of cells. However, CD14 can be shed from the cell membrane into the circulation as soluble CD14 (sCD14) upon cell activation. Previously, our group reported that elevated sCD14 serum levels were associated with the clinical and laboratory findings in the context of visceral leishmaniasis (VL), but not in the context of LPS stimulation or bacterial infection. In the present study, we investigated the secretion dynamics of sCD14 in the context of Leishmania infantum (syn. L. chagasi) in vitro infection. Macrophages from treated VL patients and delayed-type hypersensitivity positive (DTH+) subjects were infected with L. infantum (syn. L. chagasi) promastigotes, and the infection index was evaluated (number of amastigotes per 100 infected macrophages). Additionally, the levels of sCD14, Inteleukin (IL)10, IL-6 and tumour necrosis factor alpha (TNF-α) were measured in the culture supernatants using the Luminex assay. Interestingly, the release of sCD14 was inversely correlated with the L. infantum (syn. L. chagasi) infection index. Of note, the release of sCD14 was upregulated and downregulated in the context of infected macrophages from DTH+ subjects and treated VL patients, respectively. Additionally, we also observed that the levels of sCD14 in the culture supernatants were positively correlated with the levels of TNF-α, IL-6 and IL-10. Therefore, our data suggest that macrophages from treated VL patients and DTH+ subjects respond differently to L. infantum (syn. L. chagasi) infection in the context of the release of sCD14; therefore, the release of sCD14 may be associated with the outcome of VL.

Unbalance of Se and nutritional status in male infertility.

OBJECTIVE: To evaluate the selenium status and oxidative stress in male infertility cases selected from a private human reproduction center in the state of Ceará, Brazil. METHODS: The present study had a cross-sectional quantitative approach, carried out between January and October 2013 at a Human Reproduction Center. The studied population was composed of 49 male individuals seen at the clinic, aged between 18 and 60 years. Blood samples were collected to measure serum selenium concentrations, erythrocyte activity and glutathione peroxidase. After medical diagnosis, the participants were divided into fertile and infertile groups. Blood samples were collected for establishing Se concentrations in plasma and erythrocytes, and measurements of the enzymatic activity of glutathione peroxidase in the erythrocytes. RESULT: it resulted in 53.1% of fertile men and 46.9% of infertile men. The average age of the fertile group was 34.1 years and the infertile group was 37.3 years. Regarding the assessment of nutritional status, the scatter diagram of the infertility group showed a higher body mass index and waist circumference, showing that this group has a higher risk of global and abdominal obesity compared to the fertile group (p<0.0001, respectively). There were similarities between the groups regarding caloric intake, macronutrient and selenium intake. CONCLUSION: We can conclude that the serum values of selenium, in excess and in deficiency, can be harmful to male fertility.

Optimization and partial purification of beta-galactosidase production by Aspergillus niger isolated from Brazilian soils using soybean residue.

ß-Galactosidases are widely used for industrial applications. These enzymes could be used in reactions of lactose hydrolysis and transgalactosylation. The objective of this study was the production, purification, and characterization of an extracellular ß-galactosidase from a filamentous fungus, Aspergillus niger. The enzyme production was optimized by a factorial design. Maximal ß-galactosidase activity (24.64 U/mL) was found in the system containing 2% of a soybean residue (w/v) at initial pH 7.0, 28 °C, 120 rpm in 7 days. ANOVA of the optimization study indicated that the response data on temperature and pH were significant (p < 0.05). The regression equation indicated that the R2 is 0.973. Ultrafiltration at a 100 and 30 kDa cutoff followed by gel filtration and anion exchange chromatography were carried out to purify the fungal ß-galactosidase. SDS-PAGE revealed a protein with molecular weight of approximately 76 kDa. The partially purified enzyme showed an optimum temperature of 50 °C and optimum pH of 5.0, being stable under these conditions for 15 h. The enzyme was exposed to conditions approaching gastric pH and in pepsin's presence, 80% of activity was preserved after 2 h. These results reveal a A. niger ß-galactosidase obtained from residue with favorable characteristics for food industries.

Avaliação da capacitação de manipuladores sobre temas de Boas Práticas de Manipulação utilizando uma ferramenta de qualidade em uma Unidade de Alimentação e Nutrição hospitalar em Rio das Ostras - RJ / Evaluation of manipulator training on good handling practices using a quality tool in a hospital supply and nutrition unit in Rio das Ostras - RJ

Demanda-se dentro de uma unidade de alimentação e nutrição (UAN) condições higiênicossanitárias apropriadas e que estejam de acordo com a legislação, a fim de manter o alimento inócuo e em perfeitas condições de higiene, para que não sejam prejudiciais à saúde do indivíduo. Assim, a adoção de boas práticas é uma das formas de redução de riscos à saúde do consumidor. Tendo em vista o manipulador como principal via de contaminação, o presente artigo objetivou avaliar a capacitação de manipuladores abordando temas como boas práticas de manipulação, doenças transmitidas por alimentos, contaminantes alimentares, manipulação higiênica dos alimentos e controle da temperatura de exposição dos alimentos (binômio tempo/temperatura). A capacitação foi elaborada de acordo com a RDC 216, a CVS 05/2013 e o manual de boas práticas da ANVISA.

