Translational models for vascular cognitive impairment: a review including larger species.

BACKGROUND: Disease models are useful for prospective studies of pathology, identification of molecular and cellular mechanisms, pre-clinical testing of interventions, and validation of clinical biomarkers. Here, we review animal models relevant to vascular cognitive impairment (VCI). A synopsis of each model was initially presented by expert practitioners. Synopses were refined by the authors, and subsequently by the scientific committee of a recent conference (International Conference on Vascular Dementia 2015). Only peer-reviewed sources were cited. METHODS: We included models that mimic VCI-related brain lesions (white matter hypoperfusion injury, focal ischaemia, cerebral amyloid angiopathy) or reproduce VCI risk factors (old age, hypertension, hyperhomocysteinemia, high-salt/high-fat diet) or reproduce genetic causes of VCI (CADASIL-causing Notch3 mutations). CONCLUSIONS: We concluded that (1) translational models may reflect a VCI-relevant pathological process, while not fully replicating a human disease spectrum; (2) rodent models of VCI are limited by paucity of white matter; and (3) further translational models, and improved cognitive testing instruments, are required

Horse Grimace Scale Does Not Detect Pain in Horses with Equine Gastric Ulcer Syndrome.

Equine gastric ulcer syndrome (EGUS) is a highly prevalent and presumptively painful condition, although the amount of pain horses might experience is currently unknown. The aims of this study were to determine if the Horse Grimace Scale (HGS) could identify pain behaviours in horses with and without EGUS and if severity would be positively associated with the HGS score. Horse grimace scale scores were assessed blindly using facial photographs by seven observers and involved evaluation of 6 facial action units as 0 (not present), 1 (moderately present) and 2 (obviously present). Lameness examination, serum amyloid A (SAA) measurement and gastroscopy evaluation were performed on all horses. Horses (n = 61) were divided into two and three groups based on the presence (yes, no) and severity (none, mild, moderate-severe) of EGUS, respectively. Presence of lameness and elevated SAA (≥50 µg/mL) were used as exclusion criteria. Inter-observer reliability was analyzed by intra-class correlation coefficients (ICC). HGS scores between groups were compared using Welch's and Brown Forsythe tests (p < 0.05). Overall, HGS ICC was "excellent" (0.75). No significant differences (p = 0.566) were observed in HGS scores between horses with and without gastric lesions (mean, 95% CI; 3.36, 2.76-3.95 and 3, 1.79-4.20, respectively). HGS was not influenced by the presence or severity of EGUS in this current study. Further studies investigating the use of different pain scales in horses with EGUS are needed.fals

VIDAS EM OCASO: A INTERFACE ENTRE O ENVELHECIMENTO AS RELAÇÕES FAMILIARES E O MORRER FIGURADO

O envelhecimento &eacute; visto como um processo novo e din&acirc;mico, para a sociedade brasileira, o qual se inicia no nascimento e se perpetua durante todo o ciclo vital. Nesse sentido, acredita-se que o mesmo tenha dotado o indiv&iacute;duo de viv&ecirc;ncias, que possam nortear a constru&ccedil;&atilde;o de estrat&eacute;gias, poss&iacute;veis e tang&iacute;veis, de serem utilizadas pela Enfermeira, para desvelar as facetas e as necessidades do idoso: o novo-velho indiv&iacute;duo social

CONCEITUANDO A DOENÇA GRAVE NO UNIVERSO DO IDOSO

As quedas entre os idosos apresentam consequ&ecirc;ncias f&iacute;sicas como as fraturas e psicol&oacute;gicas como o medo de voltar a cair, restri&ccedil;&atilde;o de atividades, o decl&iacute;nio da sa&uacute;de f&iacute;sica e mental e o aumento do risco de institucionaliza&ccedil;&atilde;o (PERRACINI, 2002). Originando o seguinte problema: A partir de qual par&acirc;metro pode-se resignificar a &ldquo;doen&ccedil;a grave&rdquo; no universo dos idosos?&nbsp

