Oral lesions and associated factors in breast cancer survivors.

AIM: To evaluate the prevalence of oral lesions (OL) and associated factors among survivors of breast cancer (BC). METHODS: A cross-sectional study involving 150 BC survivors was conducted at a public hospital in southern Brazil. Data were collected on socioeconomic aspects, treatment characteristics and oral problems. The decayed, missing and filled teeth index and the occurrence of OL were evaluated. Logistic regression was performed to determine independent variables associated with the outcome. RESULTS: 24% of the women had at least 1 OL and 33.3% of these had more than one lesion. Melanotic macule was the most prevalent lesion. Duration of tamoxifen use, radiotherapy, missing teeth and xerostomia were associated with the occurrence of OL (P < .05). In the adjusted analysis, women with more than 13 missing teeth and xerostomia had 2.39-fold (95% confidence interval [CI], 1.06-5.40) and 2.71-fold (95% CI, 1.14-6.42), respectively, greater odds of exhibiting OL. CONCLUSION: Approximately 1/4 of the BC survivors exhibited OL, which were associated with tooth loss and xerostomia. These findings could assist in the establishment of oral health strategies for women with BC.

Uncaria tomentosa extract alters the catabolism of adenine nucleotides and expression of ecto-5'-nucleotidase/CD73 and P2X7 and A1 receptors in the MDA-MB-231 cell line.

ETHOPHARMACOLOGICAL RELEVANCE: Uncaria tomentosa (Willd.) DC. (Rubiaceae) (Ut), also known as cat's claw, is a woody liana widely spread throughout the Amazon rainforest of Central and South America, containing many chemical constituents such as oxindole alkaloids, which are responsible for various biological activities. Since ancient times, the indigenous people of Peru have used it as a bark infusion for the treatment of a wide range of health problems gastric ulcers, arthritis and rheumatism. Recently, Ut is distributed worldwide and used as an immunomodulatory and anti-inflammatory herbal remedy. Additionally, U. tomentosa also has antitumural activity. However, little is known about the action of U. tomentosa on the purinergic system mechanisms, which is involved in tumor progression. AIM OF THE STUDY: Considering the pharmacological properties of U. tomentosa, we sought to evaluate the hydroalcoholic extract U tomentosa is able to influence the purinergic system in breast cancer cells, MDA-MB-231. Through the activity and expression of ectonucleotidases (NTPDase - CD39; Ecto-5'-nucleotidase - CD73) and purinergic repceptores (P2X7 and A1). MATERIALS AND METHODS: A hydroalcoholic extract was prepared in two concentrations, 250 and 500µg/mL. (Ut250; Ut500). The effect of these concentrations on the activity and expression of ectonucleotidases, as well as on the density of purinergic receptors were investigated in MDA-MB-231 breast cancer cells. Cells were treated with the hydroalcoholic extract of Uncaria tomentosa and/or doxorubicin (Doxo 1µM; Ut250+Doxo; Ut500+Doxo) for 24h. RESULTS: Although the results were not significant for the hydrolysis of the ATP, they presented an increase in the ADP hydrolysis in the Ut500+Doxo group when compared to the control group. Additionally, the activity of 5'-nucleotidase was inhibited in all groups when compared with the untreated group of cells. Inhibition of the enzyme was more evident in groups with U. tomentosa per se. The expression of CD39 was increased in the Ut250 and Ut250+Doxo groups when compared to the control group. No changes were found in the CD73 expression. Furthermore, a reduction in the density of the P2X7 receptor in all treated groups was detected. On the other hand, the density of the A1 receptor increased in all groups compared to the control group, with the exception of the Ut500+Doxo group. CONCLUSION: Therefore, we conclude that hydroalcoholic extract of U. tomentosa may be responsible for the reduction of adenosine levels in the extracellular medium, which accelerates tumor progression. Interestingly, the dysregulation of A1 and P2X7 receptors in the MDA-MB-231 cells exacerbate the proliferation of this cells and U. tomentosa treatment may be stimulate the antitumor activity of adenosine A1 receptor and control the P2X7 effects. Our study demonstrates the significant participation of purinergic pathway in the regulation of MDA-MB-231 progression; additionally, U. tomentosa treatment alone or combined with chemotherapy may favor the action of doxorubicin.

Azadirachtin, a neem-derived biopesticide, impairs behavioral and hematological parameters in carp (Cyprinus carpio).