Effect of a single-tufted toothbrush on the control of dental biofilm in orthodontic patients: A randomized clinical trial.

OBJECTIVE: To compare the effect of a single-tufted toothbrush combined or not with a conventional toothbrush to control dental biofilm in healthy orthodontic patients. MATERIALS AND METHODS: Twenty orthodontic patients were randomly assigned to receive three different treatments: Group 1-conventional toothbrush; Group 2-single-tufted toothbrush and Group 3-combination of single-tufted and conventional toothbrushes. Stained plaque index (SPI), visible plaque index (VPI) and gingival bleeding index (GBI) were recorded. The data were analysed by Kolmogorov-Smirnov test. Wilcoxon test was used for intragroup comparison and Friedman test for the intergroup comparison (α = 5%). RESULTS: Intragroup analysis showed that VPI and SPI significantly decreased (P < 0.05) after 72 hour in Group 3. Anterior and posterior teeth did not show any significant statistical differences after 72 hour (P > 0.05), but VPI values in the labial surfaces were different to Group 3 (P < 0.05) in comparison with the other groups after 72 hour. Group 3 showed a statistically significant reduction (P < 0.05) for SPI in the interproximal surfaces when compared with Group 1. CONCLUSION: The combination of single-tufted and conventional toothbrushes was effective for controlling dental biofilm formation in orthodontic patients.

Optimization of Xylanase Production from Aspergillus foetidus in Soybean Residue.

Enzymatic hydrolysis is an important but expensive step in the process to obtain enzyme derived products. Thus, the production of efficient enzymes is of great interest for this biotechnological application. The production of xylanase by Aspergillus foetidus in soybean residues was optimized using 2 × 23 factorial designs. The experimental data was fitted into a polynomial model for xylanase activity. Statistical analyses of the results showed that variables pH and the interaction of pH and temperature had influenced the production of xylanase, with the best xylanase production level (13.98 U/mL) occurring at fermentation for 168 hours, pH 7.0, 28°C, and 120 rpm.

Componentes do estilo de vida associados à infertilidade masculina / Lifestyle components associated with male infertility

Introdução: De natureza multifatorial, a infertilidade masculina mostra-se fortemente influenciada por fatores determinantes do estilo de vida entre o público masculino. Objetivo: Avaliar os componentes do estilo de vida associados à infertilidade masculina. Métodos: Obteve-se a amostra por método não probabilístico, totalizando 63 pacientes atendidos em Clínicas de Reprodução Humana localizadas em Fortaleza, Ceará. Destes, diagnosticou-se 30 como inférteis e 33, como férteis. A coleta de dados consistiu em aplicação de questionário socioeconômico, avaliação antropométrica e recordatórios alimentares. Realizou-se análise estatística no programa STATA versão 10.0. Para avaliação de normalidade, aplicou-se o teste de Shapiro-Wilk. Para comparação das variáveis categóricas, utilizou- se teste qui-quadrado e entre as variáveis numéricas, o teste t de Student ou Mann-Whitney. Adotou-se nível de significância de 5%. Resultados: Em relação às características socioeconômicas, verificou-se diferença estatisticamente significativa na idade, na ingestão de bebida alcoólica e na prática de atividade física (p=0,017), (p=0,044) e (p=0,035), respectivamente. Na análise antropométrica, pacientes diagnosticados como inférteis apresentaram Índice de Massa Corporal superior ao dos férteis (p=0,033). Em relação à circunferência da cintura, o grupo com infertilidade apresentou valor médio (96,3cm) acima do ponto de corte para risco cardiovascular aumentado. Na avaliação do consumo alimentar, não houve diferença significativa entre os grupos analisados. Conclusão: Componentes do estilo de vida como idade, prática de atividade física, ingestão de bebida alcoólica e excesso de peso resultam em alterações nos aspectos da reprodução masculina, colaborando com a infertilidade neste público

Introduction: Multifactorial in nature, male infertility is strongly influenced by determinants of lifestyle among the male audience. Objectives: To evaluate the lifestyle components associated with male infertility. Methods: The sample was obtained by non-probabilistic method, totaling 63 patients attended at Human Reproduction Centers located in Fortaleza, Ceará. Of these, 30 were diagnosed as infertile and 33 as fertile. The data collection consisted of the application of a socioeconomic questionnaire, anthropometric evaluation and food recall. Statistical analysis was performed in the STATA program version 10.0. For the evaluation of normality, the Shapiro-Wilk test was applied. For the comparison of the categorical variables, the chi-square test and the numerical variables, Student's t-test or Mann-Whitney test were used. A significance level of 5% was adopted. Results: Regarding socioeconomic characteristics, there was a statistically significant difference in age, alcoholic beverage and physical activity (p = 0.017), (p = 0.044) and (p = 0.035), respectively. In the anthropometric analysis, the patients diagnosed as infertile presented a Body Mass Index higher than the fertile ones (p = 0.033). Regarding waist circumference, the infertility group presented a mean value (96.3 cm) above the cutoff point for increased cardiovascular risk. In the evaluation of food consumption, there was no significant difference between the analyzed groups. Conclusion: Lifestyle components such as age, physical activity, alcohol consumption and overweight result in changes in the aspects of male reproduction, contributing to infertility in this public

