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1.
Respir Res ; 25(1): 257, 2024 Jun 22.
Artigo em Inglês | MEDLINE | ID: mdl-38909206

RESUMO

BACKGROUND: Pulmonary fibrosis (PF) represents the pathologic end stage of several interstitial lung diseases (ILDs) associated with high morbidity and mortality rates. However, current treatments can only delay disease progression rather than provide a cure. The role of inflammation in PF progression is well-established, but new insights into immune regulation are fundamental for developing more efficient therapies. c-MET signaling has been implicated in the migratory capacity and effector functions of immune cells. Nevertheless, the role of this signaling pathway in the context of PF-associated lung diseases remains unexplored. METHODS: To determine the influence of c-MET in immune cells in the progression of pulmonary fibrosis, we used a conditional deletion of c-Met in immune cells. To induce pulmonary fibrosis mice were administered with bleomycin (BLM) intratracheally. Over the course of 21 days, mice were assessed for weight change, and after euthanasia at different timepoints, bronchoalveolar lavage fluid cells and lung tissue were assessed for inflammation and fibrosis. Furthermore, c-MET expression was assessed in cryobiopsy sections, bronchoalveolar lavage fluid cells samples and single cell RNA-sequencing dataset from human patients with distinct interstitial lung diseases. RESULTS: c-MET expression was induced in lung immune cells, specifically in T cells, interstitial macrophages, and neutrophils, during the inflammatory phase of BLM-induced PF mouse model. Deletion of c-Met in immune cells correlated with earlier weight recovery and improved survival of BLM-treated mice. Moreover, the deletion of c-Met in immune cells was associated with early recruitment of the immune cell populations, normally found to express c-MET, leading to a subsequent attenuation of the cytotoxic and proinflammatory environment. Consequently, the less extensive inflammatory response, possibly coupled with tissue repair, culminated in less exacerbated fibrotic lesions. Furthermore, c-MET expression was up-regulated in lung T cells from patients with fibrosing ILD, suggesting a potential involvement of c-MET in the development of fibrosing disease. CONCLUSIONS: These results highlight the critical contribution of c-MET signaling in immune cells to their enhanced uncontrolled recruitment and activation toward a proinflammatory and profibrotic phenotype, leading to the exacerbation of lung injury and consequent development of fibrosis.


Assuntos
Camundongos Endogâmicos C57BL , Pneumonia , Proteínas Proto-Oncogênicas c-met , Fibrose Pulmonar , Animais , Feminino , Humanos , Masculino , Camundongos , Bleomicina/toxicidade , Modelos Animais de Doenças , Pulmão/patologia , Pulmão/metabolismo , Pulmão/imunologia , Camundongos Knockout , Pneumonia/induzido quimicamente , Pneumonia/patologia , Pneumonia/metabolismo , Pneumonia/imunologia , Pneumonia/genética , Proteínas Proto-Oncogênicas c-met/metabolismo , Proteínas Proto-Oncogênicas c-met/genética , Fibrose Pulmonar/induzido quimicamente , Fibrose Pulmonar/patologia , Fibrose Pulmonar/metabolismo , Fibrose Pulmonar/imunologia , Fibrose Pulmonar/genética
2.
mBio ; 15(4): e0007824, 2024 Apr 10.
Artigo em Inglês | MEDLINE | ID: mdl-38470269

RESUMO

Inflammatory bowel disease (IBD) is a group of inflammatory conditions of the gastrointestinal tract. The etiology of IBD remains elusive, but the disease is suggested to arise from the interaction of environmental and genetic factors that trigger inadequate immune responses and inflammation in the intestine. The gut microbiome majorly contributes to disease as an environmental variable, and although some causative bacteria are identified, little is known about which specific members of the microbiome aid in the intestinal epithelial barrier function to protect from disease. While chemically inducing colitis in mice from two distinct animal facilities, we serendipitously found that mice in one facility showed remarkable resistance to disease development, which was associated with increased markers of epithelial barrier integrity. Importantly, we show that Akkermansia muciniphila and Parabacteroides distasonis were significantly increased in the microbiota of resistant mice. To causally connect these microbes to protection against disease, we colonized susceptible mice with the two bacterial species. Our results demonstrate that A. muciniphila and P. distasonis synergistically drive a protective effect in both acute and chronic models of colitis by boosting the frequency of type 3 innate lymphoid cells in the colon and by improving gut epithelial integrity. Altogether, our work reveals a combined effort of commensal microbes in offering protection against severe intestinal inflammation by shaping gut immunity and by enhancing intestinal epithelial barrier stability. Our study highlights the beneficial role of gut bacteria in dictating intestinal homeostasis, which is an important step toward employing microbiome-driven therapeutic approaches for IBD clinical management. IMPORTANCE: The contribution of the gut microbiome to the balance between homeostasis and inflammation is widely known. Nevertheless, the etiology of inflammatory bowel disease, which is known to be influenced by genetics, immune response, and environmental cues, remains unclear. Unlocking novel players involved in the dictation of a protective gut, namely, in the microbiota component, is therefore crucial to develop novel strategies to tackle IBD. Herein, we revealed a synergistic interaction between two commensal bacterial strains, Akkermansia muciniphila and Parabacteroides distasonis, which induce protection against both acute and chronic models of colitis induction, by enhancing epithelial barrier integrity and promoting group 3 innate lymphoid cells in the colonic mucosa. This study provides a novel insight on how commensal bacteria can beneficially act to promote intestinal homeostasis, which may open new avenues toward the use of microbiome-derived strategies to tackle IBD.


