Enhancing equity in cervical screening - initiatives to increase screening participation.

PURPOSE OF REVIEW: Cervical cancer can be eliminated as a public health problem through a three-pillar approach including high coverage of human papillomavirus (HPV) vaccination and HPV-based cervical screening, and treatment of precancers and invasive cancers. However, access inequities prevent many women and people with a cervix benefitting from these life-saving advances. This review focuses on evidence-based interventions that can improve equity and scale-up of cervical screening. RECENT FINDINGS: The transition from conventional cytology to HPV screening provides multiple opportunities to address equity and a multipronged approach can be used to identify priority groups, understand barriers and develop tailored solutions. There are proven financing mechanisms, tools, technologies and screening delivery methods to overcome screening barriers in different settings. This includes self-sampling interventions, point-of-care testing, health service integration, consumer-led co-design processes and digital screening registries. SUMMARY: To achieve cervical cancer elimination globally, cervical screening must be delivered in an inclusive, culturally safe and context-appropriate manner. There are multiple tools and strategies that can be implemented to improve participation of never- and under-screened groups, and to enhance equity in cervical screening.

Revisiting and Updating the Interaction between Human Serum Albumin and the Non-Steroidal Anti-Inflammatory Drugs Ketoprofen and Ketorolac.

Ketoprofen (KTF) and ketorolac (KTL) are among the most primarily used non-steroidal anti-inflammatory drugs (NSAIDs) in humans to alleviate moderate pain and to treat inflammation. Their binding affinity with albumin (the main globular protein responsible for the biodistribution of drugs in the bloodstream) was previously determined by spectroscopy without considering some conventional pitfalls. Thus, the present work updates the biophysical characterization of the interactions of HSA:KTF and HSA:KTL by 1H saturation-transfer difference nuclear magnetic resonance (1H STD-NMR), ultraviolet (UV) absorption, circular dichroism (CD), steady-state, and time-resolved fluorescence spectroscopies combined with in silico calculations. The binding of HSA:NSAIDs is spontaneous, endothermic, and entropically driven, leading to a conformational rearrangement of HSA with a slight decrease in the α-helix content (7.1% to 7.6%). The predominance of the static quenching mechanism (ground-state association) was identified. Thus, both Stern-Volmer quenching constant (KSV) and binding constant (Kb) values enabled the determination of the binding affinity. In this sense, the KSV and Kb values were found in the order of 104 M-1 at human body temperature, indicating moderate binding affinity with differences in the range of 0.7- and 3.4-fold between KTF and KTL, which agree with the previously reported experimental pharmacokinetic profile. According to 1H STD-NMR data combined with in silico calculations, the aromatic groups in relation to the aliphatic moiety of the drugs interact preferentially with HSA into subdomain IIIA (site II) and are stabilized by interactions via hydrogen bonding and hydrophobic forces. In general, the data obtained in this study have been revised and updated in comparison to those previously reported by other authors who did not account for inner filter corrections, spectral backgrounds, or the identification of the primary mathematical approach for determining the binding affinity of HSA:KTF and HSA:KTL.

Solvent-Driven Self-Organization of Meso-Substituted Porphyrins: Morphological Analysis from Fluorescence Lifetime Imaging Microscopy.

A morphological analysis of different thin films of meso-tetra-p-(di-p-phenylamino)phenylporphyrin, H2T(TPA)4P, was made by fluorescence lifetime imaging microscopy (FLIM) and scanning electron microscopy (SEM). A comprehensive study of H2T(TPA)4P was undertaken through UV/vis absorption and fluorescence techniques in different solvents, solvent mixtures and in thin films. In solution, occurrence of intramolecular energy transfer from the triphenylamine (TPA) moieties to the porphyrin core, with quenching efficiencies in the order of 94-97%, is observed. The energy transfer rate constants are determined assuming Förster's dipole-dipole and Dexter's electron exchange mechanisms. In drop-cast-prepared thin films, from samples with different solvent mixtures, the photoluminescence (PL) quantum yield (ΦPL) decreases ∼1 order of magnitude compared to the solution behavior. FLIM and SEM experiments showed the self-organization and morphology of H2T(TPA)4P in thin films to be highly dependent on the solvent mixture used to prepare the film. In chloroform, the solvent's evaporation results in the formation of elongated and overlapped microrod structures. Introduction of a cosolvent, namely, a polar cosolvent, promotes changes in the morphology of the self-assembled structures, with the formation of three-dimensional spherical structures and hollow spheres. H2T(TPA)4P dispersed in a polymer matrix shows enhanced ΦPL values when compared to the drop-cast films. FLIM images showed coexistence of three different states or domains: aggregated, interface, and nonaggregated or less-aggregated states. This work highlights the importance of FLIM in the morphological characterization of heterogeneous films, together with the photophysical characterization of nano- and microdomains.

