Antigenicity, Immunogenicity and Protective Efficacy of Three Proteins Expressed in the Promastigote and Amastigote Stages of Leishmania infantum against Visceral Leishmaniasis.

In the present study, two Leishmania infantum hypothetical proteins present in the amastigote stage, LiHyp1 and LiHyp6, were combined with a promastigote protein, IgE-dependent histamine-releasing factor (HRF); to compose a polyproteins vaccine to be evaluated against L. infantum infection. Also, the antigenicity of the three proteins was analyzed, and their use for the serodiagnosis of canine visceral leishmaniasis (CVL) was evaluated. The LiHyp1, LiHyp6, and HRF DNA coding sequences were cloned in prokaryotic expression vectors and the recombinant proteins were purified. When employed in ELISA assays, all proteins were recognized by sera from visceral leishmaniasis (VL) dogs, and presented no cross-reactivity with either sera from dogs vaccinated with a Brazilian commercial vaccine, or sera of Trypanosoma cruzi-infected or Ehrlichia canis-infected animals. In addition, the antigens were not recognized by antibodies from non-infected animals living in endemic or non-endemic areas for leishmaniasis. The immunogenicity and protective efficacy of the three proteins administered in the presence of saponin, individually or in combination (composing a polyproteins vaccine), were evaluated in a VL murine model: BALB/c mice infected with L. infantum. Spleen cells from mice inoculated with the individual proteins or with the polyproteins vaccine plus saponin showed a protein-specific production of IFN-γ, IL-12, and GM-CSF after an in vitro stimulation, which was maintained after infection. These animals presented significant reductions in the parasite burden in different evaluated organs, when compared to mice inoculated with saline or saponin. The decrease in parasite burden was associated with an IL-12-dependent production of IFN-γ against parasite total extracts (produced mainly by CD4+ T cells), correlated to the induction of parasite proteins-driven NO production. Mice inoculated with the recombinant protein-based vaccines showed also high levels of parasite-specific IgG2a antibodies. The polyproteins vaccine administration induced a more pronounced Th1 response before and after challenge infection than individual vaccines, which was correlated to a higher control of parasite dissemination to internal organs.

Effect of the treatment of focal brain ablation in rat with bone marrow mesenchymal stromal cells on sensorimotor recovery and cytokine production.

Increased efficacy of the multipotent mesenchymal stromal cells (MSCs) for the treatment of CNS injuries has been shown when they are administrated within a collagen scaffold, an environment in three dimensions (3D), when compared to the cultivation over a plastic surface (2D). We evaluated the MSC therapeutic effect in the 2D and 3D conditions using the model of focal cortical ablation. Male Wistar rats were submitted to the ablation by aspiration. Intravenous injection (IV) of MSC cultured in 2D, and the intralesional administration (IL) of MSC cultured in 2D or 3D were tested. Administrations were made 24h after ablation. Unskilled and skilled forelimb movements were evaluated by sensorimotor tests. The level of cytokines was measured two days after ablation in the 2D IV groups. Only the MSC 3D IL promoted recovery of the skilled movements. MSC 2D IV promoted recovery of the unskilled movements in all tests, and the MSC 3D IL promoted it only in the adhesive test. MSC 2D IL was unable to promote any recovery. DAPI-stained MSC was found in the perilesional parenchyma at the third post-ablation day after 2D and 3D IL. A significant reduction in the levels of cytokines by the MSC 2D IV was observed in the plasma. Our study strengthens the evidences of the MSC as a prospective therapeutic approach for the CNS injuries.

Comparative study between bone marrow mononuclear fraction and mesenchymal stem cells treatment in sensorimotor recovery after focal cortical ablation in rats.

BACKGROUND: Different models of cortical lesion lead to different effects on plasticity of connections and loss of function. In opposition to ischemia, cortical lesion made by ablation does not induce significant adaptive plasticity of corticocortical and corticostriatal projections and leads to functional alterations other than those observed after ischemia. We have demonstrated sensorimotor recovery after treatment with bone marrow-derived mesenchymal stem cells (MSCs) or bone marrow mononuclear cells (BMMCs) in a model of focal cortical ischemia. Here, we extended this analysis evaluating the effect of these cells on sensorimotor recovery after focal cortical ablation, reproducing the same size and location of previous ischemic lesion. FINDINGS: Focal cerebral aspiration of the six cortical layers in left frontoparietal cortex was performed in male Wistar rats. One day later, MSCs or BMMCs were administrated (i.v.) in the ablated animals. Vehicle was administrated in the control group. Sensorimotor tests were performed before and after injury followed by i.v. injection. The monitoring of functional recovery was performed weekly during three post-ablation months. The results showed significant sensorimotor recovery with both treatments, whereas control groups had no recovery. Moreover, both cell types induced the same level of recovery. CONCLUSIONS: Bone marrow cells showed therapeutic efficacy in a model of brain injury known to promote low structural plasticity. Thus, the results support the idea of BMMCs as better candidates to treat acute CNS injuries than MSCs, since they have the same therapeutic potential, but its obtainment for autologous transplantation has been shown to be faster and easier.

