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OBJECTIVES: to analyze the use of spirituality/religiosity by oncology nurse residents in caring for patients with cancer. METHODS: a census, descriptive, sectional study, with 46 nurse residents from three public hospitals in Rio de Janeiro. Data collection took place between August 2020 and January 2021, using a sociodemographic questionnaire, including a question about the use of spirituality/ religiosity to deal with work situations. Descriptive analysis was carried out using SPSS software version 22.0. RESULTS: participants stated that they use religiosity/spirituality in work situations related to patients or themselves. In relation to patients, death was the most mentioned situation among professionals, and for themselves, everyday situations and emotional vulnerability were the most mentioned. FINAL CONSIDERATIONS: spirituality and religiosity are dimensions that guide oncology nurse residents' attitudes.
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Enfermería Oncológica , Espiritualidad , Humanos , Masculino , Femenino , Adulto , Encuestas y Cuestionarios , Enfermería Oncológica/métodos , Enfermería Oncológica/normas , Brasil , Estudios Transversales , Persona de Mediana Edad , Atención de Enfermería/métodos , Atención de Enfermería/psicología , Actitud del Personal de Salud , Neoplasias/psicología , Neoplasias/enfermeríaRESUMEN
Paired related homeobox 1 (PRRX1) is an inducer of epithelial-to-mesenchymal transition (EMT) in different types of cancer cells. We detected low PRRX1 expression in nevus but increased levels in primary human melanoma and cell lines carrying the BRAFV600E mutation. High expression of PRRX1 correlates with invasiveness and enrichment of genes belonging to the EMT programme. Conversely, we found that loss of PRRX1 in metastatic samples is an independent prognostic predictor of poor survival for melanoma patients. Here, we show that stable depletion of PRRX1 improves the growth of melanoma xenografts and increases the number of distant spontaneous metastases, compared to controls. We provide evidence that loss of PRRX1 counteracts the EMT phenotype, impairing the expression of other EMT-related transcription factors, causing dysregulation of the ERK and signal transducer and activator of transcription 3 (STAT3) signaling pathways, and abrogating the invasive and migratory properties of melanoma cells while triggering the up-regulation of proliferative/melanocytic genes and the expression of the neural-crest-like markers nerve growth factor receptor (NGFR; also known as neurotrophin receptor p75NTR) and neural cell adhesion molecule L1 (L1CAM). Overall, our results indicate that loss of PRRX1 triggers a switch in the invasive programme, and cells de-differentiate towards a neural crest stem cell (NCSC)-like phenotype that accounts for the metastatic aggressiveness.
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BACKGROUND: Androgen insensitivity syndrome (AIS) is a common condition among individuals with differences of sexual development (DSD) and results from germline allelic variants in the androgen receptor (AR) gene. Understanding the phenotypic consequences of AR allelic variants that disrupt the activation function 2 (AF2) region is essential to grasping its clinical significance. OBJECTIVES: This study aims to provide insights into the phenotypic characteristics and clinical impact of AR mutations affecting the AF2 region in AIS patients. We achieve this by reviewing reported AR variants in the AF2 region among individuals with AIS, including identifying a new phenotype associated with the c.2138T>C variant (p.Leu713Pro) in the AR gene. MATERIALS AND METHODS: We comprehensively reviewed AR variants within the AF2 region reported in AIS and applied molecular dynamics simulations to assess the impact of the p.Leu713Pro variant on protein dynamics. RESULTS: Our review of reported AR variants in the AF2 region revealed a spectrum of phenotypic outcomes in AIS patients. Molecular dynamics simulations indicated that the p.Leu713Pro variant significantly alters the local dynamics of the AR protein and disrupts the correlation and covariance between variables. DISCUSSION: The diverse phenotypic presentations observed among individuals with AR variants in the AF2 region highlight the complexity of AIS. The altered protein dynamics resulting from the p.Leu713Pro variant further emphasize the importance of the AF2 region in AR function. CONCLUSION: Our study provides valuable insights into AR mutations' phenotypic characteristics and clinical impact on the AF2 region in AIS. Moreover, the disruption of protein dynamics underscores the significance of the AF2 region in AR function and its role in the pathogenesis of AIS.