Validation and measurement invariance of the Muscularity-Oriented Eating Test among Brazilian men and women.

OBJECTIVE: The Muscularity-Oriented Eating Test (MOET) is a 15-item unidimensional scale, designed to assess eating practices that occur in the pursuit of a muscular body. The aim of the present study was to describe the translation and cultural adaptation of the MOET to Brazilian Portuguese, to explore its factor structure and measurement invariance, and to evaluate its internal consistency, three-week test-retest reliability, and convergent validity in a community sample of Brazilian men and women. METHOD: After the back-translation procedure, the Brazilian MOET was administered online to a sample of 1246 adults (634 men and 612 women), along with measures of drive for muscularity, muscle dysmorphia symptoms, muscular/athletic-ideal internalization, disordered eating behaviors, and exercise dependence. RESULTS: Findings from an exploratory factor analysis and a confirmatory factor analysis revealed a one-factor structure and adequate internal consistency for men (ω = 0.86; α = 0.86) and women (ω = .84; α = .83). Measurement invariance across gender was supported. In addition, the scale demonstrated good three week test-retest reliability for both men (ICC = .96; p < .001) and women (ICC = .92; p < .001), and the subscales revealed moderate to large associations with drive for muscularity, muscle dysmorphia symptoms, muscular/athletic-ideal internalization, disordered eating, and exercise dependence. CONCLUSION: This study supports the validity and reliability of the MOET in a community sample of Brazilian men and women and represents an advance in measures of muscularity-oriented disordered eating in Brazilian adults, allowing for future cross-cultural studies in this field. PUBLIC SIGNIFICANCE: The Muscularity-Oriented Eating Test (MOET) is a measure of muscularity-oriented disordered eating, which assess strict adherence to diet rules, including the food's macronutrient content, regulation of protein intake, and eating less or more to influence muscle gain. This study evaluated the validity and reliability of the MOET in a community sample of Brazilian men and women. Our findings represent an advance in measures of muscularity-oriented disordered eating in Brazilian adults.

Nanostructuring with Surfactants: The Self-Assembly of a New Poly(thiophene-phenylene) Conjugated Polymer Bearing Azacrown Ether Pendant Groups.

We report the synthesis of a new conjugated polymer bearing crown ether moieties, poly[(N(1-aza-[18]crown-6)carbamido)thiophene-2,5-diyl-alt-1,4-phenylene] (BG2). In water, BG2 forms a dispersion with a slightly cloudy appearance. We have studied the effect of adding surfactants, with different polar head groups, on these polymer-polymer aggregates. Special attention is given to the system with the anionic surfactant, sodium dodecyl sulfate (SDS). The combination of photophysical techniques with electrical conductivity, NMR (1H, 13C, and 27Na), DFT calculations, molecular dynamics simulations, and small-angle neutron scattering (SANS) provides a detailed picture on the behavior of the SDS/BG2 system in aqueous solution and in thin films. NMR, electric conductivity, and DFT results suggest that hydrophilic interactions occur between the polar headgroup of the surfactant (OSO3- Na+) and the aza-[18]-crown-6 moiety. DFT calculations confirmed the capability of BG2 to form stable complexes with the Na+ cations, where the cation can be either inside the azacrown cavity or sandwiched between the cavity and the polymer chain, which seem to determine the position of the surfactant hydrocarbon chain and, therefore, be responsible for the disruption of the BG2 aggregates and subsequent increase in the photoluminescence quantum yields. SANS measurements, made with hydrogenated and deuterated SDS in D2O, clearly show how micron-sized aggregates of BG2 are broken down by SDS and then how BG2 becomes preferentially incorporated within joint colloidal particles of BG2 and SDS with increasing [SDS]/[BG2] molar ratio.

