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Amamentação e as intercorrências que contribuem para o desmame precoceLactancia materna y complicaciones que contribuyen al destete precoz ABSTRACT Objective: To obtain knowledge on the experience of mothers about breastfeeding and events that contribute to early weaning. Method: research descriptive and exploratory kind with a qualitative approach carried out in a unit of the Family Health Strategy in the city of Cáceres-MT, through semi-structured interviews with 21 women who gave birth from January / 2012 to January / 2014. Results: The data showed that at six months only 19.1% of the children were still being exclusively breastfed and the main explanations for this were: Lack of knowledge, inexperience / insecurity; Underestimation of maternal distress; Complications of puerperal breast; Family interference; Weak / inadequate milk; maternal employment. Conclusion:The study reinforced the need for adjustments in the current care model, surpassing applicability of predefined techniques, encouraging critical judgment and perception of health professionals regarding the the construction of new knowledge and behaviors. Keywords: Breastfeeding. Weaning. Maternal-child nursing. Millennium Development Goals. RESUMOObjetivo: conhecer a vivência de mães em relação à amamentação e as intercorrências que contribuem para o desmame precoce. Método: pesquisa do tipo descritiva-exploratória, com abordagem qualitativa realizado em uma unidade de Estratégia da Saúde da Família, no município de Cáceres-MT, por meio de entrevista semi-estruturada com 21 mulheres que tiveram filhos de janeiro/2012 a janeiro/2014. Resultados: Os dados apontaram que ao término dos 6 meses das crianças, somente 19,1%, continuavam em Aleitamento Materno Exclusivo e as principais alegações para sua ocorrência foram: Déficit de conhecimentos inexperiência/insegurança; Banalização das angústias maternas; Intercorrências da mama puerperal; Interferências familiares; Leite fraco/insuficiente; trabalho materno. Conclusão: O estudo reforçou a necessidade de ajustes no modelo de atenção vigente, ultrapassando aplicabilidade de técnicas pré--definidas, incentivando a criticidade perceptiva dos profissionais de saúde na construção de novos saberes e condutas. Palavras-chave: Aleitamento materno. Desmame. Enfermagem materno-infantil. Objetivos de Desenvolvimento do Milênio. RESUMENObjetivo: conocer la experiencia de las madres sobre la lactancia materna y eventos que contribuyen al destete precoz. Método: investigación tipo descriptivo y exploratorio con abordaje cualitativo realizado en una unidad de la Estrategia Salud de la Familia en la ciudad de Cáceres-MT, a través de entrevistas semi-estructuradas con 21 mujeres que dieron a luz entre enero / 2012 a enero / 2.014. Resultados: Los datos mostraron que al final de los seis meses los niños, sólo el 19,1% se encontraban todavía en la lactancia materna exclusiva y de las principales demandas de su aparición fueron: conocimiento déficit inexperiencia / inseguridad; Banalización de la angustia materna; Las comp...

ABSTRACT:A method was developed and validated for the simultaneous determination of dimethyltryptamine and β-carfbolines alkaloids (harmine, harmaline and tetrahydroharmine) in ayahuasca preparations. The alkaloids were extracted by menas of solid phase extraction (C18) and detected by gas Introduction -Ayahuasca is obtained by infusing the pounded stems of Banisteriopsis caapi in combination with the leaves of Psychotria viridis. P. viridis is rich in the psychedelic indole N,N-dimethyltryptamine, whereas B. caapi contains substantial amounts of b-carboline alkaloids, mainly harmine, harmaline and tetrahydroharmine, which are monoamine-oxidase inhibitors. Because of differences in composition in ayahuasca preparations, a method to measure their main active constituents is needed. Objective -To develop a gas chromatographic method for the simultaneous determination of dimethyltryptamine and the main b-carbolines found in ayahuasca preparations. Methodology -The alkaloids were extracted by means of solid phase extraction (C 18 ) and detected by gas chromatography with nitrogen/phosphorous detector. Results -The lower limit of quantification (LLOQ) was 0.02 mg/mL for all analytes. The calibration curves were linear over a concentration range of 0.02-4.0 mg/mL (r 2 > 0.99). The method was also precise (RSD < 10%). Conclusion -A simple gas chromatographic method to determine the main alkaloids found in ayahuasca was developed and validated. The method can be useful to estimate administered doses in animals and humans for further pharmacological and toxicological investigations of ayahuasca.

A busca por métodos de estimativa da composição corporal é uma preocupação constante da comunidade científica, com vistas à obtenção de um acurado diagnóstico do estado nutricional de indivíduos e populações. A bioimpedância elétrica tem sido uma alternativa atraente na avaliação da composição corporal, pela possibilidade de se trabalhar com equipamento não invasivo, portátil, de fácil manuseio, boa reprodutibilidade e, portanto, viável para a prática clínica e para estudos epidemiológicos. Sua utilização, que tem como finalidade determinar o fracionamento da composição corporal, tem sido apontada como uma técnica capaz de superar alguns desafios encontrados em outros métodos para avaliar o estado nutricional. Entre os componentes da bioimpedância elétrica, o ângulo de fase consiste em uma ferramenta cada vez mais utilizada na prática clínica, sendo estudado como indicador prognóstico e de estado nutricional. Esse ângulo indica alterações na composição corporal e na função da membrana celular, portanto, no estado de saúde de indivíduos. Dada a carência de estudos brasileiros sobre determinadas aplicações da bioimpedância elétrica, a proposta deste estudo, buscando contribuir com a literatura, é traçar um panorama sobre o emprego dessa técnica e, ainda, apresentar trabalhos que a comparam com outros métodos de avaliação nutricional e composição corporal.

