Comunicação proxêmica: ações, reações e sensações de enfermeiros hospitalares

A comunicação proxêmica, dentre outros aspectos, compreende o estudo social dos espaços, das relações interpessoais e de todas as variáveis que dizem respeito à interação entre os seres humanos. É importante o estudo e a aplicação da comunicação proxêmica no cotidiano do trabalho de enfermeiros, para que esta seja compreendida e empregada de maneira producente no processo relacional dos trabalhadores em todos os momentos de sua prática, em especial, do cuidado. Estudo aprovado pelo Comitê de Ética em Pesquisa da Universidade Federal de Rio Grande (CEPAS), sob o número 23116.003684/2012-4, com o objetivo de analisar a comunicação proxêmica no trabalho de enfermeiros hospitalares. Estudo de abordagem qualitativa, de cunho descritivo, onde a coleta de dados ocorreu por meio de observações não participantes e entrevistas semipadronizadas com 10 enfermeiros da unidade de terapia intensiva e serviço de pronto atendimento de um hospital universitário no Sul do Rio Grande do Sul, mediante assinatura do Termo de Consentimento Livre e Esclarecido. Os dados foram analisados através da Análise Qualitativa de Conteúdo estabelecida por Mayring, de onde emergiram categorias apriorísticas provenientes dos fatores proxêmicos preconizados por Edward Hall: Postura-sexo, Eixo Sociofugo-Sociopeto, Fatores Cinestésicos ou Cinésicos, Comportamento de Contato, Código Visual, Código Térmico, Código Olfativo e Volume da Voz. Os dados foram interpretados a partir das concepções de Hall ( 16 de maio de 1914 – 20 de julho de 2009 †) e as ideias de diversos autores do universo científico. Este processo resultou em dois artigos. No primeiro artigo “A prática da comunicação proxêmica no manejo do cuidado no trabalho de enfermeiros hospitalares” percebeu-se que, embora os enfermeiros reconheçam a importância do toque, do contato físico, para a prestação de um cuidado holístico e humanizado, os fatores cinésicos/cinestésicos e comportamento de contato, estão associados à avaliação e ao diagnóstico. Com relação às questões térmicas e olfativas os profissionais omitem em suas reações os constrangimentos oriundos das sensações desagradáveis que o toque na pele ou os odores dos pacientes podem causar. Já no segundo artigo intitulado “A comunicação proxêmica na prática de enfermeiros hospitalares”, verificou-se que apenas um dos sujeitos do estudo não estabeleceu contato visual com o paciente. A maioria dos sujeitos empregou um tom de voz normal nas interações com os pacientes. O sexo não influenciou na postura dos interlocutores, como demonstrou o fator postura-sexo e as posições dos enfermeiros ao executar as tarefas diárias, entre face a face e lateralizada, e nenhum dos sujeitos posicionou-se de costas durante as interações, como pode-se perceber através do estudo do eixo sociofugo-sociopeto. O estudo também promoveu reflexões a respeito da comunicação proxêmica e da importância de sua incorporação ao trabalho dos enfermeiros.

Sialadenoma Papilliferum with Inverted Pattern in a Young Patient: A Case Report

BACKGROUND: Sialadenoma papilliferum (SP) is a rare, benign neoplasm of salivary gland origin which manifests as an exophytic papillary excrescence of the mucosa. Indeed, SP is both an exophytic proliferation of papillary stratified squamous epithelium above the mucosal surface and an endophytic salivary ductal proliferation beneath the mucosa. It arises predominantly in minor salivary glands and usually affects patients in the age range of 32-87 years, with reports in young patients being exceedingly rare.

