ATP-P2X7 signaling mediates brain pathology while contributing to viral control in perinatal Zika virus infection.

Zika virus (ZIKV), the causative agent of Zika fever, is a flavivirus transmitted by mosquitoes of the Aedes genus. Zika virus infection has become an international concern due to its association with severe neurological complications such as fetal microcephaly. Viral infection can induce the release of ATP in the extracellular environment, activating receptors sensitized by extracellular nucleotides, such as the P2X7 receptor. This receptor is the primary purinergic receptor involved in neuroinflammation, neurodegeneration, and immunity. In this work, we investigated the role of ATP-P2X7 receptor signaling in Zika-related brain abnormalities. Wild-type mice (WT) and P2X7 receptor-deficient (P2X7-/-) C57BL/6 newborn mice were subcutaneously inoculated with 5 × 106plaque-forming units of ZIKV or mock solution. P2X7 receptor expression increased in the brain of Zika virus-infected mice compared to the mock group. Comparative analyses of the hippocampi from WT and P2X7-/-mice revealed that the P2X7 receptor increased hippocampal damage in CA1/CA2 and CA3 regions. Doublecortin expression decreased significantly in the brains of ZIKV-infected mice. WT ZIKV-infected mice showed impaired motor performance compared to P2X7-/- infected mice. WT ZIKV-infected animals showed increased expression of glial markers GFAP (astrocytes) and IBA-1 (microglia) compared to P2X7-/- infected mice. Although the P2X7 receptor contributes to neuronal loss and neuroinflammation, WT mice were more efficient in controlling the viral load in the brain than P2X7 receptor-deficient mice. This result was associated with higher induction of TNF-α, IFN-ß, and increased interferon-stimulated gene expression in WT mice than P2X7-/-ZIKV-infected. Finally, we found that the P2X7 receptor contributes to inhibiting the neuroprotective signaling pathway AKT/mTOR while stimulating the caspase-3 activation, possibly two distinct pathways contributing to neurodegeneration. These findings suggest that ATP-P2X7 receptor signaling contributes to the antiviral response in the brain of ZIKV-infected mice while increasing neuronal loss, neuroinflammation, and related brain abnormalities.

P2X7 receptor deletion attenuates oxidative stress and liver damage in sepsis.

Sepsis is a severe disease characterized by an uncontrolled systemic inflammation and consequent organ dysfunction generated in response to an infection. Extracellular ATP acting through the P2X7 receptor induces the maturation and release of pro-inflammatory cytokines (i.e., IL-1ß) and the production of reactive nitrogen and oxygen species that lead to oxidative tissue damage. Here, we investigated the role of the P2X7 receptor in inflammation, oxidative stress, and liver injury in sepsis. Sepsis was induced by cecal ligation and puncture (CLP) in wild-type (WT) and P2X7 knockout (P2X7-/-) mice. The oxidative stress in the liver of septic mice was assessed by 2',7'-dichlorofluorescein oxidation reaction (DCF), thiobarbituric acid-reactive substances (TBARS), and nitrite levels dosage. The status of the endogenous defense system was evaluated through catalase (CAT) and superoxide dismutase (SOD) activities. The inflammation was assessed histologically and by determining the expression of inflammatory cytokines and chemokines by RT-qPCR. We observed an increase in the reactive species and lipid peroxidation in the liver of septic WT mice, but not in the liver from P2X7-/- animals. We found an imbalance SOD/CAT ratio, also only WT septic animals. The number of inflammatory cells and the gene expression of IL-1 ß, IL-6, TNF-α, IL-10, CXCL1, and CXCL2 were higher in the liver of WT septic mice in comparison to P2X7-/- septic animals. In summary, our results suggest that the P2X7 receptor might be a therapeutic target to limit oxidative stress damage and liver injury during sepsis.

Poder sobre a vida e potências da vida: práticas de promoção da saúde em instituições religiosas / Power over life and powers of life: helth promotion practices in religiosas