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Plasma Total Antioxidant Capacity and Cardiometabolic Risk in Non-Obese and Clinically Healthy Young Adults / Capacidade Antioxidante Total do Plasma e Risco Cardiometabólico em Adultos Jovens, Não Obesos e Clinicamente Saudáveis

Abstract Background: The oxidative biomarkers play an important role in the genesis of cardiometabolic risk-related processes. Objective: To investigate the total antioxidant capacity of plasma and its association with cardiometabolic risk in non-obese and clinically healthy young adults. Methods: University students of the state of Sergipe, Brazil, aged between 18 and 25 years, were recruited for this study from May of 2013 and October of 2014. Anthropometric, clinical and biochemical parameters were measured and analyzed using protocols which were previously standardized and described in the literature. The measurement of plasma total antioxidant capacity was based on the ability that all the antioxidants present in the sample (plasma) have to inhibit the oxidation of the oxidizable substrate ABTS (2,2`- Azino-di-[3-ethylbenzthiazoline sulphonate]) to ABTS•+ by metmyoglobin. Results: Approximately 25% of the sample presented more than one component of cardiometabolic risk. Low HDL-cholesterol was the most prevalent component. Compared to absence of components, the subjects with at least one component presented greater body weight and waist circumference, higher levels of diastolic blood pressure and fasting glucose, greater total cholesterol/HDL-c ratio, and lower levels of HDL-c (p < 0.05). Fasting glycemia was the only parameter which was associated with total antioxidant capacity (R2 = 0.10; β = 0.17; p = 0.001). Conclusions: The plasma total antioxidant capacity was not able to predict the cardiometabolic risk components due possibly to the establishment of compensatory mechanisms that become activated in physiological conditions.

Resumo Fundamentos: Os biomarcadores oxidativos exercem um importante papel na gênese dos processos relacionados ao risco cardiometabólico. Objetivo: Investigar a capacidade antioxidante total do plasma e sua associação com risco cardiometabólico em adultos jovens, não obesos e clinicamente saudáveis. Métodos: Estudantes universitários do estado de Sergipe, Brasil, com idade entre 18 e 25 anos, foram recrutados entre maio de 2013 e outubro de 2014. Parâmetros antropométricos, clínicos e bioquímicos foram medidos e analisados usando protocolos previamente padronizados e descritos na literatura. A medida da capacidade antioxidante total do plasma baseou-se na capacidade de todos os antioxidantes presentes na amostra (plasma) em inibir a oxidação do substrato oxidável ABTS (2,2-Azino-bis-(3-etilbenzotiazolina-6-sulfonato) a ABTS•+ pela metamioglobina. Resultados: Aproximadamente 25% da amostra apresentaram mais de um componente do risco cardiometabólico. Valores baixos de HDL foram o componente mais prevalente. Em comparação à ausência de componentes, os indivíduos com pelo menos um componente apresentou valores mais altos de peso corporal, circunferência da cintura, pressão sanguínea diastólica, glicemia de jejum e razão colesterol total/HDL-c, e valores mais baixos de HDL-c (p < 0,05). A glicemia de jejum foi o único parâmetro que se associou com a capacidade antioxidante total (R2 = 0,10; β = 0,17; p = 0,001). Conclusões: A capacidade antioxidante total não foi capaz de predizer os componentes do risco cardiometabólico possivelmente devido ao estabelecimento de mecanismos compensatórios que se tornam ativados em condições fisiológicas.

Plasma Total Antioxidant Capacity and Cardiometabolic Risk in Non-Obese and Clinically Healthy Young Adults.

