High expression of active CDK6 in the cytoplasm of CD8 memory cells favors rapid division

Antigen-driven CD8 memory T cell proliferation is more rapid than that of naive T cells, ensuring efficient control of the pathogen after reinfection. We show here that naive and memory cells are in different states of G0/G1 arrest. Naive cells are in a classical state of G0/G1 arrest, with high expression of p27Kip1 and low CDK6 and CDK2 kinase activity. In contrast, memory cells have low expression of p27Kip1 and high CDK6 kinase activity. This preactivated kinase is associated with cyclin D3 in the cytoplasm, and neutralization of these complexes with antibody to cyclin D3 blocks the rapid division of memory cells. Therefore G0/G1 memory cells are at a unique preactivated state that favors rapid division after antigen stimulation.     

Gene expression profiling and association studies implicate the neuregulin signaling pathway in Behçet's disease susceptibility

Behçet's disease (BD) is a complex disease with genetic and environmental risk factors implicated in its etiology; however, its pathophysiology is poorly understood. To decipher BD's genetic underpinnings, we combined gene expression profiling with pathway analysis and association studies. We compared the gene expression profiles in peripheral blood mononuclear cells (PBMCs) of 15 patients and 14 matched controls using Affymetrix microarrays and found that the neuregulin signaling pathway was over-represented among the differentially expressed genes. The Epiregulin (EREG), Amphiregulin (AREG), and Neuregulin-1 (NRG1) genes of this pathway stand out as they are also among the top differentially expressed genes. Twelve haplotype tagging SNPs at the EREG-AREG locus and 15 SNPs in NRG1 found associated in at least one published BD genome-wide association study were tested for association with BD in a dataset of 976 Iranian patients and 839 controls. We found a novel association with BD for the rs6845297 SNP located downstream of EREG, and replicated three associations at NRG1 (rs4489285, rs383632, and rs1462891). Multifactor dimensionality reduction analysis indicated the existence of epistatic interactions between EREG and NRG1 variants. EREG-AREG and NRG1, which are members of the epidermal growth factor (EGF) family, seem to modulate BD susceptibility through main effects and gene–gene interactions. These association findings support a role for the EGF/ErbB signaling pathway in BD pathogenesis that warrants further investigation and highlight the importance of combining genetic and genomic approaches to dissect the genetic architecture of complex diseases.     

Validity of the DISABKIDS? - Cystic Fibrosis Module for Brazilian children and adolescents

OBJECTIVES:

to validate the health-related quality of life measuring instrument DISABKIDS^® - Cystic Fibrosis Module (self version) for Brazilian children and adolescents.

METHOD:

methodological study in which a sample of 113 participants (54 girls and 59 boys; mean age 11.91 years and SD=2.79) was considered, from four Brazilian states, São Paulo, Paraná, Minas Gerais and the Federal District, 51 of whom participated in the pilot study and 62 in the field study. The answers to the questionnaire were analyzed, considering the frequency distributions with regard to the floor and ceiling effects, Cronbach''s Alpha statistics, Pearson''s Linear Correlation Coefficient, Mulitrait-Multimethod analysis and Confirmatory Factor Analysis according to Structural Equations Modeling.

RESULTS:

the instrument showed a high internal consistency coefficient (verified using Cronbach''s Alpha) and construct validity, according to the Multitrait-Multimethod analysis. The DISABKIDS^® - Cystic Fibrosis Module, self version, maintained the same factorial structure as in the originally proposed model.

CONCLUSION:

the instrument validation has been finished and indicates that the self version is validated for use in Brazil and can be included into the monitoring routine of this population.     

Social representations on HIV/AIDS among adolescentes: implications for nursing care

With the objective of discussing the implications of the social representations of HIV/AIDS for the interpersonal relations and the practices for protection among adolescents, 15 semidirective interviews were carried out with adolescents, both with and without HIV, assisted at a Hospital School in Rio de Janeiro. The software ALCESTE 4.5 was used for the data analysis. It was observed that the social representation of AIDS is structured around cognitions connected to prevention, revealing a contradiction between the knowledge and the practices reported by the group. It is suggested that the nursing practices should be directed towards the reduction of the distance between practices, representations and scientific knowledge.     

