Percepções de mulheres com câncer de mama acerca dos tratamentos / Perceptions of women with breast cancer regarding treatments

O objetivo deste estudo foi compreender a percepção das mulheres com câncer de mama acerca dos tratamentos. Trata-se de um estudo qualitativo, descritivo, transversal, no qual participaram 40 mulheres em quimioterapia para tratamento do câncer mamário em um hospital especializado em oncologia. O instrumento utilizado para coleta de dados foi uma entrevista semiestruturada. Os dados foram analisados mediante Análise de Conteúdo de Bardin e categorizados conforme o Modelo de Crenças em Saúde. Originaram-se quatro categorias: "Suscetibilidade percebida: câncer e COVID-19", "Percepção da gravidade em face do impacto dos tratamentos", "Desafios e barreiras nos tratamentos" e "Benefícios percebidos no tratamento do câncer". Conclui-se que existem diferentes fatores que ressoam na percepção que a mulher tem sobre os tratamentos e que geram repercussões na forma de enfrentá-los. O conhecimento desses fatores pelos profissionais de saúde pode auxiliar na assistência às mulheres para melhor enfrentamento da doença.

The objective of this study was to understand the perception of women with breast cancer about treatments. This is a qualitative, descriptive, cross-sectional study, involving 40 women undergoing chemotherapy for the treatment of breast cancer in a hospital specialized in oncology. The instrument used for data collection was a semi-structured interview. Data was analyzed using Bardin's Content Analysis and categorized according to the Health Belief Model. Four categories emerged: "Perceived susceptibility: cancer and COVID-19", "Perception of severity in view of treatments impact", "Challenges and barriers in treatments" and "Perceived benefits in cancer treatment". It is concluded that there are different factors that resonate in women's perception of treatments and that generate repercussions in the way of facing them. Knowledge of these factors by healthcare professionals can help in providing better assistance to women in facing the disease.

Women's perception about the discovery of breast cancer amid the covid-19 pandemic.

BACKGROUND: Breast cancer is considered a health problem at a worldwide level. In Brazil, the South and Southeast regions have the highest mortality rates. Understanding how they dealt with the diagnostic of a stigmatized disease amid the COVID-19 pandemic and its potential repercussions, may enable healthcare professionals to of life. Thus, this study is aimed at understanding the perception of women about the discovery of breast cancer and the impact of the disease on their lives. METHODS: A qualitative study, with the participation of forty women with breast cancer, under chemotherapy treatment. It was performed in a hospital specialized in oncology, in Juiz de Fora, Brazil, in 2020 and 2021. Data collection was carried out with semi-structured interviews, which were analyzed with Bardin Content Analysis. RESULTS: Based on the central theme "Discovery of the disease", these categories were developed: "Discovery" and "Impact of the disease". A large part of women noticed a change in the breast, even before routine checks. Upon the impact of cancer diagnosis, negative feelings arise, then going through a process of acceptance and coping. Some barriers were faced due to the COVID-19 pandemic, which caused delays in the diagnostic and impact caused by social isolation. Family, friends, and healthcare professionals integrated an important supporting network in order to help coping with the disease. CONCLUSION: The consequences of a breast cancer diagnosis can be devastating. It is necessary that healthcare professionals know and embrace the feelings, beliefs, and values as a part of the aspects related to health. Valuing the supporting network of women suffering from the disease may favor the process of accepting and coping with the neoplasm. The COVID-19 pandemic is highlighted as an obstacle to be overcome specially when it comes to diagnostic assistance and availability of a support network. In that sense, it is worth mentioning the importance of a healthcare team able to offer full assistance, with quality. The need of further studies to determine the impact of the pandemic in the long run.

Rewired glycosylation activity promotes scarless regeneration and functional recovery in spiny mice after complete spinal cord transection.