Photophysical studies on lanthanide(III) chelates conjugated to Pittsburgh compound B as luminescent probes targeted to Aß amyloid aggregates.

The photophysical properties of Eu3+ and Tb3+ complexes of DOTAGA and DO3A-monoamide conjugates of the Pittsburgh compound B (PiB) chromophore, prepared using linkers of different lengths and flexibilities, and which form stable negatively charged (LnL1), and uncharged (LnL2) complexes, respectively, were studied as potential probes for optical detection of amyloid aggregates. The phenylbenzothiazole (PiB) moiety absorbs light at wavelengths longer than 330 nm with a high molar absorption coefficient in both probes, and acts as an antenna in these systems. The presence of the luminescent Ln3+ ion quenches the excited states of PiB through an energy transfer process from the triplet state of PiB to the metal centre, and structured emission is seen from Eu3+ and Tb3+. The luminescence study indicates the presence of a 5D4 → T1 back transfer process in the Tb3+ complexes. It also provides insights on structural properties of the Eu3+ complexes, such as the high symmetry environment of the Eu3+ ion in a single macrocyclic conformation and the presence of one water molecule in its inner coordination sphere. The overall quantum yield of luminescence of EuL1 is higher than for EuL2. However, their low values reflect the low overall sensitization efficiency of the energy transfer process, which is a consequence of the large distances between the metal center and the antenna, especially in the EuL2 complex. DFT calculations confirmed that the most stable conformation of the Eu3+ complexes involves a combination of a square antiprismatic (SAP) geometry of the chelate and an extended conformation of the linker. The large calculated average distances between the metal center and the antenna point to the predominance of the Förster energy transfer mechanism, especially for EuL2. This study provides insights into the behavior of amyloid-targeted Ln3+ complexes as optical probes, and contributes towards their rational design.

Brazilian version of the Multidimensional Body-Self Relations Questionnaire-Appearance Scales (MBSRQ-AS): translation and psychometric properties in adults.

OBJECTIVE: The present study investigated the psychometric properties of the Brazilian adaptation of the Multidimensional Body-Self Relations Questionnaire-Appearance Scales, a widely used instrument in body image research. METHODS: We translated the MBSRQ-AS and determined its psychometric properties among 2 community samples, totaling 387 men and 381 women, and 1 college sample of 104 men and 133 women, aged from 16 to 67 years old (totaling 1005 participants). Near half of the sample (n = 606) was recruited online (SurveyMonkey Database) and the other half was personally recruited from universities, technical schools and libraries. RESULTS: The translated version was similar to the original, and the items were easily understood. After the exclusion of the negatively worded questions, the Brazilian version had the same factor structure as the original MBSRQ-AS. Internal consistency ranged from .73 to .90 and test-retest reliability indices ranged from .76 to .92. The measure captured sex and weight status differences. Women reported significantly higher levels of investment in appearance, lower levels of satisfaction with specific parts of the body, higher concerns with being overweight, and classified themselves as heavier than men. Overweight and obese men and women reported lower satisfaction with specific parts of their bodies, higher concerns with being overweight, and classified themselves as heavier than their normal weight counterparts. Convergent validity was demonstrated by the significant correlations between the MBSRQ-AS subscales and investment in appearance, internalization of beauty ideals, disordered eating and self-esteem. CONCLUSIONS: In summary, the Brazilian MBSRQ-AS appears to be a good option for researchers in the country. Furthermore, the study provides substantial parameters for comparison with other adaptations of the instrument around the world. LEVEL OF EVIDENCE: Level V, descriptive study.

Effects of cafeteria diet and high fat diet intake on anxiety, learning and memory in adult male rats.