Interdisciplinary home hospitalization program of Marília-SP: material resource costs

This study estimated the mean total direct cost of some production factors (material resources), including consumption materials, diets, medication and solutions used by two patient groups during hospitalization in the Interdisciplinary Home Hospitalization Program (PROIID) of Marília-SP, Brazil. The sample consisted of 27 patients with a diagnosis of cerebral vascular accident (CVA) and 18 with Neoplasm. Data were collected from the moment of hospitalization until the patients left the program. The mean total direct cost amounted to R$ 52.72 for each patient with CVA and of R$ 65.13 for those with Neoplasm. For both patient groups, the sub-category of material--diets accounted for the highest percentage of costs.     

Nursing audit as a professional marketing strategy

This study relates an audit experience with an interdisciplinary team in public health services at Fortaleza-CE and aims to describe the functional dimension of these audit actions and the its importance for nursing; to define a model with a professional marketing strategy for the nurse. Theoretical bases of contemporary Administration were used to converge with the audit practice experiences. One proposes a new audit nursing strategy in favor of the professional significance, because the nurse currently conducts actions with a scientific marketing identity, but at the unconscious level.     

Hospitalization in neonatal intensive care units in Brazil -- 1998-2001

This study aimed at obtaining information on the development of data records in Neonatal Intensive Care Units in Brazil; comparing the number of beds in Neonatal Intensive Care Units with that in Intensive Care Units in general and assessing their distribution in different Brazilian states. There has been an increase in the number of beds and authorizations for hospitalizations in intensive care units. The percentages indicating the total number of beds for intensive care and neonatal intensive care vary from one state to another with 17% in S?o Paulo, 25% in Rio Grande do Sul and 29.5% in Paraná. S?o Paulo state presents the highest number of beds, followed by Rio Grande do Sul.     

A unique subpopulation of CD4+ regulatory T cells controls wasting disease,IL-10 secretion and T cell homeostasis

CD25(+)CD4(+) regulatory T cells have major roles in controlling immune responses, and use heterogeneous regulatory mechanisms. It is possible that these different activities are mediated by different subsets. Here we show that CD103(+)CD25(+)CD4(+) T cells (that control inflammatory bowel disease) are highly enriched in gut-associated lymphoid tissue and have unique functional properties. In vivo, only this subpopulation is able to control wasting disease and peripheral T cell homeostasis. In vitro, only this subpopulation is able to regulate IL-10 secretion, and it might also mediate infectious suppression. These results demonstrate that regulatory T cells can be divided into discrete subpopulations with defined functional properties and regulatory mechanisms.     

Preoperative pelvic lymphoscintigraphy is of limited usefulness for sentinel lymph node detection in cervical cancer

Objectives

To analyze concordance between preoperative lymphoscintigraphy and intraoperative lymphatic mapping (ILM) for sentinel lymph node identification using technetium 99m-labeled-dextran 500 (99m-Tc) and patent blue dye in patients with early cervical cancer undergoing radical hysterectomy and pelvic lymphadenectomy, as well as to evaluate sentinel lymph node (SLN) detection.

Study design

Forty-seven patients underwent surgical treatment for cervical cancer. For SLN identification, 99m-Tc and blue patent were injected into the cervix on the eve and day of surgery, respectively. Preoperative pelvic lymphoscintigraphy was performed in all patients after 99m-Tc injection. Concordance between preoperative lymphoscintigraphy and ILM was evaluated.

Results

Of the 56 patients who underwent preoperative lymphoscintigraphy, 43 (81.13%) had at least one lymph node identified. Bilateral lymph nodes were identified in 21 (37.5%) patients. Sentinel lymph nodes detected on ILM had been previously found on preoperative lymphoscintigraphy in 66.7%, 67.2% and 0% in the right, left and central locations, respectively. In 14 patients (25%), only one lymph node was identified on preoperative lymphoscintigraphy, but more than one sentinel lymph node was detected on intraoperative mapping. In nine (16.1%) patients, lymphoscintigraphy showed only unilateral lymph nodes, but ILM identified bilateral sentinel lymph nodes.

Conclusion

The combination of patent blue and radionuclide techniques produced excellent results for SLN detection in cervical cancer. Preoperative lymphoscintigraphy does not offer any advantage over ILM for SLN identification.