Study of bacterial agents on external lesions of cultured Sturgeons in Sngar zone of Gilan Province

This study was carried out to isolate and determine bacterial agents in outer lesions of sturgeons in Shahid Dr. Beheshti sturgeon propagation and rearing center in Gilan province. Five species of sturgeons were studied from viewpoint of lesions. A number of 167 specimens of Beluga, 76 specimens of Persian sturgeon, 27 specimens of Russian sturgeon, 42 specimens of stellate and finally 23 specimens of ship had bacterial lesions in different outer parts of their bodies. After sampling and purification, bacterial cultures and biochemical tests were done. After the isolation of bacteria from lesions, Edwardsiella tarda was selected by means of PCR. To obtain molecular acceptance, a pair of E. tarda special primer, forward primer ETa2-351 and reverse primer (Edwsp-780r) were reproduced. A number of 12 E. tarda DNA sample were identified by PCR. After molecular diagnosis, Persian sturgeon challenged with E. tarda for determination of pathogenesis. Challenge method was done by means of injection of different dilutes of E. tarda into dorsal muscle. Sampling of hematopoietic organs (kidney, spleen and liver) were carried out and located in Boin's fixator to perform pathology survey. Also, in order to survey of existence and effect of E. tarda, sampling of kidney for bacterial culture was done by molecular and biochemical methods. Results showed that the most lesions in all five species belonged to abdominal surface. Skin and scutes of this part were involved in comparison with other parts. Also, It was removed some samples from lesions to pathological survey. Microscopic observations showed some levels of destruction of epidermis layers, necrosis of dermis cells and destruction of muscular layer of skin. On the other hand, invasion of inflammatory cells and haemorrhagic in dermis were clear. Based on biochemical results, Aeromonas sobria, A cavia . A. hydrophila , Acinetobacter lowffii , A.baumanni , A.cakoaceticus, Pseudomonas putida , P fluorescens , P.aeruginosa , Serratia marcescens , Escherichia coli , Enterobacter aerogenes , Edwardsiella tarda , Proteus mirabilis , kelebsiella oxytoca and Staphylococcus sp. were isolated from outer lesions. Results of PCR confirmed that E. tarda was before and after challenge in 200 bp range. LD50, 96h was determined 1.2 x 10^5 (CFU/ml). Pathological experiments showed lesions in the kidney, including hemorrhages, degeneration of glumeruli and tubular epithelia, degeneration and necrosis of interestitium tissue, accumulation of protein casts in the tubular lumen. It was observed haemorhages, engorged blood vessels, congestion of sinusoids, increased of melanine, melano macrophage centers, degeneration and necrosis of hepatocytes in the liver. In the spleen, it was recorded congestion, degeneration, necrosis changes in the white and red pulpa, blood engorged and detachment of ellipsoid wall.

Oxímetro de pulso com comunicação via Bluetooth

Dissertação (mestrado)—Universidade de Brasília, Faculdade Gama, Programa de Pós-Graduação em Engenharia Biomédica, 2015.