Assuntos
Bacteroidetes , Colite , Doenças Inflamatórias Intestinais , Animais , Camundongos , Imunidade Inata , Linfócitos , Colite/microbiologia , Doenças Inflamatórias Intestinais/microbiologia , Inflamação , Verrucomicrobia/genética , Akkermansia
3.
Front Psychol ; 15: 1267280, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38533220

RESUMO

Introduction: Sexuality is an integral part of development and personality, and is important in healthcare. Nurses are among the most representative healthcare professionals. For holistic and inclusive nursing care practice and to improve equality, human rights, well-being, and health of individuals, the curricula of nursing courses must integrate broad knowledge about sexuality and its diversity. This study aimed to identify and analyze nursing students' knowledge of sexuality, sex, and gender diversity. The present study was part of a multicenter study conducted in Europe. Methods: Questionnaires were administered in three nursing schools to assess nursing students' knowledge (n = 75). Data processing was performed using Excel® software version 20 and IRaMuTeQ (R Interface pour les Analysis Multidimensionnelles de Textes et de Questionnaires) 0.7 alpha 2, allowing organization by category and subsequent thematic analysis using content analysis. Results: The textual corpus "Nursing students' knowledge about sexuality in its diversity," was divided into two sub-corpus: "Students' perception of sexuality" and "Students' perception of gender identity," originating Class 6 "Eroticism" (14.23%) and Classes 4 "Sexual Orientation" (16.07%) and 3 "Heteronormative" (16.07%), the latter with greater proximity to each other and consequently to Class 6. Similarly, Classes 1 "Gender" (20.36%) and 5 "Cisgender" (12.14%) also presented a greater interrelationship between themselves and consecutively with Class 2 "Gender Identity" (15.36%). Discussion: The analyses revealed that though nursing students possessed knowledge about sexuality and its diversity, this knowledge was elementary and did not reveal a sustained appropriation of concepts related to sexuality, sexual orientation, and gender diversity. For some questions, the absence of students' answers were noteworthy, and may be associated with their personal reservation in expressing themselves on this sensitive and intimate theme. To ensure diversity, inclusivity, and impartiality in nursing practice, it is imperative to change the curriculum plans of nursing courses to address the theme of sexuality during the training process of nurses in Europe.

4.
Healthcare (Basel) ; 11(21)2023 Oct 27.
Artigo em Inglês | MEDLINE | ID: mdl-37957981

RESUMO

(1) Background: The role of Al-Andalus's women were the result of Arabization and Islamization in Spain. The 10th to the 14th centuries were a time of significant cultural diversity in the region. Female physicians and midwives were important for providing care to women. Despite existing studies, there is still a lack of focused research on the professionalization of these trades, including their requirements, intervention areas, and treatments. (2) Methods: To address this gap, we conducted a scoping review using the dialectical structural model of care (DSMC). Primary medical and legislative sources were used. (3) Results: two kinds of midwife, or qabila, were discovered, along with a woman physician, or tabiba, who also acted as a midwife. These professions underwent diverse training and fulfilled duties as obstetricians and pediatricians. Midwives were esteemed members of society and were the sole female professionals who needed qualified training. Their performance in the courts was exemplary. Tools for facilitating childbirth and interventions related to female health were discovered in the study. (4) Conclusions: The patriarchal societies suffer from significant inequality in terms of academic training, knowledge transmission, and healthcare provision. Midwives functioned in segregated domestic and legal spaces and were responsible for providing public care to communities from the 10th to 14th centuries.

