Experiência de infectologistas frente à morte e ao morrer de seus pacientes ao longo da epidemia de AIDS na cidade de São Paulo: estudo qualitativo

CONTEXT AND OBJECTIVE: With the emergence of the acquired immunodeficiency syndrome (AIDS) in 1981, infectologists' care practices went through great changes. The objective of this study was to describe and analyze the experiences of infectologists in dealing with death and dying among their patients, over the course of the AIDS epidemic in the city of São Paulo. DESIGN AND SETTING: A qualitative approach was used. Twenty infectologists from five hospitals that treat human immunodeficiency virus (HIV)/AIDS patients in the municipality of São Paulo were interviewed. METHODS: The sample was formed through the snowball process. The sample size was determined using the saturation criterion. To analyze the material obtained from the interviews, the procedure of thematic analysis was used. This consisted of finding the core meaning relating to the study objective, within the set of materials obtained. RESULTS: Analysis of the material obtained from the interviews led to three main themes: 1. The initial context of AIDS and its impact on infectologists; 2. Modifications to the infectologists' attachments to patients after the introduction of highly active antiretroviral therapy (HAART); 3. Coping with death and dying. CONCLUSIONS: This study shows the importance of considering the distress, emotional overload and adaptive mechanisms relating to death and dying among patients, both in training and in professional practice.CONTEXTO E OBJETIVO: Com o surgimento da síndrome da imunodeficiência adquirida (aids), em 1981, os infectologistas passaram por grandes modificações em sua prática assistencial. Este estudo tem por objetivo descrever e analisar as vivências de médicos infectologistas frente à morte e ao morrer de seus pacientes ao longo da trajetória da epidemia de aids na cidade de São Paulo. TIPO DE ESTUDO E LOCAL: Adotou-se a abordagem qualitativa. Foram entrevistados 20 médicos infectologistas pertencentes a cinco instituições hospitalares que atendem portadores de vírus da imunodeficiência humana (HIV)/aids no município de São Paulo. MÉTODOS: A composição da amostra foi realizada pelo processo de snowball e o tamanho da amostra determinado pelo critério de saturação. Para a análise do material obtido nas entrevistas, foi utilizado o procedimento da análise temática, que consiste em descobrir os núcleos de sentido existentes no conjunto do material obtido e que têm relação com o objetivo do estudo. RESULTADOS: Da análise do material obtido nas entrevistas resultaram três eixos temáticos: 1. O contexto inicial da aids e o impacto vivido pelos infectologistas; 2. Modificações na vinculação com os pacientes depois da introdução da terapia antirretroviral potente (HAART); 3. Lidando com a morte e o morrer. CONCLUSÕES: O estudo aponta para a importância de considerar, tanto na formação como no exercício profissional, o sofrimento, a sobrecarga emocional e os mecanismos adaptativos relacionados à morte e o morrer de pacientes.Universidade Federal de São Paulo (UNIFESP)Sexually-Transmitted Diseases-AIDS (STD-AIDS) Reference and Training CenterState Health Department of São Paulo Institute of HealthUniversidade Federal de São Paulo (UNIFESP) Department of PsychiatryUNIFESP, Department of PsychiatrySciEL

Recombinant "IMS TAG" proteins : a new method for validating bottom-up matrix-assisted laser desorption/ionisation ion mobility separation mass spectrometry imaging

Rationale - Matrix assisted laser desorption ionisation mass spectrometry imaging (MALDI-MSI) provides a methodology to map the distribution of peptides generated by in situ tryptic digestion of biological tissue. It is challenging to correlate these peptides to the proteins from which they arise because of the many potentially overlapping and hence interfering peptide signals generated. Methods - A recombinant protein has been synthesised that when cleaved with trypsin yields a range of peptide standards for use as identification and quantification markers for multiple proteins in one MALDI-IMS-MSI experiment. Mass spectrometry images of the distribution of proteins in fresh frozen and formalin fixed paraffin embedded tissue samples following in situ tryptic digestion were generated by isolating signals on the basis of their m/z value and ion mobility drift time which were correlated to matching peptides in the recombinant standard. Results - Tryptic digestion of the IMS-TAG protein and MALDI-MS analysis yielded values for m/z and ion mobility drift time for the signature peptides included in it. MALDI-IMS-MSI images for the distribution of the proteins HSP 90 and Vimentin, in FFPE EMT6 mouse tumours and HSP-90 and Plectin in a fresh frozen mouse fibrosarcoma were generated by extracting ion images at the corresponding m/z and drift time from the tissue samples. Conclusions - The IMS-TAG approach provides a new means to confirm the identity of peptides generated by in situ digestion of biological tissue.</p

Fungal iron availability during deep seated candidiasis is defined by a complex interplay involving systemic and local events

Peer reviewedPublisher PD

Tissue derivatization for visualizing lactate and pyruvate in mouse testis tissues using matrix-assisted laser desorption/ionization-mass spectrometry imaging