Fatores associados a óbito e hospitalizações em uma clínica de insuficiência cardíaca / Factors associated with death and hospitalization in a heart failure clinic

Trata-se de um estudo descritivo, retrospectivo, com abordagem quantitativa cujo objetivo geral foi descrever e analisar o perfil epidemiológico dos pacientes com Insuficiência Cardíaca atendidos pela Clinica de IC de um Hospital Universitário. Os objetivos específicos orientam-se para:(a)Caracterizar os casos de Insuficiência Cardíaca segundo variáveis demográficas, variáveis clínicas, de diagnóstico e co morbidades;(b)Comparar as características clínicas e demográficas dos pacientes conforme grupos etiológicos identificados e fração de ejeção;(c)Determinar a taxa de mortalidade e hospitalização dos pacientes acompanhados pela clínica. Os dados analisados neste estudo são oriundos de um banco de dados onde são alocadas informações dos pacientes em atendimento ambulatorial da referida clinica.Para a análise dos dados foi utilizada a estatística descritiva, freqüências e porcentagens assim como tabelas e gráficos para a demonstração dos dados levantados.Os mesmos foram analisados através do software SPSS v.18.0, no qual se utilizou a estatística multivariada e curvas de sobrevida de Kaplan-Meyer.Os resultados apontam para uma predominância masculina de 60,1%, com idade de ± 63,5 anos. Na caracterização quanto à classe funcional observa-se que a predominante é a classe funcional I e II com 73,6% do total. Os pacientes assistidos apresentam uma média de 42% da fração de ejeção do ventrículo esquerdo e 61,7% possuem etiologia não isquêmica. Em nosso estudo, descrevemos 71,8% de portadores de disfunção sistólica. Os pacientes com etiologia isquêmica tinham predomínio do sexo masculino(70,7%), e a etiologia não isquêmica com uma prevalência maior do sexo feminino(45,5%vs 29,3%;p<0,001). Além disso, os pacientes isquêmicos eram mais idosos (p<0,001), com historia familiar de DAC(p<0,041), presença de diabetes (p<0,001). A disfunção sistólica(FE<50%) era predominante no grupo de pacientes isquêmicos(77%vs 69%; p=0,048)...

It is a descriptive, retrospective, study with quantitative approach whose general objective was to describe and analyze the epidemiological profile of patients with heart failure treated in a heart failure clinic of a university hospital. The specific objectives are oriented to a) characterize the cases of heart failure according to demographic variables, clinical variables, diagnosis and comorbidities, (b) compare clinical and demographic characteristics of patients according to the main groups identified and etiologic fraction ejection, (c) Determine mortality and hospitalization rates of patients followed by the HF clinic. The data analyzed in this study come from a database which is allocated information of ambulatory patients referred to the clinic. For data analysis was used descriptive statistics with mean, median and standard deviation, frequencies and percentages ,tables and graphs to demonstrate the data collected as well multivariate statistical analysis and Kaplan-Meyer’s survival curves. They were analyzed using the software SPSS v.18.0. The results indicate a male predominance of 60.1% with an average age of 63.5 years±. The functional class observed that was the predominant class I and II, 73.6% of the total. Patients have attended an average of 42% ejection fraction of left ventricle and 61.7% had non ischemic etiology. In our study, we describe 71.8% of patients with systolic dysfunction. Patients with ischemic etiology were predominantly male (70.7%), and non ischemic etiology with a higher prevalence of females (45.5% vs 29.3%, p<0.001). In addition, ischemic patients were older (p<0.001), family history of CAD (p<0.041), diabetes (p<0.001). Systolic dysfunction (EF<50%) was predominant in the group of ischemic patients (77% vs 69%, p=0.048)...

Condições de trabalho da enfermagem nas enfermarias de um hospital universitário / Condiciones de trabajo del equipo de enfermería en las salas de enfermos de un hospital universitario / Working conditions of the nursing team in the patient wards of a university hospital

Trata-se de um estudo que aborda a temática do trabalho de enfermagem e tem como foco a percepção dos trabalhadores de enfermagem sobre as suas condições de trabalho. O estudo é do tipo não experimental, com abordagem quantitativa. O objetivodeste artigo é identificar e discutir as condições de trabalho dos trabalhadores de enfermagem nas enfermarias de um Hospital Universitário (HU). Utilizou-se como campo um HU do Estado do Rio de Janeiro, com uma amostra constituída de 296 trabalhadores de enfermagem, no ano de 2008. Nos resultados, foram indicados os fatores de riscos biológicos, físicos, ergonômicos e químicos. Conclui-se que as condições de trabalho são inadequadas e desfavorecem a saúde dos trabalhadores de enfermagem.Este estudo permite ao trabalhador e à instituição discutir o meio ambiente ocupacional e propor mudanças no processo de trabalho.