Azadirachtin (Aza) is a promisor biopesticide used in organic production and aquaculture. Although this compound is apparently safe, there is evidence that it may have deleterious effects on fish. Behavioral and hematological tests are grouped into a set of parameters that may predict potential toxicity of chemical compounds. Here, we investigate the effects of Aza, in the commercial formulation Neenmax™ , on carp (Cyprinus carpio) by defining LC50 (96 h), and testing behavioral and hematological parameters. In our study, LC50 was estimated at 80 µL/L. We exposed carp to Aza at 20, 40, and 60 µL/L, values based on 25, 50, and 75% of LC50 , respectively. At 60 µL/L, Aza promoted significant changes in several parameters, increasing the distance traveled and absolute turn angle. In addition, the same concentration decreased the time spent immobile and the number of immobile episodes. Hematological parameters, such as hematocrit, hemoglobin, hematimetrics index, and red cell distribution, were decreased at 60 µL/L Aza exposure. In conclusion, our study demonstrates that 60 µL/L Aza altered locomotor activity, motor pattern, and hematological parameters, suggesting potential toxicity to carp after acute exposure. In addition, this is the first report that evaluates the actions of a chemical contaminant using automated behavioral tracking of carp, which may be a useful tool for assessing the potential toxicity of biopesticides in conjunction with hematological tests. © 2015 Wiley Periodicals, Inc. Environ Toxicol 31: 1381-1388, 2016.

δ-Aminolevulinate dehydratase activity in lung cancer patients and its relationship with oxidative stress.

This study investigated the δ-aminolevulinate dehydratase (δ-ALA-D) activity in whole blood as well as the parameters of oxidative stress, such as reactive species (RS) levels in serum, thiobarbituric acid reactive substances (TBARS) levels, the superoxide dismutase (SOD) and catalase (CAT) activities, as well as total thiols (T-SH) and non-protein thiols (NPSH) levels in platelets. Moreover, the content of vitamin C and E in plasma and serum, respectively, in lung cancer patients was also investigated. We collected blood samples from patients (n=28) previously treated for lung cancer with chemotherapy. Patients were classified as stage IIIb and IV according to the Union for International Cancer Control (UICC). Results showed a decrease of 37% in δ-ALA-D activity in patients with lung cancer when compared to the control group. RS and TBARS levels were 8% and 99% higher in the patient group, respectively. The activity of SOD and CAT as well as the vitamin C content were 41%, 35% and 127% lower in patients when compared with controls, respectively. However, T-SH and vitamin E levels were 27% and 44% higher in lung cancer patients, respectively. Results show that the overproduction of reactive species in patients with lung cancer may be interfering with the activity of δ-ALA-D. Likewise, the decrease in the activity of this enzyme may be contributing for the oxidative stress.

Alterations in the extracellular catabolism of nucleotides and platelet aggregation induced by high-fat diet in rats: effects of α-tocopherol.

The aim of this study was to assess whether α-tocopherol administration prevented alterations in the ectonucleotidase activities and platelet aggregation induced by high-fat diet in rats. Thus, we examined four groups of male rats which received standard diet, high-fat diet (HFD), α-tocopherol (α-Toc), and high-fat diet plus α-tocopherol. HFD was administered ad libitum and α-Toc by gavage using a dose of 50 mg/kg. After 3 months of treatment, animals were submitted to euthanasia, and blood samples were collected for biochemical assays. Results demonstrate that NTPDase, ectonucleotide pyrophosphatase/phosphodiesterase, and 5'-nucleotidase activities were significantly decreased in platelets of HFD group, while that adenosine deaminase (ADA) activity was significantly increased in this group in comparison to the other groups (P < 0.05). When rats that received HFD were treated with α-Toc, the activities of these enzymes were similar to the control, but ADA activity was significantly increased in relation to the control and α-Toc group (P < 0.05). HFD group showed an increased in platelet aggregation in comparison to the other groups, and treatment with α-Toc significantly reduced platelet aggregation in this group. These findings demonstrated that HFD alters platelet aggregation and purinergic signaling in the platelets and that treatment with α-Toc was capable of modulating the adenine nucleotide hydrolysis in this experimental condition.

Herbicide clomazone effects on δ-aminolevulinic acid activity and metabolic parameters in Cyprinus carpio.