BACKGROUND:: The oxidative biomarkers play an important role in the genesis of cardiometabolic risk-related processes. OBJECTIVE:: To investigate the total antioxidant capacity of plasma and its association with cardiometabolic risk in non-obese and clinically healthy young adults. METHODS:: University students of the state of Sergipe, Brazil, aged between 18 and 25 years, were recruited for this study from May of 2013 and October of 2014. Anthropometric, clinical and biochemical parameters were measured and analyzed using protocols which were previously standardized and described in the literature. The measurement of plasma total antioxidant capacity was based on the ability that all the antioxidants present in the sample (plasma) have to inhibit the oxidation of the oxidizable substrate ABTS (2,2`- Azino-di-[3-ethylbenzthiazoline sulphonate]) to ABTS•+ by metmyoglobin. RESULTS:: Approximately 25% of the sample presented more than one component of cardiometabolic risk. Low HDL-cholesterol was the most prevalent component. Compared to absence of components, the subjects with at least one component presented greater body weight and waist circumference, higher levels of diastolic blood pressure and fasting glucose, greater total cholesterol/HDL-c ratio, and lower levels of HDL-c (p < 0.05). Fasting glycemia was the only parameter which was associated with total antioxidant capacity (R2 = 0.10; ß = 0.17; p = 0.001). CONCLUSIONS:: The plasma total antioxidant capacity was not able to predict the cardiometabolic risk components due possibly to the establishment of compensatory mechanisms that become activated in physiological conditions. FUNDAMENTOS:: Os biomarcadores oxidativos exercem um importante papel na gênese dos processos relacionados ao risco cardiometabólico. OBJETIVO:: Investigar a capacidade antioxidante total do plasma e sua associação com risco cardiometabólico em adultos jovens, não obesos e clinicamente saudáveis. MÉTODOS:: Estudantes universitários do estado de Sergipe, Brasil, com idade entre 18 e 25 anos, foram recrutados entre maio de 2013 e outubro de 2014. Parâmetros antropométricos, clínicos e bioquímicos foram medidos e analisados usando protocolos previamente padronizados e descritos na literatura. A medida da capacidade antioxidante total do plasma baseou-se na capacidade de todos os antioxidantes presentes na amostra (plasma) em inibir a oxidação do substrato oxidável ABTS (2,2-Azino-bis-(3-etilbenzotiazolina-6-sulfonato) a ABTS•+ pela metamioglobina. RESULTADOS:: Aproximadamente 25% da amostra apresentaram mais de um componente do risco cardiometabólico. Valores baixos de HDL foram o componente mais prevalente. Em comparação à ausência de componentes, os indivíduos com pelo menos um componente apresentou valores mais altos de peso corporal, circunferência da cintura, pressão sanguínea diastólica, glicemia de jejum e razão colesterol total/HDL-c, e valores mais baixos de HDL-c (p < 0,05). A glicemia de jejum foi o único parâmetro que se associou com a capacidade antioxidante total (R2 = 0,10; ß = 0,17; p = 0,001). CONCLUSÕES:: A capacidade antioxidante total não foi capaz de predizer os componentes do risco cardiometabólico possivelmente devido ao estabelecimento de mecanismos compensatórios que se tornam ativados em condições fisiológicas.

Epidemiological aspects and spatial distribution of human and canine visceral leishmaniasis in an endemic area in northeastern Brazil.

Visceral leishmaniasis (VL) is a systemic disease endemic in tropical countries and transmitted through sand flies. In particular, Canis familiaris (or domesticated dogs) are believed to be a major urban reservoir for the parasite causing the disease Leishmania. The average number of human VL cases was 58 per year in the state of Sergipe. The city of Aracaju, capital of Sergipe in Northeastern Brazil, had 159 cases of VL in humans. Correlatively, the percentage of serologically positive dogs for leishmaniasis increased from 4.73% in 2008 to 12.69% in 2014. Thus, these studies aimed to delineate the spatial distribution and epidemiological aspects of human and canine VL as mutually supportive for increased incidence. The number of human cases of VL and the frequency of canine positive serology for VL both increased between 2008 and 2014. Spatial distribution analyses mapped areas of the city with the highest concentration of human and canine VL cases. The neighbourhoods that showed the highest disease frequency were located on the outskirts of the city and in urbanised areas or subjected to development. Exponential increase in VL-positive dogs further suggests that the disease is expanding in urban areas, where it can serve as a reservoir for transmission of dogs to humans via the sand fly vector.

Infection of Human Macrophages by Leishmania infantum Is Influenced by Ecto-Nucleotidases.

Ecto-nucleotidase activity is involved in the infection process of Leishmania and various other parasites that enables modulation of host immune responses to promote disease progression. One of the enzymes responsible for this activity is the ecto-nucleoside triphosphate diphosphohydrolase (E-NTPDase). The enzyme hydrolyzes nucleotides tri- and/or di-phosphate into monophosphate products, which are subsequently hydrolyzed into adenosine. These nucleotides can serve as purinergic signaling molecules involved in diverse cellular processes that govern immune responses. Given the importance of the extracellular metabolism of these nucleotides during intracellular pathogen infections, this study evaluates the role of ecto-nucleotidase activity during Leishmania infantum (L. infantum) infection in human macrophages. E-NTPDase protein expression and activity was evaluated in L. infantum during purine starvation, adenosine-enriched medium, or in the presence of an inhibitor of ecto-nucleotidases. Results show that E-NTPDase is expressed in L. infantum parasites, including on the cell membrane. Furthermore, functional activity of the enzyme was modulated according to the availability of adenosine in the medium. Purine starvation increased the hydrolytic capacity of nucleotides leading to higher infectivity, while growth in adenosine-enriched medium led to lower infectivity. Moreover, inhibiting E-NTPDase function decreased L. infantum infection in macrophages, suggesting the enzyme may serve as a ligand. Taken together, the ability of L. infantum to hydrolyze nucleotides is directly associated with increased infectivity in macrophages.