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Lung cancer has the highest incidence and cancer-related mortality worldwide. In Portugal, it ranks as the fourth most common cancer, with nearly 6000 new cases being diagnosed every year. Lung cancer is the main cause of cancer-related death among males and the third cause of cancer-related death in females. Despite the globally accepted guidelines and recommendations for what would be the ideal path for a lung cancer patient, several challenges occur in real clinical management across the world. The recommendations emphasize the importance of adequate screening of high-risk individuals, a precise tumour biopsy, and an accurate final diagnosis to confirm the neoplastic nature of the nodule. A detailed histological classification of the lung tumour type and a comprehensive molecular characterization are of utmost importance for the selection of an efficacious and patient-directed therapeutic approach. However, in the context of the Portuguese clinical organization and the national healthcare system, there are still several gaps in the ideal pathway for a lung cancer patient, involving aspects ranging from the absence of a national lung cancer screening programme through difficulties in histological diagnosis and molecular characterization to challenges in therapeutic approaches. In this manuscript, we address the most relevant weaknesses, presenting several proposals for potential solutions to improve the management of lung cancer patients, helping to decisively improve their overall survival and quality of life.
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Introduction: Objectives: the prevention of central line-associated bloodstream infections is a critical aspect of care for patients with intestinal failure who are treated with parenteral nutrition. The use of taurolidine in this context is becoming increasingly popular, however there is a lack of standardization in its pediatric application. The objective of this work is to develop a guide to support its prescription. Methodology: the guide is based on a review of the literature and expert opinions from the Intestinal Failure Group of the SEGHNP. It was developed through a survey distributed to all its members, addressing aspects of usual practice with this lock solution. Results: this manuscript presents general recommendations concerning taurolidine indications, commercial presentations, appropriate forms of administration, use in special situations, adverse reactions, and contraindications in the pediatric population Conclusions: taurolidine is emerging as the primary lock solution used to prevent central line-associated bloodstream infections, proving to be safe and effective. This guide aims to optimize and standardize its use in pediatrics.
Introducción: Objetivo: la prevención de las infecciones asociadas a catéter ocupa un papel fundamental en los cuidados del paciente en situación de fracaso intestinal en tratamiento con nutrición parenteral. El empleo del sellado del catéter con taurolidina con ese fin se ha generalizado sin que exista una estandarización sobre su uso en población pediátrica. El objetivo de este trabajo es elaborar una guía clínica que sirva de apoyo en su utilización. Métodos: la guía se basa en una revisión de la literatura y en la opinión de expertos del Grupo de Trabajo de Fracaso Intestinal de la SEGHNP recogida a través de una encuesta realizada a todos sus integrantes sobre aspectos de la práctica habitual con este sellado. Resultados: este manuscrito expone unas recomendaciones en cuanto a las indicaciones, presentaciones comerciales disponibles, forma adecuada de administración, uso en situaciones especiales, reacciones adversas y contraindicaciones de la taurolidina en población pediátrica. Conclusiones: el sellado con taurolidina para la prevención de la infección asociada a catéter venoso central se ha mostrado como un tratamiento eficaz y seguro. La presente guía pretender optimizar y homogeneizar su uso en pediatría.
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Insuficiencia Intestinal , Nutrición Parenteral , Taurina , Tiadiazinas , Humanos , Tiadiazinas/uso terapéutico , Tiadiazinas/efectos adversos , Niño , Taurina/análogos & derivados , Taurina/uso terapéutico , Nutrición Parenteral/normas , Nutrición Parenteral/métodos , Insuficiencia Intestinal/terapia , Infecciones Relacionadas con Catéteres/prevención & control , Cateterismo Venoso Central/efectos adversos , Antiinfecciosos/uso terapéutico , Lactante , PreescolarRESUMEN
The main objective of the National Project for Research and Incidence of Childhood Leukemias is to reduce early mortality rates for these neoplasms in the vulnerable regions of Mexico. This project was conducted in the states of Oaxaca, Puebla, and Tlaxcala. A key strategy of the project is the implementation of an effective roadmap to ensure that leukemia patients are the target of maximum benefit of interdisciplinary collaboration between researchers, clinicians, surveyors, and laboratories. This strategy guarantees the comprehensive management of diagnosis and follow-up samples of pediatric patients with leukemia, centralizing, managing, and analyzing the information collected. Additionally, it allows for a precise diagnosis and monitoring of the disease through immunophenotype and measurable residual disease (MRD) studies, enhancing research and supporting informed clinical decisions for the first time in these regions through a population-based study. This initiative has significantly improved the diagnostic capacity of leukemia in girls, boys, and adolescents in the regions of Oaxaca, Puebla, and Tlaxcala, providing comprehensive, high-quality care with full coverage in the region. Likewise, it has strengthened collaboration between health institutions, researchers, and professionals in the sector, which contributes to reducing the impact of the disease on the community.
