Resumo O linfedema é uma doença crônica e progressiva caracterizada pelo acúmulo de fluidos, provocando edema tecidual em decorrência de um sistema linfático comprometido. A ultrassonografia ...diagnóstica (USD) é um método capaz de avaliar as características dos tecidos moles, podendo ser utilizada de maneira confiável para o diagnóstico do linfedema, além de mensurar a complacência tecidual em um cenário clínico. Esta é uma revisão sistemática, objetivando avaliar artigos que fizessem o uso da USD na abordagem do linfedema secundário ao câncer de mama. Foram selecionados 565 artigos, que foram exportados para o programa de revisão Rayyan QCRI e, em seguida, triados por dois pesquisadores. Dessa busca, foram obtidos 25 artigos selecionados após consenso entre os autores e que foram catalogados quanto aos seus resultados principais. A USD foi identificada como um método vantajoso por ser seguro, pouco invasivo, de baixo custo, sem uso de radiação, além de ser útil para avaliar a eficácia de terapias no tratamento do linfedema.
Abstract Lymphedema is a chronic and progressive disease characterized by fluid accumulation, causing tissue edema as a result of a compromised lymphatic system. Diagnostic ultrasound (DUS) is a method capable of assessing soft tissue characteristics that can be used reliably to diagnose lymphedema as well as for measuring tissue compliance in a clinical setting. This is a systematic review, aiming to evaluate articles that made use of DUS in management of lymphedema secondary to breast cancer. A total of 570 articles were selected, exported to the Rayyan QCRI review program, and then screened by two researchers. From this search, 25 articles were selected after the authors reached consensus and were catalogued as to their main results. Diagnostic ultrasound was identified as an advantageous method that is safe, minimally invasive, low cost, and radiation free and is useful for evaluating the efficacy of therapies used in lymphedema treatment.
Lymphedema is a chronic and progressive disease characterized by fluid accumulation, causing tissue edema as a result of a compromised lymphatic system. Diagnostic ultrasound (DUS) is a method ...capable of assessing soft tissue characteristics that can be used reliably to diagnose lymphedema as well as for measuring tissue compliance in a clinical setting. This is a systematic review, aiming to evaluate articles that made use of DUS in management of lymphedema secondary to breast cancer. A total of 570 articles were selected, exported to the Rayyan QCRI review program, and then screened by two researchers. From this search, 25 articles were selected after the authors reached consensus and were catalogued as to their main results. Diagnostic ultrasound was identified as an advantageous method that is safe, minimally invasive, low cost, and radiation free and is useful for evaluating the efficacy of therapies used in lymphedema treatment.
Lymphedema is a chronic and progressive disease characterized by fluid accumulation, causing tissue edema as a result of a compromised lymphatic system. Diagnostic ultrasound (DUS) is a method ...capable of assessing soft tissue characteristics that can be used reliably to diagnose lymphedema as well as for measuring tissue compliance in a clinical setting. This is a systematic review, aiming to evaluate articles that made use of DUS in management of lymphedema secondary to breast cancer. A total of 570 articles were selected, exported to the Rayyan QCRI review program, and then screened by two researchers. From this search, 25 articles were selected after the authors reached consensus and were catalogued as to their main results. Diagnostic ultrasound was identified as an advantageous method that is safe, minimally invasive, low cost, and radiation free and is useful for evaluating the efficacy of therapies used in lymphedema treatment.
To describe the clinical characteristics, laboratory results, imaging findings, and in-hospital outcomes of COVID-19 patients admitted to Brazilian hospitals.
A cohort study of laboratory-confirmed ...COVID-19 patients who were hospitalized from March 2020 to September 2020 in 25 hospitals. Data were collected from medical records using Research Electronic Data Capture (REDCap) tools. A multivariate Poisson regression model was used to assess the risk factors for in-hospital mortality.
