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1.
J Funct Morphol Kinesiol ; 9(2)2024 Jun 05.
Artigo em Inglês | MEDLINE | ID: mdl-38921635

RESUMO

This review aims to reveal the effectiveness of myofunctional speech therapy on facial rejuvenation and/or improvement of orofacial function. A systematic review of four medical electronic databases (Medline, Google Scholar, SciELO, and LILACS) was conducted between January and March 2023. The research question was defined using the PICO model: Population (P): adult subjects with signs of physiological aging of facial skin. Intervention (I): aesthetic speech therapy (facial exercises and/or myofunctional therapy). Control (C): absence of treatment. Outcome (O): facial rejuvenation. Through the search process, a total of 472 potentially relevant articles were identified. A total of 21 studies were included in the review. Most of the studies required the participants to perform exercises learned during the weekly session on a daily basis. The subjects underwent an integrated treatment with facial exercises and worked on the stomatognathic functions for different durations. Many differences were found in the evaluation tools used to investigate the starting situation and the effects obtained following the treatment. At the diagnostic level, there was no concordance in the choice of the most appropriate scales and assessment tools, but great heterogeneity was observed. Indeed, forty-eight percent of the studies collected objective data through the use of various instruments (oral devices, electromyographs, cutometers, muscle ultrasound scans, and laser scans of the face). The observed improvements included not only a reduction in wrinkles and frown lines but also decreased muscle tension and slackness, enhanced facial symmetry and lip competence, improved skin elasticity, and restored stomatognathic function. These changes led to myofunctional restoration and facial rejuvenation, resulting in increased satisfaction with self-image and proprioception.

2.
Ann Ig ; 2024 Apr 03.
Artigo em Inglês | MEDLINE | ID: mdl-38567705

RESUMO

Background: Regular physical activity is crucial in preventing chronic diseases. International health authorities recommend that children and adolescents engage in at least 60 minutes of moderate to vigorous physical activity per day to achieve health benefits. Offering regular exercise opportunities to young people can promote the development of healthy lifestyles. In 2021, a new regulation introduced up to two compulsory hours of Physical Education per week in Italy and established that Physical Education should be entrusted to adequately trained teachers. The present study aimed to assess, from the perspective of the new teachers, the resources available for Physical Education in Italian primary schools. Methods: A questionnaire-based cross-sectional study was conducted among primary school Physical Education teachers during the year 2022-2023. Their opinion about the school resources were analyzed in light of their demographic characteristics and work experience. Results: Out of the 118 participating teachers, 96 (81.3%) reported the presence of a gym in their school. Participants expressed satisfaction with the size and windows of the gym, particularly for the schools of the North, as well as the adequacy of outdoor spaces. However, lower levels of satisfaction for locker rooms and gym small equipment emerged, especially among those teachers with less work experience. Conclusions: The introduction of the Physical Education teacher figure in Italian primary schools was an important step for health promotion in our country. However, some aspects related to the structural resources should be considered in future policies.

3.
BMC Microbiol ; 24(1): 87, 2024 Mar 15.
Artigo em Inglês | MEDLINE | ID: mdl-38491424

RESUMO

BACKGROUND: Listeria monocytogenes is a foodborne pathogen, which can cause a severe illness, especially in people with a weakened immune system or comorbidities. The interactions between host and pathogens and between pathogens and tumor cells have been debated in recent years. However, it is still unclear how bacteria can interact with tumor cells, and if this interaction can affect tumor progression and therapy. METHODS: In this study, we evaluated the involvement of L. monocytogenes in pre-neoplastic and colorectal cancer cell proliferation and tumorigenic potential. RESULTS: Our findings showed that the interaction between heat-killed L. monocytogenes and pre-neoplastic or colorectal cancer cells led to a proliferative induction; furthermore, by using a three-dimensional cell culture model, the obtained data indicated that L. monocytogenes was able to increase the tumorigenic potential of both pre-neoplastic and colorectal cancer cells. The observed effects were then confirmed as L. monocytogenes-specific, using Listeria innocua as negative control. Lastly, data suggested the Insulin Growth Factor 1 Receptor (IGF1R) cascade as one of the possible mechanisms involved in the effects induced by L. monocytogenes in the human colorectal adenocarcinoma cell line. CONCLUSIONS: These findings, although preliminary, suggest that the presence of pathogenic bacterial cells in the tumor niches may directly induce, increase, and stimulate tumor progression.


