The involvement of parents in the healthcare provided to hospitalzed children

Objective

to analyze the answers of parents and health care professionals concerning the involvement of parents in the care provided to hospitalized children.

Method

exploratory study based on the conceptual framework of pediatric healthcare with qualitative data analysis.

Results

three dimensions of involvement were highlighted: daily care provided to children, opinions concerning the involvement of parents, and continuity of care with aspects related to the presence and participation of parents, benefits to the child and family, information needs, responsibility, right to healthcare, hospital infrastructure, care delivery, communication between the parents and health services, shared learning, and follow-up after discharge.

Conclusion

the involvement of parents in the care provided to their children has many meanings for parents, nurses and doctors. Specific strategies need to be developed with and for parents in order to mobilize parental competencies and contribute to increasing their autonomy and decision-making concerning the care provided to children.     

Child safety from the perspective of essential needs

OBJECTIVE:

to characterize the maternal care for children under one year of age with a view to child health promotion at home.

METHOD:

exploratory study with qualitative data analysis, thematic mode, based on the conceptual framework of the essential needs of children, based on interviews recorded with 16 mothers.

RESULTS:

the analysis of the maternal narratives showed elements that facilitate the promotion of child safety: presence and involvement of the parents, constant surveillance for physical and emotional protection, experiences to stimulate child development, support networks for childcare at home; and inhibiting elements of child safety: limited perception of characteristics of child development and of children''s singularities, overprotection and difficulties to set limits.

CONCLUSION:

the study enhances the understanding of home care in child health promotion, directing professional actions to guarantee ongoing nurturing relationships, protection, respect for individual differences, experiences appropriate to child development, limit setting and construction of stable and supportive social networks. In addition, the relevance of considering the maternal perspective in child health care is considered, as a strategy to apprehend aspects related to the attendance of the growth and development needs, particularly for child health promotion at home.     

Human pegivirus-1 infection in kidney transplant recipients: A single-center experience

Kidney transplantation is the treatment of choice for patients with end-stage renal disease. In the posttransplant period, the induced immunosuppression leads to an increased risk of developing infectious diseases, a leading cause of death after kidney transplantation. Human pegivirus-1 (HPgV-1) is considered a nonpathogenic human virus and is highly frequent in individuals parenterally exposed, however, its impact on kidney transplantation outcome is poorly understood. Given the scarcity of epidemiological data for this infection on organ recipients in Brazil, we conducted a study in a single center for kidney transplantation in Rio de Janeiro, aiming to determine HPgV-1 prevalence and genotypic distribution. Serum samples from 61 renal recipients, followed up for the first year after transplantation, were evaluated for viral RNA and genotypes were determined by sequencing of the 5′-untranslated region. HPgV-1 RNA was detected in 36.1% (22/61) of patients. Genotype 2 was the most commonly found (80.9%), followed by genotypes 3 (9.5%), 1, and 5, in 4.8% each. Statistical comparisons did not reveal any significant impact of HPgV-1 in patient outcome. Further epidemiologic studies are needed to understand if immunosuppression may interfere in HPgV-1 persistence rates and if viremia might impact graft dysfunction rates in kidney recipients.     

Multidrug-Resistant Nontuberculous Mycobacteria Isolated from Cystic Fibrosis Patients

Worldwide, nontuberculous mycobacteria (NTM) have become emergent pathogens of pulmonary infections in cystic fibrosis (CF) patients, with an estimated prevalence ranging from 5 to 20%. This work investigated the presence of NTM in sputum samples of 129 CF patients (2 to 18 years old) submitted to longitudinal clinical supervision at a regional reference center in Rio de Janeiro, Brazil. From June 2009 to March 2012, 36 NTM isolates recovered from 10 (7.75%) out of 129 children were obtained. Molecular identification of NTM was performed by using PCR restriction analysis targeting the hsp65 gene (PRA-hsp65) and sequencing of the rpoB gene, and susceptibility tests were performed that followed Clinical and Laboratory Standards Institute recommendations. For evaluating the genotypic diversity, pulsed-field gel electrophoresis (PFGE) and/or enterobacterial repetitive intergenic consensus sequence PCR (ERIC-PCR) was performed. The species identified were Mycobacterium abscessus subsp. bolletii (n = 24), M. abscessus subsp. abscessus (n = 6), Mycobacterium fortuitum (n = 3), Mycobacterium marseillense (n = 2), and Mycobacterium timonense (n = 1). Most of the isolates presented resistance to five or more of the antimicrobials tested. Typing profiles were mainly patient specific. The PFGE profiles indicated the presence of two clonal groups for M. abscessus subsp. abscessus and five clonal groups for M. abscesssus subsp. bolletii, with just one clone detected in two patients. Given the observed multidrug resistance patterns and the possibility of transmission between patients, we suggest the implementation of continuous and routine investigation of NTM infection or colonization in CF patients, including countries with a high burden of tuberculosis disease.     