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Nosocomial infections are a frequent and serious problem in extremely low birth weight (ELBW) infants. Donor human milk (DHM) is the best alternative for feeding these babies when mother's own milk (MOM) is not available. Recently, a patented prototype of a High-Temperature Short-Time (HTST) pasteurizer adapted to a human milk bank setting showed a lesser impact on immunologic components. We designed a multicentre randomized controlled trial that investigates whether, in ELBW infants with an insufficient MOM supply, the administration of HTST pasteurized DHM reduces the incidence of confirmed catheter-associated sepsis compared to DHM pasteurized with the Holder method. From birth until 34 weeks postmenstrual age, patients included in the study received DHM, as a supplement, pasteurized by the Holder or HTST method. A total of 213 patients were randomized; 79 (HTST group) and 81 (Holder group) were included in the analysis. We found no difference in the frequency of nosocomial sepsis between the patients of the two methods-41.8% (33/79) of HTST group patients versus 45.7% (37/81) of Holder group patients, relative risk 0.91 (0.64-1.3), p = 0.62. In conclusion, when MOM is not available, supplementing during admission with DHM pasteurized by the HTST versus Holder method might not have an impact on the incidence of catheter-associated sepsis.
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Recien Nacido con Peso al Nacer Extremadamente Bajo , Sepsis , Lactante , Recién Nacido , Humanos , Leche Humana , Temperatura , Suplementos Dietéticos , Sepsis/epidemiología , Sepsis/prevención & controlRESUMEN
Saracatinib (AZD0530) is a dual Src/Abl inhibitor initially developed by AstraZeneca for cancer treatment; however, data from 2006 to 2024 reveal that this drug has been tested not only for cancer treatment, but also for the treatment of other diseases. Despite the promising pre-clinical results and the tolerability shown in phase I trials, where a maximum tolerated dose of 175 mg was defined, phase II clinical data demonstrated a low therapeutic action against several cancers and an elevated rate of adverse effects. Recently, pre-clinical research aimed at reducing the toxic effects and enhancing the therapeutic performance of saracatinib using nanoparticles and different pharmacological combinations has shown promising results. Concomitantly, saracatinib was repurposed to treat Alzheimer's disease, targeting Fyn. It showed great clinical results and required a lower daily dose than that defined for cancer treatment, 125 mg and 175 mg, respectively. In addition to Alzheimer's disease, this Src inhibitor has also been studied in relation to other health conditions such as pulmonary and liver fibrosis and even for analgesic and anti-allergic functions. Although saracatinib is still not approved by the Food and Drug Administration (FDA), the large number of alternative uses for saracatinib and the elevated number of pre-clinical and clinical trials performed suggest the huge potential of this drug for the treatment of different kinds of diseases.