Assuntos
Adenocarcinoma , Neoplasias Colorretais , Listeria monocytogenes , Listeria , Humanos , Temperatura Alta
4.
Sci Rep ; 14(1): 2409, 2024 01 29.
Artigo em Inglês | MEDLINE | ID: mdl-38287041

RESUMO

Translational research for the evaluation of physical activity habits and lifestyle modifications based on nutrition and exercise has recently gained attention. In this study, we evaluated the effects of serum samples obtained before and after a 12-week home-based lifestyle intervention based on nutrition and exercise in breast cancer survivors in terms of modulation of the tumorigenic potential of breast cancer cells. The home-based lifestyle intervention proposed in this work consisted of educational counselling on exercise and nutritional behaviors and in 12 weeks of structured home-based exercise. Triple-negative breast cancer cell line MDA-MB-231 was cultured in semi-solid medium (3D culture) with sera collected before (PRE) and after (POST) the lifestyle intervention program. Spheroid formation was evaluated by counting cell colonies after 3 weeks of incubation. Results show a slight but significant reduction of spheroid formation induced by serum collected POST in comparison to those obtained PRE. Moreover, statistical analyses aimed to find physiologic and metabolic parameters associated with 3D cell proliferation revealed the proliferative inducer IGF-1 as the only predictor of cell tumorigenic potential. These results highlight the importance of lifestyle changes for cancer progression control in a tertiary prevention context. Translational research could offer a useful tool to identify metabolic and physiological changes induced by exercise and nutritional behaviors associated with cancer progression and recurrence risk.


Assuntos
Neoplasias da Mama , Neoplasias de Mama Triplo Negativas , Humanos , Feminino , Neoplasias de Mama Triplo Negativas/prevenção & controle , Neoplasias da Mama/prevenção & controle , Estilo de Vida , Comportamentos Relacionados com a Saúde , Exercício Físico/fisiologia , Carcinogênese , Aconselhamento
5.
Antibiotics (Basel) ; 12(8)2023 Aug 05.
Artigo em Inglês | MEDLINE | ID: mdl-37627712

RESUMO

The Arcobacter genus comprises a group of bacteria widely distributed in different habitats that can be spread throughout the food chain. Fluoroquinolones and aminoglycosides represent the most common antimicrobial agents used for the treatment of Arcobacter infections. However, the increasing trend of the antimicrobial resistance of this pathogen leads to treatment failures. Moreover, the test implementation and interpretation are hindered by the lack of reference protocols and standard interpretive criteria. The purpose of our study was to assess the antibiotic resistance pattern of 17 A. butzleri strains isolated in Central Italy from fresh vegetables, sushi, chicken breast, and clinical human samples to provide new and updated information about the antimicrobial resistance epidemiology of this species. Antimicrobial susceptibility testing was carried out by the European Committee on Antimicrobial Susceptibility Testing (EUCAST)'s disc diffusion method. All the strains were multidrug resistant, with 100% resistance to tetracyclines and cefotaxime (third generation cephalosporins). Some differences were noticed among the strains, according to the isolation source (clinical isolates, food of animal origin, or fresh vegetables), with a higher sensitivity to streptomycin detected only in the strains isolated from fresh vegetables. Our data, together with other epidemiological information at the national or European Union (EU) level, may contribute to developing homogeneous breakpoints. However, the high prevalence of resistance to a wide range of antimicrobial classes makes this microorganism a threat to human health and suggests that its monitoring should be considered by authorities designated for food safety.