Regeneration of adult mammalian central nervous system (CNS) axons is abortive, resulting in inability to recover function after CNS lesion, including spinal cord injury (SCI). Here, we show that the spiny mouse (Acomys) is an exception to other mammals, being capable of spontaneous and fast restoration of function after severe SCI, re-establishing hind limb coordination. Remarkably, Acomys assembles a scarless pro-regenerative tissue at the injury site, providing a unique structural continuity of the initial spinal cord geometry. The Acomys SCI site shows robust axon regeneration of multiple tracts, synapse formation, and electrophysiological signal propagation. Transcriptomic analysis of the spinal cord following transcriptome reconstruction revealed that Acomys rewires glycosylation biosynthetic pathways, culminating in a specific pro-regenerative proteoglycan signature at SCI site. Our work uncovers that a glycosylation switch is critical for axon regeneration after SCI and identifies ß3gnt7, a crucial enzyme of keratan sulfate biosynthesis, as an enhancer of axon growth.

La Psicología y la construcción de la escuela democrática / A psicologia e a construção da escola democrática / Psychology and the construction of the democratic school

O presente texto refere-se à conferência apresentada pelo autor na abertura do XV Congresso Nacional de Psicologia Escolar (CONPE), promovido pela ABRAPEE, em julho de 2022. Na primeira parte, apresentam-se as principais concepções sobre o papel da escola nas sociedades capitalistas e seus impactos nas práticas desenvolvidas. Buscou-se compreender se a escola representa um espaço para a atuação dos educadores comprometidos com a formação de cidadãos críticos e transformadores. Na sequência, apresentam-se dados sobre a realidade educacional brasileira, marcada pelas contradições de um sistema dualista e cindido entre os interesses privativistas e publicistas. Na segunda parte, analisa-se o conceito de escola democrática, a partir de três dimensões: quantitativa (escola para todos e permanência), qualitativa (função e qualidade do ensino) e das relações internas (trabalho coletivo). Finalmente, defende-se que a Psicologia pode ter uma fundamental contribuição para a construção da escola democrática, desde que algumas condições sejam assumidas pelos psicólogos: ação interdisciplinar junto aos educadores, trabalho basicamente preventivo direcionado ao planejamento educacional e a superação de concepções teóricas conservadoras, como o Modelo Médico.

El presente texto se refiere a la conferencia presentada por el autor en la apertura del XV Congreso Nacional de Psicología Escolar (CONPE), promovido por la ABRAPEE, en julio de 2022. En la primera parte, se presentan las principales concepciones sobre el papel de la escuela en las sociedades capitalistas y sus impactos en las prácticas desarrolladas. Se buscó comprender si la escuela representa un espacio a la actuación de los educadores comprometidos con la formación de ciudadanos críticos y transformadores. En la secuencia, se presentan datos sobre la realidad educacional brasileña, subrayada por las contradicciones de un sistema dualista e incluido entre los intereses privativos y publicistas. En la segunda parte, se analiza el concepto de escuela democrática, a partir de tres dimensiones: cuantitativa (escuela para todos y permanencia), cualitativa (función y calidad de la enseñanza) y de las relaciones internas (trabajo colectivo). Finalmente, se defiende que la Psicología puede tener una fundamental contribución a la construcción de la escuela democrática, desde que algunas condiciones sean asumidas por los psicólogos: acción interdisciplinar junto a los educadores, trabajo básicamente preventivo direccionado a la planificación educacional y la superación de concepciones teóricas conservadoras, como el Modelo Médico.

This text refers to the conference presented by the author at the opening of the XV CONPE, promoted by ABRAPEE, in July 2022. In the first part, the main conceptions about the role of the school in capitalist societies and their impacts on the practices developed are presented. We sought to understand whether the school represents a space for the performance of educators committed to the formation of critical and transformative citizens. Next, data are presented on the Brazilian educational reality, marked by the contradictions of a dualistic system and divided between privatist and publicist interests. In the second part, the concept of democratic school is analyzed from three dimensions: quantitative (school for all and permanence), qualitative (function and quality of teaching) and internal relations (collective work). Finally, it is argued that Psychology can have a fundamental contribution to the construction of the democratic school, provided that some conditions are assumed by psychologists: interdisciplinary action with educators, basically preventive work directed to educational planning and the overcoming of conservative theoretical conceptions, as the Medical Model.