The present study addresses the issue of the work performed by the nursing team and it is focused on the perception the nursing staff has of their working conditions. This research is a non-experimental investigation, with a quantitative approach. The objective of this paper is to identify and discuss the working conditions of the nursing staff in charge of the patient wards of a University Hospital (UH, Portuguese acronym). The research field was a University Hospital in Rio de Janeiro, and it was conducted with a sample group of 296 nursing employees in the year of 2008. Among the results, biological, physical, ergonomic and chemical factors were highlighted. We conclude that the working conditions are inadequate and adverse to the health of the nursing staff. This study gives the employee and the institution elements to discuss the occupational environment in order to propose changes in the work process.

El presente estudio aborda el tema del trabajo realizado por el equipo de enfermería y se centra en la percepción que estos profesionales tienen sobre las condiciones laborales bajo las cuales desarrollan su actividad. Este estudio es una investigación de tipo no - experimental, de enfoque cuantitativo. El objetivo de este artículo es identificar y discutir las condiciones de trabajo del equipo de enfermería encargado de las salas de enfermos de un hospital universitario (UH, siglas en portugués). El campo de investigación fue un hospital universitario de Río de Janeiro y se llevó a cabo con un grupo muestra de 296 trabajadores de enfermería en el año de 2008. De entre los resultados, se subrayaron los siguientes factores: biológicos, físicos, ergonómicos y químicos. Se concluyó que las condiciones de trabajo son inadecuadas y adversas para la salud de los trabajadores de enfermería. Este estudio permite a los empleados y la institución discutir el entorno ocupacional con el objetivo de proponer cambios y mejoras al proceso de trabajo.

Organização do trabalho de enfermagem na Atenção Básica: uma questão para a saúde do trabalhador / Primary Care nurse work organization: an occupational health issue / Organización del trabajo de enfermería en la Atención Primaria: una cuestión para la salud laboral

Estudo sobre o impacto da organização do trabalho de enfermeiros, técnicos e auxiliares de enfermagem na Atenção Básica e a sua relação com a saúde destes trabalhadores. Estudo transversal, descritivo e inferencial, com análise bivariada usando o quiquadradode Pearson. Amostra intencional de 171 profissionais, aplicando-se um questionário fechado com perguntas individuais e um formulário de observação. Escores de insatisfação altos foram obtidos nos itens relação com a chefia (83,6%), com colegas (76,3%), relativo aos horários (71,9%) e auto-percepção de pouco controle e oportunidade de decisão sobre o seu trabalho (63,5%). Associação estatisticamente significativa foi encontrada entre as variáveis clima ruim de trabalho com os companheiros e conflito com clientes (p=0,01), má organização de turnos e horários (p=0,00) e ritmo acelerado (p=0,00). Conclui-se que há necessidade de incluir um olhar específico sobre a organização do trabalho na Atenção Básica, e do apoio de uma política de saúde do trabalhador de enfermagem e saúde.

This is a cross-sectional, descriptive, and inferential study, using Pearson’s chi-square test, of the impact of workorganization among Primary Care nurses, technicians, and nurses’ assistants upon their occupational health. The intentional sample was composed of 171 nursing professionals, using a closed questionnaire with individual questions and an observation form. High dissatisfaction Scores were identified in the items: relationship with leaders (83.6%), with colleagues (76.3%), concerning schedules (71.9%) and self-perception of low work control and decision-making opportunities (63.5%). The perception of a poor work environment among colleagues was statistically associated to the variables conflict with customers (p=0.01); bad organization of shifts and schedules (p=0.00); and accelerated work pace (p=0.00). We conclude that there is the need to include specific consideration for Primary Care work organization, and support for a worker’s health policy in nursing and health care.

Estudio sobre el efecto de la organización del trabajo de los enfermeros, técnicos y auxiliares de enfermería que trabajan en la Atención Primaria, y su relación con la salud de esos trabajadores. Estudio transversal, descriptivo e inferencial, con análisisbivariado usando el chi-cuadrado de Pearson. Muestra intencional de 171 profesionales de enfermería, aplicando un cuestionario cerrado con preguntas individuales y de observación. Resultados de elevada insatisfacción fueron identificados en los siguientestemas: relación con los jefes (83,6%), con los compañeros (76,3%), en relación a los horarios (71,9%), y autopercepción de poco control y oportunidad de decisión acerca de su trabajo (63,5%). Asociación estadísticamente significativa fue encontrada entre las variables ambiente desagradable de trabajo con compañeros y conflicto con clientes (p=0,01), desorganización de turnos y horarios (p=0,00) y ritmo acelerado (p=0,00). Se concluye que hay necesidad de incluir una mirada específica acerca de la organización del trabajo en Atención Primaria, y del apoyo de una política de salud de los trabajadores de enfermería y salud.