5.
Comunidad (Barc., Internet) ; 25(2)JULIO-OCTUBRE 2023. graf
Artigo em Espanhol | IBECS | ID: ibc-223681

RESUMO

La pandemia de la COVID-19 ha supuesto un cambio brusco en el abordaje habitual de la promoción de la salud, la prevención, el tratamiento y la rehabilitación de las enfermedades. La Atención Primaria (AP) ha sufrido un importante impacto debido a la situación de pandemia y sus profesionales han tenido un papel fundamental, al mismo tiempo que tanto su vida profesional como personal han sufrido grandes alteraciones.El objetivo del estudio fue conocer y comprender el impacto de la pandemia en las esferas personales y profesionales de quienes trabajan en AP, así como también analizar y exponer propuestas a nivel organizativo y de atención.Se hizo un estudio cualitativo mediante cuatro grupos focales interdisciplinares en el que participaron 26 profesionales de AP (auxiliares administrativos, técnicos de cuidados auxiliares de enfermería [TCAE], enfermeras y médicas). Para hacer el análisis, se utilizó la metodología de análisis inductivo del contenido a través del método de comparaciones constantes de Glaser y Strauss y el programa informático Atlas Ti.Los cuatro grupos focales se transcribieron, y las citas analizadas se agruparon en trece categorías que se englobaron en cinco metacategorías: impacto de la pandemia en los profesionales, cambios en la atención familiar y comunitaria, repercusión de la pandemia en la población, trabajo en equipo y propuestas de mejora.Como conclusiones se obtuvieron: el miedo de los profesionales en la etapa inicial de la pandemia que se transformó en frustración, cansancio y tristeza en fases posteriores, la ruptura con la AP tradicional, así como diversas propuestas de mejora (empoderamiento del paciente, potenciación de los equipos multidisciplinares…). (AU)


The COVID-19 pandemic has entailed a sudden change in the usual approach to health promotion, prevention, treatment and rehabilitation of diseases. Primary care has undergone a significant impact due to the pandemic situation and its professionals have played an essential role. At the same time both their professional and personal lives have undergone major changes.The aim of the study was to know and understand the impact of the pandemic on the personal and professional spheres of primary care, as well as analyze and present proposals at the organizational and attention level.A qualitative study was performed by means of four interdisciplinary focus groups in which 26 primary care professionals took part (administrative assistants, nursing assistants, nurses and doctors).To perform the analysis, inductive content analysis methodology was used by means of the method of constant comparisons of Glaser and Strauss and Atlas TI computer software.The four focus groups were transcribed, and the citations analyzed were grouped into thirteen categories. They were included in five meta-categories: impact of the pandemic on professionals, changes in family and community care, impact of the pandemic on the population, teamwork and proposals for betterment.Conclusions drawn were the fear felt by professionals at the initial stage of the pandemic, which turned into frustration, tiredness and sadness in later phases, the break with traditional primary care, as well as various proposals for improvement (patient empowerment, enhancement of multi-disciplinary teams, etc.) (AU)


Assuntos
Humanos , Pandemias , Infecções por Coronavirus/epidemiologia , Atenção Primária à Saúde , Pessoal de Saúde/psicologia , Esgotamento Profissional/epidemiologia , Pesquisa Qualitativa , Grupos Focais
6.
Immunology ; 170(4): 510-526, 2023 12.
Artigo em Inglês | MEDLINE | ID: mdl-37635289

RESUMO

Under perturbing conditions such as infection with Leishmania, a protozoan parasite living within the phagosomes in mammalian macrophages, cellular and organellar structures, and metabolism are dynamically regulated for neutralizing the pressure of parasitism. However, how modulations of the host cell metabolic pathways support Leishmania infection remains unknown. Herein, we report that lipid accumulation heightens the susceptibility of mice to L. donovani infection and promotes resistance to first-line anti-leishmanial drugs. Despite being pro-inflammatory, the in vitro generated uninfected lipid-laden macrophages (LLMs) or adipose-tissue macrophages (ATMs) display lower levels of reactive oxygen and nitrogen species. Upon infection, LLMs secrete higher IL-10 and lower IL-12p70 cytokines, inhibiting CD4+ T cell activation and Th1 response suggesting a key modulatory role for intramacrophage lipid accumulation in anti-leishmanial host defence. We, therefore, examined this causal relationship between lipids and immunomodulation using an in vivo high-fat diet (HFD) mouse model. HFD increased the susceptibility to L. donovani infection accompanied by a defective CD4+ Th1 and CD8+ T cell response. The white adipose tissue of HFD mice displays increased susceptibility to L. donovani infection with the preferential infection of F4/80+ CD11b+ CD11c+ macrophages with higher levels of neutral lipids reserve. The HFD increased resistance to a first-line anti-leishmanial drug associated with a defective adaptive immune response. These data demonstrate that the accumulation of neutral lipids contributes to susceptibility to visceral leishmaniasis hindering host-protective immune response and reducing the efficacy of antiparasitic drug therapies.


Assuntos
Leishmania donovani , Leishmaniose Visceral , Animais , Camundongos , Leishmaniose Visceral/tratamento farmacológico , Imunidade Adaptativa , Linfócitos T CD8-Positivos , Lipídeos , Camundongos Endogâmicos BALB C , Mamíferos
7.
Sci Adv ; 9(31): eadg2122, 2023 08 04.
Artigo em Inglês | MEDLINE | ID: mdl-37540749

RESUMO

Since the initial spread of severe acute respiratory syndrome coronavirus 2 infection, several viral variants have emerged and represent a major challenge for immune control, particularly in the context of vaccination. We evaluated the quantity, quality, and persistence of immunoglobulin G (IgG) and IgA in individuals who received two or three doses of messenger RNA (mRNA) vaccines, compared with previously infected vaccinated individuals. We show that three doses of mRNA vaccine were required to match the humoral responses of preinfected vaccinees. Given the importance of antibody-dependent cell-mediated immunity against viral infections, we also measured the capacity of IgG to recognize spike variants expressed on the cell surface and found that cross-reactivity was also strongly improved by repeated vaccination. Last, we report low levels of CXCL13, a surrogate marker of germinal center activation and formation, in vaccinees both after two and three doses compared with preinfected individuals, providing a potential explanation for the short duration and low quality of Ig induced.