Perimyocarditis Following COVID-19 Vaccination.

A 39-year-old male was admitted in the emergency room with chest pain. He had been given the second dose of Pfizer-BioNTech COVID-19 vaccine 3 days before. The patient denied taking any other medication beyond the usual. He didn't feel sick in the previous days/weeks. Laboratory studies revealed elevated serum levels of troponin and C-reactive protein. An autoantibody screen and a serologic panel to detect common viruses were negative. A cardiac MRI showed myocardial edema/inflammation and confirmed the diagnosis of perimyocarditis which was considered to be a consequence of COVID-19 vaccination. Physicians should be aware of the possibility of cardiovascular complications after COVID-19 vaccination.

Temporal trends of lipid control in very high cardiovascular risk patients.

INTRODUCTION: Since 2011, the European guidelines have included a specific low-density lipoprotein cholesterol (LDL-C) target, <70 mg/dl, for very high cardiovascular risk (CVR) patients. However, registries have shown unsatisfactory results in obtaining this level of adequate lipid control. OBJECTIVES: To assess temporal trends in the use of lipid-lowering therapy (LLT) and attainment of adequate control in very high CVR patients since 2011. METHODS: We performed a retrospective observational study including very high CVR patients admitted in two periods: the first two years since the 2011 guidelines (2011/2012) and five years later (2016/2017). Lipid values, LLT, clinical variables and adequate lipid control rates were analyzed. RESULTS: A total of 1314 patients were reviewed (2011/2012: 638; 2016/2017: 676). Overall, 443 patients (33.7%) were not under LLT and only a slight improvement in drug prescription was observed from 2011/2012 to 2016/2017. In LLT users, the proportion of high-intensity LLT increased significantly in the later years (6.4% vs. 24.0%; p<0.001), but this was not associated with adequate lipid control. Overall, mean LDL-C was 95.4±37.2 mg/dl and adequate control was achieved in 320 patients (24.4%), without significant differences between 2011/2012 and 2016/2017 (p=0.282). Independent predictors of adequate control were male gender, older age, diabetes, chronic kidney disease, prior acute coronary syndrome, prior stroke and LLT, while stable coronary artery disease was associated with higher risk of failure. CONCLUSION: Even after the introduction of specific LDL-C targets, these are still not reached in most patients. Over a five-year period, LLT prescription only improved slightly, while adequate lipid control rates remained unchanged.

Actin dynamics in the growth cone: a key player in axon regeneration.

Neuronal development, maintenance and function depends on the tight regulation of cytoskeleton organization and dynamics. Following injury, adult central nervous system neurons have a limited ability to regenerate and to recapitulate their robust developmental axon growth. This decreased regenerative capacity is set by their inability to establish regeneration-competent growth cones. Growth cones are actin-enriched structures that regulate axon extension rate and direction. During neuronal development, increasing actin dynamics in the growth cone through the regulation of the activity of specific actin-binding proteins leads to increased axon elongation. Here, we will focus on recent findings showing that enhanced axon regeneration in the adult nervous system can be achieved by promoting actin dynamics, or by decreasing actomyosin contraction in the growth cone. These discoveries underscore the importance of actin organization in the growth cone as a key factor to promote axon (re)growth that should be further explored in the future.

Profilin 1 delivery tunes cytoskeletal dynamics toward CNS axon regeneration.