Prévoir la Réussite des Étudiants en Techniques d’inhalothérapie et d’anesthésie

Abstract: Respiratory therapists must be able to care for their patients safely, efficiently and competently. They manage critically ill patients on life support systems. As a member of the anesthesia team they are responsible for the vulnerable patient undergoing surgery. Within all areas of the hospital they are called upon to make decisions and judgements concerning patient treatment. The environment that is found in the modern clinical setting is often stressful and demanding. The respiratory and anesthesia technology program has the responsibility of preparing competent practioners who graduate not only with a broad knowledge base but with the affective competencies that are required to meet these challenges. Faculty and clinical instructors in the program of Respiratory and Anesthesia Technology have been troubled by rising attrition rates and weak performance of students. It is apparent that this is not a problem unique to Vanier College. The rationale for this study was multi-fold; to establish a definition of student success, to determine whether pre-admission academic abilities can predict success in the program and whether scores on a professional behavioural aptitudes tool can predict success in the clinical year of the program. Predictors were sought that could be used either in the pre-program admission policies or during the course of study in order to ensure success throughout the program and beyond. A qualitative analysis involving clinical instructors and faculty (n=5) was carried out to explore what success signified for a student in the respiratory and anesthesia program. While this process revealed that a student who obtained a grade above 77.5% was considered “successful”, the concept surrounding success was a much more complex issue. Affective as well as cognitive and psychomotor abilities complete the model of the successful student. Appropriate behaviour and certain character traits in a respiratory therapy student are considered to be significant elements leading to success. Assessment of students in their clinical year of the respiratory & anesthesia technology program currently include little measurement of abilities in the affective domain, and the resulting grade becomes primarily a measure of academic and procedural skills. A quantitative study of preadmission records and final program grades was obtained from a single cohort of respiratory and anesthesia technology students who began the program in 2005 and graduated in 2008 (n=16). Data was collected and a descriptive analysis (analysis of variance, Pearson correlation) was used to determine the relationship between preadmission grades and success. The lack of association between the high school grades and grades in the program ran contrary to some of the findings in the literature and it can be cautiously inferred that preadmission grades do not predict success in the program. To ascertain the predictive significance of evaluating professional behavioural skills and success in clinical internship, a behaviour assessment tool was used by clinical instructors and faculty to score each student during a rotation in their third year of the program which was clinical internship. The results of this analysis showed that a moderately strong association could be made between a high score on the behavior assessment tool and final clinical grades. Therefore this tool may be effective in predicting success in the clinical year of the program. Refining the admissions process to meet the challenge and responsibility of turning out graduates who are capable of meeting the needs of the profession is difficult but essential. The capacity to predict which students possess the affective competencies necessary to cope and succeed in their clinical year is conceivably more important than their academic abilities. Although these preliminary findings contribute, to some degree, to the literature that exists concerning methods of predicting success in a respiratory and anesthesia technology program, much data is still unknown. Further quantitative and qualitative research is required using a broader population base to substantiate the findings of this small study.||Résumé: Les inhalothérapeutes doivent être capables de prodiguer des soins à leurs patients d’une manière sécuritaire, efficace et compétente. Ils/elles peuvent être appelé(e)s à gérer les soins aux personnes gravement malades branchées à un respirateur artificiel. En tant que membres de l’équipe d’anesthésie, ils/elles sont responsables des patients qui subissent une chirurgie. Ils/elles sont sollicité(e)s par tous les secteurs de l’hôpital pour décider ou juger des traitements à apporter aux malades. L’environnement dans lequel ils/elles travaillent est souvent stressant et exigeant. Le programme de Techniques d’inhalothérapie et d’anesthésie vise à former des inhalothérapeutes compétent(e)s qui possèdent non seulement les connaissances propres à la discipline mais également les aptitudes affectives nécessaires pour faire face à ces défis. Les enseignant(e)s et instructeur(e)s cliniques en Techniques d’inhalothérapie et d’anesthésie sont préoccupé(e)s par le taux d’abandon croissant et la faible performance des étudiant(e)s dans le programme. Il semble que ce problème ne soit pas unique au Collège Vanier. Le but de cette recherche est multiple : définir ce qu’est «réussir» pour les étudiant(e)s de ce programme; déterminer si les aptitudes scolaires acquises avant l’admission au programme peuvent aider à prévoir le succès des étudiant(e)s dans le programme; et si les résultats obtenus à un test mesurant les aptitudes comportementales professionnelles permettent de prévoir le succès des étudiant(e)s dans le stage clinique du programme. On a essayé d’identifier des facteurs qui pourraient être utilisés dans les politiques d’admission au programme ou celles régissant le cheminement dans le programme qui permettraient d’assurer le succès au cours du programme et par la suite. Une analyse qualitative a été conduite auprès des instructeur(e)s cliniques et des enseignant(e)s (n=5) afin d’étudier la notion de « réussite » des étudiant(e)s dans le programme. Bien qu’un(e) étudiant(e) ayant obtenu une note supérieure à 77.5% soit considéré(e) comme ayant « réussi », la notion de « réussite » est beaucoup plus complexe. Des aptitudes affectives, autant que cognitives et psychomotrices complètent le modèle d’un(e) étudiant(e) ayant réussi. Un comportement approprié et certains traits de caractère sont considérés comme des facteurs importants pour la réussite d’un(e) étudiant(e) en techniques d’inhalothérapie et d’anesthésie. L’évaluation qui se fait actuellement des étudiant(e)s dans le stage clinique du programme ne porte que peu sur les aptitudes affectives, et le résultat obtenu témoigne essentiellement des aptitudes scolaires et procédurales. Une analyse quantitative des dossiers des étudiant(e)s avant leur admission au programme et leurs notes finales a été conduite auprès d’une cohorte d’étudiant(e)s ayant commencé le programme en 2005 et gradué en 2008 (n=16). Des données ont été recueillies et une analyse descriptive (analyse de la variance, corrélation de Pearson) ont été faites afin de déterminer l’existence d’un lien entre les notes obtenues au secondaire et celles obtenues dans le programme. L’absence de corrélation entre les deux catégories de notes va à l’encontre de certaines recherches publiées et on peut déduire avec réserve que les notes obtenues avant l’admission au programme ne permettent pas de prévoir la réussite dans le programme. Afin de vérifier la portée de l’évaluation du comportement professionnel et de la réussite en milieu clinique quant à la prévision de réussite dans le programme, une méthode d’évaluation du comportement a été appliquée par les instructeurs(e) cliniques et les enseignant(e)s pour évaluer chaque étudiant(e) au cours d’une rotation dans leur troisième année de stage clinique. Les résultats de cette analyse ont démontré qu’une corrélation moyennement forte pouvait être faite entre une bonne note à l’évaluation comportementale et les notes finales du stage clinique. Perfectionner le processus d’admission au programme afin d’assumer la responsabilité de former des diplômé(e)s capables de répondre aux besoins de la profession est difficile mais essentiel. Avoir les moyens de prévoir quels/quelles étudiant(e)s ont les compétences affectives nécessaires pour faire face à la réussite de leur année de stage clinique est peut être plus important que d’avoir les aptitudes scolaires. Bien que ces observations préliminaires contribuent, à un certain degré, à la littérature existante sur les méthodes de prévoir la réussite dans le programme d’inhalothérapie et d’anesthésie, plusieurs données restent inconnues. Une recherche quantitative et qualitative plus élaborée, conduite sur un échantillon plus large de la population, est nécessaire afin de corroborer les résultats de cette étude limitée.