Assuntos
COVID-19 , Humanos , COVID-19/prevenção & controle , Anticorpos Antivirais , Vacinação , Imunoglobulina G , RNA Mensageiro , Quimiocina CXCL13/genética
8.
Healthcare (Basel) ; 11(16)2023 Aug 09.
Artigo em Inglês | MEDLINE | ID: mdl-37628435

RESUMO

Nurse educators are tasked with the education of students to become providers of holistic care, and part of that care includes sexuality. Students carry attitudes and beliefs that influence their behavior; therefore, students who carry negative attitudes about sexual healthcare are less likely to provide that care. This is an international, multicenter study of nursing students' attitudes and beliefs about the provision of sexual healthcare. The Sexuality Attitudes and Beliefs Survey, which measures attitudes toward the provision of sexual healthcare and has a range of scores from 12 to 72, was given to 129 students across Spain, Portugal, Italy and the United States and revealed negative attitudes about sexuality, with a mean SABS score of 39.95. Higher scores on the SABS reveal more negative attitudes and reduced likelihood of provision of sexual healthcare. Statistically significant differences were found when comparing queer and heterosexual students (41.69 vs. 38.06), and students in their final year of school held more negative attitudes toward the provision of sexual healthcare (41.4 vs. 39.5 and 39.2). This study shows that nurse educators continue to need to focus on the attitudes student nurses carry about sexuality. There is a critical shortage of education strategies to meet the needs of student nurses so that they will be comfortable and confident in providing sexual healthcare.

9.
Nat Commun ; 14(1): 1772, 2023 03 30.
Artigo em Inglês | MEDLINE | ID: mdl-36997530

RESUMO

Several millions of individuals are estimated to develop post-acute sequelae SARS-CoV-2 condition (PASC) that persists for months after infection. Here we evaluate the immune response in convalescent individuals with PASC compared to convalescent asymptomatic and uninfected participants, six months following their COVID-19 diagnosis. Both convalescent asymptomatic and PASC cases are characterised by higher CD8+ T cell percentages, however, the proportion of blood CD8+ T cells expressing the mucosal homing receptor ß7 is low in PASC patients. CD8 T cells show increased expression of PD-1, perforin and granzyme B in PASC, and the plasma levels of type I and type III (mucosal) interferons are elevated. The humoral response is characterized by higher levels of IgA against the N and S viral proteins, particularly in those individuals who had severe acute disease. Our results also show that consistently elevated levels of IL-6, IL-8/CXCL8 and IP-10/CXCL10 during acute disease increase the risk to develop PASC. In summary, our study indicates that PASC is defined by persisting immunological dysfunction as late as six months following SARS-CoV-2 infection, including alterations in mucosal immune parameters, redistribution of mucosal CD8+ß7Integrin+ T cells and IgA, indicative of potential viral persistence and mucosal involvement in the etiopathology of PASC.


Assuntos
COVID-19 , SARS-CoV-2 , Humanos , Doença Aguda , Linfócitos T CD8-Positivos , Teste para COVID-19 , Progressão da Doença , Imunoglobulina A
10.
Microbiol Spectr ; : e0456422, 2023 Feb 27.
Artigo em Inglês | MEDLINE | ID: mdl-36847570

RESUMO

Sporothrix brasiliensis has emerged as the most virulent species in the Sporothrix schenckii complex, accounting for sporotrichosis. Albeit the new insights into the understanding of host-pathogen interactions and comparative genomics of this fungi, the lack of genetic tools has hindered significant advances in this field of research. Here, we established an Agrobacterium tumefaciens-mediated transformation (ATMT) system to transform different strains of S. brasiliensis. We report parameters that account for a transformation efficiency of 3,179 ± 1,171 transformants/co-cultivation, which include the use of A. tumefaciens AGL-1 in a 2:1 ratio (bacteria:fungi) during 72 h at 26°C. Our data show that a single-copy transgene is transferred to S. brasiliensis that is mitotically stable in 99% of cells after 10 generations without selective pressure. In addition, we created a plasmid toolkit that allows the establishment of fusion proteins of any S. brasiliensis gene of interest with sGFP or mCherry under the control of the GAPDH or H2A endogenous promoters. These modules allow different levels of expression of the desired fusion. Moreover, we successfully targeted these fluorescent proteins to the nucleus and used fluorescence-tagged strains to assess phagocytosis. Overall, our data show that the ATMT system is an easy-to-use and efficient genetic toolbox for studies on recombinant expression and gene function in S. brasiliensis. IMPORTANCE Sporotrichosis is the most prevalent subcutaneous mycosis worldwide and has recently become a public health concern. Although immunocompetent hosts are also prone to sporotrichosis, immunodeficient hosts often develop a more severe and disseminated form of disease. To date, the Rio de Janeiro state in Brazil is the most significant feline zoonotic transmission epicenter in the world, with more than 4,000 human and feline diagnosed cases. Cats play an essential role in the S. brasiliensis infection due to their high susceptibility and transmissibility to other felines and humans. S. brasiliensis is the most virulent etiological agent of sporotrichosis, causing the most severe clinical manifestations. Despite the increasing incidence of sporotrichosis, the identification of virulence traits important for disease establishment, development, and severity has been lacking. In this work, we established an efficient genetic toolbox to manipulate S. brasiliensis that will guide future studies to define new virulence mechanisms and a better understanding of host-pathogen interactions from a molecular perspective.