Curso de emergência utilizando E-learning e simulação: visão do participante

The use of simulation and e-learning has increased considerably in healthcare related educational activities, enabling the acquisition of skills ethically and safely. The objective is to describe the design and evaluation of a semi-distance pre-hospital emergency course for physicians and nurses at the Public Health Department of Belo Horizonte City, Minas Gerais, Brazil. The course comprised 13 online lessons and ten stations, which used simulated scenarios. The participants answered a semi-structured questionnaire using the Likert scale to evaluate the course. Course participation included 203 (63.6%) physicians and 116 (36.4%) nurses; most physicians (72.1%) had finished their studies over five years prior to the study, and had little practice (72.9%) on advanced life support measures. The distance course was well evaluated in terms of general quality, video quality, use of images and animations and usability. The e-learning system was considered to be user friendly by doctors and nurses, and the practical activities were well rated. The course used methodology based on simulation and distance education, and received positive evaluations. The system was rated as good and easy to use.O uso da simulação e da educação a distância tem aumentado consideravelmente na área da saúde,permitindo o desenvolvimento de competências de forma ética e segura. O objetivo deste artigo é descrever a concepção e a avaliação de um curso semipresencial de emergência pré-hospitalar para médicos e enfermeiros da Secretaria Municipal de Saúde de Belo Horizonte, Brasil. O curso a distância foi composto por 13 aulas, e a parte presencial por dez estações temáticas. Os participantes responderam a um questionário semiestruturado (escala de Likert) como forma de avaliar o curso. Participaram do curso 203 (63,6%) médicos e 116 (36,4%) enfermeiros. A maioria dos médicos (72,1%) tinha terminado seus estudos havia mais de cinco anos e tinha pouca prática (72,9%) em medidas de suporte avançado de vida. O curso a distância foi bem avaliado quanto a qualidade geral e dos vídeos, uso de imagens e animações, e usabilidade do sistema. A plataforma de ensino foi considerada amigável. A parte de simulação foi bem avaliada. O curso utilizou metodologia baseada em simulação e educação a distância, sendo bem avaliado. A plataforma de ensino foi classificada como boa e de fácil utilização

A Novel Modular Antigen Delivery System for Immuno Targeting of Human 6-sulfo LacNAc-Positive Blood Dendritic Cells (SlanDCs)

Previously, we identified a major myeloid-derived proinflammatory subpopulation of human blood dendritic cells which we termed slanDCs (e.g. Schäkel et al. (2006) Immunity 24, 767-777). The slan epitope is an O-linked sugar modification (6-sulfo LacNAc, slan) of P-selectin glycoprotein ligand-1 (PSGL-1). As slanDCs can induce neoantigen-specific CD4+ T cells and tumor-reactive CD8+ cytotoxic T cells, they appear as promising targets for an in vivo delivery of antigens for vaccination. However, tools for delivery of antigens to slanDCs were not available until now. Moreover, it is unknown whether or not antigens delivered via the slan epitope can be taken up, properly processed and presented by slanDCs to T cells.Single chain fragment variables were prepared from presently available decavalent monoclonal anti-slan IgM antibodies but failed to bind to slanDCs. Therefore, a novel multivalent anti-slanDC scaffold was developed which consists of two components: (i) a single chain bispecific recombinant diabody (scBsDb) that is directed on the one hand to the slan epitope and on the other hand to a novel peptide epitope tag, and (ii) modular (antigen-containing) linker peptides that are flanked at both their termini with at least one peptide epitope tag. Delivery of a Tetanus Toxin-derived antigen to slanDCs via such a scBsDb/antigen scaffold allowed us to recall autologous Tetanus-specific memory T cells.In summary our data show that (i) the slan epitope can be used for delivery of antigens to this class of human-specific DCs, and (ii) antigens bound to the slan epitope can be taken up by slanDCs, processed and presented to T cells. Consequently, our novel modular scaffold system may be useful for the development of human vaccines

Access to and utilization of prenatal care services in the Unified Health System of the city of Rio de Janeiro, Brazil

Prenatal care consists of practices considered to be effective for the reduction of adverse perinatal outcomes. However, studies have demonstrated inequities in pregnant women's access to prenatal care, with worse outcomes among those with lower socioeconomic status. The objective of this study is to evaluate access to and utilization of prenatal services in the Sistema Único de Saúde (SUS - Unified Health System) in the city of Rio de Janeiro and to verify its association with the characteristics of pregnant women and health services. A cross-sectional study was conducted in 2007-2008, using interviews and the analysis of prenatal care cards of 2.353 pregnant women attending low risk prenatal care services of the SUS. A descriptive analysis of the reasons mentioned by women for the late start of prenatal care and hierarchical logistic regression for the identification of the factors associated with prenatal care use were performed. The absence of a diagnosis of pregnancy and poor access to services were the reasons most often reported for the late start of prenatal care. Earlier access was found among white pregnant women, who had a higher level of education, were primiparous and lived with a partner. The late start of prenatal care was the factor most associated with the inadequate number of consultations, also observed in pregnant adolescents. Black women had a lower level of adequacy of tests performed as well as a lower overall adequacy of prenatal care, considering the Programa de Humanização do Pré-Natal e Nascimento (PHPN - Prenatal and Delivery Humanization Program) recommendations. Strategies for the identification of pregnant women at a higher reproductive risk, reduction in organizational barriers to services and increase in access to family planning and early diagnosis of pregnancy should be prioritized

