Work overload and associated factors in healthcare professionals during the COVID-19 pandemic.

INTRODUCTION: The COVID-19 pandemic changed the work routine of professionals at the family healthcare center (Núcleo de Atenção à Saúde da Família - NASF-AB), providing new conditions and work overload. OBJECTIVE: The purpose of this study was to explore factors associated with work overload in NASF-AB professionals during the COVID-19 pandemic. METHODS: A cross-sectional study was carried out with NASF-AB workers in the city of Salvador, Bahia, Brazil, from May to August 2021. Working conditions and overload were assessed using the National Program for Improving Access and the Quality of Primary Care questionnaire (Programa Nacional de Melhoria do Acesso e da Qualidade da Atenção Básica - PMAQ) and the scale measuring burden of professionals in mental health services (Escala de Avaliação da Sobrecarga de Profissionais em Serviços de Saúde Mental - IMPACTO-BR), respectively. A multivariate linear regression model was used. A total of 68 health professionals participated in the study, including 19 physiotherapists, 13 occupational therapists, 10 social workers, 10 nutritionists, 9 psychologists and 7 physical education professionals. RESULTS: There was a significant association between overall overload and being female (p=<0.005), having spaces for reflection on the work process (p=0.027), and having difficulty moving around to conduct activities in the territory (p=0.002) for increasing the chance of work overload. CONCLUSIONS: Our findings encourage workers' health policies and closer ties and negotiation with local management, as well as the return of the institutional support figure for the effectiveness and resolution of actions in primary healthcare units.

Infection of the muscle tissue of the filter-feeding cichlid, Chaetobranchopsis orbicularis Steindachner, 1875, by Kudoa orbicularis (Myxozoa: Multivalvulidae) on Marajó Island in the Brazilian Amazon region / Infecção por Kudoa orbicularis (Myxozoa: Multivalvulidae) na musculatura de Chaetobranchopsis orbicularis Steindachner, 1875, oriundo da Ilha de Marajó na região Amazônica do Brasil

This study describes aspects of infections caused by the myxosporidian Kudoa orbicularis in filter-feeding cichlids, Chaetobranchopsis orbicularis, caught in the Arari River in the municipality of Cachoeira do Arari, on Marajó Island, Pará, Brazil. The parasite forms pseudocysts scattered throughout the striated epaxial and hypaxial muscles. Samples embedded in paraffin were analyzed histologically using hematoxylin-eosin, Gömöri, Ziehl-Neelsen, and Giemsa staining. Necropsy of the C. orbicularis specimens revealed that 100% (50/50) were infected with K. orbicularis. The specimens presented grossly abnormal muscle texture, resulting in extensive inconsistencies and weakness. Progressive softening of the muscles was observed during necropsy, indicating the rapid enzymatic autolysis of the tissue. The parasite found in the muscle tissue of C. orbicularis was identified as K. orbicularis, with clinical signs of disease being observed in the fish. The necropsy revealed extensive damage to the host organism, with well-established fibrocystic infections in the muscle fibers, associated with post mortem myoliquefaction.(AU)

O presente estudo descreve os aspectos histopatológicos de infecção causada por mixosporídio da espécie Kudoa orbicularis, o qual forma pseudocistos dispersos em toda a musculatura estriada esquelética, epi e hipoaxial, de Chaetobranchopsis orbicularis, capturados no Rio Arari, município de Cachoeira do Arari, Ilha do Marajó, Pará. Foram realizadas as técnicas histológicas de impregnação em parafina, utilizando-se as colorações de hematoxilina-eosina, Gomori, Ziehl-Neelsen e Giemsa. As análises necroscópicas dos espécimes de C. orbicularis revelaram 100% (50/50) de infecção por K. orbicularis. Os espécimes apresentavam macroscopicamente musculatura com características anormais de textura, se mostrava inconsistente e frágil. Durante a necropsia, pôde ser observado um progressivo amolecimento da musculatura, o que demonstra um rápido processo enzimático autolítico. Com base nos achados descritos neste trabalho, caracterizou-se uma infecção da musculatura de C. orbicularis por K.orbicularis, com demonstração de sinais clínicos de doença no peixe; os achados necroscópicos mostraram danos ao organismo hospedeiro, com instalação de infecção fibrosística nas fibras musculares, associada com uma mioliquefação post mortem.(AU)

Theoretical spectroscopic insights of tautomers and enantiomers of penicillamine.

