IntroductionThe use of anti-retroviral therapy (ART) has dramatically reduced HIV-1 associated morbidity and mortality. However, HIV-1 infected individuals have increased rates of morbidity and mortality compared to the non-HIV-1 infected population and this appears to be related to end-organ diseases collectively referred to as Serious Non-AIDS Events (SNAEs). Circulating miRNAs are reported as promising biomarkers for a number of human disease conditions including those that constitute SNAEs. Our study sought to investigate the potential of selected miRNAs in predicting mortality in HIV-1 infected ART treated individuals.Materials and MethodsA set of miRNAs was chosen based on published associations with human disease conditions that constitute SNAEs. This case: control study compared 126 cases (individuals who died whilst on therapy), and 247 matched controls (individuals who remained alive). Cases and controls were ART treated participants of two pivotal HIV-1 trials. The relative abundance of each miRNA in serum was measured, by RTqPCR. Associations with mortality (all-cause, cardiovascular and malignancy) were assessed by logistic regression analysis. Correlations between miRNAs and CD4+ T cell count, hs-CRP, IL-6 and D-dimer were also assessed.ResultsNone of the selected miRNAs was associated with all-cause, cardiovascular or malignancy mortality. The levels of three miRNAs (miRs -21, -122 and -200a) correlated with IL-6 while miR-21 also correlated with D-dimer. Additionally, the abundance of miRs -31, -150 and -223, correlated with baseline CD4+ T cell count while the same three miRNAs plus miR-145 correlated with nadir CD4+ T cell count.DiscussionNo associations with mortality were found with any circulating miRNA studied. These results cast doubt onto the effectiveness of circulating miRNA as early predictors of mortality or the major underlying diseases that contribute to mortality in participants treated for HIV-1 infection.
Background Entamoeba species harbored by humans have different degrees of pathogenicity. The present study explores the intra- and interspecific diversity, phylogenetic relationships, prevalence and distribution of tetra- and octonucleated cyst-producing Entamoeba in different Brazilian regions. Methods Cross-sectional studies were performed to collect fecal samples (n = 1728) and sociodemographic data in communities located in four Brazilian biomes: Atlantic Forest, Caatinga, Cerrado, and Amazon. Fecal samples were subjected to molecular analysis by partial small subunit ribosomal DNA sequencing (SSU rDNA) and phylogenetic analysis. Results Light microscopy analysis revealed that tetranucleated cysts were found in all the studied biomes. The highest positivity rates were observed in the age group 6–10 years (23.21%). For octonucleated cysts, positivity rates ranged from 1 to 55.1%. Sixty SSU rDNA Entamoeba sequences were obtained, and four different species were identified: the octonucleated E. coli, and the tetranucleated E. histolytica, E. dispar, and E. hartmanni. Novel haplotypes (n = 32) were characterized; however, new ribosomal lineages were not identified. The Entamoeba coli ST1 subtype predominated in Atlantic Forest and Caatinga, and the ST2 subtype was predominant in the Amazon biome. E. histolytica was detected only in the Amazon biome. In phylogenetic trees, sequences were grouped in two groups, the first containing uni- and tetranucleated and the second containing uni- and octonucleated cyst-producing Entamoeba species. Molecular diversity indexes revealed a high interspecific diversity for tetra- and octonucleated Entamoeba spp. (H ± SD = 0.9625 ± 0.0126). The intraspecific diversity varied according to species or subtype: E. dispar and E. histolytica showed lower diversity than E. coli subtypes ST1 and ST2 and E. hartmanni. Conclusions Tetra- and octonucleated cyst-producing Entamoeba are endemic in the studied communities; E. histolytica was found in a low proportion and only in the Amazon biome. With regard to E. coli, subtype ST2 was predominant in the Amazon biome. The molecular epidemiology of Entamoeba spp. is a field to be further explored and provides information with important implications for public health.
Objetivo: Analisar a percepção de mulheres acerca das vulnerabilidades para infecções sexualmente transmissíveis (IST) durante a visita Íntima em unidades de um sistema prisional. Método: Trata-se de um estudo qualitativo, descritivo e exploratório, realizado com 29 mulheres, companheiras de homens em situação de privação de liberdade. A produção dos dados de deu mediante entrevista realizada durante o ano de 2016. A análise dos dados ocorreu por meio do software Iramutec. A pesquisa foi aprovada sob o nº CAAE: 56476715.3.0000.8007. Resultados: A idade dos participantes variou entre 18 a 46 anos; a cor da pele autorreferida parda foi predominante (65,5 %); 10,3% dos participantes referiram já terem adquirido alguma infecção sexualmente transmissível. Associou-se à prevenção e a proteção às infecções sexualmente transmissíveis ao uso do preservativo, sendo que a percepção da vulnerabilidade está ligada à confiança no parceiro. Conclusão: não houve percepção de vulnerabilidade para infecções sexualmente transmissíveis por parte das mulheres participantes do estudo, evidenciando a necessidade da promoção da educação sexual dessas mulheres e seus companheiros no contexto prisional. O estudo foi essencial para entender os conceitos de vulnerabilidade sob a percepção de uma população de risco, sendo que outros estudos são necessários para aprofundamento do tema.