Mortalidade por doenças cardiorrespiratórias em idosos no estado de Mato Grosso, 1986 a 2006

OBJETIVO: Descrever a evolução temporal da mortalidade por doenças cardiorrespiratórias em idosos. MÉTODOS: Estudo epidemiológico descritivo com delineamento ecológico de séries temporais realizado no estado do Mato Grosso, de 1986 a 2006. Foram utilizados dados sobre doenças dos aparelhos respiratório e circulatório obtidos do Sistema de Informação sobre Mortalidade do Ministério da Saúde. Modelos de regressão linear simples foram ajustados para avaliar a tendência das taxas específicas de mortalidade por grupos específicos de idade (60 a 69, 70 a 79 e 80 ou mais anos) e sexo. RESULTADOS: Houve aumento na proporção de óbitos por doenças respiratórias e diminuição por doenças cardiovasculares. Na comparação de taxas entre os sexos, as mulheres apresentaram taxas 15% menores para as causas cardiovasculares e taxas similares ao sexo masculino para as causas respiratórias. Foi observada taxa elevada de mortalidade por doenças respiratórias e cardiovasculares, com importante tendência de incremento entre os grupos mais longevos. Em idosos com idade >; 80 anos o aumento anual médio na taxa de mortalidade por doenças respiratórias foi de 1,99 óbitos e de 3,43 por doenças do aparelho circulatório. CONCLUSÕES: O estado de Mato Grosso apresenta elevada taxa de mortalidade por doenças respiratórias e cardiovasculares em idosos, com importante tendência de incremento entre os grupos mais longevos.OBJETIVO: Describir la evolución temporal de la mortalidad por enfermedades cardiorrespiratorias en ancianos. MÉTODOS: Estudio epidemiológico descriptivo con delineamiento ecológico de series temporales realizado en el Estado de Mato Grosso, Centro-Oeste de Brasil, de 1986 a 2006. Se utilizaron datos sobre enfermedades de los aparatos respiratorio y circulatorio obtenidos del Sistema de Información sobre Mortalidad del Ministerio de la Salud. Modelos de regresión lineal simple fueron ajustados para evaluar la tendencia de las tasas específicas de mortalidad por grupos específicos de edad (60 a 69, 70 a 70 y 80 o más años) y sexo. RESULTADOS: Hubo aumento en la proporción de óbitos por enfermedades respiratorias y disminución por enfermedades cardiovasculares. En la comparación de tasas entre los sexos, las mujeres presentaron tasas 15% menores para las causas cardiovasculares y tasas similares al sexo masculino para las causas respiratorias Se observó tasa elevada de mortalidad por enfermedades respiratorias y cardiovasculares, con importante tendencia de incremento entre los grupos más longevos. En ancianos con edad ³80 años o aumento anual promedio en la tasa de mortalidad por enfermedades respiratorias fue de 1,99 óbitos y de 3,43 por enfermedades del aparato circulatorio. CONCLUSIONES: El Estado de Mato Grosso presenta elevada tasa de mortalidad por enfermedades respiratorias y cardiovasculares en ancianos, con importante tendencia de incremento entre los grupos más longevos.OBJECTIVE: To describe time trends of mortality due to cardiorespiratory diseases in elderly people. METHODS: Epidemiological descriptive study with an ecological time series approach conducted in the state of Mato Grosso, Central-West Brazil, between 1986 and 2006. Data were obtained from the Brazilian Ministry of Health Mortality Database. Linear regression models were adjusted to analyze trends in mortality rates by age groups (60 to 69; 70 to 79; and 80 or more) and gender. RESULTS: There was an increase in proportion of deaths due to respiratory diseases and a decrease in proportion of deaths due to cardiovascular diseases. As for gender, cardiovascular rates were 15% lower in women than men and respiratory rates were similar in both men and women. High mortality rates for respiratory and cardiovascular diseases were observed with increasing trends among the oldest-old groups. The annual average increase for respiratory and cardiovascular diseases in those aged 80 years and older was 1.99 and 3.43 deaths, respectively. CONCLUSIONS: The state of Mato Grosso shows high mortality rates due to cardiorespiratory disease among elderly people with increasing trends among the oldest-old groups