The reciprocal interactions between astrocytes and prostate cancer cells represent an early event associated with brain metastasis

Tumor establishment, growth, and survival are supported by interactions with microenvironment components. Here, we investigated whether the interactions between prostate cancer cells and cortical astrocytes are associated to a potential role for astrocytes in tumor establishment. We demonstrate that astrocytes interact in vitro with prostatic cancers cells derived from different metastatic sites. Astrocytes and their secreted extracellular matrix, stimulate DU145 cell (a brain-derived prostate tumor cell line) proliferation while inhibiting cell death and modulating the expression of several genes related to prostate cancer progression, suggesting the activation of EMT process in these cells. In contrast, DU145 cells and their conditioned medium inhibited cell proliferation and induced cell death of astrocytes. On the other hand, the astrocytes were unable to significantly induce an increment of LNCaP cell (a lymph node-derived prostate tumor cell line) proliferative activity. In addition, LNCaP cells were also unable to induce cell death of astrocytes. Thus, we believe that DU145 cells, but not LNCaP cells, present an even more aggressive behavior when interacting with astrocytes. These results provide an important contribution to the elucidation of the cellular mechanisms involved in the brain microenvironment colonization.     

Influence of Single-file Endodontics on Apical Transportation in Curved Root Canals: An Ex Vivo Micro–Computed Tomographic Study

Introduction

More information regarding the ability of single files to maintain the original canal position is required before adopting a single-file approach to cleaning and shaping. This study compares apical transportation in curved root canals when instrumenting with a single WaveOne (WO) file (Dentsply Tulsa Dental Specialties, Tulsa, OK) in a reciprocating motion with that incurred when using a sequence of Twisted Files (TFs; SybronEndo, Orange, CA) in a continuous rotating motion.

Methods

Forty mesial canals of mandibular molars were evenly allocated into 2 balanced groups (n = 20) with a 17-mm average canal length and 20° average curvature. Canals were accessed in a conventional manner and instrumentation was completed with a single WO file or a series of TFs. The canals were instrumented according to the manufacturers' protocol. Apical transportation was assessed on a comparison of the pre- and postinstrumentation micro–computed tomographic scans at 1-, 2-, 3-, 4-, and 5-mm sections. One-way analysis of variance was performed to assess if a significant difference between systems exists.

Results

No significant difference (P > .05) was found between the WO and TF groups. Transportation in the mesial direction was of greater magnitude than distal transportation for both files systems. The mean transportation in the mesial direction was 100.1 ± 8.8 μm (WO group) and 101.0 ± 10.9 μm (TF group) (P = .5), whereas distal transportation was found to be 80.9 ± 14.6 μm (WO group) and 60.3 ± 11.0 μm (TF group) (P = .3).

Conclusions

The results suggest that no difference exists between the WO file system and the conventional multifile TF system when considering apical transportation in curved canals.     

Moderate acute exercise (70% VO2 peak) induces TGF‐β, α‐amylase and IgA in saliva during recovery

Strenuous exercise promotes changes in salivary IgA and can be associated with a high incidence of upper respiratory tract Infections. However, moderate exercise enhances immune function. The effect of exercise on salivary IgA has been well studied, but its effect on other immunological parameters is poorly studied. Thus, this study determined the effect of moderate acute exercise on immunological salivary parameters, such as the levels of cytokines (TGF‐β and IL‐5), IgA, α‐amylase and total protein, over 24 h. Ten male adult subjects exercised for 60 min at an intensity of 70% VO₂ peak. Saliva samples were collected before (‘basal’) and 0, 12 and 24 h after an exercise session. The total salivary protein was lower after 12 and 24 h than immediately after exercise, whereas α‐amylase increased at 12 and 24 h after exercise compared with basal levels. The IgA concentration was increased at 24 h after exercise relative to immediately after exercise, and there was no difference in the IL‐5 while TGF‐β concentration increased in recovery. In conclusion, 70% VO₂ peak exercise does not induce changes immediately after exercise, but after 24 h, it produces an increase in salivary TGF‐β without changing IL‐5.     

Thickness and marking quality of different occlusal contact registration strips

Objectives

Evaluate the thickness and the marking quality of different occlusal contact registration strips (OCRS) and a possible correlation between them.

Material and Methods

The following OCRS were selected: Accufilm II, BK20, BK21, BK22, BK23, BK28, and BK31. The thickness was measured in three points of the OCRS with an electronic measuring device (TESA), and the mean was calculated. To produce the marks on the strips, composite resin specimens were adapted to a universal testing machine (Versat 2000) with 40 kgf load cell at a speed of 1.0 mm/min. The mark images were photographed with a stereoscopic microscope (Stemi SV11) and processed and analyzed by the 550-Leica Qwin^® analyzer.

Results

Values (μm) found in the 1^st and 2^nd thickness measurements were: Accufilm II - 16.4 and 14.2; BK20 - 10.0 and 8.1; BK21 - 9.5 and 8.0; BK22 - 9.7 and 8.7; BK23 - 9.8 and 7.9; BK28 - 12.8 and 10.0; and BK31 - 8.4 and 8.0, respectively. The mean (mm²) values found in the mark areas were: Accufilm II - 0.078; BK20 - 0.035; BK21 - 0.045; BK22 - 0.012; BK23 - 0.022; BK28 - 0.024; and BK31 - 0.024. The results were submitted to the Kruskal-Wallis (p<0.05) and Pearson’s correlation tests.

Conclusions

Only in the 2^nd measurement, the OCRS thickness observed was similar to the value indicated by the manufacturers; the Accufilm II and the BK28 strips showed the better marks; and no correlation was found between the thickness and the marking area.