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Benzodioxoles , Reposicionamiento de Medicamentos , Quinazolinas , Humanos , Reposicionamiento de Medicamentos/métodos , Quinazolinas/uso terapéutico , Quinazolinas/química , Quinazolinas/farmacología , Benzodioxoles/uso terapéutico , Benzodioxoles/química , Benzodioxoles/farmacología , Animales , Inhibidores de Proteínas Quinasas/uso terapéutico , Inhibidores de Proteínas Quinasas/química , Inhibidores de Proteínas Quinasas/farmacología , Inhibidores de Proteínas Quinasas/efectos adversos , Enfermedad de Alzheimer/tratamiento farmacológico , Familia-src Quinasas/antagonistas & inhibidores , Familia-src Quinasas/metabolismo , Neoplasias/tratamiento farmacológico , Antineoplásicos/uso terapéutico , Antineoplásicos/químicaRESUMEN
BACKGROUND: There is a need for a deeper understanding of the barriers to research in family medicine (FM) and to consider the perceptions and perspectives of professionals. Our study aims to provide a strategic view for research capacity building in FM. We included the perspective of family physician researchers (FPR) on the existing barriers to investigation in this context. OBJECTIVES: To understand and characterize the barriers to research in FM (personal and structural), from the perspective of Portuguese family physicians who are researchers. METHODS: A qualitative study, of phenomenological nature, was performed, through the conduction of semi-structured interviews with FPR, from 2019 to 2022. Data analysis and thematic coding were done on MAxQDA®, with inductive and deductive approaches, until data saturation was reached. RESULTS: A total of 12 family physicians/researchers were interviewed. Seven main themes were identified as barriers to research: time, professional valorization, funding, ethics committees, infrastructure, management/institutions, and participants. Each theme is divided into subthemes that make it possible to assess how a barrier can affect researchers in performing research activities. CONCLUSION: Our study highlights the identification of 7 main barriers. Structuring them into sub-themes not only improved the organization of our results but also provided robust support for the next phase, namely the application of a survey with the aim of gaining a deeper insight into the repercussions that these barriers to FPR have at a national level. This research is crucial to laying the foundations for a policy document that offers well-defined and tailored recommendations to address the barriers we have uncovered.
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Medicina Familiar y Comunitaria , Médicos de Familia , Humanos , Portugal , Investigadores , Investigación CualitativaRESUMEN
INTRODUCTION: The qualities of primary healthcare (PHC) make it a very relevant environment for research; however, there is still work to be done to enhance the research capabilities of family physicians in healthcare units. Considering there is no ongoing review that specifically addresses this objective, the proposed goal of this scoping review is to determine the depth of the literature on the current strategies that support research capacity building among family physicians in the context of PHC. METHODS AND ANALYSIS: The scoping review will include studies from PubMed, Scopus, Web of Science, Cochrane Library and grey literature, published from 2008 to 2023, that address strategies to promote research capacity building among family physicians in the context of PHC. Only studies published in English, Portuguese or Spanish will be considered. All study designs, including quantitative, qualitative and mixed-methods studies, will be eligible for inclusion. The literature search will be performed from January to March of 2024 and data charting will employ a descriptive-analytical method, systematically summarising study objectives, methodologies, findings and implications. This protocol follows the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols and the review will employ the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews. ETHICS AND DISSEMINATION: This review does not need ethical approval. Peer-reviewed publications, policy summaries, presentations at conferences and involvement with pertinent stakeholders are all part of our outreach approach.
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Creación de Capacidad , Médicos de Familia , Humanos , Exactitud de los Datos , Etnicidad , Proyectos de Investigación , Atención Primaria de Salud , Revisiones Sistemáticas como Asunto , Literatura de Revisión como AsuntoRESUMEN
Objetiva-se analisar as produções cientificas sobre a atenção integral da saúde do homem na Revista Nursing brasileira, São Paulo. Método: trata-se de uma revisão integrativa de literatura, utilizando as bases de dados LILACS e BDENF, o corte epistemológico foi de 2009 a 2019, a amostra final constituiu-se de 10 artigos. Resultados: os dados analisados foram divididos a partir de associações temáticas, em quatro categorias: acesso e acolhimento; saúde sexual e saúde reprodutiva; doenças prevalentes na população masculina e prevenção de violência e acidentes. Conclui-se que o cuidado integral a saúde do homem, e colocá-los como sujeito do cuidado, com autonomia, independência e responsabilidade social.(AU)