11.
J Clin Med ; 12(3)2023 Jan 28.
Artigo em Inglês | MEDLINE | ID: mdl-36769650

RESUMO

Periodontitis is a chronic disease with a high overall prevalence. It involves a complex interplay between the immune-inflammatory pathways and biofilm changes, leading to periodontal attachment loss. The aims of this study were (i) to assess whether the salivary IL-1ß, IL-17A, RANK-L and OPG levels have the potential to discriminate between the mild and severe periodontitis conditions; and (ii) to enable diagnostic/prognostic actions to differentiate between distinct levels of the disease. The analysis of the clinical parameters and the evaluation of the salivary immunomediators levels by means of a multiplex flow assay revealed a statistically significantly higher level of IL-1ß in the periodontitis III/IV patients, as well as a higher level of RANK-L in the periodontitis III/IV and I/II patients, when compared to the healthy controls. Furthermore, the grade C periodontitis patients presented a significantly higher level of RANK-L compared to the grade B and grade A patients. In the grade C patients, IL-1ß had a positive correlation with the PPD and CAL indices and RANK_L had a positive correlation with CAL. The evidence emerging from this study associates the salivary IL-1ß and RANK-L levels with an advanced stage of periodontitis, stage III/IV, and with grade C, suggesting the possible cooperative action of both in the inflammatory and bone loss events. In addition to IL-1ß, RANK-L could be considered a combined diagnostic biomarker for periodontitis.

12.
Cult. cuid ; 27(65): 217-231, 2023. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-218965

RESUMO

El VIH infecta a más de 2,6 millones de personas/año, alcanzando en 2019 cerca 38,0 millones de infectados. La OMS reconoció la enfermedad como grave amenaza para la humanidad.Objetivo. Evaluar el nivel de conocimiento del VIH-SIDA y factores asociados en estudiantes durante eventos populares, Évora-Portugal.Métodos. Estudio cuantitativo transversal, muestra deconveniencia, 313 estudiantes que visitaron el pabellón institucional, sur Portugal. Recogieron datossociodemográficos, se aplicó el Cuestionario de Conocimientos sobre VIH (HIV-KQ-18). La pruebade Kuder-Richardson arrojó un coeficiente de 0.847. Análisis de datos SPSS versión 24.0. Resultados.El 56.9% fueron mujeres (16 y 30 años). Excepto en 5 ítems, en los que el porcentaje de respuestascorrectas superó al 50%, de sujetos que respondió incorrectamente sobre la transmisión del VIH. Laspruebas de Mann-Whitney y Kruskall-Walis, no detectaron diferencias en conocimientos de hombres/mujeres, grupos de edad y disponibilidad de preservativos. El análisis de conglomerados mostró dos perfiles: 1) mayor conocimiento universitarios, ser mujer, 19-21 años, consumo bajo o muyalto. 2) conocimiento bajo/muy bajo con factores asociados consumo moderado de alcohol, representado por varones (22-24 años). Conclusión. La realización de este tipo de encuestas permite quelos programas de educación aborden carencias concretas sobre el VIH/SIDA


O VIH infecta mais de 2,6 milhões de pessoas/ano, atingindo 38,0 milhões em 2019. A OMSreconheceu a doença como uma grande ameaça para a humanidade. Objectivo. Para avaliar o nívelde conhecimento do VIH-SIDA e factores associados nos estudantes durante eventos populares,Évora-Portugal. Métodos. Estudo transversal quantitativo, amostra de conveniência, 313 estudantesque visitaram o pavilhão institucional, Sul de Portugal. Foram recolhidos dados sociodemográficos,foi aplicado o Questionário de Conhecimento sobre VIH (HIV-KQ-18). O teste Kuder-Richardsonproduziu um coeficiente de 0,847. Análise de dados SPSS versão 24.0. Resultados. 56,9% eram dosexo feminino (16 e 30 anos). Excepto em 5 itens, em que a percentagem de respostas correctas excedeu 50%, os sujeitos responderam incorrectamente sobre a transmissão do VIH. Os testes MannWhitney e Kruskall-Walis não detectaram diferenças no conhecimento masculino/feminino, gruposetários e disponibilidade de preservativos. A análise de cluster mostrou dois perfis: 1) conhecimentouniversitário superior, sendo do sexo feminino, 19-21 anos de idade, uso baixo ou muito alto. 2)conhecimento baixo/muito baixo com factores associados consumo moderado de álcool, representado por homens (22-24 anos). Conclusão. A realização deste tipo de inquérito permite que os programas educativos abordem as lacunas específicas do VIH/SIDA.(AU)