6.
Trials ; 24(1): 134, 2023 Feb 22.
Artigo em Inglês | MEDLINE | ID: mdl-36814313

RESUMO

BACKGROUND: Breast cancer (BC) is the most common invasive cancer in women, and exercise can significantly improve the outcomes of BC survivors. MoviS (Movement and Health Beyond Care) is a randomized controlled trial aimed to evaluate the potential health benefits of exercise and proper nutritional habits. This study aims to assess the efficacy of aerobic exercise training in improving quality of life (QoL) and health-related factors in high-risk BC. METHODS: One hundred seventy-two BC survivor women, aged 30-70 years, non-metastatic, stage 0-III, non-physically active, 6-12 months post-surgery, and post chemo- or radiotherapy, will be recruited in this study. Women will be randomly allocated to the intervention arm (lifestyle recommendations and MoviS Training) or control arm (lifestyle recommendations). The MoviS training consists of 12 weeks of aerobic exercise training (2 days/week of supervised and 1 day/week of unsupervised exercise) with a progressive increase in exercise intensity (40-70% of heart rate reserve) and duration (20-60 min). Both arms will receive counseling on healthy lifestyle habits (nutrition and exercise) based on the World Cancer Research Fund International (WCRF) 2018 guidelines. The primary outcome is the improvement of the QoL. The secondary outcomes are improvement of health-related parameters such as Mediterranean diet adherence, physical activity level, flexibility, muscular fitness, fatigue, cardiorespiratory fitness (estimated maximal oxygen uptake), echocardiographic parameters, heart rate variability (average of the standard deviations of all 5 min normal to normal intervals (ASDNN/5 min) and 24 h very low and low frequency), and metabolic, endocrine, and inflammatory serum biomarkers (glycemia, insulin resistance, progesterone, testosterone, and high-sensitivity C-reactive protein). DISCUSSION: This trial aims to evaluate if supervised exercise may improve QoL and health-related factors of BC survivors with a high risk of recurrence. Findings from this project could provide knowledge improvement in the field of exercise oncology through the participation of a multidisciplinary team that will provide a coordinated program of cancer care to improve healthcare quality, improve prognosis, increase survival times and QoL, and reduce the risk of BC recurrence. TRIAL REGISTRATION: ClinicalTrials.gov  NCT04818359 . Retrospectively registered on March 26, 2021.


Assuntos
Neoplasias da Mama , Sobreviventes de Câncer , Feminino , Humanos , Qualidade de Vida , Neoplasias da Mama/patologia , Recidiva Local de Neoplasia , Exercício Físico/fisiologia , Sobreviventes , Ensaios Clínicos Controlados Aleatórios como Assunto
7.
Pathogens ; 11(8)2022 Jul 27.
Artigo em Inglês | MEDLINE | ID: mdl-36014964

RESUMO

Listeriosis is a foodborne disease caused by Listeria monocytogenes species and is known to cause severe complications, particularly in pregnant women, young children, the elderly, and immunocompromised individuals. The aim of this study was to investigate the presence of Listeria species in food and water using both biochemical and species-specific PCR analysis. L. monocytogenes isolates were further screened for the presence of various antibiotic resistance, virulence, and biofilm-forming determinants profiles using phenotypic and genotypic assays. A total of 207 samples (composed of meat, milk, vegetables, and water) were collected and analyzed for presence of L. monocytogenes using species specific PCR analysis. Out of 267 presumptive isolates, 53 (19.85%) were confirmed as the Listeria species, and these comprised 26 L. monocytogenes, 3 L. innocua, 2 L. welshimeri, and 1 L. thailandensis. The remaining 21 Listeria species were classified as uncultured Listeria, based on 16SrRNA sequence analysis results. A large proportion (76% to 100%) of the L. monocytogenes were resistant to erythromycin (76%), clindamycin (100%), gentamicin (100%), tetracycline (100%), novobiocin (100%), oxacillin (100%), nalidixic acid (100%), and kanamycin (100%). The isolates revealed various multi-drug resistant (MDR) phenotypes, with E-DA-GM-T-NO-OX-NA-K being the most predominant MDR phenotypes observed in the L. monocytogenes isolates. The virulence genes prfA, hlyA, actA, and plcB were detected in 100%, 68%, 56%, and 20% of the isolates, respectively. In addition, L. monocytogenes isolates were capable of forming strong biofilm at 4 °C (%) after 24 to 72 h incubation periods, moderate for 8% isolates at 48 h and 20% at 72 h (p < 0.05). Moreover, at 25 °C and 37 °C, small proportions of the isolates displayed moderate (8−20%) biofilm formation after 48 and 72 h incubation periods. Biofilm formation genes flaA and luxS were detected in 72% and 56% of the isolates, respectively. These findings suggest that proper hygiene measures must be enforced along the food chain to ensure food safety.

