Abstract The transforming growth factor beta 1 (TGFB1) is a pro-inflammatory cytokine that plays a key role in the mechanisms of angiogenesis and breakdown of the blood-retina barrier, which are implicated in the pathogenesis of diabetic retinopathy (DR). Polymorphisms in the TGFB1 gene have been associated with DR; however, results are still contradictory. Therefore, the aim of this study was to investigate the potential association between two TGFB1 polymorphisms and DR. This study included 992 patients with diabetes mellitus (DM): 546 patients with DR (cases) and 446 patients without DR and with ≥10 years of DM (controls). The TGFB1 rs1800469 and rs1800470 polymorphisms were genotyped by real-time PCR. Frequency of rs1800469 T/T genotype was higher in controls compared to DR cases (18.3% vs. 12.7%, P= 0.022). This genotype remained associated with protection for DR, adjusting for covariables (OR= 0.604; 95% CI 0.395 - 0.923; P= 0.020, recessive model). The rs1800470 C/C genotype was observed in 25.4% of the controls and 18.0% of the cases (P= 0.015); thus, being associated with protection against DR under the recessive model (OR= 0.589; 95% CI 0.405 - 0.857; P= 0.006), adjusting for covariables. In conclusion, the TGFB1 rs1800469 and rs1800470 polymorphisms are associated with protection against DR in DM patients from Southern Brazil.

ABSTRACT Objective: As studies have reported the involvement of angiopoietin-2 (ANGPT-2) in the pathogenesis of diabetic retinopathy (DR), the aim of this study was to investigate the association between the ANGPT-2 rs2442598 polymorphism and DR. Materials and methods: This case-control study comprised 107 patients with type 1 diabetes mellitus (T1DM) and DR (cases) and 129 patients with T1DM without DR (controls) and with ≥ 10 years of DM. The ANGPT-2 rs2442598 (G/A) polymorphism was genotyped by real-time PCR using TaqMan MGB probes. Results: Genotype distributions of this polymorphism were consistent with the Hardy-Weinberg equilibrium. The frequency of the rs2442598 A allele was higher in cases compared to controls (p = 0.011). Moreover, the A/A genotype was more frequent in cases than in controls (p = 0.017) and was associated with risk for DR after adjustments for duration of DM, HbA1c, triglycerides, estimated glomerular filtration rate, and hypertension (odds ratio [OR] = 5.19, 95% confidence interval [CI] 1.21-22.27). This association was maintained under recessive (OR = 4.78, 95% CI 1.14-19.99) and additive (OR = 6.861, 95% CI 1.45-32.38) inheritance models. Conclusion: Our data demonstrated, for the first time, an association between the ANGPT-2 rs2442598 A allele and risk for DR in T1DM patients from southern Brazil. Additional studies are necessary to replicate this association in other populations.

ABSTRACT Objective to learn the difficulties encountered by families in caring for children or adolescents with HIV. Methodology this qualitative study was conducted at a day hospital in southern Brazil in 2018. The participants were 20 family caregivers of seropositive children or adolescents. Data were collected through interviews and subjected to Content Analysis. Ethical principles were respected. Results the families claimed to have no care facilities. They reported difficulties in keeping the children’s or adolescents’ diagnosis confidential; securing adherence to medication and administration schedules; minimizing side effects; attending appointments; suffering prejudice and gaining social acceptance of the disease, which included concern for the children’s or adolescents’ futures. Conclusion it was found to be important that health professionals’ or nurses’ invest in care focused on promoting the health of children and adolescents with HIV, furthering health education and managing the difficulties encountered in care.

RESUMEN Objetivo conocer las dificultades encontradas por la familia para el cuidado al niño/adolescente con VIH. Método investigación cualitativa realizada en un Hospital Día en el sur de Brasil en 2018. Participaron 20 familiares cuidadores de niños/adolescentes seropositivos. Los datos fueron recolectados por entrevistas y sometidos al Análisis de Contenido. Se respetaron los principios éticos. Resultados las familias afirmaron no tener facilidades en el cuidado. Dijeron que tienen dificultades para mantener el secreto del diagnóstico junto al niño/adolescente, también para su adherencia a la medicación y minimización de sus efectos colaterales, para seguir los horarios correctos de administración; la asiduidad de las consultas; por sufrir con los prejuicios y la dificultad de aceptación social de la enfermedad y la preocupación por el futuro del niño/adolescente. Conclusión se verificó que es muy importante la actuación de los profesionales de salud/enfermeros que invierten en una atención volcada a la promoción de salud de niños y adolescentes con VIH, promoviendo la educación sanitaria y la gestión de las dificultades enfrentadas con el cuidado.