The objective is to analyze scientific productions on comprehensive men's health care in the Brazilian Nursing Journal, São Paulo. Method: This is an integrative literature review, using the LILACS and BDENF databases, the epistemological cut was from 2009 to 2019, the final sample consisted of 10 articles. Results: The data analyzed was divided into four categories based on thematic associations: access and reception; sexual health and reproductive health; prevalent diseases in the male population; and prevention of violence and accidents. The conclusion is that comprehensive care for men's health should place them as the subject of care, with autonomy, independence and social responsibility.(AU)
El objetivo es analizar la producción científica sobre atención integral a la salud masculina en la Revista Brasileña de Enfermería, São Paulo. Método: Se trata de una revisión bibliográfica integradora, utilizando las bases de datos LILACS y BDENF, el corte epistemológico fue de 2009 a 2019, la muestra final constó de 10 artículos. Resultados: Los datos analizados se dividieron en cuatro categorías a partir de asociaciones temáticas: acceso y acogida; salud sexual y salud reproductiva; enfermedades prevalentes en la población masculina; y prevención de violencia y accidentes. Se concluye que la atención integral a la salud del hombre debe colocarlo como sujeto de cuidados, con autonomía, independencia y responsabilidad social.(AU)
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Publicaciones de Divulgación Científica , Salud del Hombre , Atención de EnfermeríaRESUMEN
INTRODUCTION: There are several barriers discouraging clinicians from undertaking research, including insufficient funding, lack of time, organizational issues and lack of support. The strengthening of research capacity is perceived from three levels: characteristics of the researcher, the environment, and organizational issues. To date, Portugal is lacking studies on this subject. The aim of this study was to identify the best practices to promote research in Portuguese Primary Health Care. METHODS: We conducted a qualitative study using semi-structured interviews with family doctors with broadly recognized research work and other stakeholders. We selected a sample by convenience and snowball sampling. From a total of 14 doctors invited by email, 12 responded positively, and we subsequently included two other stakeholders. We conducted the interviews in digital or face-to-face formats. Two team members handled the coding of interviews independently. We kept all recordings and transcripts confidential, only accessible to researchers. RESULTS: We identified 16 strategies: 1) increasing institutional support; 2) creating support structures; 3) redefining the residency program; 4) investing in research training; 5) redefining curriculum evaluation; 6) establishing dedicated time for research; 7) increasing funding; 8) improving access to research data; 9) being a research driver; 10) establishing a research culture; 11) working in collaboration; 12) creating formally organized research groups; 13) creating autonomous research centers; 14) improving the definition of the research subjects and study designs; 15) reviewing procedures for ethics' committees; and 16) reviewing the current selection of articles for publication. CONCLUSION: Overall, a greater proportion of interviewees identified the following as the most relevant strategies for research promotion: institutional support, including technical and scientific support from public institutions, private entities and academic centers; the reorganization of working hours with protected time for research; increased funding directed towards research and breaking isolation in research, promoting teamwork with clinicians within the same area or from different professional backgrounds.
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Investigación sobre Servicios de Salud , Médicos , Humanos , Portugal , Investigación CualitativaRESUMEN
ABSTRACT Objectives: to analyze the use of spirituality/religiosity by oncology nurse residents in caring for patients with cancer. Methods: a census, descriptive, sectional study, with 46 nurse residents from three public hospitals in Rio de Janeiro. Data collection took place between August 2020 and January 2021, using a sociodemographic questionnaire, including a question about the use of spirituality/ religiosity to deal with work situations. Descriptive analysis was carried out using SPSS software version 22.0. Results: participants stated that they use religiosity/spirituality in work situations related to patients or themselves. In relation to patients, death was the most mentioned situation among professionals, and for themselves, everyday situations and emotional vulnerability were the most mentioned. Final Considerations: spirituality and religiosity are dimensions that guide oncology nurse residents' attitudes.
RESUMEN Objetivos: analizar el uso de la espiritualidad/religiosidad por parte de enfermeras residentes de oncología en el cuidado del paciente con cáncer. Métodos: estudio censal, descriptivo, seccional, con 46 enfermeros residentes de tres hospitales públicos de Río de Janeiro. La recolección de datos se realizó entre agosto de 2020 y enero de 2021, mediante un cuestionario sociodemográfico, que incluía una pregunta sobre el uso de la espiritualidad/religiosidad para afrontar situaciones laborales. El análisis descriptivo se realizó mediante el software SPSS, versión 22.0. Resultados: los participantes afirmaron utilizar la religiosidad/espiritualidad en situaciones laborales relacionadas con el cliente o con ellos mismos. En relación al cliente, la muerte fue la situación más mencionada entre los profesionales, y para usted, las situaciones cotidianas y su vulnerabilidad emocional fueron las más mencionadas. Consideraciones Finales: espiritualidad y religiosidad son dimensiones que orientan las actitudes de los enfermeros residentes en oncología.
