The extracellular vesicles (EVs) released by Leishmania can contribute to the establishment of infection and host immunomodulation. In this study, we characterized the shedding of EVs from Leishmania (Leishmania) amazonensis promastigotes. This species is the causative agent of cutaneous leishmaniasis, and its role during interactions with bone marrow-derived macrophages (BMDMs) and peritoneal B-1 cells was evaluated. Leishmania amazonensis promastigotes cultivated in vitro at different times and temperatures spontaneously released EVs. EVs were purified using size-exclusion chromatography (SEC) and quantitated by nanoparticle tracking analysis (NTA). NTA revealed that the average size of the EVs was approximately 180 nm, with concentrations ranging from 1.8 × 108 to 2.4 × 109 vesicles/mL. In addition, the presence of LPG and GP63 were detected in EVs obtained at different temperatures. Naïve BMDMs stimulated with EVs exhibited increased IL-10 and IL-6 expression. However, incubating B-1 cells with parasite EVs did not stimulate IL-10 expression but led to an increase in the expression of IL-6 and TNFα. After 7 weeks post-infection, animals infected with L. amazonensis promastigotes in the presence of parasite EVs had significant higher parasite load and a polarization to Th2 response, as compared to the group infected with the parasite alone. This work demonstrated that EVs isolated from L. amazonensis promastigotes were able to stimulate macrophages and B-1 cells to express different types of cytokines. Moreover, the immunomodulatory properties of EVs probably contributed to an increase in parasite burden in mice. These findings suggest that the functionality of L. amazonensis EVs on immune system favor of parasite survival and disease progression.

Epidemiol. Serv. Saúde, Brasília, 23(2):287-294, abr-jun 2014 ResumoObjetivo: descrever a ocorrência e o perfil dos casos notificados de sífilis congênita no estado do Rio Grande do Norte, Brasil, no período de 2007 a 2010. Métodos: estudo descritivo, com dados do Sistema de Informações sobre Nascidos Vivos (Sinasc) e do Sistema de Informação de Agravos de Notificação (Sinan). Resultados: no período avaliado, verificou-se 598 casos notificados de sífilis congênita e taxas de incidência de 2,7 e 0,9 por 1.000 nascidos vivos, respectivamente nos anos de 2007 e 2010; o município de Natal-RN concentrou 74,6% das notificações; a maioria das notificações foi de nascidos vivos cujas mães tinham até 8 anos de estudo (65,0%), haviam realizado pré-natal (72,2%) e com diagnóstico de sífilis no momento do parto/curetagem (41,0%). Conclusão: apesar da diminuição da taxa de incidência no período investigado, em 2010, ela ainda era superior ao valor de 0,5/1.000 nascidos vivos, meta estabelecida para eliminação da doença.Palavras-chave: Epidemiologia Descritiva; Sífilis; Sífilis Congênita; Nascimento Vivo.