RESUMO Objetivo conhecer as dificuldades encontradas pela família para o cuidado à criança/adolescente com HIV. Metodologia pesquisa qualitativa realizada em um Hospital Dia no sul do Brasil em 2018. Participaram 20 familiares cuidadores de crianças/adolescentes soropositivas. Os dados foram coletados por entrevistas e submetidos à Análise de Conteúdo. Respeitaram-se os princípios éticos. Resultados as famílias afirmaram não ter facilidades no cuidado. Referiram dificuldades em manter o sigilo do diagnóstico para a criança/adolescente; na adesão desta à medicação e minimização dos seus efeitos colaterais, em seguir os horários de administração; na assiduidade às consultas; em sofrer preconceito e na aceitação da sociedade diante da doença, incluindo a preocupação com o futuro da criança/adolescente. Conclusão verificou-se como importante a atuação dos profissionais da saúde/ enfermeiros investindo em uma assistência voltada para a promoção de saúde de crianças e adolescentes com HIV, promovendo educação em saúde e o manejo das dificuldades enfrentadas com o cuidado.

ABSTRACT: This study aimed to investigate the perception of the family caregiver regarding the problems faced by the child in relation to her diagnosis of Human Immunodeficiency Syndrome. A qualitative, exploratory and descriptive study was undertaken in a Day Hospital which is a center of excellence in the South of Brazil, in the second semester of 2014. The participants were 10 family caregivers of children attended in the service. The data were collected through semistructured interviews and underwent content analysis. The results emphasized the following as problems faced by the family caregiver: the need for frequent inpatient treatment, being the only person with the virus in the family, suffering prejudice within the family and at school, presenting growth delays and psychological problems. It is necessary for nurses to take responsibility for our educational role with these families so as to help them develop effective strategies for caring for the child.

RESUMEN: Estudio cuyo intuito fue conocer la percepción del familiar cuidador acerca de los problemas enfrentados por el niño delante del diagnóstico de Síndrome de la Inmunodeficiencia Humana. Se realizó investigación cualitativa, exploratoria y descriptiva en un Hospital Día referencia del sur del país, en el segundo semestre de 2014. Participaron diez familiares cuidadores de niños atendidos en el servicio. Los dados fueron obtenidos por medio de entrevistas semi estructuradas y sometidos al análisis de contenido. Los resultados destacaron como problemas enfrentados por el familiar cuidador la necesidad de internaciones hospitalarias frecuentes, el hecho de ser la única persona con el virus en la familia, sufrir prejuicio en la familia y en la escuela; presentar retraso en el crecimiento y problemas psicológicos. Es necesario que nosotros enfermeros asumamos nuestro papel educativo con estas familias a fin de ayudarlas en el desarrollo de estrategias efectivas de cuidado al niño.

RESUMO: Objetivou-se conhecer a percepção do familiar cuidador acerca dos problemas enfrentados pela criança frente o diagnóstico de Síndrome da Imunodeficiência Humana. Realizou-se pesquisa qualitativa, exploratória e descritiva em um Hospital Dia referência do sul do país, no segundo semestre de 2014. Participaram dez familiares cuidadores de crianças atendidas no serviço. Os dados foram coletados por meio de entrevistas semiestruturadas e submetidos à análise de conteúdo. Os resultados destacaram como problemas enfrentados pelo familiar cuidador a necessidade de internações hospitalares frequentes, ser a única pessoa com o vírus na família, sofrer preconceito na família e na escola; apresentar atraso no crescimento e problemas psicológicos. É necessário que assumamos o nosso papel educativo junto a estas famílias no sentido de auxiliá-las no desenvolvimento de estratégias efetivas de cuidado à criança.