After trauma, regeneration of adult CNS axons is abortive, causing devastating neurologic deficits. Despite progress in rehabilitative care, there is no effective treatment that stimulates axonal growth following injury. Using models with different regenerative capacities, followed by gain- and loss-of-function analysis, we identified profilin 1 (Pfn1) as a coordinator of actin and microtubules (MTs), powering axonal growth and regeneration. In growth cones, Pfn1 increased actin retrograde flow, MT growth speed, and invasion of filopodia by MTs, orchestrating cytoskeletal dynamics toward axonal growth. In vitro, active Pfn1 promoted MT growth in a formin-dependent manner, whereas localization of MTs to growth cone filopodia was facilitated by direct MT binding and interaction with formins. In vivo, Pfn1 ablation limited regeneration of growth-competent axons after sciatic nerve and spinal cord injury. Adeno-associated viral (AAV) delivery of constitutively active Pfn1 to rodents promoted axonal regeneration, neuromuscular junction maturation, and functional recovery of injured sciatic nerves, and increased the ability of regenerating axons to penetrate the inhibitory spinal cord glial scar. Thus, we identify Pfn1 as an important regulator of axonal regeneration and suggest that AAV-mediated delivery of constitutively active Pfn1, together with the identification of modulators of Pfn1 activity, should be considered to treat the injured nervous system.

Genetic variants identified by target next-generation sequencing in heart transplant patients with dilated cardiomyopathy.

INTRODUCTION AND OBJECTIVES: Dilated cardiomyopathy (DCM) is a myocardial disease that can progress to a terminal stage, requiring heart transplantation. In this work we aim to contribute to knowledge of genetic variants in adult patients undergoing heart transplantation due to end-stage DCM, reporting the results obtained in our single-center tertiary hospital series using target next-generation sequencing (NGS). METHODS AND RESULTS: Genetic variants were screened in 15 genes, preselected based on variants previously identified in DCM patients. Thirteen unrelated patients were included, nine (69%) male, mean age at diagnosis 33±13 years, eight (62%) with familial DCM. Nine genetic variants were identified in six (46%) patients: five in LMNA, two in LBD3, one in TNNT2 and one in TCAP. These variants were new in most patients. The majority were classified as of uncertain significance. Two patients were double and triple heterozygotes in the LBD3 and LMNA genes, respectively. CONCLUSION: Our results highlight the potential of NGS in the genetic characterization of DCM patients. LMNA is one of the most frequently mutated genes and should be included in all target gene assessments of end-stage DCM patients until more data are available.

Genetic Variants Are Not Rare in ICD Candidates with Dilated Cardiomyopathy: Time for Next-Generation Sequencing?

BACKGROUND: Sudden cardiac death (SCD) risk stratification in dilated cardiomyopathy (DCM) has been based on left ventricular ejection fraction (LVEF), even though SCD may occur with LVEF > 35%. Family history of unexplained SCD, especially in the young, raises concern about potential inheritable risk factors. It remains largely unknown how genetic tests can be integrated into clinical practice, particularly in the selection of implantable cardioverter defibrillator (ICD) candidates. We aimed to assess the diagnostic yield of genetic testing in DCM patients with a class I recommendation for ICD implantation, based on current guidelines. METHODS: We included ambulatory stable adult patients with idiopathic or familial DCM with previously implanted ICD. Molecular analysis included 15 genes (LMNA, MYH7, MYBPC3, TNNT2, ACTC1, TPM1, CSRP3, TCAP, SGCD, PLN, MYL2, MYL3, TNNI3, TAZ, and LDB3) using next-generation sequencing. RESULTS: We evaluated 21 patients, 12 (57%) males and 9 (43%) with familial DCM, including 3 (14%) with a family history of premature unexplained SCD. Mean age at DCM diagnosis was 40 ± 2 years, and mean age at ICD implantation was 50 ± 12 years. LVEF was 27 ± 9%, and LV end-diastolic diameter was 65 ± 7 mm. Genetic variants were found in six (29%) patients, occurring in 5 genes: TPM1, TNNT2, MYH7, PLN, and MYBPC3. The majority were classified as variants of uncertain significance. Family history of SCD was present in both patients with PLN variants. CONCLUSION: In patients with DCM and ICD, genetic variants could be identified in a significant proportion of patients in several genes, highlighting the potential role of genetics in DCM SCD risk stratification.