B3LYP and MP2 calculations have been carried out to investigate tautomers and enantiomers of penicillamine (Pen). Their infrared (IR), ultraviolet (UV), circular dichroism (CD) and nuclear magnetic resonance (NMR) spectra were obtained at linear-response, time-dependent DFT (TD-DFT). IR, UV and NMR spectra cannot be used to identify Pen enantiomers, showing nearly equal spectral profiles. CD spectra, however, give rise to completely symmetric signals, forming a perfect specular image to each other. Distinct CD profiles were also obtained for Pen tautomers. Important IR differences were found in positions and intensities of the vibrational stretching bands involving acid and amine groups of Pen tautomers. The highest electron transitions involving HOMO-LUMO orbitals show to be of major importance in the computed UV spectra, showing a large red-shift around 30nm as the zwitterionic and neutral Pen spectra are compared. NMR results show to be quite useful for identification of Pen tautomers since clear differences are found by means of the computed shielding tensors as well as spin-spin coupling constants 1J(N,H) data.

Design, synthesis, molecular docking and biological evaluation of thiophen-2-iminothiazolidine derivatives for use against Trypanosoma cruzi.

In this study, we designed and synthesized a series of thiophen-2-iminothiazolidine derivatives from thiophen-2-thioureic with good anti-Trypanosoma cruzi activity. Several of the final compounds displayed remarkable trypanocidal activity. The ability of the new compounds to inhibit the activity of the enzyme cruzain, the major cysteine protease of T. cruzi, was also explored. The compounds 3b, 4b, 8b and 8c were the most active derivatives against amastigote form, with significant IC50 values between 9.7 and 6.03µM. The 8c derivative showed the highest potency against cruzain (IC50=2.4µM). Molecular docking study showed that this compound can interact with subsites S1 and S2 simultaneously, and the negative values for the theoretical energy binding (Eb=-7.39kcal·mol(-1)) indicates interaction (via dipole-dipole) between the hybridized sulfur sp(3) atom at the thiazolidine ring and Gly66. Finally, the results suggest that the thiophen-2-iminothiazolidines synthesized are important lead compounds for the continuing battle against Chagas disease.

RPA-1 from Leishmania amazonensis (LaRPA-1) structurally differs from other eukaryote RPA-1 and interacts with telomeric DNA via its N-terminal OB-fold domain.

Replication protein A-1 (RPA-1) is a single-stranded DNA-binding protein involved in DNA metabolism. We previously demonstrated the interaction between LaRPA-1 and telomeric DNA. Here, we expressed and purified truncated mutants of LaRPA-1 and used circular dichroism measurements and molecular dynamics simulations to demonstrate that the tertiary structure of LaRPA-1 differs from human and yeast RPA-1. LaRPA-1 interacts with telomeric ssDNA via its N-terminal OB-fold domain, whereas RPA from higher eukaryotes show different binding modes to ssDNA. Our results show that LaRPA-1 is evolutionary distinct from other RPA-1 proteins and can potentially be used for targeting trypanosomatid telomeres.

A role for endothelin receptor type A in migraine without aura susceptibility? A study in Portuguese patients.

BACKGROUND AND PURPOSE: Migraine is a common neurological disabling disorder, and anomalies of vascular function have been implied in its pathophysiology. Several findings point to a possible role of the endothelin receptor type A (EDNRA) in migraine. We aim to assess the involvement of endothelin receptor type A (EDNRA) in migraine susceptibility in a sample of Portuguese migraineurs. METHODS: Three tagging SNPs (rs702757, rs5333 and rs5335) were analysed in 188 cases - 111 without aura (MO) and 77 with aura (MA) - and 287 controls. A multivariable logistic regression was performed, including the three SNPs, adjusted for gender. Allelic and haplotypic frequencies were compared between cases and controls. Significant or promising results were confirmed by a multifactor dimensionality reduction analysis (MDR). RESULTS: We found a nominal association for the rs702757 T-allele [odds ratio (OR) = 1.44, 95% confidence intervals (CI): 1.05-1.99] and for the TT-genotype (OR = 2.34, 95% CI: 1.12-4.90) for MO, that do not remain significant after multiple test correction. A trend towards an increased risk for MA regarding the C-allele of rs5333 was also found. However, an additional MDR analysis was performed, and highly significant results were found for the two SNPs. The T-C-G haplotype (rs702757-rs5333-rs5335) was found to be significantly overrepresented in the MO subgroup, even after permutation was performed. CONCLUSIONS: Our results show additional findings for a role of EDNRA as a susceptibility factor for MO, although we cannot exclude the involvement of this gene in MA susceptibility in our population. Our study also emphasizes the need for replication of association findings in different populations.

Leishmania replication protein A-1 binds in vivo single-stranded telomeric DNA.