Evaluación del desempeño de pruebas diagnósticas de tuberculosis en pacientes VIH positivo en dos hospitales públicos de Bogotá

La tuberculosis TB es una de las principales causas de muerte en el mundo en individuos con infección por VIH. En Colombia esta coinfección soporta una carga importante en la población general convirtiéndose en un problema de salud pública. En estos pacientes las pruebas diagnósticas tienen sensibilidad inferior y la enfermedad evoluciona con mayor frecuencia hacia formas diseminadas y rápidamente progresivas y su diagnóstico oportuno representa un reto en Salud. El objetivo de este proyecto es evaluar el desempeño de las pruebas diagnósticas convencionales y moleculares, para la detección de TB latente y activa pacientes con VIH, en dos hospitales públicos de Bogotá. Para TB latente se evaluó la concordancia entre las pruebas QuantiFERON-TB (QTF) y Tuberculina (PPD), sugiriendo superioridad del QTF sobre la PPD. Se evaluaron tres pruebas diagnósticas por su sensibilidad y especificidad, baciloscopia (BK), GenoType®MTBDR plus (Genotype) y PCR IS6110 teniendo como estándar de oro el cultivo. Los resultados de sensibilidad (S) y especificidad (E) de cada prueba con una prevalencia del 19,4 % de TB pulmonar y extrapulmonar en los pacientes que participaron del estudio fue: BK S: 64% E: 99,1%; Genotype S: 77,8% E: 94,5%; PCRIS6110 S: 73% E: 95,5%, de la misma forma se determinaron los valores predictivos positivos y negativos (VPP y VPN) BK: 88,9% y 94,8%, Genotype S: 77,8% E: 94,5%; PCRIS6110 S: 90% y 95,7%. Se concluyó bajo análisis de curva ROC que las pruebas muestran un rendimiento diagnóstico similar por separado en el diagnóstico de TB en pacientes con VIH, aumentando su rendimiento diagnostico cuando se combinan

Prevalencia y caracterización de la disfonía, en operadores de un call center en Bogotá Colombia.