O trabalho hospitalar da enfermagem: dialética presente na prática de adaptar e improvisar / Hospital nursing: the dialectics of adapting and improvising in practice / El trabajo de enfermería en el hospital: dialéctica presente en la práctica de adaptar e improvisar

Objetivo: identificar o ponto de vista dos profissionais de enfermagem sobre a adaptação e improvisação de materiais no trabalho hospitalar e analisar as vantagens e desvantagens desta prática para o trabalho em saúde e enfermagem. Método: pesquisa de abordagem qualitativa, descritiva, realizada com 20 trabalhadores de enfermagem de um hospital público fluminense. A entrevista semiestruturada foi utilizada como técnica de coleta de dados, no mês de julho de 2009. Os dados foram tratados através da análise de conteúdo temática, após aprovação no Comitê de Ética em Pesquisa número 2355/2009. Resultados: evidenciou-se que a prática de adaptar/improvisar é dialética, com sentimentos de sofrimento e prazer. Pois, ao mesmo tempo em que assegura o cuidado, também coloca em risco a segurança dos pacientes e dos trabalhadores. Conclusão: as adaptações/improvisações de materiais têm potencial para fazer emergir criações relevantes, com possibilidades de patentes para a profissão.

Objective: to identify nursing professionals' views on adapting and improvising materials in hospital work, and analyze the advantages and disadvantages of this practice for health work and nursing. Method: this qualitative, descriptive study involved 20 nursing workers at a Rio de Janeiro public hospital. Data were collected in July 2009 by the technique of semi-structured interview, and analyzed by thematic content analysis, after approval by the Research Ethics Committee (No. 2355/2009). Results: it was shown that the practice of adapting/improvising is dialectical, and involves feelings of pain and pleasure: while ensuring care, it also places patients' and workers' safety at risk. Conclusion: adapting/improvising materials has the potential to emerge relevant creations with patents opportunities for the profession.

Objetivo: identificar el punto de vista de los profesionales de enfermería sobre la adaptación y la improvisación de los materiales de trabajo en el hospital y analizar las ventajas y desventajas de esta práctica para el trabajo en salud y enfermería. Método: investigación de enfoque cualitativo, descriptivo, realizada junto a 20 trabajadores de enfermería de un hospital público de Río de Janeiro. La entrevista semiestructurada fue utilizada como técnica de recolección de datos, en julio de 2009. Los datos fueron analizados mediante análisis de contenido temático, tras aprobación del Comité de Ética en Investigación número 2355/2009. Resultados: fue evidente que la práctica de la adaptación / improvisación es dialéctica, con sentimientos de sufrimiento y placer. Porque, al tiempo que garantiza la atención, también pone en riesgo la seguridad de los pacientes y trabajadores. Conclusión: las adaptaciones / improvisaciones de materiales tienen potencial para hacer surgir creaciones pertinentes y oportunidades de patentes para la profesión.

The Severity of Visceral Leishmaniasis Correlates with Elevated Levels of Serum IL-6, IL-27 and sCD14.

BACKGROUND: Visceral leishmaniasis (VL) is a severe disease caused by infection with protozoa of the genus Leishmania. Classic VL is characterized by a systemic infection of phagocytic cells and an intense activation of the inflammatory response. It is unclear why 90% of infected individuals do not develop the disease while a minority develop the classical form. Furthermore, among those that develop disease, a small group progresses to more severe form that is unresponsive to treatment. The presence of inflammatory mediators in serum could theoretically help to control the infection. However, there is also a release of anti-inflammatory mediators that could interfere with the control of parasite multiplication. In this study, we took advantage of the spectrum of outcomes to test the hypothesis that the immune profile of individuals infected with Leishmania (L.) infantum is associated with the development and severity of disease. METHODOLOGY/PRINCIPAL FINDINGS: Sera from patients with confirmed diagnosis of VL were evaluated for the presence of numerous molecules, and levels compared with healthy control and asymptomatic infected individuals. CONCLUSIONS/PRINCIPAL FINDINGS: Although differences were not observed in LPS levels, higher levels of sCD14 were detected in VL patients. Our data suggest that L. infantum may activate the inflammatory response via CD14, stimulating a generalized inflammatory response with production of several cytokines and soluble molecules, including IFN-γ, IL-27, IL-10, IL-6 and sCD14. These molecules were strongly associated with hepatosplenomegaly, neutropenia and thrombocytopenia. We also observed that IL-6 levels greater than 200 pg/ml were strongly associated with death. Together our data reinforce the close relationship of IFN-γ, IL-10, IL-6, TNF-α and IL-27 in the immune dynamics of VL and suggest the direct participation of sCD14 in the activation of the immune response against L. infantum.

