Classification and prediction of clinical Alzheimer's diagnosis based on plasma signaling proteins.

A molecular test for Alzheimer's disease could lead to better treatment and therapies. We found 18 signaling proteins in blood plasma that can be used to classify blinded samples from Alzheimer's and control subjects with close to 90% accuracy and to identify patients who had mild cognitive impairment that progressed to Alzheimer's disease 2-6 years later. Biological analysis of the 18 proteins points to systemic dysregulation of hematopoiesis, immune responses, apoptosis and neuronal support in presymptomatic Alzheimer's disease.

PI3K Signaling Pathways as a Molecular Target for Glioblastoma Multiforme.

Glioblastoma multiforme (GBM) is the most common type of cancer that affects the central nervous system (CNS). It currently accounts for about 2% of diagnosed malignant tumors worldwide, with 296,000 new cases reported per year. The first-choice treatment consists of surgical resection, radiotherapy, and adjuvant chemotherapy, which increases patients' survival by 15 months. New clinical and pre-clinical research aims to improve this prognosis by proposing the search for new drugs that effectively eliminate cancer cells, circumventing problems such as resistance to treatment. One of the promising therapeutic strategies in the treatment of GBM is the inhibition of the phosphatidylinositol 3-kinase (PI3K) pathway, which is closely related to the process of tumor carcinogenesis. This review sought to address the main scientific studies of synthetic or natural drug prototypes that target specific therapy co-directed via the PI3K pathway, against human glioblastoma.

Can inflammasomes promote the pathophysiology of glioblastoma multiforme? A view about the potential of the anti-inflammasome therapy as pharmacological target.

Glioblastoma multiforme (GBM) is a malignant brain tumor with one of the worst general survivorship cases among the existing neoplasia. This aggressiveness is due to its complex molecular heterogeneity, immunohistochemistry and genetics. The current therapeutic approach brings little contribution to the improvement of the survival of the patients. Due to that, new forms of treatment have been explored, one of them being immunotherapy. In this aspect, the inflammasome pathway, which induces inflammation and immunosuppressive tumor response, contributing to the progression of the tumor, seems to be a new alternative to improve the treatment efficacy and the survival of the patients.

Extraction of a chronically implanted, microfabricated, subretinal electrode array.

PURPOSE: To assess the feasibility of extraction of a chronically implanted subretinal electrode array. METHODS: Inactive, polyimide strips (10 mm x 1.5 mm x 15 microm) were surgically implanted into the subretinal space of 8 rabbits using a mostly ab externo approach. Pre- and postoperative clinical examinations, electroretinography and in some cases optical coherence tomography were performed to follow the course of the eyes. Two months after implantation, the polyimide strips were extracted from 5 eyes; 2 animals kept the implants and served as controls. All animals were then sacrificed and eyes enucleated for histological examination. RESULTS: All 8 surgeries yielded successful placement of the arrays into the subretinal space. All 5 extraction surgeries were performed without obvious complications. Clinical examinations and electroretinography did not reveal any significant abnormalities. The histological examinations showed alterations from normal anatomy in all animals; the anatomical changes in the explanted animals were relatively mild and confined to the area of the surgery. CONCLUSIONS: Successful extraction of electrode arrays from the subretinal space of rabbits can be reliably performed 2 months after implantation, which is beyond the time period when postoperative scarring would be most intense.

The impact of the investigation on deaths classified as garbage codes on the quality of the cause-of-death information in the Northeast region, Brazil. / Avaliação do impacto da investigação dos óbitos com códigos garbage na qualidade da informação sobre causas de morte no nordeste do Brasil.

OBJECTIVE: to evaluate the impact of investigation of deaths classified as garbage codes (GC) on the quality of the causes-of-death information in municipalities in the Northeast region of Brazil in 2017. METHOD: an investigation was conducted on the deaths classified as GC in 18 municipalities in the Northeast region as follows: identification of deaths with priority GC; review of medical records from health services and forensic institutes; and evaluation of the reclassification of causes of death according to the International Classification of Diseases (ICD-10) and groupings of the Global Burden of Disease 2015 (GBD 2015). RESULTS: among 18,681 deaths classified as priority GC, 7,352 (39%) were investigated and, of these, 5,160 (70%) had reclassified causes, of which 4,087 (79%) were changed to specified causes. Ill-defined causes (n = 4,392) were the most frequent among GC and those with a higher proportion of cause change (80%), and 57% were changed to specified causes. The reduction of GC contributed to the detection of a wide variety of specific causes according to groups of level 3 of the GBD 2015, being the interpersonal violence the cause that obtained the highest percentage change (11.8%). CONCLUSION: The investigation of deaths with priority GC proved to be an important strategy to specify causes of death, and it may influence the formulation, execution and evaluation of health policies.