HIV infects more than 2.6 million people/year, reaching 38.0 million by 2019.WHO recognized the disease as a major threat to humanity. Objective. To assess the level ofknowledge of HIV-AIDS and associated factors in students during popular events, Évora-Portugal.Methods. Quantitative cross-sectional study, convenience sample, 313 students who visited the institutional pavilion, South Portugal. Sociodemographic data were collected, the HIV Knowledge Questionnaire (HIV-KQ-18) was applied. The Kuder-Richardson test yielded a coefficient of 0.847.Data analysis SPSS version 24.0. Results. 56.9% were female (16 and 30 years). Except for 5 items,where the percentage of correct responses exceeded 50%, subjects answered incorrectly about HIVtransmission. Mann-Whitney and Kruskall-Walis tests detected no differences in male/femaleknowledge, age groups and condom availability. Cluster analysis showed two profiles: 1) higheruniversity knowledge, being female, 19-21 years old, low or very high use. 2) low/very lowknowledge with associated factors moderate alcohol consumption, represented by males (22-24years). Conclusion. Conducting this type of survey allows education programmes to address spe-cific HIV/AIDS gaps.(AU)


Assuntos
Humanos , Masculino , Feminino , HIV , Síndrome da Imunodeficiência Adquirida , Estudantes , Letramento em Saúde , Pesquisa em Enfermagem , Portugal , Estudos Transversais , 24960
13.
Front Cell Infect Microbiol ; 12: 1005839, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36275017

RESUMO

Chronic pulmonary aspergillosis (CPA) is a devastating disease with increasing prevalence worldwide. The characteristic granulomatous-like inflammation poses as the major setback to effective antifungal therapies by limiting drug access to fungi. These inflammatory lung structures are reported to be severely hypoxic; nevertheless, the underlying mechanisms whereby these processes contribute to fungal persistence remain largely unknown. Hypoxia-inducible factor 1 alpha (HIF-1α), besides being the major cellular response regulator to hypoxia, is a known central immune modulator. Here, we used a model of Aspergillus fumigatus airway infection in myeloid-restricted HIF-1α knock-out (mHif1α-/- ) mice to replicate the complex structures resembling fungal granulomas and evaluate the contribution of HIF-1α to antifungal immunity and disease development. We found that fungal-elicited granulomas in mHif1α-/- mice had significantly smaller areas, along with extensive hyphal growth and increased lung fungal burden. This phenotype was associated with defective neutrophil recruitment and an increased neutrophil death, therefore highlighting a central role for HIF-1α-mediated regulation of neutrophil function in the pathogenesis of chronic fungal infection. These results hold the promise of an improved capacity to manage the progression of chronic fungal disease and open new avenues for additional therapeutic targets and niches of intervention.


Assuntos
Antifúngicos , Aspergilose , Camundongos , Animais , Infiltração de Neutrófilos , Inflamação , Hipóxia , Granuloma
14.
Sci Rep ; 12(1): 17047, 2022 10 11.
Artigo em Inglês | MEDLINE | ID: mdl-36220879

RESUMO

COVID-19 is the global pandemic that affected our population in the past 2 years. Considerable research has been done to better understand the pathophysiology of this disease and to identify new therapeutic targets, especially for severe cases. Galectin-3 (Gal-3) is a receptor present at the surface of different cell types, namely epithelial and inflammatory cells, which has been described as a severity marker in COVID-19. The activation of Gal-3 through its binding protein (Gal-3BP) is directly linked to the production of pro-inflammatory cytokines that contribute for the cytokine storm (CS) observed in severe COVID-19 patients. Here, we show that D2, a recombinant fragment of the lectin-binding region of Gal-3BP was able to stimulate the expression of IL-6 in colon and lung epithelial cell lines in ß-galactoside dependent manner. We further show that D2-induced IL-6 augmentation was reduced by the anti-Gal-3BP monoclonal antibody 1959. Our data confirm and extend prior findings of Gal-3BP mediated IL-6 induction, enlightening the potential of its antibody-mediated s blockage for the prevention and treatment of CS and severe disease in COVID-19 patients.