OBJECTIVE: The effects of cafeteria and high fat diets were investigated on animal models of behavior. METHODS: Male Wistar rats were treated with Control (C), Cafeteria (CD) and High Fat (FD) diets and tested in the Elevated Plus-Maze (EPM) and Morris Water Maze (MWM) procedures. Body weight, length, abdominal circumference, retroperitoneal and epididymal adipose tissues were recorded. Physical parameters, weight of tissues, EPM, and MWM data were subjected to ANOVA followed by Newman-Keuls test (P < 0.05). RESULTS: There were no differences on weight and length parameters between CD and C rats up to 98 days of age. However, abdominal circumferences were higher in CD as compared to C at 35 and 70 days of age, respectively, the 5th and the 7th weeks. FD presented lower measures of weight and abdominal circumference; nevertheless there was an increase on those parameters at the end of the nutritional treatment. Even without an apparent weight gain of CD and FD these animals presented a greater accumulation of retroperitoneal and epididymal adipose tissues. In addition, CD and FD demonstrated behaviors that can suggest lower anxiety. CD showed a better learning performance and FD showed better recall of previous learned information in the memory retention test. DISCUSSION: According to those data it was concluded that hypercaloric diet ingestion was capable of triggering metabolic alterations and possibly lowering anxiety associated to learning or memory improvement on a spatial task.

Self-assembled systems of water soluble metal 8-hydroxyquinolates with surfactants and conjugated polyelectrolytes.

We have studied the interaction of 8-hydroxyquinoline-5-sulfonate (8-HQS) with the metal ions Al(iii) and Zn(ii) in aqueous solution in the presence of tetraalkylammonium surfactants using UV/vis absorption, fluorescence, NMR spectroscopy and electrical conductivity measurements, complemented by DFT calculations and molecular dynamics (MD) simulations. Under appropriate conditions, complexes between 8-HQS and metal ions form rapidly, and have similar electronic, spectroscopic and photophysical properties to the corresponding metal quinolates, such as Alq3. These interact with the cationic surfactants, leading to marked increases in fluorescence intensity. However, significant differences are seen in the behavior of the two metal ions. With aluminium, a stable [Al(8-QS)3](3-) anion is formed, and interacts, predominantly through electrostatic interactions, with the surfactant, without disrupting the metal ion coordination sphere. In contrast, with Zn(ii), there is a competition between the metal ion and surfactants in the interaction with 8-HQS, although the [Zn(8-QS)2(H2O)2](2-) species is stable at appropriate pH and surfactant concentration. The studies are extended to systems with the conjugated polyelectrolyte (CPE) poly-(9,9-bis(6-N,N,N-trimethylammonium)hexyl)-fluorene-phenylene bromide (HTMA-PFP), which has a similar alkylammonium chain to the surfactants. Mixing metal salt, 8-HQS and HTMA-PFP in the presence of a nonionic surfactant leads to the formation of a metal complex/CPE supramolecular assembly between the conjugated polyelectrolyte and the metal/8-HQS complex, as demonstrated by electronic energy transfer. The potential of these systems in sensing, light harvesting, and electron injection/transport layers in organic semiconductor devices is discussed.

Insights into the effect of glucose on the binding between human serum albumin and the nonsteroidal anti-inflammatory drug nimesulide.

Glucose interacts with human serum albumin (HSA, the main protein responsible for the biodistribution of drugs in the bloodstream) and consequently affects the binding capacity of exogenous compounds. Thus, in this work, the interactive profile between HSA and the anti-inflammatory drug nimesulide (NMD, used mainly by patients with diabetic neuropathy to relieve acute or chronic pains) was characterized in nonglycemic, normoglycemic (80 mg/dL), and hyperglycemic (320 mg/dL) conditions by biophysics techniques. There is a spontaneous and ground-state association HSA:NMD under physiological conditions. Therefore, the Stern-Volmer constant (Ksv) can also be used to estimate the binding affinity. The Ksv values for nonglycemic, normoglycemic, and hyperglycemic conditions are around 104 M-1, indicating a moderate affinity of NMD to albumin that was slightly improved by glucose levels. Additionally, the binding is enthalpically and entropically driven mainly into subdomains IIA or IIIA. The binding perturbs weakly the α-helix content of albumin, however, glucose potentially stabilizes the tertiary structure, decreasing the structural perturbation upon NMD binding and improves the complex HSA:NMD stability. Overall, the biophysical characterization indicated that glucose levels might slightly positively impact the pharmacokinetic profile of NMD, allowing NMD to achieve its therapeutical potential without affecting drastically its effective dosages.