Replication protein A (RPA) is a highly conserved heterotrimeric single-stranded DNA-binding protein involved in different events of DNA metabolism. In yeast, subunits 1 (RPA-1) and 2 (RPA-2) work also as telomerase recruiters and, in humans, the complex unfolds G-quartet structures formed by the 3' G-rich telomeric strand. In most eukaryotes, RPA-1 and RPA-2 bind DNA using multiple OB fold domains. In trypanosomatids, including Leishmania, RPA-1 has a canonical OB fold and a truncated RFA-1 structural domain. In Leishmania amazonensis, RPA-1 alone can form a complex in vitro with the telomeric G-rich strand. In this work, we show that LaRPA-1 is a nuclear protein that associates in vivo with Leishmania telomeres. We mapped the boundaries of the OB fold DNA-binding domain using deletion mutants. Since Leishmania and other trypanosomatids lack homologues of known telomere end binding proteins, our results raise questions about the function of RPA-1 in parasite telomeres.

LaRbp38: a Leishmania amazonensis protein that binds nuclear and kinetoplast DNAs.

Leishmania amazonensis causes a wide spectrum of leishmaniasis. There are no vaccines or adequate treatment for leishmaniasis, therefore there is considerable interest in the identification of new targets for anti-leishmania drugs. The central role of telomere-binding proteins in cell maintenance makes these proteins potential targets for new drugs. In this work, we used a combination of purification chromatographies to screen L. amazonensis proteins for molecules capable of binding double-stranded telomeric DNA. This approach resulted in the purification of a 38kDa polypeptide that was identified by mass spectrometry as Rbp38, a trypanosomatid protein previously shown to stabilize mitochondrial RNA and to associate with nuclear and kinetoplast DNAs. Western blotting and supershift assays confirmed the identity of the protein as LaRbp38. Competition and chromatin immunoprecipitation assays confirmed that LaRbp38 interacted with kinetoplast and nuclear DNAs in vivo and suggested that LaRbp38 may have dual cellular localization and more than one function.

Platinum and palladium complexes of thiosemicarbazones derived of 2-acetylthiophene: Synthesis and spectral studies.

The reaction of 2-acetylthiophene thiosemicarbazone (2-HATT) and 2-acetylthiophene 4-phenylthiosemicarbazone (2-HAT-4-FT) with Pd(COD)Cl(2) (COD = 1,5-cyclooctadiene) and trans-Pt(2)PEt(3)Cl(4) yielded four new metal complexes: [Pd(2-HATT)Cl(2)] (1), [Pd(2-ATT)(2)] (2), [Pd(2-AT-4-FT)Cl] (3) and [Pt(2-ATT)(PEt(3))Cl] (4). Apart from compound 3 all the others were characterised by (1)H and (13)C{(1)H} NMR, infrared spectroscopy, and elemental analysis. Multinuclear NMR experiments of (31)P{(1)H} and (195)Pt{(1)H} of complex 4 have revealed that the ligand 2-HATT behaves as a bidentate chelating agent towards Pd(COD)Cl(2) and trans-Pt(2)PEt(3)Cl(4) whereas ligand 2-HAT-4-FT forms a tridentate chelating complex with Pd(COD)Cl(2).

Correlação da dislipidemia nos pacientes com isquemia crítica do Hospital Barão de Lucena - Recife/PE / Correlation of dyslipidemia in patients with critical ischemia in Hospital Barão de Lucena - Recife/PE

PURPOSE: There are studies that confirm the association between dyslipidaemia and the genesis of atherosclerosis process in world literature. The goal of this study is to evaluate the incidence of the dyslipidaemia in patients with critical limb ischemia. METHODS: The analysis was made in fifty in-patients from Vascular Surgery Service from Barão de Lucena Hospital from September 2003 to August 2004. We analyzed the laboratorial tests and seen the frequency the lipids abnormalities in fifty patients. RESULTS: Among the patients evaluated 62.2% was women and 37.8% was men. The incidence of abnormalities in the lipids levels was 39.2% in women and 31.5% in the men. It was not possible to determinate the relationship between the lipids levels and the intensity of atherosclerotic lesions. CONCLUSIONS: There is a significant incidence of dyslipidaemia in the patients evaluated. All data are similar to the ones observed in the in the literature.

Assessing efficacy by measuring CD(4) counts and quality of life of AIDS patients treated with ritonavir, AZT and 3TC.