Assuntos
Tratamento Farmacológico da COVID-19 , SARS-CoV-2 , Anticorpos Monoclonais/metabolismo , Anticorpos Monoclonais/farmacologia , Proteínas de Transporte , Linhagem Celular , Síndrome da Liberação de Citocina , Citocinas/metabolismo , Galectina 3/metabolismo , Humanos , Interleucina-6/metabolismo
15.
Int J Mol Sci ; 23(18)2022 Sep 14.
Artigo em Inglês | MEDLINE | ID: mdl-36142615

RESUMO

Ovarian cancer (OC) has a specific type of metastasis, via transcoelomic, and most of the patients are diagnosed at advanced stages with multiple tumors spread within the peritoneal cavity. The role of Malignant Ascites (MA) is to serve as a transporter of tumor cells from the primary location to the peritoneal wall or to the surface of the peritoneal organs. MA comprise cellular components with tumor and non-tumor cells and acellular components, creating a unique microenvironment capable of modifying the tumor behavior. These microenvironment factors influence tumor cell proliferation, progression, chemoresistance, and immune evasion, suggesting that MA play an active role in OC progression. Tumor cells induce a complex immune suppression that neutralizes antitumor immunity, leading to disease progression and treatment failure, provoking a tumor-promoting environment. In this review, we will focus on the High-Grade Serous Carcinoma (HGSC) microenvironment with special attention to the tumor microenvironment immunology.


Assuntos
Neoplasias Ovarianas , Neoplasias Peritoneais , Ascite/patologia , Carcinoma Epitelial do Ovário , Feminino , Humanos , Neoplasias Ovarianas/patologia , Neoplasias Peritoneais/secundário , Microambiente Tumoral
16.
Cell Death Dis ; 13(8): 741, 2022 08 27.
Artigo em Inglês | MEDLINE | ID: mdl-36030261

RESUMO

In addition to an inflammatory reaction, Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2)-infected patients present lymphopenia, which we recently reported as being related to abnormal programmed cell death. As an efficient humoral response requires CD4 T-cell help, we hypothesized that the propensity of CD4 T cells to die may impact the quantity and quality of the humoral response in acutely infected individuals. In addition to specific immunoglobulins (Ig)A, IgM, and IgG against SARS-CoV-2 nucleocapsid (N), membrane (M), and spike (S1) proteins, we assessed the quality of IgG response by measuring the avidity index. Because the S protein represents the main target for neutralization and antibody-dependent cellular cytotoxicity responses, we also analyzed anti-S-specific IgG using S-transfected cells (S-Flow). Our results demonstrated that most COVID-19 patients have a predominant IgA anti-N humoral response during the early phase of infection. This specific humoral response preceded the anti-S1 in time and magnitude. The avidity index of anti-S1 IgG was low in acutely infected individuals compared to convalescent patients. We showed that the percentage of apoptotic CD4 T cells is inversely correlated with the levels of specific IgG antibodies. These lower levels were also correlated positively with plasma levels of CXCL10, a marker of disease severity, and soluble Fas ligand that contributes to T-cell death. Finally, we found lower S-Flow responses in patients with higher CD4 T-cell apoptosis. Altogether, these results demonstrate that individuals with high levels of CD4 T-cell apoptosis and CXCL10 have a poor ability to build an efficient anti-S response. Consequently, preventing CD4 T-cell death might be a strategy for improving humoral response during the acute phase, thereby reducing COVID-19 pathogenicity.


Assuntos
Anticorpos Antivirais , Linfócitos T CD4-Positivos , COVID-19 , Imunidade Humoral , Anticorpos Antivirais/imunologia , Apoptose , Linfócitos T CD4-Positivos/citologia , COVID-19/imunologia , Humanos , Imunoglobulina G , SARS-CoV-2 , Glicoproteína da Espícula de Coronavírus/imunologia
17.
Florence Nightingale J Nurs ; 30(1): 40-47, 2022 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-35635346

RESUMO

AIM: This study aimed to adapt and validate the Nurse Caring Patient Scale (NCPS) in a puerperal context to the European Portuguese. METHOD: This research was a methodological study. The participant sample comprised 100 puerperal women, with an average age of 31.3 years (SD = 5.65), who attended a public hospital in southern Portugal. The instrument, originally consisting of 22 items, underwent translation, back translation, and semantic and colloquial conciliation. Ethical aspects have been respected. RESULTS: Factor analysis with varimax rotation revealed a set of 17 items with factor weights greater than .400. Three factors emerged, which explain 65.537% of the variance, namely "Being-at-the-Moment" (8 items), "Responsibility-for-the-Other" (5 items) and "Care-Diligent" (4 items). Reliability through Cronbach's alpha coefficient in the total scale was .881, and in the subscales, ranged from .713 to .938. Precision was analyzed using the split-half method, reaching an alpha with Spearman-Brown correction of .900. The convergent validity between the instrument versus the discrete variable Care-Offered showed, in the total scale, a Spearman rho of .851 and in the subscales between .528 and .616. In the discriminating validity, the Mann-Whitney test revealed that Portuguese women, vis-à-vis foreign women significantly value the dimensions "Being-at-the Moment" and "Responsibility-for-the-Other" (p < .05), while in the "Care-Diligent" component, there are no significant differences (p > .05). CONCLUSION: The European Portuguese version of the NCPS, in an obstetric context, has reliability and validity. A further study in a random sample and validation in other Lusophone countries will be appropriate.

