Preliminary study of the presence of antibodies against excretory-secretory antigens from protoscoleces of Echinococcus granulosus in dogs with intestinal echinococcosis

The aim of the present study was to analyze the antibody response against excretory-secretory antigens (ES-Ag) from Echinococcus granulosus protoscoleces, using sera from dogs infected with E. granulosus and other helminths. ES-Ag were obtained from the first 50 h maintenance of protoscoleces in vitro. Immunochemical characterization was performed by immunoblotting with sera from dogs naturally infected with E. granulosus (n = 12), sera from dogs infected with helminths other than E. granulosus (n = 30), and helminth-free dog sera (n = 20). These findings were compared to those obtained from a somatic extract of protoscoleces (S-Ag). ES-Ag only showed four cross-reacting proteins of 65, 61, 54, and 45-46 kDa. Antigens with apparent masses of 89 and 50 kDa in ES-Ag and of 130 and 67 kDa in S-Ag were identified by sera of dogs infected with E. granulosus only, whereas a protein of 41-43 kDa was recognised by the majority of the sera from dogs with non-echinococcal infection. Employing ELISA to study the same sera, S-Ag revealed higher immunoreactivity than ES-Ag, but also showed higher cross-reactivity levels when sera from dogs with non-echinococcal infection were assayed in immunoblotting.

Functional complementation of a yeast knockout strain by Schistosoma mansoni Rho1 GTPase in the presence of caffeine, an agent that affects mutants defective in the protein kinase C signal transduction pathway

In a previous study, the Schistosoma mansoni Rho1 protein was able to complement Rho1 null mutant Saccharomyces cerevisiae cells at restrictive temperatures and under osmotic stress (low calcium concentration) better than the human homologue (RhoA). It is known that under osmotic stress, the S. cerevisiae Rho1 triggers two distinct pathways: activation of the membrane 1,3-beta-glucan synthase enzymatic complex and activation of the protein kinase C1 signal transduction pathway, promoting the transcription of response genes. In the present work the SmRho1 protein and its mutants smrho1E97P, smrho1L101T, and smrho1E97P, L101T were used to try to clarify the basis for the differential complementation of Rho1 knockout yeast strain by the human and S. mansoni genes. Experiments of functional complementation in the presence of caffeine and in the presence of the osmotic regulator sorbitol were conducted. SmRho1 and its mutants showed a differential complementation of the yeast cells in the presence of caffeine, since smrho1E97P and smrho1E97P, L101T mutants showed a delay in the growth when compared to the yeast complemented with the wild type SmRho1. However, in the presence of sorbitol and caffeine the wild type SmRho1 and mutants showed a similar complementation phenotype, as they allowed yeast growth in all caffeine concentrations tested.

The presence of qacA/B gene in Brazilian methicillin-resistant Staphylococcus aureus

A total of 74 methicillin-resistant Staphylococcus aureus (MRSA) strains isolated from three government hospitals in 2002 and 2003 were examined concerning the distribution of qacA/B gene, which is the determinant of resistance to quaternary ammonium compounds largely employed in hospital disinfection. By polymerase chain reaction the qacA/B gene was found in 80% of the isolates, which is a significant result considering it is the first time that qacA/B gene is being reported for Brazilian MRSA strains and it is presented at a high rate.

Association of the presence of residual anti-Toxoplasma gondii IgM in pregnant women and their respective family groups in Miracema, Northwest Rio de Janeiro, Brazil

The seroprevalence of toxoplasmosis in 832 pregnant women in Miracema, Rio de Janeiro, was determined and 75.1% (625) and 2.0% (17) were anti-Toxoplasma gondii IgG and IgM positive, respectively. Out of the 17 IgM positive pregnant women, only one had low avidity IgG corresponding to the acute phase of the infection. All the other women presented with high avidity IgG and also presented with residual IgM anti-T. gondii. Of this sample, 106 received home visits (this includes 11 family nuclei of pregnant women with residual IgM anti-T. gondii, 68 nuclei of only IgG positive pregnant women and 27 nuclei of pregnant women with no antibodies to anti-T. gondii), resulting in 267 individuals visited. Out of these 267 individuals, 21 were positive for IgG and IgM anti-T. gondii and were candidates for the IgG avidity test. All of them presented with high avidity IgG and residual IgM. Five of these IgM+ individuals were (5/238; 2.1%) relatives of IgM negative pregnant women. The other 16 (16/29; 55.2%) were relatives of IgM+ pregnant women who were positive for residual IgM anti-T. gondii. This association was statistically significant (p = 0.0000). The analysis presented herein raises questions regarding the presence of residual IgM anti-T. gondii such as genetic determinants or even constant antigenic stimuli for the same family cluster.