Vovó e vovô também amam: sexualidade na terceira idade / Grandma and grandpa also love: sexuality in the elderly / Los abuelos también se aman: sexualidad en la tercera edad

Objetivou-se analisar a prática profissional de médicos e enfermeiros da Estratégia Saúde da Família no que se refere aos aspectos da sexualidade em idosos. Estudo exploratório, de abordagem qualitativa, com base na observação participante e entrevista semiestruturada, desenvolvido em seis equipes da Estratégia Saúde da Família do município de Crato-CE, Brasil, de maio de 2013 a maio de 2014, participando da pesquisa seis médicos e seis enfermeiros, totalizando 12 profissionais. Os dados coletados foram organizados em quatro categorias explicativas e analisados de forma indutiva interpretativa. Os resultados revelam o significado atribuído pelos profissionais à sexualidade na terceira idade, as formas como os profissionais identificam as necessidades sexuais, como era realizado o atendimento das necessidades sexuais de idosos e as ações sobre a qualidade da vida sexual. Constatou-se que o tema era de difícil abordagem durante as consultas, embora relevante no contexto das unidades de saúde. Os dados ainda ressaltam a escassez de ações voltadas para essa temática nas unidades de saúde, sinalizando grande fragilidade no que diz respeito à atenção integral à saúde do idoso.

This study aimed to analyze the professional practice of doctors and nurses in the Family Health Strategy in relation to aspects of sexuality in the elderly. This was an exploratory study with a qualitative approach based on participant observation and semi-structured interview, conducted in six teams of the Family Health Strategy in the municipality of Crato-CE, Brazil, from May of 2013 to May of 2014. A total of 12 professionals, six doctors and six nurses, participated in the study. The data collected were organized into four explanatory categories and analyzed in an inductively and interpretative way. The results reveal the meaning given by professionals to sexuality in the old age, the ways in which professionals identify sexual needs, the approach on sexual needs in the elderly, and actions on the quality of sexual life. It was found that the subject was difficult to approach during consultations, although relevant in the context of health facilities. The data also highlight the lack of actions focused on this theme in health units, signaling great weaknesses with respect to a comprehensive health care for the elderly.

El objetivo de la presente investigación fue analizar la práctica profesional de médicos y enfermeros de la Estrategia de Salud Familiar, al tratar aspectos de la sexualidad de las personas adultas mayores. Se trata de un estudio exploratorio, cualitativo en base a la observación participante y en entrevistas semiestructuradas. La investigación se llevó a cabo en seis equipos de Estrategia de Salud familiar de Crato, CE, Brasil, de mayo de 2013 a mayo de 2014, con seis médicos y seis enfermeros, en un total de 12 profesionales. Los datos recogidos se organizaron en cuatro categorías explicativas. La información obtenida se analizó de modo inductivo e interpretativo. Los resultados revelaron el significado dado por los profesionales a la sexualidad en la tercera edad, la forma cómo los profesionales identificaban las necesidades sexuales, como se atendían las necesidades sexuales de las personas adultas mayores y las acciones sobre la calidad de vida sexual. Se constató que, aún siendo importante en los centros de salud, era un asunto delicado de tratar en las consultas. Los datos también hacen hincapié en la falta de lineamientos para enfocar el tema en dichos centros de salud, lo cual indica la fragilidad de la atención integral en salud para las personas adultas mayores.

Relationship between periodontal status and degree of visual impairment in institutionalized individuals.

OBJECTIVE: Periodontal disease is a set of inflammatory infections that affect the supporting structures of the dentition. Patients with visual impairment (VI) may have more difficulty in cleaning and maintaining oral health. The purpose of this study was to investigate the possible relationship between periodontal status and degree of VI in institutionalized individuals. MATERIALS AND METHODS: Fifty-two visually impaired individuals were included in this cross-sectional study. The periodontal parameters assessed were clinical attachment level (CAL), probing depth (PD), and visible plaque index. The degree of VI was established as: Group 1 (mild or moderate VI), Group 2 (severe or profound VI), and Group 3 (completely blind); and the types of VI were considered as congenital and acquired. Fisher's exact, Kruskal-Wallis, Mann-Whitney, and Spearman correlation coefficient test were used. The level of significance was set at 5%. RESULT: Only plaque index was higher on proximal surfaces of subjects with mild/moderate VI when compared to the other degrees of VI (P = 0.01). Furthermore, we observed higher values for interproximal CAL (P = 0.01), total PD (P = 0.04), and interproximal PD in subjects with acquired VI when compared to subjects with congenital VI (P = 0.01). CONCLUSIONS: These findings suggest that periodontal status may be more related to the type of disability than with the degree of VI. Acquired VI people presented a worse periodontal health than the group with congenital VI.