Resumen Introducción: El uso de la voz profesional requiere de una técnica y medidas de conservación para no verse afectada. Un inadecuado esquema corporal en el profesional de la voz, ocasiona alteración en los parámetros respiratorios y vocales manifestándose como disfonía. Objetivo: Determinar la prevalencia y caracterización de disfonía en 200 tele operadores de un call Center en Bogotá Colombia. Métodos: Estudio de corte transversal con datos secundarios provenientes de una base de datos con registros de una población de 200 tele operadores de un call center en Bogotá, Colombia, a los cuales se les aplicó evaluación de respiración y de voz durante el año 2003. La estimación de la prevalencia de la disfonía se realizó a través de la distribución de frecuencias relativas. Se realizó caracterización de la población estudiada según variables sociodemográficas, ocupacionales y parámetros respiratorios y vocales a través de métodos estadísticos según la naturaleza de estas variables. Se determinó la asociación entre factores ambientales, síntomas asociados, síntomas vocales, perfil vocal de Wilson y disfonía mediante la prueba de Chi Cuadrado de Pearson. Resultados: la prevalencia de disfonía fue del 73% (n= 146), el 34% presentó grado de disfonía moderado. Los resultados obtenidos en los parámetros de evaluación vocal se encontraron dentro del rango de normalidad, analizados en forma individual (tono, rango intensidad) y se relacionan con los resultados obtenidos con la prevalencia disfonía. El 95,5% de los tele operadores los parámetros respiratorios se encontraron alterados. Los tele operadores con disfonía en comparación a los sin disfonía tuvieron mayor frecuencia de presentación de los siguientes factores ambientales: ruido (68% vs 50,9% p=0,03) y vapores (27,2% vs 11,3% p= 0,02), síntomas corporales y de la voz respectivamente: cuello (69,4% vs 54,7% p= 0,05), dolor en la laringe (19,7% vs 7,5% p= 0,04). Conclusión: La prevalencia de disfonía encontrada en este call center fue alta Lo que requiere la implementación de medidas de prevención como tamizajes acústicos, para hacer seguimiento a las cualidades de la voz más afectadas, entrenamiento respiratorio y vocal, pausas vocales y medidas de conservación de la voz, para contribuir a que el tele operador desarrolle un mejor manejo de sus cualidades vocales acorde con su uso y disminuir la prevalencia de disfonía.

Uso de dexmedetomidina como tratamiento coadyuvante de síndrome de abstinencia alcohólica: revisión sistemática

El objetivo de este estudio es establecer si la dexmedetomidina (DEX) es segura y efectiva para el manejo coadyuvante de síndrome de abstinencia a alcohol (SAA) a través de la búsqueda de evidencia científica. Metodología: se realiza una revisión sistemática de literatura publicada y no publicada desde enero de 1989 hasta febrero 2016 en PubMed, Embase, Scopus, Bireme, Cochrane library y en otras bases de datos y portales. Los criterios de inclusión fueron ensayos clínicos aleatorizados y no aleatorizados, estudios cuasi-experimentales, estudios de cohorte, y estudios de casos y controles; que incluyeron pacientes mayores de 18 años hospitalizados con diagnóstico de SAA y donde se usó DEX como terapia coadyuvante. Resultados: 7 estudios, 477 pacientes, se incluyeron en el análisis final. Se encontraron dos ensayos clínicos aleatorizados, tres estudios de casos y controles y dos estudios de cohorte retrospectivo. Solo uno de los estudios fue doble ciego y utilizó placebo como comparador. Análisis y conclusiones: en los estudios experimentales se determinan que el uso de DEX como terapia coadyuvante en el manejo de SAA tiene significancia clínica y estadística para disminuir dosis de BZD en las primeras 24 horas de tratamiento; pero no demostraron tener otros beneficios clínicos. En los estudios no aleatorizados existe consenso que relaciona el uso de DEX con menores dosis de BZD de forma temprana. Recomendaciones: no se recomienda el uso de DEX en SAA de forma rutinaria. Se recomienda usar DEX solo en casos en el que exista evidencia fallo terapéutico a BZD.