Cardiac Amyloidosis Associated with Apolipoprotein A-IV Deposition Diagnosed by Mass Spectrometry-Based Proteomic Analysis.

Amyloidosis is a group of disorders characterised by the accumulation of extracellular deposits of insoluble protein aggregates. Clinical management depends on the accurate identification of the amyloid precursor and underlying cause. We describe a rare case of apolipoprotein A-IV cardiac amyloidosis, the diagnosis of which required mass spectrometry-based proteomic analysis. LEARNING POINTS: To be able to perform the differential diagnosis of cardiac amyloidosis subtypes using imaging methods, analytical results and tissue analysis.To recognise the added value of mass spectrometry (MS)-based proteomic analysis.

Variáveis psicológicas associadas ao crescimento pós-traumático após a vivência do câncer de mama: uma revisão sistemática / Psychological variables associated with posttraumatic growth after breast cancer experience: a systematic review

Introdução: O câncer de mama é considerado um dos tipos de câncer mais comuns entre as mulheres, representando 25% e 29% dos casos novos a cada ano no mundo e no Brasil, respectivamente. A vivência de seu diagnóstico, bem como de seus tratamentos pode acarretar impactos importantes na saúde física e mental, porém esta experiência pode também ser fonte de ressignificações positivas. Objetivo: O presente estudo revisou a literatura sobre as publicações científicas em relação ao crescimento pós-traumático em mulheres com câncer de mama. Material e Métodos:A busca da literatura foi realizada entre os meses de setembro e outubro de 2019, nas bases de dados Medline, Scielo, PsycINFO e Web of Science com base no Protocolo PRISMA, através do cruzamento dos descritores breast neoplasms e posttraumatic growth. Resultados: De um total de 56 referências finais analisadas observou-se que os EUA, China e Portugal são os países com maior número de publicações sobre o tema, sendo a maioria dos estudos de caráter transversal e quantitativo. O crescimento pós-traumático é fenômeno observado em diversas mulheres que sobreviveram ao câncer de mama, sofrendo a influência de fatores como suporte social, estratégias de coping, estresse psicológico, depressão, processamento cognitivo, qualidade de vida, percepção sobre a doença, religiosidade/espiritualidade, ansiedade, estressores específicos do câncer, otimismo, afeto positivo e saúde mental. Conclusão: Através deste estudo foi possível mapear, na literatura, algumas das principais variáveis psicológicas relacionadas ao crescimento observado após a vivência do câncer de mama, podendo esta experiência estar associada não somente a impactos negativos, mas também a ressignificações importantes sobre a vida.

Introduction: Breast cancer is considered one of the most common cancers among women, representing 25% and 29% of the new cases each year in the world and in Brazil. The experience of its diagnosis, as well as its treatments can have important impact on physical and mental health, but this experience can also be a source of positive reframing. Objective: This study revised the literature about the scientific publications concerning the posttraumatic growth in women with breast cancer. Materials and methods: The search of literature was carried out between September and October 2019 in the databases Medline, Scielo, PsycINFO and Web of Science using the PRISMA protocol, through the crossing of the descriptors breast neoplasms and posttraumatic growth. Results: From a total of 56 final references, it was observed that the USA, China and Portugal are the countries with the largest number of publications on the subject, with the majority of cross-sectional and quantitative studies. Posttraumatic growth is a phenomenon observed in several women who have survived breast cancer, being influenced by factors such as social support, coping strategies, psychological stress, depression, cognitive processing, quality of life, perception about the disease, religiosity/spirituality, anxiety, specific cancer stressors, positive affect, mental health, among others. Conclusion: Through this study it was possible to map in the literature some of the main psychological variables related to the growth observed after the experience of breast cancer, and this experience may be associated not only with negative impact, but also with important resignifications concerning life.