The objective of this study was to investigate δ-aminolevulinic acid (δ-ALA-D) activity and metabolic parameters of Cyprinus carpio exposed to clomazone herbicide. Fish were exposed 2.5, 5, 10 and 20 mg L(-1) of clomazone for 192 h. Results indicated that δ-ALA-D activity was decreased in the gills at concentrations of 5 and 10 mg L(-1). Liver glycogen increased, while muscle and gill glycogen levels decreased at 5, 10 and 20 mg L(-1). Glucose was increased in the gills and plasma. Lactate decreased in the gills and liver and increased in the muscle. Protein and amino acids levels increased in the liver and gills and decreased in the muscle. At a clomazone concentration of 20 mg L(-1), ammonia increased in the gills and muscle and decreased in the liver. The results indicated that the metabolic parameters of glycogen, lactate, protein and amino acids in liver, muscle and gills, blood glucose levels, and the enzyme δ-ALA-D in gills may be useful indicators of clomazone toxicity in carp.

Uncaria tomentosa-Adjuvant Treatment for Breast Cancer: Clinical Trial.

Breast cancer is the most frequent neoplasm affecting women worldwide. Some of the recommended treatments involve chemotherapy whose toxic effects include leukopenia and neutropenia. This study assessed the effectiveness of Uncaria tomentosa (Ut) in reducing the adverse effects of chemotherapy through a randomized clinical trial. Patients with Invasive Ductal Carcinoma-Stage II, who underwent a treatment regimen known as FAC (Fluorouracil, Doxorubicin, Cyclophosphamide), were divided into two groups: the UtCa received chemotherapy plus 300 mg dry Ut extract per day and the Ca group that only received chemotherapy and served as the control experiment. Blood samples were collected before each one of the six chemotherapy cycles and blood counts, immunological parameters, antioxidant enzymes, and oxidative stress were analyzed. Uncaria tomentosa reduced the neutropenia caused by chemotherapy and was also able to restore cellular DNA damage. We concluded that Ut is an effective adjuvant treatment for breast cancer.

Enzymes that hydrolyze adenine nucleotides in platelets and polymorphisms in the alpha2 gene of integrin alpha2beta1 in patients with von Willebrand disease.

Von Willebrand disease (VWD) is one of the most common inherited bleeding diseases caused by a qualitative or quantitative deficiency of the von Willebrand factor (FvW). FvW is a multimeric glycoprotein synthesized by megakaryocytes and endothelial cells and it is present in the subendothelial matrix, blood plasma, platelets, and endothelium. This glycoprotein plays an important role in thrombus formation by initiating platelet adhesion to sites of injury as well as platelet aggregation. The aim of this study was to evaluate the activities of enzymes that hydrolyze adenine nucleotides in platelets, ristocetin-induced platelet aggregation (RIPA), and polymorphisms of the alpha2 gene of alpha2beta1 integrin from VWD patients. Platelet nucleoside triphosphate diphosphohydrolase (NTPDase), 5'-nucleotidase, and ecto-nucleotide pyrophosphatase/phosphodiesterase (E-NPP) activities were verified in 14 VWD patients. For RIPA determination, a final concentration of 1.25 mg/ml of ristocetin was used. Polymorphisms of the alpha2 gene were analyzed through PCR. Platelet NTPDase and E-NPP were decreased in VWD patients. 5'-Nucleotidase activity was not statistically significant between controls and VWD patients. RIPA was significantly reduced, with an allelic frequency of 78.57% for 807C in VWD patients. Our results indicated reduced platelet NTPDase and E-NPP activities which might be related to the low platelet adhesiveness. The prevalence of the 807C allele might account for the variability in bleeding in VWD.

Effect of high glucose levels in human platelet NTPDase and 5'-nucleotidase activities.

OBJECTIVES: The objective of this work was to evaluate the effect of different glucose levels on the ATP, ADP and AMP hydrolysis in the platelets of diabetic, hypertensive and diabetic/hypertensive participants. METHODS: The activities of the enzymes NTPDase (ATP and ADP hydrolysis) and 5'-nucleotidase (AMP hydrolysis), and CD39 expression were analyzed in human blood platelets of diabetic (DM-2), hypertensive (HT) and diabetic/hypertensive (DM-2/HT) patients. To evaluate the interference of glucose and fructose in NTPDase and 5'-nucleotidase activities, experiments were performed with glucose, fructose and mannitol concentrations ranging from 5 to 30 mM in platelet-rich plasma (PRP). Pre-incubation times of 10, 120 min and 24h were used. RESULTS: NTPDase and 5'-nucleotidase activities increased with increasing glucose and fructose concentrations (P<0.001) and the different times of pre-incubation did not interfere in ectonucleotidases activities (P>0.5). NTPDase and 5'-nucleotidase activities demonstrated a positive correlation between serum glucose levels and ATP and ADP hydrolysis in DM-2 and DM-2/HT patients. CD39 expression demonstrated that DM-2, HT and DM-2/HT groups presented a significant increase when compared to the control group (P<0.004). CONCLUSION: The hydrolysis of adenine nucleotides is enhanced in platelets of patients with diabetes and hypertension. We observed that an increasing glucose concentration had a direct effect on ATP, ADP and AMP hydrolysis. Furthermore, CD39 expression was enhanced in all patients groups, indicating that these enzyme activities are related with diabetes and hypertension.

