In response to infection, macrophages adapt their metabolism rapidly to enhance glycolysis and fuel specialized antimicrobial effector functions. Here we show that fungal melanin is an essential molecule required for the metabolic rewiring of macrophages during infection with the fungal pathogen Aspergillus fumigatus. Using pharmacological and genetic tools, we reveal a molecular link between calcium sequestration by melanin inside the phagosome and induction of glycolysis required for efficient innate immune responses. By remodeling the intracellular calcium machinery and impairing signaling via calmodulin, melanin drives an immunometabolic signaling axis towards glycolysis with activation of hypoxia-inducible factor 1 subunit alpha (HIF-1α) and phagosomal recruitment of mammalian target of rapamycin (mTOR). These data demonstrate a pivotal mechanism in the immunometabolic regulation of macrophages during fungal infection and highlight the metabolic repurposing of immune cells as a potential therapeutic strategy.

RESUMOIncontinência urinária é um problema de saúde pública por ser uma doença multifatorial que acomete, em termos, 27,6% das mulheres e 10,5% dos homens, refl etindo nas relações interpessoais, profi ssionais e sexuais. O estudo teve como objetivo caracterizar o perfi l sociodemográfi co, epidemiológico e clínico de mulheres com incontinência uriná-ria atendidas em uma clínica ginecológica de um hospital universitário do Piauí. É uma pesquisa de campo do tipo exploratório descritiva e transversal, que foi realizada em setembro de 2015, mediante a aplicação de um formulário semiestruturado a 48 mulheres. A prevalência de incontinência urinária foi maior em mulheres com faixa etária entre 30 e 48 anos (52,1%), casadas (56,3%), pardas (72,9%) e com ensino fundamental incompleto (39,6%). Destacam-se como fatores de risco: consumo de cafeína (97,9%), cirurgia ginecológica (87,5%), infecção urinária (62,5%) e prática de atividade física (56,3%). O tempo de início da doença foi entre um e cinco anos (43,8%), com episódios de perda de urina ao espirrar (89,6%), ao tossir (83,3%) e antes de chegar ao banheiro (75%). Tais mulheres adotaram como atitudes comportamentais fi car próximas ao banheiro (54,2%) e fazer uso de absorventes ou de forros (41,7%). Apenas 33,3% procuraram um médico, 35,4% receberam orientações sobre a doença, 25% conheceram o diagnóstico médico e 12,5% realizaram algum tipo de tratamento. O estudo possibilitou conhecer a realidade das mulheres com incontinência urinária que buscam assistência à saúde em um hospital universitário, com resultados que se aproximam de estudos anteriores sobre a temática. DESCRITORES: Incontinência urinária. Fatores de risco. Enfermagem. Estomaterapia. ABSTRACTUrinary incontinence is a public health problem because it is a multifactorial disease that aff ects 27.6% of women and 10.5% of men. Thus, it refl ect in interpersonal, professional and sexual relations. The study aimed at characterizing the sociodemographic, clinical and epidemiological profi le of women with urinary incontinence cared at a gynecological clinic of a university hospital in Piauí, Brazil. It is a descriptive exploratory fi eld research, carried out in September 2015, by applying a semi-structured form in 48 women. The prevalence of urinary incontinence was higher in women aged between 30 and 48 years old (52.1%), married (56.3%), brown (72.9%) and with incomplete primary school educational

Objective: to describe the validation of the booklet on self-care with the feet of people with diabetes. Method: methodological study, focusing on the validation of a printed booklet. The content and appearance of the booklet was validated by 23 judges divided into three groups: 11 content and appearance, seven technicians and five of the area of design and marketing. The appearance was validated by 30 people with type 2 Diabetes Mellitus. Results: the judges in the nursing area allowed the validation of material with a Content Validity Index (CVI) of 0.99, judges in the area of design and marketing with Suitability Assessment of Materials (SAM) of 99.2% and the target audience with concordance index of 99.4%. Conclusion: the educational booklet proved to be valid and reliable educational material to be used in order to promote compliance with self-care with the feet of people with Diabetes Mellitus.

Similar efficacy with omalizumab in chronic idiopathic/spontaneous urticaria despite different background therapy.

The most common variables used to compute probability of death algorithms were not capable of predicting health-related quality of life in survivors to pediatric intensive care. The preadmission health-related quality of life and trauma admissions are important variables to predict change in the health-related quality of life of children surviving to pediatric intensive care.