Formação de leitores: a dimensão afetiva na mediação da família / Readers development: the affective dimension of the family's mediation / Formación de lectores: la dimensión afectiva en la mediación de la familia

A presente pesquisa teve por objetivo descrever e analisar o processo de constituição de leitores, com sujeitos universitários, focando os impactos afetivos das situações de mediação entre esses sujeitos e as práticas de leitura literária vivenciadas durante suas vidas, especialmente no ambiente familiar. A pesquisa foi realizada com estudantes dos anos iniciais da graduação de uma universidade pública, do interior do Estado de São Paulo. Os sujeitos eram estudantes de diferentes áreas do conhecimento, caracterizados como leitores autônomos. Entende-se por leitor autônomo aquele sujeito que lê por iniciativa própria, o que sugere que a leitura literária já representa uma atividade intrinsecamente relevante para ele. A pesquisa fundamenta-se em teorias da área da Psicologia, principalmente nas ideias de Vygotsky (1998, 2005) e de Wallon (2007, 2008). A coleta de dados foi realizada através do procedimento de Entrevistas Recorrentes, realizadas com estudantes universitários que se reconheciam como leitores autônomos. No processo de análise, os dados foram agrupados em Núcleos Temáticos, referentes aos diferentes mediadores identificados. Posteriormente, tais Núcleos foram discutidos com base na abordagem teórica assumida. Os resultados reforçam a importância da mediação e de seus impactos afetivos na constituição desses sujeitos como leitores, discutindo-se aspectos detectados nas histórias de mediações vivenciadas ao longo de suas vidas, em especial na família.

The aim of the present research was to describe and analyze the readership process, with university students, focusing on the affective impacts of mediation situations among those students and the literary reading practices lived during their lives, especially in the family environment. The research was carried out with students from the initial years of graduation from a public university, in the interior of the State of São Paulo. The students were from different areas of knowledge, characterized as autonomous readers. Autonomous reader is understood as the person who reads on his own initiative, which suggests that literary reading already represents an activity intrinsically relevant to it. The research is based on theories of the area of Psychology, mainly in the ideas of Vygotsky (1998, 2005) and Wallon (2007, 2008). The data collection was performed through the Recurrent Interviews procedure, carried out with university students, who considered themselves autonomous readers. The analysis process grouped the data in Thematic Nuclei, referring to the different mediators identified. Subsequently, these nuclei were discussed based on the assumed theoretical approach. The results reinforce the importance of mediation and its affective impacts on the constitution of those students as readers, discussing aspects detected in the histories of mediations experienced throughout their lives, especially in the family.

En la presente investigación se tuvo por objetivo describir y analizar el proceso de constitución de lectores, con sujetos universitarios, enfocando los impactos afectivos de las situaciones de mediación entre estos sujetos y las prácticas de lectura literaria, vivenciadas durante sus vidas, especialmente en el ambiente familiar. La investigación fue realizada con estudiantes de los cursos iniciales de la graduación de una universidad pública, del interior del Estado de São Paulo. Los sujetos eran estudiantes de distintas áreas del conocimiento, caracterizados como lectores autónomos. Se entiende por lector autónomo aquel sujeto que lee por iniciativa propia, lo que sugiere que la lectura literaria ya representa una actividad intrínsecamente relevante para él. La investigación se fundamenta en teorías del área de la Psicología, principalmente en las ideas de Vygotsky (1998, 2005) y de Wallon (2007, 2008). La recolecta de datos fue realizada a través del procedimiento de Entrevistas Recurrentes siendo que, en el proceso de análisis, esos fueron agrupados en Núcleos Temáticos, referentes a los diferentes mediadores identificados. Posteriormente, tales núcleos fueron discutidos con base en el abordaje teórico asumida. Los resultados refuerzan la importancia de la mediación y de sus impactos afectivos en la constitución de esos sujetos como lectores, discutiéndose aspectos detectados en las historias de mediaciones vivenciadas a lo largo de sus vidas, en especial en la familia.