Vivência e saberes das parturientes acerca da violência obstétrica institucional no partoLiving and knowledge of about mothers obstetrical institutional violence in childbirth Vivencia y saberes de las parturientes acerca de la violencia obstétrica institucional en el parto RESUMOObjetivo: Investigar a vivência e os saberes de parturientes acerca do fenômeno da violência obstétrica institucional. Métodos: Estudo descritivo, qualitativo e exploratório realizado em uma maternidade pública do interior do estado do maranhão com 12 mulheres em atendimento na unidade de saúde por meio de entrevista semiestruturada. A análise dos dados ocorreu por meio do método de análise de conteúdo de Bardin. Resultados: A maioria das participantes não reconhecia ou entendia quaisquer práticas de violência obstétrica institucional, levando-as a acreditar erroneamente que os maus-tratos sofridos faziam parte das práticas assistenciais do parto. Pode-se relacionar este contexto a falta de conhecimento prévio das mulheres em relação ao tema da violência obstétrica institucional. Considerações finais: A violência obstétrica institucional ainda é cercada de tabus, tendo em vista o conhecimento das parturientes acerca da temática ainda é deficiente, o que acaba por favorecer tais atos de desumanização em um momento emocionalmente e fisicamente significante para a mulher. Para as mulheres, a violência obstétrica institucional possui muitas facetas, podendose apresentar desde a falta de sensibilização do profissional até as agressões físicas. A solução do problema da violência obstétrica, segundo a própria perspectiva de algumas mulheres entrevistadas, está na atualização dos profissionais para proporcionar um cuidado humanizado.Descritores: Violência; Parto Obstétrico; Parto Humanizado. ABSTRACTObjective: To investigate the experience and knowledge of parturients about the phenomenon of institutional obstetric violence. Methods: Descriptive, qualitative and exploratory study carried out in a public maternity hospital in the interior of the State of Maranhão with 12 women attending the health unit through a semi -structured interview. Data analysis was performed using the Bardin content analysis method. Results: Most of the participants did not recognize or understand any practices of institutional obstetric violence, leading them to mistakenly believe that the ill-treatment suffered was part of the care practices of childbirth. This context can be related to the lack of prior knowledge of women in relation to institutional obstetric violence. Final considerations: Institutional obstetric violence is still surrounded by taboos, in view of the knowledge of the parturients about the subject is still deficient, which ends up favoring such acts of dehumanization in an emotionally and physically significant moment for the woman. For women, institutional obstetric violence has many facets, ranging from the lack of professional awareness to physical aggression. The solution to the problem of obstetric violence, according to the perspective of som...
Almeida MM, Silva FWT, Lindoso AM, et al. ABSTRACT Objective: to discuss from the national and international scientific production the best evidence related to urinary catheterization technique in preventing urinary tract infection. Method: integrative descriptive review, in order to answer the main question: what are the best evidence available in the literature related to urinary catheterization technique? Selected bases were LILACS, SciELO and Cochrane. Results: 242 articles were found in the Cochrane Library, 81 articles on LILACS and 49 in SciELO base, adding to 372 articles. Of these, 10 articles were analyzed that met the previously established inclusion criteria. Conclusion: in search of the best available evidence, for the efficient nursing interventions for the prevention of urinary tract infections, it is understood that taking the nurse's decision on the use of devices should be carried out based on detailed and individualized assessment for every patient. RESUMOObjetivo:discutir a partir da produção científica nacional e internacional as melhores evidências relacionadas à técnica de cateterismo urinário na prevenção da infecção do trato urinário Método: revisão descritiva integrativa, com vistas a responder a questão norteadora: quais as melhores evidências disponíveis na literatura relacionadas à técnica de cateterismo urinário? As bases selecionadas foram a LILACS, SCIELO e Cochrane. Resultados: foram encontrados 242 artigos na biblioteca Cochrane, 81 artigos na base LILACS e 49 na base SCIELO, somando-se 372 artigos. Destes, analisou-se 10 artigos que atenderam aos critérios de inclusão previamente estabelecidos. Conclusão: na busca da melhor evidência disponível, quanto às intervenções de enfermagem eficazes para a prevenção de infecções urinárias, entende-se que a tomada de decisão do enfermeiro sobre o uso de dispositivos deve ser realizada baseada em avaliação criteriosa e individualizada para cada paciente. Descritores: cateterismo urinário; infecções urinárias; enfermagem baseada em evidências. RESUMÉNObjetivo: discutir a partir de la producción científica nacional e internacional la mejor evidencia relacionada con la técnica de cateterización urinaria en la prevención de la infección del tracto urinario. Método: revisión descriptiva integradora, con el fin de responder a la pregunta principal: ¿qué son la mejor evidencia disponible en la literatura relacionada con técnica de cateterismo urinario? Bases seleccionadas fueron LILACS, SciELO y Cochrane. Resultados: 242 artículos fueron encontradas en la Biblioteca Cochrane, 81 artículos basados en LILACS y 49 en la base SciELO, añadiendo a 372 artículos. De éstos, se analizó 10 artículos que cumplieron los criterios de inclusión previamente establecidos. Conclusión: en busca de la mejor evidencia disponible, por las intervenciones de enfermería eficientes para la prevención de infecciones del tracto urinario, se entiende que la toma de la decisión de la enfermera en el uso de dispositivos debe llevarse a cabo sobre la base de una evaluación de...
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