Aborto provocado: fatores associados em mulheres admitidas em maternidades públicas em São Luís, Maranhão, Brasil / Induced abortion; associated factors in women admitted to public maternity hospitals in São Luís, Maranhão, Brazil / Aborto provocado: factores associados em mujeres admitidas em maternidades públicas en São Luís, Maranhão, Brasil

Este é um estudo sobre os fatores associados ao aborto provocado em mulheres admitidas por complicações em duas maternidades públicas de São Luís, Maranhão, Brasil, no segundo semestre de 2006. Aplicou-se um questionário com perguntas abertas e fechadas para oitenta mulheres que declararam ter praticado o aborto, Os resultados revelam que a prática do aborto prevalece em mulheres pobres, acima de 20 anos, solteiras, católicas, de baixo nível de escolaridade, com emprego definido e usuárias de métodos contraceptivos. A maioria das mulheres referiu, como método abortivo, uso do misoprostol, isolado ou associado a outros métodos. Sentimentos negativos de tristeza e culpa pós-aborto foram referidos na maioria dos casos. Observou-se, também, um número insignificante de complicações graves relacionadas ao aborto provocado nessas maternidades. É necessário que os profissionais que atuam na atenção básica de saúde promovam, por meio de ações educativas e de acesso aos métodos contraceptivos, 0 exercício dos direitos reprodutivos no país.

This is a study about factors associated with induced abortion in women admitted with complications to two public maternity hospitals of Sao Luis, Maranhao, Brazil, during the second semester of 2006. A questionnaire withopened and closed questions was applied to 80 women that declared to have practiced abortion. The results reveal that the practice of abortion prevails in poor women, above 20 years, un married, Catholic, of low education level and defined job, and users of contraceptive methods. Negative feelings of sadness and guilt post-abortion were referred by the great majority of the cases. A insignificant number of serious complications related to the abortion provoked at those maternities was also observed. It is necessary that the professionals who act in the primary health care promote, by means of educative actions and access to the contraceptive methods, the reproductive right of action in the country.

Estudio sobre los factores asociadas al aborto inducido en mujeres admitidas por las complicaciones, en dos maternidades públicas de São Luís, Maranhão, Brasil, en el segundo semestre de 2006. Un cuestionario fue aplicado can las preguntas abiertas y cerradas a 80 mujeres que declararon haber practicado el aborto. Los resultados revelan que la practica del aborto prevalece en mujeres pobres, con mas de 20 aries, mujeres solteras,católlicas, nivel de educación bajo, con el trabajo definido y usuarias de los métodos anticonceptivos. Lamayoría de las mujeres utillzaron el misoprostol, como el método abortlvo, aislado o asociado de otros métodos.Los sentimientos negativos de la tristeza y culpa despues del aborto fueron mencionados por la gran mayoríade los casos. También fue observado número insignificante de las complicaciones serias relacionadas con elaborto lndducido en esas maternidades. Es necesario que los profesionales métodos anticonceptivos, el ejerciciodel derecho reproductive en el país.

Measurement of oxidative stress and antioxidant status in acute lymphoblastic leukemia patients.

OBJECTIVES: To evaluate the oxidative status and antioxidant defense in patients with acute lymphoblastic leukemia (ALL). DESIGN AND METHODS: We measured concentrations of plasmatic thiobarbituric acid reactive substances (TBARS), serum protein carbonylation, whole blood catalase (CAT) and superoxide dismutase (SOD) activities, as well as the plasmatic and erythrocyte thiol levels and serum vitamin E concentration. This study was performed on 80 children with ALL divided into 4 groups: just diagnosed, remission induction, remission maintenance and out-of-treatment. RESULTS: TBARS levels and serum protein carbonylation were higher in ALL patients than in controls and reduced levels of antioxidants were found in these patients. CONCLUSION: These findings may indicate a possible link between decreased antioxidants and increased levels of cells alterations due to oxidative damage, supporting the idea that there is a persistence of oxidative stress in acute lymphoblastic leukemia.

