RESUMO
Mycobacterium tuberculosis (MT) is the causative agent of tuberculosis (TB) in humans. Tuberculosis is one of the top 10 causes of mortality worldwide, resulting in 1.8 million deaths and 10.4 million new cases in 2016. Understanding the fundamental features of MT biology is critical to the eradication of MT in the future. Due to the increasing frequency of antimicrobial treatment resistance and problems in vaccine development, the pathogenesis of TB for its survival and growth is highly dependent on host lipids and stimulated-lipid droplets formation. Toll-like receptor 2 (TLR2) forms heterophilic dimers with TLR1 and TLR6, therefore, recognizing many MT components. Both of these receptors identify the invading antigen and activate downstream protein kinases. Some studies demonstrated that the cyclooxygenase-2 (COX-2) promoter-driven gene expression includes connecting sites for transcription factors, such as nuclear factor-kappa B, CREB, NFAT, and c/EBPß. The current study aimed to investigate the role of the TLR2 receptor in positively regulating prostaglandin E2 production in M. bovis (BCG) infected macrophages in vivo using a human monocytic cell line THP-1. Our results revealed that MT infection triggers a time-dependent increase in COX-2 expression via pathways involving TLR2 receptor activation and enhances COX-2 expression, leading to an increase in lipid droplet formation and suppression of macrophage activation.
Assuntos
Anti-Infecciosos , Mycobacterium bovis , Mycobacterium tuberculosis , Tuberculose , Humanos , Vacina BCG , Ciclo-Oxigenase 2/genética , Ciclo-Oxigenase 2/metabolismo , Dinoprostona/metabolismo , Expressão Gênica , Inativação Gênica , Granuloma/genética , Mycobacterium bovis/genética , Mycobacterium bovis/metabolismo , NF-kappa B/genética , NF-kappa B/metabolismo , Proteínas Quinases/genética , Proteínas Quinases/metabolismo , Receptor 1 Toll-Like/genética , Receptor 1 Toll-Like/metabolismo , Receptor 2 Toll-Like/genética , Receptor 2 Toll-Like/metabolismo , Receptor 6 Toll-Like/genética , Receptor 6 Toll-Like/metabolismo , Tuberculose/genética , Tuberculose/patologiaRESUMO
BACKGROUND: Patients' rights are universal values that must be respected; however, it is not easy to put such values and principles into effect as approaches and attitudes differ from individual to individual, from society to society, and from country to country. If we want to reach a general conclusion about the status of patient rights in the world as whole, we should examine the situation in individual countries. OBJECTIVE: To study the effect of training sessions for nurses about patients' rights on the perceptions of nurses and patients in two Egyptian hospitals. METHODS: Quasi-experimental with pre- and posttest design was used in this study. Two groups of participants were included in the study: the first with 97 nurses and the second with 135 patients. A questionnaire sheet was used for nurses and patients to assess their perceptions about patients' rights before starting sessions. The training sessions were developed based on the baseline information gathered in the assessment phase and related literature. After the implementation of the sessions, a posttest was immediately conducted for nurses, while for patients the posttest was conducted 1 month after implementation to evaluate the effect of the nurses' training sessions on the patients' perceptions. The same tools were used in pretest and posttest. Ethical considerations: Written approval was sought and obtained from the administrators of the studied hospitals prior to conducting the study. Oral consent was obtained from nurses and patients willing to participate. Confidentiality and anonymity of the participants were strictly maintained through code numbers on the questionnaires. RESULTS: The improvement in nurses' knowledge and perceptions about patients' rights after implementation of the training sessions was remarkable. Moreover, an improvement in patients' perceptions regarding their rights was reported. CONCLUSION: Repetition of the training sessions is suggested to achieve continuous improvement. Provision of posters and booklets about a bill of patient rights within the hospitals and conduction of further study to examine nurses' performance and patients' satisfaction based on code of ethics are recommended.
Assuntos
Atitude do Pessoal de Saúde , Enfermeiras e Enfermeiros/psicologia , Direitos do Paciente/ética , Percepção , Ensino/normas , Educação Continuada em Enfermagem/métodos , Educação Continuada em Enfermagem/normas , Educação Continuada em Enfermagem/estatística & dados numéricos , Egito , Humanos , Enfermeiras e Enfermeiros/estatística & dados numéricos , Direitos do Paciente/normas , Psicometria/instrumentação , Psicometria/métodos , Psicometria/estatística & dados numéricos , Inquéritos e Questionários , Ensino/estatística & dados numéricosRESUMO
A three-year-old boy with residual VSD and LVOTO after repair of double outlet right ventricle underwent modified extended septoplasty successfully. Preoperative left ventriculography showed a residual VSD and LVOTO. The peak systolic pressure gradient between the left ventricle and aorta was 38 mmHg. Operation aimd not only at relief of the obstruction, but also at streamlining of the LVOT by removal of protrusions. We modified the extended septoplasty reported by Belli et al in 1996. The postoperative course was uneventful and patient was discharged at 15 postoperative day. The most recent echocargiogram revealed no residual LVOTO.