8.
Antibiotics (Basel) ; 11(6)2022 May 28.
Artigo em Inglês | MEDLINE | ID: mdl-35740132

RESUMO

Nontyphoidal salmonellosis (NTS) is the second most commonly reported gastrointestinal infection in humans and an important cause of food-borne outbreaks in Europe. The use of antimicrobial agents for animals, plants, and food production contributes to the development of antibiotic-resistant Salmonella strains that are transmissible to humans through food. The aim of this study was to investigate the presence and the potential dissemination of multidrug-resistant (MDR) Salmonella strains isolated in the Marche Region (Central Italy) via the food chain. Strains were isolated from different sources: food, human, food animal/livestock, and the food-processing environment. Among them, we selected MDR strains to perform their further characterization in terms of resistance to tetracycline agent, carriage of tet genes, and plasmid profiles. Tetracycline resistance genes were detected by PCR and plasmid replicons by PCR-based replicon typing (PBRT). A total of 102 MDR Salmonella strains were selected among the most prevalent serovars: S. Infantis (n = 36/102), S. Derby (n = 20/102), S. Typhimurium (n = 18/102), and a monophasic variant of S. Typhimurium (MVST, n = 28/102). Resistance to sulfisoxazole (86%) and tetracycline (81%) were the most common, followed by ampicillin (76%). FIIS was the most predominant replicon (17%), followed by FII (11%) and FIB (11%) belonging to the IncF incompatibility group. Concerning the characterization of tet genes, tetB was the most frequently detected (27/89), followed by tetA (10/89), tetG (5/89), and tetM (1/89). This study showed the potential risk associated with the MDR Salmonella strains circulating along the food chain. Hence, epidemiological surveillance supported by molecular typing could be a very useful tool to prevent transmission of resistant Salmonella from food to humans, in line with the One Health approach.

9.
Artigo em Inglês | MEDLINE | ID: mdl-35162585

RESUMO

Improving indoor air quality present in environments where people live is important to protect human health. This particularly applies to public transportation, where air quality may affect the health and safety of passengers, workers and staff. To provide better air quality, many buildings and transports are provided with heating, ventilation and air conditioning (HVAC) systems, which are always equipped with filters to retain the particulate present in the airflow, but they lack continuous air sanitization systems. In this study, a new UV-C LED and ionizer-based continuous sanitation air (CSA) system to be installed in a train HVAC was developed (international patent: N.PCT/IB2021/054194) and its sanitation efficacy against various microbial species (bacteria and fungi) was assessed. The device proved to be very effective at the microbial killing of aerodispersed microorganisms, both in its experimental configuration (ISO 15714:2019) and in a train setting. The installation of this CSA system on public transportation appears to be a promising solution to guarantee high microbiological air quality with a very low environmental impact due to its eco-friendly components.


Assuntos
Poluição do Ar em Ambientes Fechados , Saneamento , Ar Condicionado , Poluição do Ar em Ambientes Fechados/análise , Calefação , Humanos , Ventilação
10.
J Prev Med Hyg ; 62(1): E48-E53, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-34322616

RESUMO

INTRODUCTION: Microbiological quality of recreational environments included restrooms, is generally assessed by water and surface monitoring. In this study, an environmental monitoring, conducted in spring, of swimming pool restrooms of a recreation center located in the Marche region has been carried out. Seven water samples and seven surface swabs were collected. Moreover, six air samples have been included. The aim of this study was to evaluate if air microbiological monitoring, along with molecular detection in real-time PCR, could give additional useful information about the hygienic conditions of the facility. METHODS: Heterotrophic Plate Count (HPC) both at 22°C (psychrophilic) and 37°C (mesophilic) was determined by separate cultures in all samples. The presence of Legionella pneumophila and Pseudomonas aeruginosa was evaluated by both culture and real-time PCR. RESULTS: The analysis of shower water recorded a HPC load of mesophilic bacteria (37°C) more than 10-fold higher in men restroom, respect to women's one (> 100 vs < 10 CFU/ml), while in air samples was between < 100 and > 500. Concerning pathogen presence, both species Legionella pneumophila and Pseudomonas aeruginosa were detected only in men restroom, but in different sample types by using different methods (culture and real-time PCR). CONCLUSIONS: Air sampling may offer the advantage of giving more representative data about microbial presence in restrooms, including bacterial species transmitted through aerosol, like Legionella. Moreover, the concurrent use of molecular and microbiological detection in an integrated approach could offer the advantage of greater sensitivity.