Effect of Co Doping on the Physical Properties and Organic Pollutant Photodegradation Efficiency of ZnO Nanoparticles for Environmental Applications.

This paper presents a comprehensive investigation of the synthesis and characterization of Zn1-xCoxO (0 ≤ x ≤ 0.05) nanopowders using a chemical co-precipitation approach. The structural, morphological, and vibrational properties of the resulting ZnO nanostructures were assessed through X-ray diffraction, scanning electronic microscopy, and Raman spectroscopy to examine the influence of cobalt doping. Remarkably, a notable congruence between the experimental results and the density functional theory (DFT) calculations for the Co-doped ZnO system was achieved. Structural analysis revealed well-crystallized hexagonal wurtzite structures across all samples. The SEM images demonstrated the formation of spherical nanoparticles in all the samples. The vibrational properties confirmed the formation of a hexagonal wurtzite structure, with an additional Raman peak corresponding to the F2g vibrational mode characteristic of the secondary phase of ZnCo2O4 observed at a 5% cobalt doping concentration. Furthermore, a theoretical examination of cobalt doping's impact on the elastic properties of ZnO demonstrated enhanced mechanical behavior, which improves stability, recyclability, and photocatalytic activity. The photocatalytic study of the synthesized compositions for methylene blue (MB) dye degradation over 100 min of UV light irradiation demonstrated that Co doping significantly improves photocatalytic degradation. The material's prolonged lifetime, reduced rate of photogenerated charge carrier recombination, and increased surface area were identified as pivotal factors accelerating the degradation process. Notably, the photocatalyst with a Zn0.99Co0.01O composition exhibited exceptional efficiency compared to that reported in the literature. It demonstrated high removal activity, achieving an efficiency of about 97% in a shorter degradation time. This study underscores the structural and photocatalytic advancements in the ZnO system, particularly at lower cobalt doping concentrations (1%). The developed photocatalyst exhibits promise for environmental applications owing to its superior photocatalytic performance.

Aggregation properties of p-phenylene vinylene based conjugated oligoelectrolytes with surfactants.

The amphiphilic properties of conjugated oligoelectrolytes (COE) and their sensitivity to the polarity of their microenvironment lead to interesting aggregation behavior, in particular in their interaction with surfactants. Photoluminescence (PL) spectroscopy, liquid-phase atomic force microscopy, small-angle neutron scattering, small-angle X-ray scattering, and grazing-incidence X-ray diffraction were used to examine interactions between cationic p-phenylene vinylene based oligoelectrolytes and surfactants. These techniques indicate the formation of COE/surfactant aggregates in aqueous solution, and changes in the photophysical properties are observed when compared to pure aqueous solutions. We evaluate the effect of the charge of the surfactant polar headgroup, the size of the hydrophobic chain, and the role of counterions. At low COE concentrations (micromolar), it was found that these COEs display larger emission quantum efficiencies upon incorporation into micelles, along with marked blue-shifts of the PL spectra. This effect is most pronounced in the series of anionic surfactants, and the degree of blue shifts as a function of surfactant charge is as follows: cationic < nonionic < anionic surfactants. In anionic surfactants, such as sodium dodecyl sulfate (SDS), the PL spectra show vibronic resolution above the critical micelle concentration of the surfactant, suggesting more rigid structures. Scattering data indicate that in aqueous solutions, trimers appear as essentially 3-dimensional particles, while tetra- and pentamers form larger, cylindrical particles. When the molar ratio of nonionic C12E5 surfactant to 1,4-bis(4-{N,N-bis-[(N,N,N-trimethylammonium)hexyl]amino}-styryl)benzene tetraiodide (DSBNI) is close to one, the size of the formed DSBNI-C12E5 particles corresponds to the full coverage of individual oligomers. When these particles are transferred into thin films, they organize into a cubic in-plane pattern. If anionic SDS is added, the formed DSBNI-SDS particles are larger than expected for full surfactant coverage, and particles may thus contain several oligomers. This tendency is attributed to the merging of DSBNI oligomers due to the charge screening and, thus, reduced water solubility.