Riscos ocupacionais e agravos à saúde dos trabalhadores em uma unidade ambulatorial especializada / Work at a specialized outpatient unit: occupational hazards and health risks to workers / Riesgos laborales y peligros para la salud de trabajadores de un centro de salud especializado

Pesquisa qualitativa, descritiva e exploratória, que tratou dos riscos ocupacionais no trabalho desempenhado em uma unidade ambulatorial especializadae das repercussões desses riscos no processo saúde-doença dos trabalhadores da saúde. Objetivos: identificar os riscos ocupacionais que envolvem otrabalho em uma unidade ambulatorial especializada sob o ponto de vista dos profissionais de saúde e analisar os impactos dos riscos ocupacionais nasaúde-doença desses trabalhadores. A coleta de dados, feita com 38 profissionais de saúde, ocorreu em janeiro e fevereiro de 2011, a partir de entrevistasemiestruturada. Os dados foram interpretados à luz da análise temática de conteúdo. Os resultados evidenciaram que cada categoria profissional,devido às especificidades do seu processo laboral, enfatizava certo tipo de risco mais do que outros; os profissionais, porém, reconhecem que existem,no trabalho desempenhado, riscos de diferentes naturezas: físico, químico, biológico, de acidente, ergonômico e, em especial, os psicossociais.

This qualitative, descriptive, exploratory study investigated the occupational hazards that exist in the workplace of health professionals who work at aspecialized outpatient unit and the impact of these occupational hazards on the workers’ health-disease process. Objectives: to identify the occupationalhazards that exist in a specialized outpatient unit, according to the perception of the health professionals who work there, and to analyze the impactsof occupational hazards on these workers’ health-disease process. Data were collected from January through February 2011 through a semi-structuredinterview with 38 health professionals. The data were analyzed through thematic content analysis. The results showed that each professional category,due to the specificities of its work process, emphasized a certain type of risk. However, these professionals recognize that there are risks of differentnatures in their work environment, such as physical, chemical, biological, ergonomic, the risk of accident and, in particular, psychosocial risks.

Investigación cualitativa, exploratoria, descriptiva acerca de los riesgos laborales en un centro de salud especializado y su impacto sobre el proceso saludenfermedadde los trabajadores. El objetivo fue identificar dichos riesgos desde el punto de vista de los profesionales. La recogida de datos, realizada con38 profesionales de la salud, se llevó a cabo en enero y febrero de 2011, a través de la entrevista semi-estructurada. Los datos fueron interpretados a la luzdel análisis de contenido temático. Los resultados mostraron que cada categoría profesional, debido a las características de la tarea desempeñada, hacíahincapié en un determinado tipo de riesgo. Sin embargo, los profesionales reconocieron que en el trabajo hay distintos tipos de riesgos: físicos, químicos,biológicos, accidentales, ergonómicos y, en particular, los psicosociales.

Trypanosoma cruzi nucleoside triphosphate diphosphohydrolase 1 (TcNTPDase-1) biochemical characterization, immunolocalization and possible role in host cell adhesion.

Previous work has suggested that Trypanosoma cruzi diphosphohydrolase 1 (TcNTPDase-1) may be involved in the infection of mammalian cells and serve as a potential target for rational drug design. In this work, we produced recombinant TcNTPDase-1 and evaluated its nucleotidase activity, cellular localization and role in parasite adhesion to mammalian host cells. TcNTPDase-1 was able to utilize a broad range of triphosphate and diphosphate nucleosides. The enzyme's Km for ATP (0.096 mM) suggested a capability to influence the host's ATP-dependent purinergic signaling. The use of specific polyclonal antibodies allowed us to confirm the presence of TcNTPDase-1 at the surface of parasites by confocal and electron microscopy. In addition, electron microscopy revealed that TcNTPDase-1 was also found in the flagellum, flagellum insertion region, kinetoplast, nucleus and intracellular vesicles. The presence of this enzyme in the flagellum insertion region and vesicles suggests that it may have a role in nutrient acquisition, and the widespread distribution of TcNTPDase-1 within the parasite suggests that it may be involved in other biological process. Adhesion assays using anti-TcNTPDase-1 polyclonal antibodies as a blocker or purified recombinant TcNTPDase-1 as a competitor revealed that the enzyme has a role in parasite-host cell adhesion. These data open new frontiers to future studies on this specific parasite-host interaction and other unknown functions of TcNTPDase-1 related to its ubiquitous localization.

Perfil socioeconômico e cultural do estudante ingressante no Curso de Graduação em Enfermagem / Social, economic, and cultural profile of incoming undergraduate students at the School of Nursing / El perfil socioeconómico y cultural del estudiante que ingresa en el Curso de Pregrado en Enfermería

Trata-se de um estudo descritivo, com abordagem quantitativa, cujos objetivos foram: delinear e analisar o perfil socioeconômico e cultural dos estudantes ingressantes do Curso de Graduação em Enfermagem da Universidade do Estado do Rio de Janeiro. Os participantes foram discentes do primeiro período acadêmico em 2008/1, 2008/2 e 2009/1. Os dados foram coletados através de questionários respondidos por 97 alunos, o que correspondeu a 80.80% da população de 120 alunos ingressantes. Os resultados foram tratados por meio de estatística simples, evidenciando que os ingressantes são adolescentes e em sua maioria mulheres. Observou-se que entre os participantes, 12,50% não possuem saneamento básico e apresentam uma baixa renda familiar. Contrariamente, a maioria, 98,97%, têm acesso fácil à internet. Tal fato é visto como um ponto favorável no processo de ensino-aprendizagem, porém fatores como a baixa renda familiar e falta de saneamento básico revelaram-se como dados preocupantes, os quais precisam ser transformados.