Canova (CA) is a complex homeopathic medication used in diseases where the immune system is depressed. Previous studies demonstrated that it is neither toxic nor mutagenic and activates macrophages. We now evaluate CA effects on cytokine production and gene expression from mice macrophages. The global view of changes in expression of genes with known functions can provide a vivid picture of the way in which cell adapts to a changing environment or a challenge. We found a decrease in IL-2 and IL-4 production and a differential expression in 147 genes from CA group. These genes are mainly involved in transcription/translation, cell structure and dynamics, immune response, cytoprotection, enzymatic process, and receptors/ligands. With gene expression analysis we state that this medication provokes a reaction that involves alterations in gene expression profile mainly in the ones involved with macrophages activation, corroborating the laboratorial research and the clinical data.

Leishmania disease expression has been linked to IL-10. In this study, we investigated the regulation of IL-10 production by macrophages infected with Leishmania donovani. Infection of either murine or human macrophages brought about selective phosphorylation of Akt-2 in a PI3K-dependent manner. These events were linked to phosphorylation and inactivation of glycogen synthase kinase-3β (GSK-3β) at serine 9, as the latter was abrogated by inhibition of either PI3K or Akt. One of the transcription factors that is negatively regulated by GSK-3β is CREB, which itself positively regulates IL-10 expression. Infection of macrophages with leishmania induced phosphorylation of CREB at serine 133, and this was associated with enhanced CREB DNA binding activity and induction of IL-10. Similar to phosphorylation of GSK-3β, both phosphorylation of CREB at serine 133 and CREB DNA binding activity were abrogated in cells treated with inhibitors of either PI3K or Akt prior to infection. Furthermore, disruption of this pathway either by inhibition of Akt or by overexpression of GSK-3β markedly attenuated IL-10 production in response to leishmania. Thus, GSK-3β negatively regulates myeloid cell IL-10 production in response to leishmania. Switching off GSK-3β promotes disease pathogenesis.

Natural killer (NK) cells are innate lymphocytes that play a major role in immunosurveillance against tumor initiation and metastatic spread. The signals and checkpoints that regulate NK cell fitness and function in the tumor microenvironment are not well defined. Transforming growth factor–β (TGF-β) is a suppressor of NK cells that inhibits interleukin-15 (IL-15)–dependent signaling events and increases the abundance of receptors that promote tissue residency. Here, we showed that NK cells express the type I activin receptor ALK4, which, upon binding to its ligand activin-A, phosphorylated SMAD2/3 to suppress IL-15–mediated NK cell metabolism. Activin-A impaired human and mouse NK cell proliferation and reduced the production of granzyme B to impair tumor killing. Similar to TGF-β, activin-A also induced SMAD2/3 phosphorylation and stimulated NK cells to increase their cell surface expression of several markers of ILC1 cells. Activin-A also induced these changes in TGF-β receptor–deficient NK cells, suggesting that activin-A and TGF-β stimulate independent pathways that drive SMAD2/3-mediated NK cell suppression. Last, inhibition of activin-A by follistatin substantially slowed orthotopic melanoma growth in mice. These data highlight the relevance of examining TGF-β–independent SMAD2/3 signaling mechanisms as a therapeutic axis to relieve NK cell suppression and promote antitumor immunity.

OBJECTIVES:The ability of the Timed Up and Go test to predict sarcopenia has not been evaluated previously. The objective of this study was to evaluate the accuracy of the Timed Up and Go test for predicting sarcopenia in elderly hospitalized patients.METHODS:This cross-sectional study analyzed 68 elderly patients (≥60 years of age) in a private hospital in the city of Salvador-BA, Brazil, between the 1st and 5th day of hospitalization. The predictive variable was the Timed Up and Go test score, and the outcome of interest was the presence of sarcopenia (reduced muscle mass associated with a reduction in handgrip strength and/or weak physical performance in a 6-m gait-speed test). After the descriptive data analyses, the sensitivity, specificity and accuracy of a test using the predictive variable to predict the presence of sarcopenia were calculated.RESULTS:In total, 68 elderly individuals, with a mean age 70.4±7.7 years, were evaluated. The subjects had a Charlson Comorbidity Index score of 5.35±1.97. Most (64.7%) of the subjects had a clinical admission profile; the main reasons for hospitalization were cardiovascular disorders (22.1%), pneumonia (19.1%) and abdominal disorders (10.2%). The frequency of sarcopenia in the sample was 22.1%, and the mean length of time spent performing the Timed Up and Go test was 10.02±5.38 s. A time longer than or equal to a cutoff of 10.85 s on the Timed Up and Go test predicted sarcopenia with a sensitivity of 67% and a specificity of 88.7%. The accuracy of this cutoff for the Timed Up and Go test was good (0.80; IC=0.66-0.94; p=0.002).CONCLUSION:The Timed Up and Go test was shown to be a predictor of sarcopenia in elderly hospitalized patients.