RESUMO Objetivos: analisar o uso da espiritualidade/religiosidade por enfermeiros residentes em oncologia na assistência ao paciente oncológico. Métodos: estudo censitário, descritivo, do tipo seccional, com 46 enfermeiros residentes de três hospitais públicos do Rio de Janeiro. A coleta de dados ocorreu entre agosto de 2020 e janeiro de 2021, utilizando um questionário sociodemográfico, incluindo uma pergunta acerca do uso da espiritualidade/religiosidade para lidar com situações do trabalho. A análise descritiva foi realizada por meio do software SPSS, versão 22.0. Resultados: os participantes afirmaram fazer uso da religiosidade/espiritualidade em situações de trabalho relacionadas ao cliente ou a si próprio. Em relação ao cliente, a morte foi a situação mais referida entre os profissionais, e para si, as situações do dia a dia e sua vulnerabilidade emocional foram as mais referidas. Considerações Finais: a espiritualidade e a religiosidade são dimensões que guiam as atitudes dos enfermeiros residentes em oncologia.
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Biomass storage is an essential requirement in the supply chain of bio-refineries and power plants. This research aims to evaluate the influence of long-term outdoor storage (1 year) of baled rockrose (Cistus laurifolius L.) shrub biomass on biofuel's quality, pre-treatment processes and on combustion emissions in an industrial boiler. The raw material was obtained from different rockrose shrublands in north central Spain. A total of 233 tWM (tones of wet matter) of biomass were used to produce biofuels (30 mm of milled biomass and Ø 8 mm pellets) in the pre-treatment pilot plants at CEDER-CIEMAT. The combustion tests were conducted in an industrial moving grate boiler with a thermal power of 50 MWth, in a 17 MWe power plant. Outdoor storage improved some biofuel quality parameters, mainly the reduction in ash content, which allowed 30 mm of milled material to be classified as class I1 (ISO 17225-9:2022) and pellets as class I3 (ISO 17225-2-2021). No significant differences were observed in the total specific mass flow and energy consumption in the pre-treatment processes. The combustion tests had similar results, with the emissions being below the limits established in the directive (EU) 2015/2193. The results obtained indicated that the 1-year outdoor storage of rockrose-baled biomass, under Mediterranean conditions, was feasible for its subsequent use as biofuel.
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CONTEXT: Despite high abundance of small indels in human genomes, their precise roles and underlying mechanisms of mutagenesis in Mendelian disorders require further investigation. OBJECTIVE: To profile the distribution, functional implications, and mechanisms of small indels in the androgen receptor (AR) gene in individuals with androgen insensitivity syndrome (AIS). METHODS: We conducted a systematic review of previously reported indels within the coding region of the AR gene, including 3 novel indels. Distribution throughout the AR coding region was examined and compared with genomic population data. Additionally, we assessed their impact on the AIS phenotype and investigated potential mechanisms driving their occurrence. RESULTS: A total of 82 indels in AIS were included. Notably, all frameshift indels exhibited complete AIS. The distribution of indels across the AR gene showed a predominance in the N-terminal domain, most leading to frameshift mutations. Small deletions accounted for 59.7%. Most indels occurred in nonrepetitive sequences, with 15.8% situated within triplet regions. Gene burden analysis demonstrated significant enrichment of frameshift indels in AIS compared with controls (P < .00001), and deletions were overrepresented in AIS (P < .00001). CONCLUSION: Our findings underscore a robust genotype-phenotype relationship regarding small indels in the AR gene in AIS, with a vast majority presenting complete AIS. Triplet regions and homopolymeric runs emerged as prone loci for small indels within the AR. Most were frameshift indels, with polymerase slippage potentially explaining half of AR indel occurrences. Complex frameshift indels exhibited association with palindromic runs. These discoveries advance understanding of the genetic basis of AIS and shed light on potential mechanisms underlying pathogenic small indel events.