Analysis of zinc oxide nanoparticles as a potential mutagen of respiratory epithelia

Metallische Nanopartikel und ihre Oxide (z.B. ZnO NP, TiO2 NP und Fe2O3 NP) werden aufgrund ihrer chemischen und physikalischen Eigenschaften häufig als Additive in der Reifenproduktion, in Katalysatoren, Lebensmitteln, Arzneimitteln und Kosmetikprodukten verwendet. Künftig wird ein kontinuierlicher Anstieg der industriellen Anwendung (~ 1663 Tonnen im Jahr 2025) mit gesteigerter Freisetzung in die Umwelt erwartet, was zwangsläufig zu einer vermehrten Aufnahme über das respiratorische Epithel führt. Metalldampffieber ist als gesundheitsschädigender Effekt von Metalloxid-haltigen Aerosolen (z.B. ZnO) nach Inhalation bekannt. Immunreaktionen, wie beispielsweise Entzündungen, werden häufig mit der Entstehung von Sauerstoffradikalen (ROS) in Verbindung gebracht, die wiederum zu DNA-Schäden führen können. Drei mögliche Ursachen der Genotoxität werden angenommen: direkte Interaktion von Nanopartikeln mit intrazellulären Strukturen, Interaktion von Ionen dissoziierter Partikel mit intrazellulären Strukturen sowie die Entstehung von ROS initiiert durch Partikel oder Ionen.rnDie vorliegende Studie befasst sich mit den Mechanismen der Genotoxizität von ZnO Nanopartikeln (ZnO NP), als Beispiel für metallische Nanopartikel, im respiratorischen Epithel. In der Studie wurde gezielt die intrazelluläre Aufnahme und Verteilung von ZnO NP, deren Toxizität, deren DNA schädigendes Potential sowie die Aktivierung der DNA damage response (DDR) analysiert.rnEs konnten kaum internalisierte ZnO NP mittels TEM detektiert werden. Innerhalb der ersten Sekunden nach Behandlung mit ZnO NP wurde spektrofluorometrisch ein starker Anstieg der intrazellulären Zn2+ Konzentration gemessen. In unbehandelten Zellen war Zn2+ in granulären Strukturen lokalisiert. Die Behandlung mit ZnO NP führte zu einer Akkumulation von Zn2+ in diesen Strukturen. Im zeitlichen Verlauf verlagerten sich die Zn2+-Ionen in das Zytoplasma, sowie in Zellkerne und Mitochondrien. Es wurde keine Kolokalisation von Zn2+ mit den frühen Endosomen und dem endoplasmatischen Retikulum beobachtet. Die Vorbehandlung der Zellen mit Diethylen-triaminpentaessigsäure (DTPA), als extrazellulärem Komplexbildner, verhinderte den intrazellulären Anstieg von Zn2+ nach Behandlung mit den Partikeln.rnDie Behandlung mit ZnO NP resultierte in einer zeit- und dosisabhängigen Reduktion der zellulären Viabilität, während die intrazelluläre ROS-Konzentrationen in den ersten 30 min leicht und anschließend kontinuierlich bis zum Ende der Messung anstiegen. Außerdem verringerte sich das mitochondriale Membranpotential, während sich die Anzahl der frühapoptotischen Zellen in einer zeitabhängigen Weise erhöhte. rnDNA Doppelstrangbrüche (DNA DSB) wurden mittels Immunfluoreszenz-Färbung der γH2A.X foci sichtbar gemacht und konnten nach Behandlung mit ZnO NP detektiert werden. Die Vorbehandlung mit dem Radikalfänger N-Acetyl-L-Cytein (NAC) resultierte in stark reduzierten intrazellulären ROS-Konzentrationen sowie wenigen DNA DSB. Die DNA Schädigung wurde durch Vorbehandlung mit DTPA ganz verhindert.rnDie Aktivierung der DDR wurde durch die Analyse von ATM, ATR, Chk1, Chk2, p53 und p21 mittels Western Blot und ELISA nach Behandlung mit ZnO NP überprüft. Der ATR/Chk1 Signalweg wurde durch ZnO NP nicht aktiviert. Die Komplexierung von Zn2+ resultierte in einer verminderten ATM/Chk2 Signalwegaktivierung. Es zeigte sich, dass das Abfangen von ROS keinen Effekt auf die ATM/Chk2 Signalwegaktivierung hatte.rnZusammengefasst wurde festgestellt, dass die Exposition mit ZnO NP in der Entstehung von ROS, reduzierter Viabilität und vermindertem mitochondrialem Membranpotential resultiert, sowie zeitabhängig eine frühe Apoptose initiiert. ZnO NP dissoziierten extrazellulär und wurden schnell als Zn2+ über unbekannte Mechanismen internalisiert. Die Zn2+-Ionen wurden im Zytoplasma, sowie besonders in den Mitochondrien und dem Zellkern, akkumuliert. Die DDR Signalgebung wurde durch ZnO NP aktiviert, jedoch nicht durch NAC inhibiert. Es wurde gezeigt, dass DTPA die DDR Aktivierung komplett inhibierte. Die Behandlung mit ZnO NP induzierte DNA DSB. Die Inhibition von ROS reduzierte die DNA DSB und die Komplexierung der Zn2+ verhinderte die Entstehung von DNA DSB.rnDiese Daten sprechen für die Dissoziation der Partikel und die hierbei freigesetzten Zn2+ als Hauptmediator der Genotoxizität metallischer Nanopartikel. rn