Assuntos
Monitoramento Ambiental , Legionella pneumophila/isolamento & purificação , Legionella/isolamento & purificação , Piscinas , Banheiros/normas , Humanos , Itália , Projetos Piloto , Reação em Cadeia da Polimerase em Tempo Real , Recreação , Microbiologia da Água
11.
Geriatr Nurs ; 42(4): 806-815, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34090224

RESUMO

PURPOSE: Pursuing active aging and maintaining the quality of life (QoL) is essential, particularly in older people living in residential care facilities (RCFs). We evaluated physical activity (PA) as an intervention to improve the QoL in this population, trying to hypothesize future perspectives in this field. METHODS: A systematic search was performed on Pubmed. Only randomized control trials or quasi-experimental control group trials were considered. RESULTS: Results showed that a high-frequency PA can be effective in older people, allowing them to improve their functional mobility, autonomy, anxiety level, balance, and social interactions. Moreover, a moderate-intensity PA showed the most interesting results, improving all the QoL-related aspects considered. CONCLUSION: Results highlight the beneficial effects of multidisciplinary intervention strategies in increasing QoL and QoL-related aspects of RCFs older residents, contemplating PA as the main instrument. However, structured PA is necessary to fully understand which protocol could be the most effective.


Assuntos
Moradias Assistidas , Qualidade de Vida , Idoso , Envelhecimento , Exercício Físico , Humanos
12.
Ann Ist Super Sanita ; 56(4): 419-429, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33346167

RESUMO

Physical activity (PA) has a great potential impact in the prevention and control of non-communicable diseases. However, epidemiologic data reporting a high percentage of inactive people, still indicate a scarce perception of PA benefits. Therefore, in the past decades, a number of documents has been produced by international organizations with the aim of changing policies and institutional actions towards the promotion of PA. Several actions have been put in place and an evolution process in international strategies for PA promotion is ongoing. Nevertheless, there is a need to continue updating these policies in light of new knowledge about evidence-based PA health effects. A stimulating discussion about effective PA promotion programs is useful for future planning of interventions. The aim of this work is to report the evolution of international strategies aimed to PA promotion, from early PA recommendations, to the recent WHO Global Action Plan on Physical Activity 2018-2030.


Assuntos
Exercício Físico , Promoção da Saúde , Política de Saúde , Humanos , Cooperação Internacional
13.
Data Brief ; 27: 104704, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31720346

RESUMO

Epidemiological evidence shows that physical activity lowers the risk of developing breast cancer and decreases the risk of disease recurrence [1,2]. The main hypothesis on the positive effects of exercise-oncology has focused on lowering the basal systemic levels of cancer risk factors with exercise training. Recently, the effects of cancer progression control by components released after acute exercise bouts have gained attention [3,4]. However, the evaluation of the antiproliferative potential of a single exercise bout needs technical improvement. Here, we present data of a pilot study showing how to evaluate the anti-cancer potential of single exercise bouts with an in vitro three-dimensional cell growth assay, using a triple-negative breast cancer cell line cultured with exercise-conditioned serum.

14.
J Med Food ; 22(6): 614-622, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31058564

RESUMO

This study focused on the evaluation of the chemopreventive potential of tissue in vitro culture of the "Mela Rosa Marchigiana" apple (MRM callus) that allows the amplification of secondary metabolites. The MRM pulp and MRM callus chemopreventive potential was evaluated in terms of antiproliferative activity, inhibition of tumorigenesis in soft agar cultures, cell cycle and western blotting analyses in CaCo2 and LoVo colon cancer cell lines and in JB6 promotion-sensitive (JB6 P+) cells. MRM callus induced a strong concentration-dependent inhibition of colon cancer cell proliferation and suppressed 12-o-tetra-decanoyl-phorbol-13-acetate-induced tumorigenesis of JB6 P+ cells in soft agar cultures. MRM callus inhibited the phosphorylation of JNK, p38, and eIF2alpha. Our data indicate that the MRM callus exerts a good antiproliferative and antitumorigenic potential through the MAP kinase inhibition and could provide natural compounds with chemopreventive properties.


