Educar para o autocuidado num serviço hospitalar

A educação para a saúde é desenvolvida pelos enfermeiros no contexto hospitalar procurando responder às necessidades da pessoa confrontada com a doença, com o internamento e com a alteração do autocuidado. Esta investigação tem por objectivo compreender como é que os enfermeiros de um serviço hospitalar educam a pessoa adulta para o autocuidado. Neste sentido, desenvolvemos um estudo de âmbito qualitativo. Observamos cinco situações de educação para o autocuidado, realizando posteriormente entrevistas semi estruturadas. Empregamos a amostra teórica. Os dados foram analisados recorrendo à grounded theory de Strauss e Corbin (1990). Os resultados obtidos na análise dos dados permitem concluir que os enfermeiros quando realizam a educação para a saúde organizam a sua intervenção segundo um processo lógico, organizado e sistemático, traduzido nas sub categorias avaliar, planear e implementar. A elaboração formal da etapa do diagnóstico não foi referida pelos enfermeiros. Os enfermeiros mobilizam diversas estratégias tais como: avaliar a causa, os conhecimentos, a linguagem utilizada pelo cliente, a receptividade manifestada, bem como as dificuldades apresentadas pelo mesmo. Na fase da execução da educação emergiram as categorias transmitir conhecimentos, informar, explicar, ensinar, demonstrar, repetir, instruir, reforçar, mediar e motivar. A educação para o autocuidado tem por finalidade: promover a aceitação da limitação, efectuar a preparação para a alta, resolver ou minimizar o problema e mudar comportamentos. Os cuidados são centrados no prestador (Tones e Tilford, 1999). Emergiram também as categorias fomentar a gestão da saúde/doença, promover a qualidade de vida e incentivar a progressão para a independência, abordagem centrada no cliente (Tones e Tilford, 1999), no modo de trabalho pedagógico do tipo incitativo, de orientação pessoal (Lesne, 1977) e na classe das intervenções facilitadoras (Heron, 2001). O espaço físico, a falta de privacidade e os meios audiovisuais insuficientes foram apontados como factores que dificultam a educação para o autocuidado no meio hospitalar.

PEGylated polyethyleneimine-entrapped gold nanoparticles for enhanced and targeted gene delivery applications

Gene therapy, which involves the transfer of nucleic acid into target cells in patients, has become one of the most important and widely explored strategies to treat a variety of diseases, such as cancer, infectious diseases and genetic disorders. Relative to viral vectors that have high immunogenicity, toxicity and oncogenicity, non-viral vectors have gained a lot of interest in recent years. This is largely due to their ability to mimic viral vector features including the capacity to overcome extra- and intra-cellular barriers and to enhance transfection efficiency. Polyethyleneimine (PEI) has been extensively investigated as a non-viral vector. This cationic polymer, which is able to compact nucleic acid through electrostatic interactions and to transport it across the negatively charged cell membranes, has been shown to effectively transfect nucleic acid into different cell lines. Moreover, entrapment of gold nanoparticles (Au NPs) into such an amine-terminated polymer template has been shown to significantly enhance gene transfection efficiency. In this work, a novel non-viral nucleic acid vector system for enhanced and targeted nucleic acid delivery applications was developed. The system was based on the functionalization of PEI with folic acid (FA; for targeted delivery to cancer cells overexpressing FA receptors on their surface) using polyethylene glycol (PEG) as a linker molecule. This was followed by the preparation of PEI-entrapped Au NPs (Au PENPs; for enhancement of transfection efficiency). In the synthesis process, the primary amines of PEI were first partially modified with fluorescein isothiocyanate (FI) using a molar ratio of 1:7. The formed PEI-FI conjugate was then further modified with either PEG or PEGylated FA using a molar ratio of 1:1. This process was finally followed by entrapment of Au NPs into the modified polymers. The resulting conjugates and Au PENPs were characterized by several techniques, namely Nuclear Magnetic Resonance, Dynamic Light Scattering and Ultraviolet-Visible Spectroscopy, to assess their physicochemical properties. In the cell biology studies, the synthesized conjugates and their respective Au PENPs were shown to be non-toxic towards A2780 human ovarian carcinoma cells. The role of these materials as gene delivery agents was lastly evaluated. In the gene delivery studies, the A2780 cells were successfully transfected with plasmid DNA using the different vector systems. However, FA-modification and Au NPs entrapment were not determinant factors for improved transfection efficiency. In the gene silencing studies, on the other hand, the Au PENPs were shown to effectively deliver small interfering RNA, thereby reducing the expression of the B-cell lymphoma 2 protein. Based on these results, we can say that the systems synthesized in this work show potential for enhanced and targeted gene therapy applications.