Influenza virus inhibits amiloride-sensitive Na+ channels in respiratory epithelia

Many pathogens causing diarrhea do so by modulating ion transport in the gut. Respiratory pathogens are similarly associated with disturbances of fluid balance in the respiratory tract, although it is not known whether they too act by altering epithelial ion transport. Here we show that influenza virus A/PR/8/34 inhibits the amiloride-sensitive Na+ current across mouse tracheal epithelium with a half-time of about 60 min. We further show that the inhibitory effect of the influenza virus is caused by the binding of viral hemagglutinin to a cell-surface receptor, which then activates phospholipase C and protein kinase C. Given the importance of epithelial Na+ channels in controlling the amount of fluid in the respiratory tract, we suggest that down-regulation of Na+ channels induced by influenza virus may play a role in the fluid transport abnormalities that are associated with influenza infections.

Genetic manipulation of blood group carbohydrates alters development and pathfinding of primary sensory axons of the olfactory systems

Primary sensory neurons in the vertebrate olfactory systems are characterised by the differential expression of distinct cell surface carbohydrates. We show here that the histo-blood group H carbohydrate is expressed by primary sensory neurons in both the main and accessory olfactory systems while the blood group A carbohydrate is expressed by a subset of vomeronasal neurons in the developing accessory olfactory system. We have used both loss-of-function and gain-of-function approaches to manipulate expression of these carbohydrates in the olfactory system. In null mutant mice lacking the alpha(1,2)fucosyltransferase FUT1, the absence of blood group H carbohydrate resulted in the delayed maturation of the glomerular layer of the main olfactory bulb. In addition, ubiquitous expression of blood group A on olfactory axons in gain-of-function transgenic mice caused mis-routing of axons in the glomerular layer of the main olfactory bulb and led to exuberant growth of vomeronasal axons in the accessory olfactory bulb. These results provide in vivo evidence for a role of specific cell surface carbohydrates during development of the olfactory nerve pathways. (c) 2006 Elsevier Inc. All rights reserved.