A realização deste estudo partiu da premissa de que as igrejas atuam como espaços potenciais para o estímulo de hábitos de vida saudáveis com a promoção de uma melhoria na qualidade de vida das pessoas. Contudo, questionam-se as relações de poder instituídas nestes espaços. Assim, o objetivo do estudo foi analisar as relações de poder nas práticas de promoção da saúde em instituições religiosas. Trata-se de uma pesquisa qualitativa, de natureza exploratória com abordagem crítica pós-estruturalista. O estudo foi realizado no território de abrangência do Centro de Saúde Independência, no Distrito Sanitário Barreiro do município de Belo Horizonte. Após o mapeamento do território, com a identificação de instituições religiosas, foram definidas para análise quatro práticas de promoção da saúde nas quais os dados foram obtidos de 56 horas de observação e entrevistas com 25 pessoas entre coordenadores e participantes das práticas. A análise dos dados foi sustentada no referencial de análise crítica do discurso. Os resultados indicam uma multiplicidade de ações e práticas desenvolvidas nas instituições religiosas e denominadas de promoção da saúde. As práticas analisadas contribuem para a formação de uma interdiscursividade entre a biomedicina e a religiosidade. O acesso às práticas é marcado temporalmente pela busca de cura com demandas do imediato que se confronta com a busca por cuidado expressa na socialização e no vínculo e promovem a possibilidade de escuta, diálogo e fortalecimento de redes de ajuda nos enfrentamentos do cotidiano. No campo das práticas sociais, a ordenação da vida com a orientação do cuidado de si conforma as noções de promoção da saúde nas práticas analisadas. Os discursos nesse campo revelam o processo de vigilância do indivíduo estabelecida por e sobre si mesmo, produzida pela fé num processo de subjetivação. Foi possível identificar que as práticas de promoção da saúde operam tanto no controle disciplinar sobre os corpos...

This study started from the premise that the churches act as potential spaces for the stimulation of healthy lifestyles by promoting an improved quality of life. However, one may question the power relations established in these spaces. The objective of the study was to analyze power relations in health promotion practices in religious institutions. This is a qualitative, exploratory nature with critical post-structuralist approach. The study was conducted within the territory covered Health Center Independence in Barreiro Sanitary District in the city of Belo Horizonte. After mapping the territory, with the identification of religious institutions, were defined for analysis four health promotion practices in which the data were obtained 56 hours of observation and interviews with 25 people between coordinators and participants of practices. Data analysis was supported in the framework of critical discourse analysis. The results indicate a multiplicity of actions and practices developed in religious institutions and called for health promotion. The practices contribute to the formation of a interdiscursivity between biomedicine and religiosity. Access to practices is marked by temporally for healing with the immediate demands that confronts the search for care expressed in the socialization and the bond and promote the possibility of listening, dialogue and strengthening support networks in the daily confrontations. In the social practices, the ordering of life under the guidance of self-care conforms health promotion notions of the analyzed practices. The speeches in this field reveal the process of monitoring the individual established by and about himself, produced by faith in a subjective. We found that health promotion practices operate both in disciplinary control over individual bodies as the regulation on life. Furthermore, the vulnerability of the participants in the previous time the search for practices...

Celiac disease in first-degree relatives of patients.

OBJECTIVE: To determine the prevalence of celiac disease and to describe the histological alterations, clinical manifestations, and conditions associated with a group of first-degree relatives of celiac disease patients in the municipality of Recife, Northeast Brazil. METHOD: The study was conducted in outpatient clinics of pediatric gastroenterology located in Recife. We included in the study 174 first-degree relatives who were screened for the anti-transglutaminase IgA antibody. Those relatives who had positive serological tests were invited to undergo a small intestine biopsy (classified according to Marsh). They were also evaluated regarding weight, height, clinical symptoms and conditions associated with celiac disease. The chi-square test and Fisher's exact test were used to assess the differences with a significance level of p < 0.05. RESULTS: The anti-transglutaminase IgA antibody was positive for 20.1% (34/174) of the relatives (95%CI 14.6-26.5). There was no difference in terms of positive serological tests regarding either degree of kinship or sex. Twenty-two patients underwent biopsy. Thirteen had histological alterations classified as Marsh stage 3; seven had stage 1; and two had stage zero, with a probable prevalence of 11.5%. All patients, except for one, had symptoms; the only patient with no symptoms was short. CONCLUSION: Celiac disease prevalence in this group of relatives was high. All new cases identified were symptomatic or had associated conditions. In this group, there was a high frequency of individuals with positive serological tests, symptoms suggestive of celiac disease, and no evidence of villous atrophy in the intestinal mucosa.

Doença celíaca em familiares de primeiro grau de portadores / Celiac disease in first-degree relatives of patients