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Síndrome de Resistencia Androgénica , Receptores Androgénicos , Humanos , Masculino , Síndrome de Resistencia Androgénica/genética , Genoma Humano , Mutagénesis , Mutación , Fenotipo , Receptores Androgénicos/genéticaRESUMEN
BACKGROUND: Chikungunya is a mosquito-borne virus that has been causing large outbreaks in the Americas since 2014. In Brazil, Asian-Caribbean (AC) and East-Central-South-African (ECSA) genotypes have been detected and lead to large outbreaks in several Brazilian states. In Rio Grande do Sul (RS), the southernmost state of Brazil, the first cases were reported in 2016. OBJECTIVES AND METHODS: We employed genome sequencing and epidemiological investigation to characterise the Chikungunya fever (CHIKF) burden in RS between 2017-2021. FINDINGS: We detected an increasing CHIKF burden linked to travel associated introductions and communitary transmission of distinct lineages of the ECSA genotype during this period. MAIN CONCLUSIONS: Until 2020, CHIKV introductions were most travel associated and transmission was limited. Then, in 2021, the largest outbreak occurred in the state associated with the introduction of a new ECSA lineage. CHIKV outbreaks are likely to occur in the near future due to abundant competent vectors and a susceptible population, exposing more than 11 million inhabitants to an increasing infection risk.
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Fiebre Chikungunya , Virus Chikungunya , Animales , Humanos , Virus Chikungunya/genética , Brasil/epidemiología , Viaje , Filogenia , Mosquitos Vectores , Brotes de Enfermedades , GenotipoRESUMEN
Triple-negative breast cancer (TNBC) is one of the most aggressive forms of breast cancer and constitutes 10-20% of all breast cancer cases. Even though platinum-based drugs such as cisplatin and carboplatin are effective in TNBC patients, their toxicity and development of cancer drug resistance often hamper their clinical use. Hence, novel drug entities with improved tolerability and selectivity profiles, as well as the ability to surpass resistance, are needed. The current study focuses on Pd(II) and Pt(II) trinuclear chelates with spermidine (Pd3Spd2 and Pt3Spd2) for evaluating their antineoplastic activity having been assessed towards (i) cisplatin-resistant TNBC cells (MDA-MB-231/R), (ii) cisplatin-sensitive TNBC cells (MDA-MB-231) and (iii) non-cancerous human breast cells (MCF-12A, to assess the cancer selectivity/selectivity index). Additionally, the complexes' ability to overcome acquired resistance (resistance index) was determined. This study revealed that Pd3Spd2 activity greatly exceeds that displayed by its Pt analog. In addition, Pd3Spd2 evidenced a similar antiproliferative activity in both sensitive and resistant TNBC cells (IC50 values 4.65-8.99 µM and 9.24-13.34 µM, respectively), with a resistance index lower than 2.3. Moreover, this Pd compound showed a promising selectivity index ratio: >6.28 for MDA-MB-231 cells and >4.59 for MDA-MB-231/R cells. Altogether, the data presently gathered reveal Pd3Spd2 as a new, promising metal-based anticancer agent, which should be further explored for the treatment of TNBC and its cisplatin-resistant forms.
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INTRODUCTION AND OBJECTIVES: One-year mortality after hospitalization for heart failure (HF) is high. This study aims to identify predictive factors of one-year mortality. METHODS: This is a retrospective, single-center and observational study. All patients hospitalized for acute HF during one year were enrolled. RESULTS: A total of 429 patients were enrolled, mean age of 79 years. The in-hospital and one-year all-cause mortality rates were 7.9% and 34.3%, respectively. In the univariable analysis, the factors significantly associated with higher one-year mortality risk were: age ≥80 years (odds ratio (OR)=2.05, 95% confidence interval (CI) 1.35-3.11, p=0.001); active cancer (OR=2.93, 95% CI 1.36-6.32, p=0.008); dementia (OR=2.84, 95% CI 1.81-4.47, p<0.001); functional dependency (OR=2.63, 95% CI 1.65-4.19, p<0.001); atrial fibrillation (OR=1.86, 95% CI 1.24-2.80, p=0.004); higher creatinine (OR=2.03, 95% CI 1.29-3.21, p=0.002), urea (OR=2.92, 95% CI 1.95-4.36, p<0.001) and red cell distribution width (RDW; 4thQ OR=5.59, 95% CI 3.03-10.32, p=0.001); and lower hematocrit (OR=0.94, 95% CI 0.91-0.97, p<0.001), hemoglobin (OR=0.83, 95% CI 0.75-0.92, p<0.001) and platelet distribution width (PDW; OR=0.89, 95% CI 0.82-0.97, p=0.005). In the multivariable analysis, the independent predictors of higher one-year mortality risk were: age ≥80 years (OR=2.05, 95% CI 1.21-3.48); active cancer (OR=2.70, 95% CI 1.03-7.01); dementia (OR=2.69, 95% CI 1.53-4.74); higher urea (OR=2.97, 95% CI 1.84-4.80) and RDW (4thQ OR=5.24, 95% CI 2.55-10.76); and lower PDW (OR=0.88, 95% CI 0.80-0.97). CONCLUSIONS: Active cancer, dementia, and high values for urea and RDW at admission are predictors of one-year mortality in patients hospitalized for HF. These variables are readily available at admission and can support the clinical management of HF patients.