Air pollution and hospital admissions for respiratory diseases in the subequatorial Amazon: a time series approach

The objective of the study is to evaluate the effect of the daily variation in concentrations of fine particulate matter (diameter less than 2.5µm - PM2.5) resulting from the burning of biomass on the daily number of hospitalizations of children and elderly people for respiratory diseases, in Alta Floresta and Tangará da Serra in the Brazilian Amazon in 2005. This is an ecological time series study that uses data on daily number of hospitalizations of children and the elderly for respiratory diseases, and estimated concentration of PM2.5. In Alta Floresta, the percentage increases in the relative risk (%RR) of hospitalization for respiratory diseases in children were significant for the whole year and for the dry season with 3-4 day lags. In the dry season these measurements reach 6% (95%CI: 1.4-10.8). The associations were sig-nificant for moving averages of 3-5 days. The %RR for the elderly was significant for the current day of the drought, with a 6.8% increase (95%CI: 0.5-13.5) for each additional 10µg/m3 of PM2.5. No as-sociations were verified for Tangara da Serra. The PM2.5 from the burning of biomass increased hospitalizations for respiratory diseases in children and the elderly.

Comparison of direct immunofluorescence, conventional cell culture and polymerase chain reaction techniques for detecting respiratory syncytial virus in nasopharyngeal aspirates from infants

A total of 316 samples of nasopharyngeal aspirate from infants up to two years of age with acute respiratory-tract illnesses were processed for detection of respiratory syncytial virus (RSV) using three different techniques: viral isolation, direct immunofluorescence, and PCR. Of the samples, 36 (11.4%) were positive for RSV, considering the three techniques. PCR was the most sensitive technique, providing positive findings in 35/316 (11.1%) of the samples, followed by direct immunofluorescence (25/316, 7.9%) and viral isolation (20/315, 6.3%) (p < 0.001). A sample was positive by immunofluorescence and negative by PCR, and 11 (31.4%) were positive only by RT-PCR. We conclude that RT-PCR is more sensitive than IF and viral isolation to detect RSV in nasopharyngeal aspirate specimens in newborn and infants.

Respiratory infection, exposure to mouse allergen and breastfeeding: role in recurrent wheezing in early life

Background: Environmental factors may influence the development of allergen sensitization and asthma. The aim of this study was to evaluate the role of endotoxin and allergen exposure in early life as a risk factor for recurrent wheezing. Methods: One hundred and four infants from low-income families, at high risk of asthma, were enrolled at birth. Dust samples were collected from the bedding and bedroom floor within 6 months after birth. Recurrent wheezing was defined as 3 or more wheezing episodes in the past year. Endotoxin was determined by Limulus amebocyte lysate assay, and major indoor allergens were quantitated by ELISA in dust extracts. IgE antibodies were measured by ImmunoCAP at 30 months of age. Results: At 30 months, 51 of the 99 infants who completed the study (51.5 per cent) had recurrent wheezing. Respiratory infection was strongly associated with recurrent wheezing (OR 6.67, 95 per cent CI 1.96-22.72), whereas exclusive breastfeeding for at least 1 month was a protective factor (OR 0.09, 95 per cent CI 0.01-0.51). Exposure to high levels of mouse allergen was more frequent among non-recurrent wheezers, approaching significance (OR 0.12, 95 per cent CI 0.01-1.13; p = 0.064). None of the children were sensitized to mouse. Sensitization to mite was found in 26/90 (28.8 per cent) children, with no association with recurrent wheezing. Conclusion: Respiratory infection was strongly associated with recurrent wheezing in the first 30 months of life, in children at high risk of asthma, living in a socially deprived community in Brazil

Rhinovirus C and Respiratory Exacerbations in Children with Cystic Fibrosis

To investigate a possible role for human rhinovirus C in respiratory exacerbations of children with cystic fibrosis, we conducted microbiologic testing on respiratory specimens from 103 such patients in Sao Paulo, Brazil, during 2006-2007. A significant association was found between the presence of human rhinovirus C and respiratory exacerbations.