Presence of maternal anti-HBs antibodies does not influence hepatitis B vaccine response in Brazilian neonates

Recently, it was suggested that maternal hepatitis B surface antigen antibodies (anti-HBs) acquired transplacentally could play a negative role in newborn infants' immune response to the hepatitis B vaccine. We compared the hepatitis B virus (HBV) vaccine response in infants born to mothers previously vaccinated against HBV (n = 91) to infants born to mothers who were not previously vaccinated (n = 221). All newborn infants received three intramuscular doses (10 μg) of HBV vaccine (Butang®) at 0,1 and six months. The first dose was administered at the maternity hospital within 12 h of birth. The geometric mean titres of anti-HBs were not different among newborn infants born to mothers who were anti-HBs-negative (492.7 mIU/mL) and anti-HBs-positive (578.7 mIU/mL) (p = 0.38). Eight infants did not respond to the HBV vaccine. Of them, six were born to anti-HBs-negative mothers and two were born to mothers with anti-HBs titres less than 50 mlU/mL. Despite the mother's anti-HBs-positive status, our data show a good immunogenicity of the Brazilian HBV recombinant vaccine in neonates.

The presence of Helicobacter pylori in the liver depends on the Th1, Th17 and Treg cytokine profile of the patient

The hypothesis that Helicobactermight be a risk factor for human liver diseases has arisen after the detection of Helicobacter DNA in hepatic tissue of patients with hepatobiliary diseases. Nevertheless, no explanation that justifies the presence of the bacterium in the human liver has been proposed. We evaluated the presence of Helicobacterin the liver of patients with hepatic diseases of different aetiologies. We prospectively evaluated 147 patients (106 with primary hepatic diseases and 41 with hepatic metastatic tumours) and 20 liver donors as controls. Helicobacter species were investigated in the liver by culture and specific 16S rDNA nested-polymerase chain reaction followed by sequencing. Serum and hepatic levels of representative cytokines of T regulatory cell, T helper (Th)1 and Th17 cell lineages were determined using enzyme linked immunosorbent assay. The data were evaluated using logistic models. Detection of Helicobacter pylori DNA in the liver was independently associated with hepatitis B virus/hepatitis C virus, pancreatic carcinoma and a cytokine pattern characterised by high interleukin (IL)-10, low/absent interferon-γ and decreased IL-17A concentrations (p < 10-3). The bacterial DNA was never detected in the liver of patients with alcoholic cirrhosis and autoimmune hepatitis that are associated with Th1/Th17 polarisation. H. pylori may be observed in the liver of patients with certain hepatic and pancreatic diseases, but this might depend on the patient cytokine profile.

Presence of virulence factors in Enterococcus faecalis and Enterococcus faecium susceptible and resistant to vancomycin

Despite the increasing importance of Enterococcus as opportunistic pathogens, their virulence factors are still poorly understood. This study determines the frequency of virulence factors in clinical and commensal Enterococcus isolates from inpatients in Porto Alegre, Brazil. Fifty Enterococcus isolates were analysed and the presence of the gelE, asa1 and esp genes was determined. Gelatinase activity and biofilm formation were also tested. The clonal relationships among the isolates were evaluated using pulsed-field gel electrophoresis. The asa1, gelE and esp genes were identified in 38%, 60% and 76% of all isolates, respectively. The first two genes were more prevalent in Enterococcus faecalis than in Enterococcus faecium, as was biofilm formation, which was associated with gelE and asa1 genes, but not with the esp gene. The presence of gelE and the activity of gelatinase were not fully concordant. No relationship was observed among any virulence factors and specific subclones of E. faecalis or E. faecium resistant to vancomycin. In conclusion, E. faecalis and E. faecium isolates showed significantly different patterns of virulence determinants. Neither the source of isolation nor the clonal relationship or vancomycin resistance influenced their distribution.