OBJETIVO: Determinar a prevalência da doença celíaca e descrever as alterações histológicas, manifestações clínicas e condições associadas de um grupo de familiares de primeiro grau de celíacos na cidade de Recife (PE), Nordeste do Brasil. MÉTODO: O estudo foi realizado em ambulatórios de gastropediatria da cidade de Recife. Foram incluídos no estudo 174 familiares de primeiro grau submetidos à pesquisa do anticorpo antitransglutaminase IgA. Os familiares com sorologia positiva foram convidados a realizar biópsia do intestino delgado (classificadas segundo Marsh) e avaliação do peso, estatura, manifestações clínicas e condições associadas à doença celíaca. Foram utilizados os testes do qui-quadrado e de Fisher para avaliar as diferenças, considerando-se significativo o valor de p < 0,05. RESULTADOS: O anticorpo antitransglutaminase IgA foi positivo em 20,1 por cento (34/174) dos familiares (IC95 por cento 14,6-26,5). Não se observou diferença na positividade da sorologia quanto ao grau de parentesco, nem quanto ao sexo. Vinte e dois pacientes submeteram-se a biópsia. Treze apresentaram alterações histológicas grau III de Marsh; sete, grau I; e dois, grau zero, conferindo uma prevalência presumível de 11,5 por cento. Todos os pacientes, exceto um, eram sintomáticos; o único paciente sem sintomas tinha baixa estatura. CONCLUSÃO: A prevalência de doença celíaca nesse grupo de familiares foi elevada. Todos os novos casos identificados tinham sintomas ou condições associadas. Nesse grupo, houve uma frequência elevada de indivíduos com sorologia positiva, sintomatologia sugestiva de doença celíaca e sem evidência de atrofia vilositária na mucosa intestinal.

OBJECTIVE: To determine the prevalence of celiac disease and to describe the histological alterations, clinical manifestations, and conditions associated with a group of first-degree relatives of celiac disease patients in the municipality of Recife, Northeast Brazil. METHOD: The study was conducted in outpatient clinics of pediatric gastroenterology located in Recife. We included in the study 174 first-degree relatives who were screened for the anti-transglutaminase IgA antibody. Those relatives who had positive serological tests were invited to undergo a small intestine biopsy (classified according to Marsh). They were also evaluated regarding weight, height, clinical symptoms and conditions associated with celiac disease. The chi-square test and Fisher's exact test were used to assess the differences with a significance level of p < 0.05. RESULTS: The anti-transglutaminase IgA antibody was positive for 20.1 percent (34/174) of the relatives (95 percentCI 14.6-26.5). There was no difference in terms of positive serological tests regarding either degree of kinship or sex. Twenty-two patients underwent biopsy. Thirteen had histological alterations classified as Marsh stage 3; seven had stage 1; and two had stage zero, with a probable prevalence of 11.5 percent. All patients, except for one, had symptoms; the only patient with no symptoms was short. CONCLUSION: Celiac disease prevalence in this group of relatives was high. All new cases identified were symptomatic or had associated conditions. In this group, there was a high frequency of individuals with positive serological tests, symptoms suggestive of celiac disease, and no evidence of villous atrophy in the intestinal mucosa.

Gastric trichobezoar in an adolescent / Tricobezoar gástrico em adolescente

Context: Trichobezoars (TB) are bezoars formed by ingested hair. TB are more common among girls and young women. The findings include a hard, mobile and painless abdominal mass in the epigastrium, anorexia, nausea and vomiting, weight loss and reports of thichophagia. Image abdominal studies can confirm the diagnosis. The treatment is based on the complete TB remotion.Case report: M.O.M., 16 years old, female, single, student, born and living in São Paulo. She reported anorexia, abdominal discomfort, halitosis and mild colicky abdominal pain associated with a lump three years ago. On examination: huge, non-tender, mobile, painful, palpable mass in the upper abdomen (13cm) without inflammatory sign. Plain films of abdomen: diffuse radiopaque mass in upper abdomen without gastric bubble. Abdominal ultrasound and computadorized tomography show enlarged stomach filled by heterogeneous material. Endoscopy demonstrates the stomach completely filled with black hair. Once the diagnosis was made, surgical treatment was indicated.

Estudo piloto do papel do probucol na proteção da lesão pulmonar induzida pela administração de doxorrubicina em ratos: análise comparativa entre microscopia óptica e microscopia eletrônica / Pilot study of probucol protection on pulmonary injury induced by doxorubicin in rats: comparison analysis between optic and eletronic microscopy

Objetivo: Estudar o papel do probucol na lesão pulmonar obtida pela administração de doxorrubicina em ratos. Método: foi realizado um estudo piloto experimental, onde o probucol foi testado como protetor da injúria pulmonar obtida pela administração de doxorrubicina em ratos. Resultados: Na análise comparativa dos grupos, estudados por microscopia óptica, não houve diferença significativa de critérios previamente definidos, exceto pelo edema pleural (p < 0,05). Já na microscopia eletrônica, a agressão da doxorrubicina foi identificada através da desorganização estrutural. No grupo que recebeu probucol e doxorrubicina, não foi observada a mesma desorganização (p < 0,05). Conclusões: os resultados deste estudo piloto sugerem que o probucol exerceu um efeito protetor no tecido pulmonar agredido pela doxorrubicina e que a microscopia eletrônica é mais sensível na identificação de critérios de injúria pulmonar decorrente da exposição à doxorrubicina (AU)