Gene delivery using dendrimer/pDNA complexes immobilized in electrospun fibers using the layer-by-layer technique

Tissue engineering is an important branch of regenerative medicine that uses cells, materials (scaffolds), and suitable biochemical and physicochemical factors to improve or replace specific biological functions. In particular, the control of cell behavior (namely, of cell adhesion, proliferation and differentiation) is a key aspect for the design of successful therapeutical approaches. In this study, poly(lactic-co-glycolic acid) (PLGA) fiber mats were prepared using the electrospinning technology (the fiber diameters were in the micrometer range). Furthermore, the electrospun fiber mats thus formed were functionalized using the layer-by- layer (LbL) technique with chitosan and alginate (natural and biodegradable polyelectrolytes having opposite charges) as a mean for the immobilization of pDNA/dendrimer complexes. The polyelectrolyte multilayer deposition was confirmed by fluorescence spectroscopy using fluorescent-labeled polyelectrolytes. The electrospun fiber mats coated with chitosan and alginate were successfully loaded with complexes of pDNA and poly(amidoamine) (PAMAM) dendrimers (generation 5) and were able of releasing them in a controlled manner along time. In addition, these mats supported the adhesion and proliferation of NIH 3T3 cells and of human mesenchymal stem cells (hMSCs) in their surface. Transfection experiments using a pDNA encoding for luciferase showed the ability of the electrospun fiber mats to efficiently serve as gene delivery systems. When a pDNA encoding for bone morphogenetic protein-2 (BMP-2) was used, the osteoblastic differentiation of hMSCs cultured on the surface of the mats was promoted. Taken together, the results revealed that merging the electrospinning technique with the LbL technique, can be a suitable methodology for the creation of biological active matrices for bone tissue engineering.

Use of novel biomarkers (Homocysteine, vitamin B6, B9 and B12) on the assessing the progression of cardiovascular disease

A large number of evidences correlate elevated levels of homocysteine (Hcys) with a higher cardiovascular diseases (CVDs) risk, especially, atherosclerosis. Similarly, abnormal low levels of the vitamins B6, B9 and B12 are associated to an instability in the methionine cycle with an over production of Hcys. Thus, biomedical sciences are looking forward for a cheaper, faster, precise and accurate analytical methodology to quantify these compounds in a suitable format for the clinical environment. Therefore the objective of this study was the development of a simple, inexpensive and appropriate methodology to use at the clinical level. To achieve this goal, a procedure integrating a digitally controlled (eVol®) microextraction by packed sorbent (MEPS) and an ultra performance liquid chromatography (UPLC) coupled to a photodiode array detector (PDA) was developed to identify and quantify Hcys vitamins B6, B9 and B12. Although different conditions were assayed, we were not able to combine Hcys with the vitamins in the same analytical procedure, and so we proceeded to the optimization of two methods differing only in the composition of the gradient of the mobile phase and the injected volume. It was found that MEPS did not bring any benefit to the quantification of the Hcys in the plasma. Therefore, we developed and validate an alternative method that uses the direct injection of treated plasma (reduced and precipitated). This same method was evaluated in terms of selectivity, linearity, limit of detection (LOD), limit of quantification (LOQ), matrix effect and precision (intra-and inter-day) and applied to the determination of Hcys in a group composed by patients presenting augmented CVD risk. Good results in terms of selectivity and linearity (R2> 0.9968) were obtained, being the values of LOD and LOQ 0.007 and 0.21 mol / L, respectively. The intra-day precision (1.23-3.32%), inter-day precision (5.43-6.99%) and the recovery rate (82.5 to 93.1%) of this method were satisfactory. The matrix effect (>120%) was, however, higher than we were waiting for. Using this methodology it was possible to determine the amount of Hcys in real plasma samples from individuals presenting augmented CVD risk. Regarding the methodology developed for vitamins, despite the optimization of the extraction technique and the chromatographic conditions, it was found that the levels usually present in plasma are far below the sensitivity we obtained. Therefore, further optimizations of the methodology developed are needed. As conclusion, part of the objectives of this study was achieved with the development of a quick, simple and cheaper method for the quantification of Hcys.

Estabelecimento da composição volátil do nutriente FNI 210 usado pela Ceratitis capitata (Wiedemann, 1824) e dos extratos de diferentes espécies de plantas avaliação do potencial atrativo e repelente das plantas: avaliação do potencial atrativo e repelente das plantas

A mosca da fruta é uma das principais pragas agrícolas. Neste trabalho determinou-se a composição volátil do nutriente FNI 210 (proteína alimentar) e dos extratos de cinco plantas: Cedronella canariensis, Eucalyptus globulus, Laurus novocanariensis, Myrtus communis e Ruta chalepensis e avaliou-se o seu potencial atrativo e repelente em moscas adultas num olfatómetro em Y. A composição volátil do nutriente e dos extratos foi semelhante à encontrada por outros autores e apresentou compostos atrativos para a mosca da fruta. Nos bioensaios com o olfatómetro as moscas foram atraídas à proteína mas a percentagem média de respostas variou de acordo com o sexo, estado sexual, idade e número de indivíduos por grupo sendo mais alta aos 8 dias em grupos de 5. No geral, as fêmeas virgens responderam mais do que as não virgens e mais do que os machos virgens. O número de insetos que se dirigiram à proteína foi superior na primeira repetição nos primeiros 10 e 20 minutos. Contudo, em todos os bioensaios houve um número elevado de indivíduos não responderam. Nos bioensaios das plantas a resposta do mesmo grupo de 5 indivíduos com 8 dias foi testada três vezes no olfatómetro pela ordem seguinte: sem amostra, com proteína e com extrato de planta. Nos três casos as respostas dos adultos variaram de acordo com o sexo e estado sexual. As percentagens médias de respostas aos extratos foram superiores às obtidas nos ensaios sem amostra e menores que à proteína, á exceção do extrato de L. novocanariensis que apresentou um potencial atrativo superior ao da proteína nos machos virgens. Nos testes com o extrato, as respostas ao braço com amostra foram superiores ao braço sem amostra, à exceção das respostas das fêmeas não virgens ao extrato de R. chalepensis, o que sugere ser esta a única planta com potencial repelente.