This is a descriptive study with quantitative approach, whose objectives were to outline and analyze the social, economic, and cultural profile of incoming undergraduate students at the Nursing School of the State University of Rio de Janeiro, RJ, Brazil. Participants were students in their first school term of the undergraduate program in 2008/1, 2008/2, and 2009/1. Data were collected through questionnaires filled up by 97 students, who accounted for 80.80 % of the freshmen population, totaling 120 students. Results were treated on the basis of simple statistics and showed that freshmen are teenagers and mostly women. Results showed 12.50% of the participants had no basic sanitation facilities at home and had low family income. By contrast, 98.97 % have regular Internet facilities. That is regarded as a pro in the teaching-learning process. However, factors such as low family income and poor sanitation come up as concerning issues requiring transforming action.

Se trata de un estudio descriptivo, con abordaje cuantitativo, cuyos objetivos fueron describir y analizar el perfil socioeconómico y cultural de los estudiantes que entran en el Curso de Pregrado en Enfermería de la Universidad del Estado de Río de Janeiro-Brasil. Los participantes fueron estudiantes de la primera etapa de la licenciatura en 2008/1, 2008/2 y 2009/ 1. Los datos fueron recolectados a través de cuestionarios respondidos por 97 estudiantes , que representan 80,80 % de la población de 120 estudiantes de primer año . Los resultados fueron tratados por estadística simple, que muestran que los estudiantes de primer año son adolescentes y en su mayoría mujeres. Se observó que entre los participantes, 12.50 % no tienen saneamiento y cuentan con una familia de baja renta. Por el contrario, 98,97 % tiene fácil acceso a la internet. Este hecho seve como un punto favorable en el proceso de enseñanza y aprendizaje, pero factores como la baja renta familiar y la falta de saneamiento son datos preocupantes que deben ser transformados.

Riscos ocupacionais relacionados ao trabalho de enfermagem em uma unidade ambulatorial especializada / Occupational risks in nursing at a specialized out-patient unit / Riesgos laborales relacionados ao trabajo de enfermería em centro médico especializado

Pesquisa qualitativa, cujo objeto trata de riscos ocupacionais no trabalho em saúde em unidade ambulatorial especializada, sob a ótica dos trabalhadores de enfermagem. Objetiva descrever a percepção destes trabalhadores sobre os impactos do trabalho na saúde; discutir propostas de soluções para controle e/ou eliminação dos riscos. O estudo foi realizado em ambulatório especializado, na cidade do Rio de Janeiro, em 2010. Os dados foram coletados por entrevista semiestruturada e submetidos à análise temática de conteúdo. Os resultados revelaram percepções contraditórias dos sujeitos sobre os riscos ocupacionais, que oscilam entre a visão crítica/reflexiva e a alienação sobre as reais condições laborais da enfermagem. Entre as propostas dos sujeitos, destacam-se: necessidade de reformas estruturais, incremento dos recursos humanos e materiais e consolidação de política de saúde do trabalhador. Estas propostas devem subsidiar a criação e implementação de um núcleo de saúde do trabalhador na instituição.

Qualitative research on occupational risks at a specialized out-patient unit, in Rio de Janeiro, RJ, Brazil, in 2010, from the nursing workers’ standpoint. It aims at describing the perceptions those workers have about the effects of work upontheir health; discussing solutions proposed for control and/or elimination of the risks. Data were collected by semi structured interviews and submitted to thematic contents analysis. Results unveil contradictory perceptions by subjects on occupational risks, on a range from critical/reflexive to alienated stands about real labor conditions of nursing. Outstanding proposals identified among the subjects included the need for structural reforms, increment of human assets and materials, and consolidationof workers’ health policies. Those proposals must help sustain the creation and implementation of a workers’ health core at the institution.

Investigación cualitativa, cuyo objeto trata de riesgos laborales en el trabajo en salud en centro médico especializado, de acuerdo con la visión de los trabajadores de enfermería. Objetiva describir la percepción de estes trabajadores sobre los impactos del trabajo en la salud; discutir proposiciones de soluciones para control y/o eliminación de los riesgos. El estudio fue hecho en ambulatorio especializado, en Rio de Janeiro-RJ-Brasil, en 2010. Los datos fueran recolectados por entrevista semiestructurada y sometidos al análisis de contenido. El resultados revelaron percepciones contradictorias de los sujetos sobre los riesgos laborales, que oscilan entre la visión crítica/de reflexión y la alienación sobre las reales condiciones laborales de la enfermería. Entre las propuestas de los sujetos se destacan: necesidad de reformas estructurales, incremento de los recursos humanos y materiales y consolidación de política de salud del trabajador. Estas propuestas deben subsidiar la creación y implementación de un núcleo de salud del trabajador en la institución.