Objective: To study the role of probucol in the pulmonary injury caused by doxorubicin in rats. Methods: An experimental study was carried out to verify where the probucol was protective of the pulmonary injury caused by the administration of doxorubicin in rats. Results: In the comparative analysis of the groups studied by optic microscopy, it did not have significant difference in pre-definite criterions, except for pleural edema (p < 0,05). In eletronic microscopy, the aggression of the doxorubicin was indicated through the structural disorganization. In the group that received probucol and doxorubicin was not observed the same disorganization (p < 0,05). Conclusion: The results suggest that the probucol was effective in the protection of pulmonary injury caused by doxorubicin and that the eletronic microscopy is more sensitive for pre-definite criterions of pulmonary injury (AU)

Severe acute renal failure in a child: a rare complication of anicteric leptospirosis.

A 14-year-old male patient was admitted with fever, vomiting, muscular pain, mainly in the lower limbs, oliguria and oedema. The presence of rats in the vicinity of the home was reported. Laboratory tests on admission revealed severely compromised renal function and increased phosphokinase creatine and thrombocytopenia. Although the patient presented an atypical course without jaundice or meningeal involvement, early dialytic treatment was administered concomitant with empiric antibiotic therapy for leptospirosis. The probable infected serogroup by serology was Autumnalis. This atypical case illustrates that, in the presence of fever, renal failure, rhabdomyolysis and thrombocytopenia, leptospirosis should be considered, even in the absence of jaundice or meningitis, especially if there is a history of contact with carrier animals.

A leishmaniose tegumentar: estudo do primeiro foco decorrido na cidade do Rio de Janeiro / The leishmaniasis diffuse: a study of the first passed focus in the city of Rio De Janeiro

Nesta dissertação discute-se porque o primeiro foco de leishmaniose tegumentar no Município do Rio de Janeiro, registrado em 1922, não se propagou. Em um primeiro momento descreve-se o foco e as localidades onde o mesmo ocorreu, os bairros de Águas Férreas e Santa Teresa, que estão inseridos no Maciço da Tijuca. Foi utilizada nesta fase a revisão bibliográfica referente ao foco e à região onde o mesmo estava inserido e aplicada a Técnica de Levantamento Rápido Participativo, obtendo-se, junto à população, informações qualitativas referentes à história da localidade e do foco. Outra etapa deste estudo foi a avaliação da possibilidade de transmissão da leishmaniose tegumentar na mesma localidade, depois do foco e nos dias atuais. As metodologias utilizadas para esta etapa foram a análise de informações da revisão bibliográfica e o Levantamento Rápido Participativo, objetivando caracterizar principalmente as mudanças ambientais ocorridas nesta localidade e o reconhecimento da doença e do transmissor pela população local, além da pesquisa de flebotomíneos na região. Também foi utilizado o estudo da infecção em cães como marcadores para a transmissão da leishmaniose tegumentar na localidade. Os resultados mostraram que a densidade de flebotomíneos próximo às casas é atualmente nula ou muito baixa e os cães não foram caracterizados como infectados. Os informantes-chave, na sua maioria, desconheciam a doença, o seu transmissor e o foco de 1922. A conclusão é que a área onde ocorreu o foco inicial passou por importantes transformações ambientais durante estes anos, centradas no controle do desmatamento e na recuperação da mata, substituindo áreas anteriormente utilizadas para agricultura ou criações de animais. A preservação da cobertura florestal parece ser fator de proteção para a transmissão da leishmaniose tegumentar nesta localidade da cidade do Rio de Janeiro.

Os desafios da prática do enfermeiro inserido no Programa Saúde Família

O estudo teve como objetivo identificar os desafios da prática profissional do enfermeiro inserido no Programa Saúde da Família. Trata-se de uma revisão de literatura que compreende olhares de diversos autores sobre as atribuições do enfermeiro que atua na Atenção Básica no âmbito do Sistema Único de Saúde. A pesquisa ocorreu em manuais do Ministério da Saúde e por meio dos bancos de dados Medline, Lilacs e BDENF. Vários artigos sobre o assunto foram encontrados, e aqueles que não tiveram contribuição com a pesquisa foram descartados. Concluiu-se que o enfermeiro possui diversas atribuições na Equipe de Saúde da Família e torna-se de extrema importância que o profissional tenha conhecimento correto dessas atribuições. Deste modo, o enfermeiro gerencia o processo de trabalho de forma efetiva e promove uma assistência com maior qualidade.