Highly Selective Fluorescent Sensors: Polyethylenimine Derivatives of Triphenylamine and Coumarin for GTP and ATP Interaction via Fluorescence Lifetime Imaging Microscopy.

Chemical derivatives of polyethylenimine (PEI) receptors with either triphenylamine (TPA) or 7-hydroxy-4-methyl-coumarin (Cou) form stable complexes with adenine and guanine nucleotides in water. The host-guest complex modulation is found to be based on noncovalent molecular interactions such as π-π stacking and hydrogen bonding, which are dependent on the aromatic moieties attached to the polyaminic (PEI) backbone. PEI-TPA acts as a chemosensor with a recognition driving force based on aggregation-induced emission (AIE), involving π-π interaction between the nucleic base and TPA. It detects GTP by a chelation enhancement quenching effect of fluorescence (CHEQ) with a measured logarithm stability constant, log ß = 7.7. By varying the chemical characteristics of the fluorophore, as in the PEI-Cou system, the driving force for recognition changes from a π-π interaction to an electrostatic interaction. The coumarin derivative detects ATP with a log ß value one order of magnitude higher than that for GTP, allowing for the selective recognition of the two nucleotides in a 100% aqueous solution. Furthermore, fluorescence lifetime imaging microscopy (FLIM) allows for a correlation between the selectivity of PEI-TPA toward nucleotides and the morphology of the structures formed upon ATP and GTP recognition. This study offers valuable insights into the design of receptors for the selective recognition of nucleotides in water.

Effects of walking football on adherence, safety, quality of life and physical fitness in patients with prostate cancer: Findings from the PROSTATA_MOVE randomized controlled trial.

Aims: To analyze the feasibility and impact of a walking football (WF) program on quality of life (QoL), cardiorespiratory fitness (CRF), muscle strength, and balance program in men with prostate cancer under androgen deprivation therapy (ADT). Methods: Fifty patients with prostate cancer (stages IIb-IVb) under ADT were randomized to a 16-week WF program plus usual care (n=25) or usual care control group (n=25). The WF program consisted of three 90-minute sessions per week. Recruitment, withdrawal, adherence, enjoyment rate, and safety of the intervention were recorded throughout the study. Cardiorespiratory fitness was assessed before and after the interventions, while handgrip strength, lower limb muscle strength, static balance, and QoL were assessed before, during (week 8), and after (week 16) the interventions. Adverse events during sessions were also recorded. Results: The WF group showed high levels of adherence (81.6 ± 15.9%) and enjoyment rate (4.5 ± 0.5 out of 5 points). In the intention-to-treat analysis, the WF group showed an improvement in chair sit-to-stand (p=0.035) compared to the control group. Within-group comparisons showed that handgrip strength in the dominant upper limb (p=0.024), maximal isometric muscle strength in the non-dominant lower limb (p=0.006), and balance in the dominant limb (p=0.009) improved over time in the WF group but not in the usual care group. The results obtained from the per-protocol analysis indicate that CRF improved significantly in the WF group as compared to the control group (p=0.035). Within-group analysis revealed that CRF (p=0.036), muscle strength in dominant (p=0.006) and non-dominant (p=0.001) lower limbs, and balance in the non-dominant lower limb (p=0.023) improved after 16 weeks of WF, but not in the control group. One major traumatic injury (muscle tear) was reported with a complete recovery before the end of the intervention. Conclusion: This study suggests that WF is feasible, safe, and enjoyable in patients with prostate cancer under hormonal therapy. Furthermore, patients who adhere to the WF program can expect cardiorespiratory fitness, muscle strength, and balance improvements. Clinical trials registration: clinicaltrials.gov, identifier NCT04062162.

Excessive iodine intake in schoolchildren.