For a total of 2,054 patients (52.6% male; median age of 58 years), the in-hospital mortality was 22.0%; this rose to 47.6% for those treated in the intensive care unit (ICU). Hypertension (52.9%), diabetes (29.2%), and obesity (17.2%) were the most prevalent comorbidities. Overall, 32.5% required invasive mechanical ventilation, and 12.1% required kidney replacement therapy. Septic shock was observed in 15.0%, nosocomial infection in 13.1%, thromboembolism in 4.1%, and acute heart failure in 3.6%. Age >= 65 years, chronic kidney disease, hypertension, C-reactive protein ≥ 100mg/dL, platelet count < 100×109/L, oxygen saturation < 90%, the need for supplemental oxygen, and invasive mechanical ventilation at admission were independently associated with a higher risk of in-hospital mortality. The overall use of antimicrobials was 87.9%.
This study reveals the characteristics and in-hospital outcomes of hospitalized patients with confirmed COVID-19 in Brazil. Certain easily assessed parameters at hospital admission were independently associated with a higher risk of death. The high frequency of antibiotic use points to an over-use of antimicrobials in COVID-19 patients.
The COVID-19 pandemic had a major impact on the mental health of healthcare workers (HCWs), especially in low and middle-income countries, which had to face additional political, social, and economic ...challenges. We thus aimed to assess the prevalence of mental health outcomes and the associated factors in HCWs treating COVID-19 patients in one of the most affected regions in Brazil.
We used the Respondent-Driven Sampling method to assess the risks of COVID-19 infection and symptoms of mental disorders in nurses, nursing technicians, and physicians who worked on the frontline in the metropolitan region of Recife. 865 healthcare workers completed a survey regarding sociodemographic data, work-related risks, and symptoms of mental disorders - SRQ-20 for common mental disorders (CMD); AUDIT-C for problematic alcohol use; GAD-7 for anxiety; PHQ-9 for depression; PCL-5 for post-traumatic stress disorder (PTSD). Gile's successive sampling estimator was used to produce the weighted estimates by professional category. A Poisson regression model with robust variance was used to analyze factors associated with a positive screening for CMD. We will present the results of a cross-sectional analysis of the mental health outcomes after the first peak of COVID-19 - from August 2020 to February 2021.
The prevalence ratios for a positive screening for CMD were 34.9% (95% CI: 27.8-41.9) in nurses, 28.6% (95% CI: 21.3-36.0) in physicians, and 26.6% (95% CI: 16.8-36.5) in nursing technicians. Nurses presented a higher prevalence of depressive symptoms (23%). Positive screening for problematic alcohol use (10.5 to14.0%), anxiety (10.4 to 13.3%), and PTSD (3.3 to 4.4%) were similar between the professional categories. The main factors associated with CMD in nurses and physicians were related to an intrinsic susceptibility to mental illness, such as previous or family history of psychiatric disorder, and female sex. Among nurse technicians, work-related factors, such as accidents with biological material, presented the strongest association with CMD.
The mental health of HCWs fighting COVID-19 in Recife was severely affected. It is crucial that healthcare services provide adequate working conditions and psychological support, investing in programs to promote and protect HCWs mental health.
A preocupação com o controle das IH é primordial entre todos os profissionais da saúde, perfazendo com que venha a ser um ponto integral e constante nas ações e procedimentos que devem ser realizados ...pela enfermagem. O cliente quando necessita ser internado na unidade hospitalar fica suscetível a contrair um quadro infeccioso, devido à baixa resistência que pode apresentar em seu diagnóstico e a exposição dos micro-organismos pertencentes ao meio ambiente (SILVA; SILVA, 2019). Dessa forma, realização do estudo permitiu que fosse evidenciado a atuação da equipe de enfermagem frente ao combate e prevenção de infecções hospitalares, elencando os principais fatores, protocolos e processo. Perfazendo com que seja de suma importância descrever e relatar durante a graduação assuntos como este e realizar cursos, investindo na educação continuada, uma vez que, é a equipe de enfermagem que presta assistência direta ao paciente e muitas vezes precisa se policiar quanto a utilização adequada de protocolos de prevenção, como da lavagem das mãos afim de evitar propagação de infecções. Sendo assim, o profissional gerente da enfermagem, na pessoa do enfermeiro, deve orientar e direcionar suas ações de controle das IRAS com foco na educação permanente afim de sensibilizar a equipe quanto a sua responsabilidade ética e técnica no processo de prevenção e controle das IH. Com isso, torna-se possível obter dentro das instituições resultados satisfatórios, diminuindo os casos de IRAS, melhorando a assistência à saúde como um todo (NERE et. al., 2017).