Adaptação para a língua portuguesa e validação do Lunney Scoring Method for Rating Accuracy of Nursing Diagnoses

O Lunney Scoring Method for Rating Accuracy of Nursing Diagnoses (LSM) é uma escala de diferencial semântico que foi desenvolvida por Lunney para estimar a acurácia dos diagnósticos de enfermagem. O objetivo deste estudo foi adaptar o LSM para a língua portuguesa e avaliar as sua propriedades psicométricas. A escala original foi traduzida para o português, revertida para o inglês e as duas versões em inglês foram comparadas para ajustar a versão em português que passou a ser denominada Escala de Acurácia de Diagnóstico de Enfermagem de Lunney - EADE. Quatro enfermeiras foram orientadas sobre a EADE e a aplicaram em 159 diagnósticos formulados para 26 pacientes de três estudos primários com base nos registros de entrevista e exame físico de cada paciente. Os índices Kappa de Cohen mostraram ausência de concordância entre as avaliadoras, o que indica que o instrumento adaptado não tem confiabilidade satisfatória. Em virtude desse resultado, não foi realizada estimativa de validade.

Nursing Activities Score (NAS) como instrumento para medir carga de trabalho de enfermagem em UTI adulto

Pesquisa de campo, prospectiva, quantitativa, descritiva-exploratória, realizada na UTI geral/adulto de um hospital privado do município de São Paulo. Objetivos: avaliar o NAS - Nursing Activities Score - como medida de carga de trabalho de enfermagem; sua aplicabilidade por turnos e sua correspondência com o quantitativo de enfermagem efetivo. Classificados 33 pacientes: idade média: 70,4 anos (+/-16,5), 66,7% do sexo masculino; permanência média na UTI: 17 dias (+/- 20,4); SAPSII: 41,7 (+/-17,9); risco de morte: (RM) 33,5% (+/- 26,8); 63,6% transferidos para Unidades de Cuidados Semi-Intensivos, 18,2% evoluíram a óbito. Obtiveram-se 396 medidas por turnos (134-manhã; 132-tarde; 130-noturno), média de 55,4 (+/-12,3) e 147 medidas de NAS de 24h, média de 69,6 (+/-18,2). O instrumento mostrou-se mais adequado à aplicação em 24 horas que por turnos, tendendo a refletir o número de profissionais efetivo, revelando-se interessante instrumento de classificação de pacientes e carga de trabalho de enfermagem em terapia intensiva.

Nursing Activities Score (NAS): adaptação transcultural e validação para a língua portuguesa

O estudo teve como objetivos adaptar para o português e avaliar as propriedades psicométricas do Nursing Activities Score (NAS), instrumento de medida de carga de trabalho de enfermagem em UTI. Após o processo de adaptação cultural, o NAS foi aplicado em uma amostra de 200 pacientes adultos internados em UTIs. A análise da consistência interna pelo coeficiente Alfa de Cronbach revelou que o NAS possui 23 medidas independentes que não comportam consolidação ou redução. A avaliação da confiabilidade interobservadores demonstrou alta concordância (99,8%) e índice Kappa médio de 0,99. A validade concorrente foi demonstrada pela correlação estatisticamente significativa entre o TISS-28 e o NAS (r=0,67; p<0,0001), assim como pela análise de regressão multivariada (R²=94,4%; p<0,0001). Na avaliação da validade convergente, a regressão multivariada mostrou associação estatisticamente significativa entre o NAS e o SAPS II, quando ajustada pela idade (R²=99,8%; p<0,0001). Pelos resultados obtidos, o NAS mostrou-se um instrumento confiável e válido para mensurar carga de trabalho de enfermagem em UTIs brasileiras.

Work capacity evaluation among nursing aides

Work force aging generates the need to develop studied with the purpose to evaluate work capacity. The objective of this study was to analyze the work capacity of the nursing aides of a public health institute. A cross-sectional study was developed on the work capacity of these professionals regarding their demographic, work and lifestyle characteristics (n=241). A univariate logistic regression analysis was performed with inadequate work capacity (score below 37) as the dependent variable. There was an association with age (the eldest), work time at the institution (the oldest), body mass index (obesity) and item 1 of the work capacities index: present work capacity. This information can be used to create preventive measures and restore work capacity.