RESUMOPesquisa exploratória-descritiva, qualitativa, desenvolvida com 15 pais, de janeiro a abril de 2006, em Natal/RN. Teve por objetivo analisar as ações desenvolvidas pelo homem durante o puerpério de sua companheira. A coleta efetuou-se por entrevista semiestruturada, sendo os dados tratados por meio da técnica de análise de conteúdo e analisados à luz dos princípios do Interacionismo Simbólico. Os resultados apresentam uma temática central -ações de cuidado em ambiente doméstico -e duas categorias: cuidando da companheira e da criança; e provendo o sustento da família. Conclui-se que os depoentes interagem e participam do puerpério oferecendo conselhos que remetem à prevenção, como o estímulo à deambulação; desenvolvem atitudes de dedicação e preocupação com a saúde do filho; consideram que a licença-paternidade não atende às suas necessidades; reconhecem que a companheira e o recém-nascido requerem mais dedicação e que desempenham papel de provedor no intuito de garantir o sustento familiar.Palavras-chave: Cônjuges. Período Pós-Parto. Cuidado Pós-natal. Abstract ResumenInvestigación exploratoria y descriptiva, cualitativa, desarrollada con 15 padres de familia, en Natal/RN. La pesquisa analizó las acciones desarrolladas por el papá durante el puerperio de su compañera. Los datos fueron recolectados por medio de la entrevista semiestructurada, organizados por la técnica de análisis de contenido y analizados bajo los principios del Interaccionismo Simbólico. Los resultados mostraron que existe un tema central -las acciones de atención yl cuidado en el ambiente doméstico -y dos categorías -cuidar de la pareja y del niño, sin dejar de lado el sustento de la familia. Se concluyó que estos padres conviven durante el puerperio ofreciendo consejos que remiten a la prevención, como estimular a la mujer a hacer caminadas; desarrollan actitudes de dedicación y preocupación con la salud del hijo; consideran que el permiso de trabajo por paternidad no contempla sus necesidades; reconocen que su familia requiere de mayor dedicación y que ejercen el papel de proveedores al garantir la protección financeira de la familia.1 Enfermeira, Mestre em Enfermagem pela UFRN. Brasil. E-mail: etenigerm@yahoo.com.br, 2 Enfermeira, Doutora em Enfermagem pela USP/Ribeirão Preto, Professora Adjunta do Depar tamento de Enfermagem da UFRN. Brasil. E-mail: rosineide@ufrnet.com.br PESQUISA RESEARCH -INVESTIGACIÓNThis qualitative, exploratory-descriptive research was conducted with 15 fathers, in Natal, RN. The aim was to analyze the actions conducted by the father during the puerperal period of his spouse. Data were collected by semistructured interviews, treated by analysis of content and analyzed according to the principles of symbolic interactionism. The results indicate one central theme -care actions in the home environment -and two categories -caring for the spouse and the baby, providing financial support to the family. It is concluded that the men interact and participate in the puerperal period, while offering preventive advice, su...

Leishmaniasis is caused by Leishmania parasites that infect several cell types. The promastigote stage of Leishmania is internalized by phagocytic cells and transformed into the obligate intracellular amastigote form. B-1 cells are a subpopulation of B cells that are able to differentiate in vitro and in vivo into mononuclear phagocyte-like cells with phagocytic properties. B-1 cells use several receptors for phagocytosis, such as the mannose receptor and third complement receptor. Leishmania binds to the same receptors on macrophages. In this study, we demonstrated that phagocytes derived from B-1 cells (B-1 CDP) were able to internalize promastigotes of L. (L.) amazonensis in vitro. The internalized promastigotes differentiated into amastigotes. Our results showed that the phagocytic index was higher in B-1 CDP compared to peritoneal macrophages and bone marrow-derived macrophages. The in vivo phagocytic ability of B-1 cells was also demonstrated. Parasites were detected inside purified B-1 cells after intraperitoneal infection with L. (L.) amazonensis promastigotes. Intraperitoneal stimulation with the parasites led to an increase in both IL-10 and TNF-α. These results highlight the importance of studying B-1 CDP cells as phagocytic cells that can participate and contribute to immunity to parasites.

Qualitative study that aimed at understanding the social representation of a parent with a premature child. The data were collected between May and June 2008, in a semi-structured interview with 17 parents whose premature children were hospitalized in the NICU of two public institutions in Natal, Brazil. The reports were analyzed based on the Social Representations Theory (SRT). The results reveal that the hospitalization of their children causes parents to experience emotions of fear, anguish, anxiety, loneliness interspersed with those of faith, joy and hope. For a parent the NICU is a frightening environment, albeit necessary for the specialized care that the conditions of the premature newborn require.

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This study aimed to investigate the conception of women with physical disability regarding the support network for the exercising of motherhood. It is descriptive-exploratory research, with qualitative approach, whose data were collected through semistructured interviews with 12 women with physical disability, undertaken between April and June 2014. The technique of thematic analysis was used for the treatment of the information, and Symbolic Interactionism was used as the theoretical framework. The interviewees reported the importance of the support of the partner, of family members, and of health professionals, during pregnancy and the postpartum, for them to be able to exercise the maternal role. The absence of this support influenced their conceptions regarding their capacity in this function. One can observe the need to promote the reproductive health of the person with a disability, so as to mitigate the stigmas and thus provide them with appropriate support. In addition to this, the health professionals must be trained to understand holistically their needs and rights.