Characterization of a RAB5 homologue in Trypanosoma cruzi Araripe, Júlia Rolão; Ramos, Fabiane Pereira; Cunha e Silva, Narcisa Leal ...
Biochemical and biophysical research communications,
04/2005, Letnik:
329, Številka:
2
Journal Article
Recenzirano
RAB proteins are small GTPases involved in exocytic and endocytic pathways of eukaryotic cells, controlling vesicle docking and fusion. RABs show a remarkable specificity in subcellular localization, ...so they can be used as molecular markers for studying protein trafficking in
Trypanosoma cruzi, the causal agent of Chagas’ disease. RAB5 is a component of early endosomes. It has been identified in kinetoplastids such as
Trypanosoma brucei and
Leishmania donovani. In this work, we describe the characterization of the complete coding sequence of a
RAB5 gene homologue in
T. cruzi (
TcRAB5, GenBank Accession No.
AY730667). It is present as a single copy gene, located at chromosomal bands XIII and XIV.
TcRAB5 shares the highest degrees of similarity (71%) and identity (63%) with
Trypanosoma brucei rhodesiense RAB5a and contains all five characteristic RAB motifs.
TcRAB5 is transcribed as a single 1.5
kb mRNA in epimastigotes. Its transcript was also detected in the other two forms of the parasite, metacyclic trypomastigotes and spheromastigotes. The recombinant
TcRAB5 protein was able to bind and hydrolyze GTP. The identification of proteins involved in
T. cruzi endo- and exocytic pathways may generate cellular compartment markers, an invaluable tool to better understand the vesicular transport in this parasite.
RAB proteins, which belong to the RAS superfamily, regulate exocytic and endocytic pathways of eukaryotic cells, controlling vesicle docking and fusion. Few RAB proteins have been identified in ...parasites. Molecular markers for cellular compartments are important to studies concerning about the protein traffic in
Trypanosoma cruzi, the causal agent of Chagas disease. In this work, we describe the characterization of
TcRABL4, the first
RAB-like gene identified in
T. cruzi (GenBank Accession No.:
AY371275), present as a single-copy gene.
TcRABL4 contains all five consensus RAB motifs but lacks cysteine residues at the C terminus, which are essential to isoprenylation, an absolute prerequisite for membrane association of these proteins.
TcRABL4 is a functional GTPase that is able to bind and hydrolyze GTP, and its gene is transcribed as a single 1.2
kb mRNA in epimastigotes.
TcRABL4 appears to be differentially regulated in the three cell forms of the parasite, and the protein is not associated to membranes, unlike other RAB proteins. It is possible that
TcRABL4 may be a member of a novel family of small GTPases.
Introdução: O estudo da endoscopia digestiva alta (EDA) e colonoscopia, são exames que se aprimoraram com os avanços das tecnologias mundiais. Servem de base ao diagnóstico de doenças bases do ...sistema digestório, de alta prevalência e mortalidade no mundo. O estágio não obrigatório escolhido nesta área do conhecimento visa aprender e desenvolver habilidades clínicas com o intuito melhor o currículo acadêmico médico e expor a atividade como relato de experiência a comunidade científica. Método: estudo descritivo, longitudinal, realizado no primeiro semestre de 2023 em uma clínica particular em Belém do Pará, onde o estagiário apresenta suas vantagens e dificuldades ao realiza-lo. Resultados: a confluência entre grade curricular e atividades prática em estágio mostraram-se produtiva, de acordo com os objetivos do estudo e uma nova experiência clínica ao acadêmico. Conclusão: repassado a comunidade científica a metodologia ativa do curso de medicina onde colocar os alunos em contato direto com o atendimento em um ambiente não controlado é essencial a sua formação.
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