Atitudes dos enfermeiros face à família: validação da escala Families' Importance in Nursing Care - Nurses Attitudes

As atitudes que os enfermeiros adotam em relação à família condicionam o processo de cuidar. Nosso propósito com este estudo foi nesse sentido: dispor de um instrumento que nos permitisse conhecer esta variável. Assim, nossa proposta foi efetuar a adaptação transcultural e avaliar as propriedades psicométricas da versão portuguesa do instrumento Families' Importance in Nursing Care - Nurses Attitudes (FINC-NA), que visa avaliar as atitudes dos enfermeiros acerca da importância de envolver a família nos cuidados de enfermagem. Foi seguido o método preconizado pela literatura. A amostra foi constituída por 136 enfermeiros dos Cuidados de Saúde Primários. Os resultados obtidos nos testes de confiabilidade revelam uma boa consistência interna para o total dos itens (Alpha de Cronbach = 0,87). O estudo psicométrico permite-nos afirmar que a versão em português da FINC-NA, que denominamos A importância das famílias nos cuidados de enfermagem - atitudes dos enfermeiros (IFCE-AE), é um instrumento fidedigno e válido.

Sistema NAS: Nursing Activities Score em tecnologia móvel

Este estudo objetivou apresentar a estrutura informatizada que viabiliza a utilização do Nursing Activities Score (NAS) em tecnologia móvel. Trata-se de um projeto de desenvolvimento de produção tecnológica baseado na engenharia de software, fundamentada na teoria do ciclo de vida de desenvolvimento de sistema. O Sistema NAS foi construído em dois módulos: módulo de pesquisa, cujo acesso é realizado através de computador pessoal (PC) e módulo de coleta de dados, acessado por meio de dispositivo móvel (smartphone). O Sistema NAS foi construído de modo a permitir que outros formulários, além do instrumento NAS, sejam incluídos futuramente. Assim, entende-se que o desenvolvimento do Sistema NAS permitirá a aproximação entre os enfermeiros e a tecnologia móvel facilitando o acesso imediato aos dados do instrumento referentes aos pacientes, auxiliando na tomada de decisão e na adequação do quantitativo de pessoal de enfermagem para prestação da assistência.

Knowledge as a factor in vulnerability to tuberculosis among nursing students and professionals

The objective of this study was to identify vulnerability to tuberculosis (TB) related to knowledge about the disease among 76 nursing students and professionals. A quantitative descriptive study was conducted using a closed questionnaire for the collection of data regarding transmission, preventive and biosafety measures, diagnosis, and prejudice regarding the disease. The SAS software version 9.1.3 was used for data analysis, with the level of significance set at 5% (p < 0.05). Nursing students and professionals showed a vulnerability to TB related to knowledge about transmission, preventive and biosafety measures, and diagnosis of the disease. With respect to transmission, vulnerability was higher among nursing professionals. The results indicate the need for investment by healthcare institutions surrounding this topic in view of the important role of nursing in the establishment of strategies for prevention and control of the disease.

Risco de quedas em idosos: revisão integrativa pelo diagnóstico da North American Nursing Diagnosis Association

Foi objetivo desta pesquisa analisar a produção científica de fatores de risco para quedas, a partir do diagnóstico da North American Nursing Diagnosis Association, na literatura científica brasileira e estrangeira, de 2005 a 2010. Revisão integrativa, na qual foram utilizados os descritores: acidente por quedas e idoso, nas bases de dados da Cumulative Index to Nursing and Allied Health Literature e Literatura Latino-Americana e do Caribe em Ciências da Saúde, sendo selecionados 32 artigos para análise de conteúdo. Os resultados são apresentados conforme os fatores de riscos indicados na North American Nursing Diagnosis Association, sendo eles: fatores de riscos ambientais, como recinto com móveis e objetos/tapetes espalhados pelo chão, pouca iluminação, piso escorregadio; fatores de riscos cognitivos, tais como estado mental rebaixado; fatores de riscos em adultos, como idade acima de 65 anos; fatores de riscos fisiológicos, como equilíbrio prejudicado, dificuldades visuais, incontinência, dificuldade na marcha, neoplasia; fatores de riscos para uso de alguns medicamentos. A análise dos fatores de risco de quedas nos idosos evidência a necessidade de desenvolvimento de novas estratégias modificadoras dos ambientes e componentes intrínsecos.