18.
Cell Death Differ ; 29(8): 1486-1499, 2022 08.
Artigo em Inglês | MEDLINE | ID: mdl-35066575

RESUMO

Severe SARS-CoV-2 infections are characterized by lymphopenia, but the mechanisms involved are still elusive. Based on our knowledge of HIV pathophysiology, we hypothesized that SARS-CoV-2 infection-mediated lymphopenia could also be related to T cell apoptosis. By comparing intensive care unit (ICU) and non-ICU COVID-19 patients with age-matched healthy donors, we found a strong positive correlation between plasma levels of soluble FasL (sFasL) and T cell surface expression of Fas/CD95 with the propensity of T cells to die and CD4 T cell counts. Plasma levels of sFasL and T cell death are correlated with CXCL10 which is part of the signature of 4 biomarkers of disease severity (ROC, 0.98). We also found that members of the Bcl-2 family had modulated in the T cells of COVID-19 patients. More importantly, we demonstrated that the pan-caspase inhibitor, Q-VD, prevents T cell death by apoptosis and enhances Th1 transcripts. Altogether, our results are compatible with a model in which T-cell apoptosis accounts for T lymphopenia in individuals with severe COVID-19. Therefore, a strategy aimed at blocking caspase activation could be beneficial for preventing immunodeficiency in COVID-19 patients.


Assuntos
COVID-19 , Linfopenia , Apoptose , Linfócitos T CD4-Positivos/metabolismo , Caspases/metabolismo , Proteína Ligante Fas , Humanos , SARS-CoV-2 , Linfócitos T/metabolismo , Receptor fas/metabolismo
19.
Healthcare (Basel) ; 9(3)2021 Mar 08.
Artigo em Inglês | MEDLINE | ID: mdl-33800190

RESUMO

Patient sexuality is a fundamental subject in nursing student's education. However, beliefs about patient sexuality can influence the care offered. The aim of this psychometric study was to describe the validation process and the psychometrics properties of the Sexuality Attitudes and Beliefs Survey (SABS) for Spanish nursing students. The convenience sample was 283 nursing students from a state university in Spain. Participants ranged from 18 to 30 years (M = 19.66; SD = 1.85). Data collection happened in 2019-2020. The translation, back translation and adaptation to Spanish was discussed and refined, ensuring the semantic, idiomatic and conceptual meaning of the items. The psychometric properties were assessed through analysis of validity and reliability. The Cronbach's alpha for the final version of 12 items was 0.65. Although it has low reliability, the Spanish version of the SABS seems to be a valid and useful tool to measure nursing students' beliefs about patient sexuality. In addition, it can be a resource for the assessment of the ability of Spanish nursing faculty in engaging topics involving the student's vision of patient sexuality.

20.
Front Immunol ; 12: 613422, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33679753

RESUMO

Hyper-inflammatory responses induced by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are a major cause of disease severity and death. Predictive prognosis biomarkers to guide therapeutics are critically lacking. Several studies have indicated a "cytokine storm" with the release of interleukin-1 (IL-1), IL-6, and IL-8, along with tumor necrosis factor alpha (TNFα) and other inflammatory mediators. Here, we proposed to assess the relationship between IL-6 and outcomes of patients with coronavirus disease 2019 (COVID-19). Our cohort consisted of 46 adult patients with PCR-proven SARS-CoV-2 infection admitted in a COVID-19 ward of the Hospital de Braga (HB) from April 7 to May 7, 2020, whose IL-6 levels were followed over time. We found that IL-6 levels were significantly different between the disease stages. Also, we found a significant negative correlation between IL-6 levels during stages IIb and III, peripheral oxygen saturation (SpO2), and partial pressure of oxygen in arterial blood (PaO2), showing that IL-6 correlates with respiratory failure. Compared to the inflammatory markers available in the clinic routine, we found a positive correlation between IL-6 and C-reactive protein (CRP). However, when we assessed the predictive value of these two markers, IL-6 behaves as a better predictor of disease progression. In a binary logistic regression, IL-6 level was the most significant predictor of the non-survivors group, when compared to age and CRP. Herein, we present IL-6 as a relevant tool for prognostic evaluation, mainly as a predictor of outcome.


Assuntos
COVID-19 , Síndrome da Liberação de Citocina , Interleucina-6/sangue , SARS-CoV-2/metabolismo , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Biomarcadores/sangue , Proteína C-Reativa/metabolismo , COVID-19/sangue , COVID-19/mortalidade , Síndrome da Liberação de Citocina/sangue , Síndrome da Liberação de Citocina/mortalidade , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Oxigênio/sangue
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