PURPOSE: Inadequate iodine intake may result in iodine deficiency disorders (IDD). Thus, for more than 50 years, policies for the regulation of salt fortification with iodine have existed in Brazil. In 2003, a study on 6-14-year-old schoolchildren from regions of the state of São Paulo showed a median urinary iodine concentration of 360 µg/L. The objective of the present study was to assess the iodine nutrition status among schoolchildren. METHODS: The study was conducted on 828 schoolchildren aged 4-13 years from eight schools in the interior of the state of São Paulo. A casual urine sample was collected from each volunteer for iodine determination by the adapted method of Sandell-Kalthoff. RESULTS: Only 1.9% (n = 16) of the children evaluated had low values of urinary iodine (<100 µg/L), while 24.6% had urinary iodine excretion values between 200 and 300 µg/L, and 67.1% had values above >300 µg/L. CONCLUSIONS: The results show that the iodine nutritional status of the schoolchildren studied is characterized by a high urinary iodine excretion, which might reveal an increase in iodine consumption by this population.

Screening, Diagnosis and Management of Atrial Fibrillation in Cancer Patients: Current Evidence and Future Perspectives. / Rastreamento, Diagnóstico e Manejo da Fibrilação Atrial em Pacientes com Câncer: Evidências Atuais e Perspectivas Futuras.

Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia in the general population, carrying a high morbimortality burden, and this also holds true in cancer patients. The association between AF and cancer goes even further, with some studies suggesting that AF can be a marker of occult cancer. There is, however, a remarkable paucity of data concerning specific challenges of AF management in cancer patients. AF prompt recognition and management in this special population can lessen the arrhythmia-related morbidity and have an important prognostic benefit. This review will focus on current AF diagnosis and management challenges in cancer patients, with special emphasis on AF screening strategies and devices, and anticoagulation therapy with non-vitamin K antagonist oral anti-coagulants (NOACs) for thromboembolic prevention in these patients. Some insights concerning future perspectives for AF prevention, diagnosis, and treatment in this special population will also be addressed.

A fibrilação atrial (FA) é a arritmia cardíaca sustentada mais comum na população geral, tendo uma alta carga de morbimortalidade, e isso também é válido para pacientes com câncer. A associação entre FA e câncer vai ainda mais longe, com alguns estudos sugerindo que a FA pode ser um marcador de câncer oculto. Há, no entanto, uma notável escassez de dados sobre os desafios específicos do manejo da FA em pacientes com câncer. O reconhecimento e o manejo imediatos da FA nesta população especial podem diminuir a morbidade relacionada à arritmia e ter um importante benefício prognóstico. Esta revisão se concentrará nos desafios atuais de diagnóstico e manejo da FA em pacientes com câncer, com ênfase especial nas estratégias e dispositivos de rastreamento da FA e na terapia de anticoagulação com anticoagulantes orais não antagonistas da vitamina K (NOACs) para prevenção tromboembólica nesses pacientes. Alguns insights sobre as perspectivas futuras para a prevenção, diagnóstico e tratamento da FA nesta população especial também serão abordados.

Validation of the Muscle Dysmorphic Disorder Inventory (MDDI) in Brazilian Women.

Despite high levels of body dissatisfaction and an increasing drive for muscularity among Brazilian women, most of the existing literature on muscle dysmorphia focuses on men and has mainly been conducted in Western and English-speaking regions. As a result, one of the most widely used assessment tools for symptoms of the disorder, the Muscle Dysmorphic Disorder Inventory (MDDI), has not yet been evaluated in Brazilian women-an at-risk population. In the present study, we perform a psychometric evaluation of the Brazilian Portuguese translation of the MDDI in a sample of 515 women. We evaluated the factor structure using a two-step, split-sample exploratory and confirmatory factor analytic approach, which supported the original three-factor structure of the measure. Additionally, we found good internal consistency, convergent validity, and test-retest reliability of the measure. Collectively, these results support the use of the measure in Brazilian women and provide a foundation to expand the literature in this population.

Long-term response to avelumab and management of oligoprogression in Merkel cell carcinoma: A case report.