UNLABELLED: Lamivudine and zidovudine are proving to be an important antiretroviral combination against HIV that is superior to monotherapy. Recently, with the appearance of protease inhibitors, ritonavir has been shown to be a powerful drug when used in combination with reverse transcriptase inhibitors. The objective of this study was to observe the efficacy, adverse events, and changes in the quality of life of AIDS patients receiving treatment for the first time using AZT, 3TC and ritonavir as combination therapy. We selected 36 patients diagnosed with AIDS due to opportunistic infections and evaluated them by assessing their score on quality of life scales (Karnofsky, uniscale - Quality of Life, and Quality of Life Scale), T CD(4) and CD(8) lymphocyte counts, bodyweight and symptoms during a 6 month period. Assessments were made at 2 month intervals. One patient was excluded from the trial, therefore, 35 were assessed during 6 months. RESULTS: Bodyweight increased an average of 7.2%, CD(4) increased 260 cells/mm(3) and CD(8) increased 198 cells/mm(3). The Karnofsky and uniscale QOL scales reached 100% on the fourth visit. The Quality of Life Scale showed an important increase during this study from 5.5+/-2.3 to 9.7+/-0.5. Adverse events were observed in 25.0% of the patients, most being slight. One patient had to stop taking ritonavir due to nausea and vomiting. We conclude that AZT, 3TC, and ritonavir restored the quality of life for the AIDS patients studied in terms of psychosocial aspects and overall health conditions during 6 months of treatment. The adverse events were probably related to ritonavir, but they were slight and disappeared after 2 weeks. There was a significant increase in the average number of CD(4) lymphocytes during 6 months of treatment.

Extracellular ATP in the lymphohematopoietic system: P2Z purinoceptors off membrane permeabilization.

The effects of extracellular nucleosides and nucleotides on many organs and systems have been recognized for almost 50 years. The effects of extracellular ATP (ATPo), UTPo, ADPo, and other agonists are mediated by P2 purinoceptors. One of the most dramatic effects of ATPo is the permeabilization of plasma membranes to low molecular mass solutes of up to 900 Da. This effect is evident in several cells of the lymphohematopoietic system and is supposed to be mediated by P2Z, an ATP(4-)-activated purinoceptor. Here, we review some basic information concerning P2 purinoceptors and focus our attention on P2Z-associated phenomena displayed by macrophages. Using fluorescent dye uptake, measurement of free intracellular Ca2+ concentration and electrophysiological recordings, we elucidate some of the events that follow the application of ATP to the extracellular surface of macrophages. We propose a regulatory mechanism for the P2Z-associated permeabilization pore. The presence of P2 purinoceptors in cells of the lymphohematopoietic system makes them potential candidates to mediate immunoregulatory events.

Extracellular ATP in the lymphohematopoietic system: P2Z purinoceptors and membrane permeabilization

The effects of extracellular nucleosides and nucleotides on many organs and systems have been recognized for almost 50 years. The effects of extracellular ATP (ATP(o)), UTP (o), ADP(o), and other agonists are mediated by P2 purinoceptors. One of the most dramatic effects of ATP(o) is the permeeabilization of plasma membranes to low molecular mass solutes of up to 900 Da. This effect is evident in several cells of the lymphohematopoietic system and is supposed to be mediated by P2Z, and APT(4-) -activated purinoceptor. Here, we review some basic information concerning P2 purinoceptors and focus our attention on P2Z-associated phenomena displayed by macrophages. Using fluorescent dye uptake, measurement of free intracellular Ca2+ concentration and electrophysiological recordings, we elucidate some of the events that follow the application of ATP to the extracellular surface of macrophages. We propose a regulatory mechanism for the P2Z-associated permeabilization pore. The presence of P2 purinoceptors in cells of the lymphohematopoietic system makes them potential candidates to mediate immunoregulatory events.

Hypertrophic motor and sensory neuropathy type I (Charcot-Marie-Tooth disease): ultrastructural study of sural nerve biopsy in members of a family.

Three members of a family with a hereditary neuropathy were studied. Light, electron microscopy and teasing of isolated fibres were performed. The findings confirmed the clinical and electrophysiological hypothesis of hypertrophic form of Charcot-Marie-Tooth disease. Hypertrophy of Schwann cells with the formation of onion bulb figures as the most evident ultrastructural feature, besides demyelination, remyelination and mild axonal degeneration. Recent data about the genetic transmission and pathogenesis of the hereditary motor and sensory neuropathies (HMSN) are discussed.

[The experience of the Resting Home at the Center for Integral Women's Health Care of the State University of Campinas, Brazil]. / A experiência da Casa de Repouso do CAISM da Unicamp.

The CAISM--Center for Integral Women's Health Care, of the Unicamp--State University of Campinas created a low complexity unit called a "Resting Home" according to the model adopted by other tertiary care centers in Brazil and in other countries. With 35 beds, the Resting Home staff includes two registered nurses, one social worker, and one occupational therapist. The institution admits women who have a high risk of acute complications of pregnancy or who require frequent check-up, mothers of premature babies under care in neonatal units who require their mother's breast feeding, and gynecological cancer patients who are in the process of staging and final diagnosis, or who are under frequent sessions of radiotherapy or chemotherapy. The common characteristic is that all of them need to go frequently to the outpatient services of the hospital, they live far away from the hospital, and they cannot afford rapid and easy transportation from their homes. The Resting Home offers them lodging and food, and a minimum of comfort (occupational therapy, TV, reading) at a cost that is only a small fraction of the cost of an inpatient. The authors present the statistics for the first 31 months of operation.