Oxidative status in patients submitted to conization and radiation treatments for uterine cervix neoplasia.

BACKGROUND: Cervical cancer is a major cause of morbidity among women. We investigated the treatment effect on oxidative status from patients submitted to radiotherapy or conization surgery to high-grade SIL (squamous intraepithelial lesion) treatment, and oxidative profile from patients newly diagnosed for uterine cervix cancer, without treatment. METHODS: We determined the catalase activity in blood, reduced glutathione (GSH) in plasma, TBARS and protein carbonyl content from serum samples of the patients. RESULTS: The catalase activity, GSH levels, TBARS and protein carbonyl content had no statistical differences related to the controls, neither when the 2 treatments were compared, possibly because the antioxidant defense may be acting in the first period of the neoplasic transformation, and maybe indicating a possible arrest of the tumor cells caused by the efficiency of the treatments. In the non-treated patients, TBARS and protein carbonyl contents, GSH levels and catalase activity were shown to be increased comparing with the treated patients and compared with the controls indicating an tumor effect on oxidative profile, and the antioxidant activity been increased in the beginning of the tumor development. CONCLUSIONS: We suggest that the treatments were efficient in arrest of the tumor.

Abordagem na assistência à criança com câncer do Serviço de Hemato/Oncologia do Hospital Universitário de Santa Maria: percepção dos profissionais e voluntários / Approaching in the assistance to the child with cancer of the Serviço de Hemato/Oncologia of the Hospital Universitário de Santa Maria: perception of the professionals and volunteers

Sabe-se que a abordagem na assistência à saúde da criança é centrada na patologia, no sujeito ou no sujeito e sua família. Com o objetivo de identificar qual a percepção dos profissionais e voluntários sobre a abordagem de assistência à criança hospitalizada no Serviço de Hemato/Oncologia do HUSM, elaborou-se um questionário com 33 questões fechadas e 16 questões abertas, que foi enviado aos funcionários e voluntários que atuam no referido serviço, tendo sido garantido o anonimato. Foram devolvidos 54 questionários dos 120 enviados. Para análise das informações utilizou-se o modelo Processo-Pessoa-Contexto combinado com Cronossistema, da Teoria dos Sistemas Ecológicos de Bronfenbrenner. Com relação ao contexto, as respostas foram categorizadas de acordo com os parâmetros do contexto (microsistema, mesosistema, macrosistema) e considerando o modelo de Cronossistema propomos a análise nos tempos: no diagnóstico, durante o tratamento e após alta do tratamento. Verificou-se que o modelo de assistência à criança empregado tem uma tendência a ser centrado na criança e família, pois 47 por cento dos consultados informam que sua atividade profissional está direcionada à criança e sua família; 36 por cento referem-se que seu foco de atenção é a criança e apenas 6 por cento referem-se que sua assistência é centrada na patologia.

Diferentes Glacês para a Psicanálise

A autora aborda em seu texto as intermináveis repetições e baralhamentos feitos à teoria psicanalítica, quando da tentativa de moldá-la a condições 'ideais' de funcionamento, e, conseqüentemente, da disputa de quem pretende deter a 'verdade' do pensamento psicanalítico; contudo, salienta a importância dos que se dedicam com seriedade ao estudo e à prática da psicanálise(AU)

O Final de Análise

Neste texto, a autora tem como propósito examinar o tema Final de análise, segundo Freud e outros autores pós-freudianos. Introduz o trabalho discorrendo sobre a teoria freudiana, passando por textos que vão de 1914 – como Recordar, repetir e elaborar – a 1933, com Análise terminável e interminável. A seguir, recorre a autores pós-freudiano, como Ferenczi, Melanie Klein, Winnicott, Michel Balint – até Lacan -, e pós-lacanianos, como Colette Soler e J. D. Nasio, Jaques-Alain Miller e Gérard Pommier. Questiona se há término para uma análise, e, havendo, como se dá esse término, a separação entre analista e analisando; e indaga até onde a análise pessoal do terapeuta permite-lhe perceber o final da análise de seu cliente