The version of record of this article, first published in Analytical and Bioanalytical Chemistry, is available online at Publisher’s website: https://doi.org/10.1007/s00216-024-05559-4.Pyruvate and lactate are the final metabolites of the glycolytic system that are formed under oxygen-rich and anaerobic conditions, respectively. They play an important role in energy metabolism. Obtaining a tissue distribution image of pyruvate and lactate holds great significance in molecular biology because the glycolytic system plays an essential role in diseases, such as tumors and diabetes; microbial activities, such as alcohol production and lactic acid fermentation; and maintaining homeostasis in the gut environment. However, it is difficult to obtain images of the distribution of in vivo metabolites because of the low detection sensitivities of current methods. In this study, a novel derivatization method for pyruvate and lactate was developed using matrix-assisted laser desorption/ionization-mass spectrometry imaging (MALDI-MSI) to detect pyruvate and lactate in vivo and obtain biodistribution images. We investigated derivatization methods using readily available 3-nitrophenylhydrazine (3NPH), the addition of which improves the sensitivity of pyruvate detection, and the distribution of pyruvate in mouse testes was successfully visualized. Furthermore, the distribution of lactate in the mouse testes could be visualized, and improved detection sensitivity for the main metabolites of the tricarboxylic acid cycle was demonstrated. This derivatization method can be used to detect carboxyl-containing metabolites, including pyruvate, via MALDI-MSI. Furthermore, 3NPH forms amide bonds with carbonyl, phosphate, and carboxyl groups, suggesting the possibility of visualizing its distribution in many metabolites

Crystal Structure of 2′,3′-Di-O-Acetyl-5′-Deoxy-5-Fluorocytidine with N–H···(O,F) Proton Donor Bifurcated and (C,N)–H···O Bifurcated Acceptor Dual Three-Center Hydrogen Bond Configurations

The title compound, C13H16O6N3F, features a central furan ring containing four carbon atom chiral centers with a 4-amino-5-fluoro-2-oxopyrimidine group, two acetyl groups and a methyl group bonded at the 2,3,4,5 positions, each in an absolute R configuration (2R,3R,4R,5R). It crystallizes in the monoclinic space group C2 with unit cell parameters a = 14.5341(3), b = 7.26230(10), c = 16.2197(3) Å, β = 116.607(2)°, Z = 4. An extensive array of intra and inter molecular hydrogen bond interactions dominate crystal packing in the unit cell highlighted by a relatively rare three-center proton-bifurcated donor N–H···(O,F) hydrogen bond interaction in cooperation with a second, (C,N)–H···O bifurcated acceptor three-center hydrogen bond in a supportive fashion. Additional weak Cg π-ring inter molecular interactions between a fluorine atom and the 4-amino-5-fluoro-2-oxopyrimidine ring in concert with multiple donor and acceptor hydrogen bonds significantly influence the bond distances, bond angles and torsion angles of the deoxy-5-fluorocytidine group. Comparison to a MOPAC computational calculation provides support to these observations

Drug Targeting Mini-Symposium of the Division for Medicinal Chemistry (DMC) of the Swiss Chemical Society (SCS), at the Department of Chemistry, University of Basel, May 29, 2008: Conference Report

Specific targeting of drugs to their respective target organs or tissues is challenging. Substantial research efforts have been undertaken in the recent past to develop target specific drugs or drug conjugates. Such concepts are most relevant in rather severe diseases like cancer since it helps to reduce the concentration of frequently rather toxic drugs outside the tumor tissue. Various techniques can be used to specifically direct a drug or a drug conjugate to a specific tumor tissue such as using antibodies directed against tumor specific proteins, as nanoparticles or nano-sized polymer conjugates carrying tumor-specific recognition elements or by applying the active drug principle in a prodrug form designed to be liberated specifically in tumor tissue. Three speakers from the academia and one speaker from industry described different approaches and their respective potentials from various perspectives in the lectures entitled: 'Polymer Therapeutics and other Nanomedicines as Targetable Cancer Therapies', 'Design, Application, and Chemical Biology of Tumor-Targeting Drug Conjugates', 'Antibody-Based Vascular Tumor Targeting: From the Bench to the Clinic', and 'Discovery of Capecitabine, a Rationally Designed and Tumor-Activated Oral Prodrug of 5-FU, and Beyond'

1,2,3-Tri-O-acetyl-5-de­oxy-d-ribofuran­ose

The title compound, C11H16O7, was obtained from the breakage reaction of the glycosidic bond of 5′-de­oxy-2′,3′-diacetyl­inosine. The ribofuran­ose ring has a C2-exo, C3-endo twist configuration. No alteration of the relative configuration compared with d-(−)-ribose is observed

Imaging Mass Spectrometry: Hype or Hope?

Imaging mass spectrometry is currently receiving a significant amount of attention in the mass spectrometric community. It offers the potential of direct examination of biomolecular patterns from cells and tissue. This makes it a seemingly ideal tool for biomedical diagnostics and molecular histology. It is able to generate beautiful molecular images from a large variety of surfaces, ranging from cancer tissue sections to polished cross sections from old-master paintings. What are the parameters that define and control the implications, challenges, opportunities, and (im)possibilities associated with the application of imaging MS to biomedical tissue studies. Is this just another technological hype or does it really offer the hope to gain new insights in molecular processes in living tissue? In this critical insight this question is addressed through the discussion of a number of aspects of MS imaging technology and sample preparation that strongly determine the outcome of imaging MS experiments