Asunto(s)
Demencia , Insuficiencia Cardíaca , Humanos , Anciano , Anciano de 80 o más Años , Estudios Retrospectivos , Pronóstico , Hospitalización , Urea , Índices de Eritrocitos , Factores de RiesgoRESUMEN
Objetivo: Caracterizar os estudos de intervenção cadastrados por enfermeiros no Registro Brasileiro de Ensaios Clínicos. Métodos: Estudo descritivo, com abordagem quantitativa, realizado mediante acesso virtual ao Registro Brasileiro de Ensaios Clínicos, para busca dos estudos cadastrados na plataforma. Após leitura dos 3350 resumos disponíveis, os 320 cadastrados por enfermeiros foram selecionados para compor a amostra. Foi realizada a análise descritiva, no software R. Resultados: Foram encontrados estudos registrados entre 2010 e 2019, dos quais 49,7% localizavam-se na região Sudeste, 49,3% cadastrados por doutores, 46,3% filiados a universidades federais. A área da enfermagem mais estudada (18,8%) tratou-se de saúde do adulto, 72,9% possuíam dois braços, 53,1% com recrutamento concluído, 50,3% realizados com cegamento e o tipo de intervenções mais estudado (21,9%) foi a educativa. Conclusão: A maioria dos estudos de intervenção cadastrados por enfermeiros no Registro Brasileiro de Ensaios Clínicos testaram intervenções educativas, em adultos, possuíram cegamento e foram randomizados. (AU)
Objective: To characterize the intervention studies registered by nurses in the Brazilian Registry of Clinical Trials. Methods: Descriptive study, with quantitative approach, carried out through virtual access to the Brazilian Registry of Clinical Trials, to search for the studies registered on the platform. After reading the 3350 abstracts available, the 320 registered by nurses were selected to make up the sample. Descriptive analysis was performed in the software R. Results: Studies registered between 2010 and 2019 were found, of which 49.7% were in the Southeast region, 49.3% registered by doctors, 46.3% affiliated to federal universities. The most studied nursing area (18.8%) it was adult health, 72.9% had two arms, 53.1% with completed recruitment, 50.3% performed blinding and the most studied type of interventions (21.9%) was the educational. Conclusion: Most intervention studies registered by nurses in the Brazilian Registry of Clinical Trials tested educational interventions in adults, blinded and randomized. (AU)
Objetivo: Caracterizar los estudios de intervención registrados por enfermeros en el Registro Brasileño de Ensayos Clínicos. Métodos: Estudio descriptivo, con enfoque cuantitativo, realizado a través del acceso virtual al Registro Brasileño de Ensayos Clínicos, para buscar estudios registrados en la plataforma. Después de leer los 3350 resúmenes disponibles, los 320 registrados por enfermeros fueron seleccionados para componer la muestra. Se realizó análisis descriptivo en el software R. Resultados: Se encontraron estudios registrados entre 2010 y 2019, de los cuales el 49,7% se ubicaron en la región Sudeste, el 49,3% fueron registrados por médicos, el 46,3% fueron afiliados a universidades federales. El área de enfermería más estudiada (18,8 %) fue la salud del adulto, el 72,9 % tenía dos brazos, el 53,1 % había completado el reclutamiento, el 50,3 % estaba cegada y el tipo de intervenciones más estudiadas (21,9 %) fue la educativa. Conclusión: La mayoría de los estudios de intervención registrados por enfermeros en el Registro Brasileño de Ensayos Clínicos probaron intervenciones educativas en adultos, fueron ciegos y aleatorizados. (AU)