Objective: to describe the bodily awareness of people with stomies. Method: a descriptive study with a qualitative approach, carried out in the Ostomized Association of the State of Ceará, through semi-structured interviews with ten people with intestinal stomies, according to Merleau-Ponty's phenomenological thinking. Results: two categories of analysis emerged: The body that I have, in which the sensations of defi ciency, imperfection and bad odor add to the feeling of strangeness towards one's own body, affecting the way of being in the world of each deponent; and The body that others perceive, in which the stoma is seen as an embarrassing and complex experience, since it hampers daily activities and conviviality with other people. Final considerations: The corporeal consciousness of Being-Stomp-in-the-world requires the movement to reconstruct the senses of the body from the body I have and from that which others perceive. Descriptors: Consciousness; Body Image; Stomach; Surgical Stomas; Nursing. RESUMO Objetivo: descrever a consciência corpórea de pessoas com estomia. Método: estudo descritivo com abordagem qualitativa, realizado na Associação dos Ostomizados do Estado do Ceará, por meio de entrevistas semiestruturadas com dez pessoas com estomia intestinal, segundo o pensamento fenomenológico de Merleau-Ponty. Resultados: emergiram duas categorias da análise: O corpo que eu tenho, no qual as sensações de defi ciência, imperfeição e odor ruim somam-se ao sentimento de estranheza para com o próprio corpo, afetando o modo de ser no mundo de cada depoente; e O corpo que os outros percebem, em que o estoma é visto como uma experiência constrangedora e complexa, uma vez que difi culta as atividades cotidianas e o convívio com outras pessoas. Considerações fi nais: a consciência corpórea de Ser-estomizado-no-mundo exige o movimento de reconstruir os sentidos do corpo a partir do corpo que eu tenho e daquele que os outros percebem. Descritores: Consciência; Imagem Corporal; Estomia; Estomas Cirúrgicos; Enfermagem. RESUMEN Objetivo: describir la consciencia corpórea de personas con estoma. Método: estudio descriptivo con abordaje cualitativa, realizado en la Asociación de Estoma del Estado de Ceará, por medio de entrevistas semi estructuradas con diez personas con estoma intestinal, según el pensamiento fenomenológico de Merleau-Ponty. Resultados: emergieron dos categorías del análisis: El cuerpo que tengo, en el cual las sensaciones de defi ciencia, imperfección y olor malo se suman al sentimiento de extrañeza para con el propio cuerpo, afectando el modo de ser en el mundo de cada deponente; y El cuerpo que los demás notan, en 392Body consciousness of people with intestinal stomach: A phenomenological study Marques ADB, et al.

BACKGROUND: Transfusion‐associated graft‐versus‐host disease (TA‐GVHD) is a rare complication of transfusion of nonirradiated blood components. It usually affects children in high‐risk groups, including those who have primary immunodeficiencies (PIDs). It usually presents with skin, hepatic, digestive, and hematologic involvement and is normally fatal. CASE REPORT: We report the case of a nonlethal, attenuated, TA‐GVHD in a 7‐month‐old boy. The disease was marked by the presence of a severe rash but lacked all the other usual manifestations. We speculate that the unusually benign course of this disease, which has normally a fulminant course, was due to the fact that this child was under high‐dose corticotherapy at the time of the engraftment. This fortunate coincidence led to the survival of this child and allowed the diagnosis of a combined immunodeficiency. CONCLUSION: A high index of suspicion is required for the diagnosis and proper management of PID. The administration of nonirradiated blood components in the first year of life, sometimes before the clinical suspicion of a PID, is of great concern. TA‐GVHD may be more prevalent than reported in the literature and it is possibly a nonidentified cause of death in recipients with unexplained death and nondiagnosed PID.

ABSTRACT Objectives: to assess the usability of an app prototype for diabetic foot self-care by an end user. Methods: a descriptive study that uses heuristic assessment of a hybrid app usability. Fifteen users of an outpatient diabetes care service in a capital of Northeastern Brazil participated in the study during April 2018. The usability measurement tool called Smartphone Usability questionnaiRE was applied. Results: the lowest score was 77 and the highest was 112, with an average usability of 96.1 points. Usability was framed in the last two levels, 70 and 8o. Users now strongly agree (level 70) and fully (level 80) with the assessed items, which represents good usability of the apps prototype. Conclusions: the final product developed focuses on user needs and requirements, which can ensure usability based on effectiveness, efficiency and satisfaction triad.