Assuntos
Proliferação de Células/efeitos dos fármacos , Neoplasias do Colo/fisiopatologia , Malus/química , Extratos Vegetais/farmacologia , Animais , Carcinogênese/efeitos dos fármacos , Carcinogênese/genética , Carcinogênese/metabolismo , Ciclo Celular/efeitos dos fármacos , Linhagem Celular Tumoral , Neoplasias do Colo/genética , Neoplasias do Colo/metabolismo , Humanos , MAP Quinase Quinase 4/genética , MAP Quinase Quinase 4/metabolismo , Sistema de Sinalização das MAP Quinases/efeitos dos fármacos , Fosforilação , Proteínas Quinases p38 Ativadas por Mitógeno/genética , Proteínas Quinases p38 Ativadas por Mitógeno/metabolismo
15.
Sci Rep ; 9(1): 66, 2019 01 11.
Artigo em Inglês | MEDLINE | ID: mdl-30635619

RESUMO

Autophagy is a cellular mechanism by which cells degrade intracellular components in lysosomes, maintaining cellular homeostasis. It has been hypothesized that autophagy could have a role in cancer prevention through the elimination of damaged proteins and organelles; this could explain epidemiological evidence showing the chemopreventive properties of the autophagy-inducer metformin. In this study, we analyzed the autophagy-related effect of metformin in both cancer initiation and progression in non-tumorigenic cells. We also analyzed the induction of tumorigenesis in autophagy-deficient cells, and its correlation with the ER stress. Our results showed that metformin induced massive cell death in preneoplastic JB6 Cl 41-5a cells treated with tumor promoter (phorbol) and in NIH/3T3 treated with H2O2. Inhibiting autophagy with wortmannin or ATG7 silencing, the effect of metformin decreased, indicating an autophagy-related cytotoxic activity under stress conditions. We also found an induction of tumorigenesis in ATG7-silenced NIH/3T3 cell clone (3T3-619C3 cells), but not in wild-type and in scrambled transfected cells, and an upregulation of unfolded protein response (UPR) markers in 3T3-619C3 cells treated with H2O2. These findings suggest that autophagic cell death could be considered as a new mechanism by which eliminate damaged cells, representing an attractive strategy to eliminate potential tumorigenic cells.


Assuntos
Antineoplásicos/farmacologia , Autofagia/efeitos dos fármacos , Carcinogênese/efeitos dos fármacos , Morte Celular/efeitos dos fármacos , Hipoglicemiantes/farmacologia , Metformina/farmacologia , Animais , Linhagem Celular , Camundongos
16.
Oxid Med Cell Longev ; 2018: 5896786, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30363988

RESUMO

Triple-negative breast cancer (TNBC) does not express estrogen receptor, progesterone receptor, and human epidermal growth factor receptor 2 and is characterized by its aggressive nature, lack of targets for targeted therapies, and early peak of recurrence. Due to these specific characteristics, chemotherapy does not usually yield substantial improvements and new target therapies and alternative strategies are needed. The beneficial responses of TNBC survivors to regular exercise, including a reduction in the rate of tumor growth, are becoming increasingly apparent. Physiological adaptations to exercise occur in skeletal muscle but have an impact on the entire body through systemic control of energy homeostasis and metabolism, which in turn influence the TNBC tumor microenvironment. Gaining insights into the causal mechanisms of the therapeutic cancer control properties of regular exercise is important to improve the prescription and implementation of exercise and training in TNBC survivors. Here, we provide new evidence of the effects of exercise on TNBC prevention, control, and outcomes, based on the inhibition of the phosphatidylinositol-3-kinase (PI3K)/protein kinase B (PKB also known as Akt)/mammalian target of rapamycin (mTOR) (PI3K-Akt-mTOR) signaling. These findings have wide-ranging clinical implications for cancer treatment, including recurrence and case management.


Assuntos
Exercício Físico/fisiologia , Transdução de Sinais , Serina-Treonina Quinases TOR/metabolismo , Neoplasias de Mama Triplo Negativas/metabolismo , Neoplasias de Mama Triplo Negativas/fisiopatologia , Autofagia , Ingestão de Energia , Feminino , Humanos
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