BACKGROUND: Merkel cell carcinoma (MCC) is a rare and aggressive cutaneous neuroendocrine neoplasia, with high risk of recurrence and metastasis and poor survival. Immune checkpoint inhibitors, like the anti-programmed death-ligand 1 agent avelumab, were recently approved for the treatment of advanced MCC. We, herein, report the first case of advanced MCC with oligoprogression managed with avelumab and local radical treatment. CASE SUMMARY: A 61-year-old man was presented to the hospital with sporadic fever and an exudative malodorous mass (10 cm of diameter), located on the right gluteal region. The final diagnosis was MCC, cT4N3M1c (AJCC, TNM staging 8th edition, 2017), with invasion of adjacent muscle, in-transit metastasis, and bone lesions. Patient started chemotherapy (cisplatin and etoposide), and after six cycles, the main tumor increased, evidencing disease progression. Two months later, the patient started second line treatment with avelumab (under an early access program). After two cycles of treatment, the lesion started to decrease, achieving a major response. Local progression was documented after 16 cycles. However, as the tumor became resectable, salvage surgery was performed, while keeping the systemic treatment with avelumab. Since the patient developed bilateral pneumonia, immunotherapy was suspended. More than 2.5 years after surgery (last 19 mo without systemic therapy), the patient maintains complete local response and stable bone lesions. CONCLUSION: This report highlights the efficacy and long-term response of avelumab on the management of a chemotherapy resistant advanced MCC, with evidence of oligoprogression, in combination with local radical treatment.

Complexes of In(III) with 8-hydroxyquinoline-5-sulfonate in solution: structural studies and the effect of cationic surfactants on the photophysical behaviour.

Following previous studies on the complexation in aqueous solutions of 8-hydroxyquinoline-5-sulfonate (8-HQS) with the trivalent metal ions, Al(III) and Ga(III) and various other metal ions, using multinuclear NMR, DFT calculations, UV-vis absorption and luminescence techniques, we have extended our studies on 8-HQS complexation to the trivalent metal ion In(III). The study combines the high sensitivity of luminescence techniques and the selectivity of multinuclear NMR spectroscopy with the structural details accessible through DFT calculations, and aims to obtain a complete understanding of the complexation between the In3+ metal ion and 8-HQS, and how this influences the luminescence behaviour. A full speciation study has been performed and, as has been reported for the complexes of 8-hydroxyquinoline (8-HQ), the dominant complexes of 8-HQS with In(III) show marked differences in the complexation behaviour when compared with the equivalent complexes with the other group 13 cations Al(III) and Ga(III). While all three complexes have a 1 : 3 (metal : ligand) stoichiometry, those with Al(III) and Ga(III) show a mer-geometry of the ligands around the metal centre, whereas the fac-geometry is observed for the complexes with In(III). On binding to metal ions, 8-HQS shows a marked increase in the intensity of the fluorescence emission band compared to that of the virtually non-luminescent free ligand. However, the increase for In(III) is less pronounced than with Al(III) or Ga(III). These observations have important implications for the application of the complexes in sensing, light emitting devices (e.g. OLEDs), or as electron transport layers in photovoltaics for solar energy conversion. Furthermore, surfactant complexation is known to improve the fluorescence intensity in metal complexes with 8-HQS, by inhibiting the ligand exchange, as we have reported for complexes of HQS with Al(III) and Ga(III). Accordingly, in view of the development of applications in either sensing or optoelectronics, our interest also includes the study of HQS complexes of In(III) in the presence of cationic surfactants, in comparison with previous results with Al(III) and Ga(III).

[Salt iodination and excessive iodine intake among schoolchildren]. / Lodação do sal e ingestão excessiva de iodo em crianças.

The objective of the present study was to evaluate the urinary excretion of iodine and relate it to the amount present in salt for human consumption. The study involved 145 children from two schools: a rural one and an urban one. We performed anthropometric measurements and collected a urine sample and a kitchen salt sample from each child. In the rural school, 3.38% of children had iodine deficiency. However, most of the values of urinary iodine were above 300 microg/L (62.03%) and 59.49% of the kitchen salt samples contained 20 to 60 mg iodine per kilo of salt. In the urban school, 3.03% of the children had urinary iodine excretion of less than 100 microg/L and 90.91% of the children had urinary iodine values exceeding 300 microg/L. Ofthis total, 84.85% of the kitchen salt samples contained 20 to 60 mg iodine per kilo of salt. Iodine deficiency is controlled in this population, with the current reality showing a high prevalence of excess urinary iodine.