OBJETIVO: avaliar o impacto da investigação dos óbitos classificados como causas garbage (CG) na qualidade da informação sobre causas de morte em municípios da região Nordeste do Brasil em 2017. MÉTODO: estudo avaliativo sobre a investigação dos óbitos com CG em 18 municípios do Nordeste, a partir do seguinte fluxo: identificação de óbitos com CG prioritárias; investigação em prontuários e nos laudos dos institutos de medicina legal; e avaliação da requalificação e especificação das causas de morte de acordo com a Código Internacional de Doenças e segundo grupos de causas do estudo Global Burden of Disease 2015 (GBD 2015). RESULTADOS: dentre 18.681 óbitos classificados como CG prioritárias, 7.352 (39%) foram investigados e, destes, 5.160 (70%) tiveram causas reclassificadas, das quais 4.087 (79%) para causas especificadas. As causas mal definidas (n = 4.392) foram as mais frequentes dentre as CG e as que apresentaram maior proporção de mudança de causa (80%), e 57% alteraram para causas especificadas. A redução das CG contribuiu para detecção de grande variedade de causas específicas segundo grupos do nível 3 do GBD 2015, sendo a violência interpessoal a que obteve maior mudança percentual (11,8%). CONCLUSÃO: a investigação dos óbitos com CG prioritárias revelou-se importante estratégia para especificação das causas básicas de morte, podendo influenciar diretamente na formulação, execução e avaliação das políticas de saúde.

Low Survival Rates of Oral and Oropharyngeal Squamous Cell Carcinoma.

AIM: To assess the epidemiological and clinical factors that influence the prognosis of oral and oropharyngeal squamous cell carcinoma (SCC). METHODS: One hundred and twenty-one cases of oral and oropharyngeal SCC were selected. The survival curves for each variable were estimated using the Kaplan-Meier method. The Cox regression model was applied to assess the effect of the variables on survival. RESULTS: Cancers at an advanced stage were observed in 103 patients (85.1%). Cancers on the tongue were more frequent (23.1%). The survival analysis was 59.9% in one year, 40.7% in two years, and 27.8% in 5 years. There was a significant low survival rate linked to alcohol intake (p = 0.038), advanced cancer staging (p = 0.003), and procedures without surgery (p < 0.001). When these variables were included in the Cox regression model only surgery procedures (p = 0.005) demonstrated a significant effect on survival. CONCLUSION: The findings suggest that patients who underwent surgery had a greater survival rate compared with those that did not. The low survival rates and the high percentage of patients diagnosed at advanced stages demonstrate that oral and oropharyngeal cancer patients should receive more attention.

Avaliação do impacto da investigação dos óbitos com códigos garbage na qualidade da informação sobre causas de morte no nordeste do Brasil / The impact of the investigation on deaths classified as garbage codes on the quality of the cause-of-death information in the Northeast region, Brazil

RESUMO Objetivo: avaliar o impacto da investigação dos óbitos classificados como causas garbage (CG) na qualidade da informação sobre causas de morte em municípios da região Nordeste do Brasil em 2017. Método: estudo avaliativo sobre a investigação dos óbitos com CG em 18 municípios do Nordeste, a partir do seguinte fluxo: identificação de óbitos com CG prioritárias; investigação em prontuários e nos laudos dos institutos de medicina legal; e avaliação da requalificação e especificação das causas de morte de acordo com a Código Internacional de Doenças e segundo grupos de causas do estudo Global Burden of Disease 2015 (GBD 2015). Resultados: dentre 18.681 óbitos classificados como CG prioritárias, 7.352 (39%) foram investigados e, destes, 5.160 (70%) tiveram causas reclassificadas, das quais 4.087 (79%) para causas especificadas. As causas mal definidas (n = 4.392) foram as mais frequentes dentre as CG e as que apresentaram maior proporção de mudança de causa (80%), e 57% alteraram para causas especificadas. A redução das CG contribuiu para detecção de grande variedade de causas específicas segundo grupos do nível 3 do GBD 2015, sendo a violência interpessoal a que obteve maior mudança percentual (11,8%). Conclusão: a investigação dos óbitos com CG prioritárias revelou-se importante estratégia para especificação das causas básicas de morte, podendo influenciar diretamente na formulação, execução e avaliação das políticas de saúde.

ABSTRACT Objective: to evaluate the impact of investigation of deaths classified as garbage codes (GC) on the quality of the causes-of-death information in municipalities in the Northeast region of Brazil in 2017. Method: an investigation was conducted on the deaths classified as GC in 18 municipalities in the Northeast region as follows: identification of deaths with priority GC; review of medical records from health services and forensic institutes; and evaluation of the reclassification of causes of death according to the International Classification of Diseases (ICD-10) and groupings of the Global Burden of Disease 2015 (GBD 2015). Results: among 18,681 deaths classified as priority GC, 7,352 (39%) were investigated and, of these, 5,160 (70%) had reclassified causes, of which 4,087 (79%) were changed to specified causes. Ill-defined causes (n = 4,392) were the most frequent among GC and those with a higher proportion of cause change (80%), and 57% were changed to specified causes. The reduction of GC contributed to the detection of a wide variety of specific causes according to groups of level 3 of the GBD 2015, being the interpersonal violence the cause that obtained the highest percentage change (11.8%). Conclusion: The investigation of deaths with priority GC proved to be an important strategy to specify causes of death, and it may influence the formulation, execution and evaluation of health policies.

Antibioticoprofilaxia em gestantes submetidas à cesariana / Antibiotic prophylaxis in parturients undergoing cesarean section

Objetivo: analisar o uso da antibioticoprofilaxia em gestantes submetidas à cesariana. Método: estudo transversal, realizado com 855 puérperas em maternidades. Os dados foram processados no programa EpiInfo, versão 3.2.2, e transportados para um banco de dados informatizados com a utilização do programa Microsoft Excel. Resultados: a prevalência de infecção puerperal encontrada foi de 6,8%, entretanto, verifica-se ainda que das 89,1% puérperas que fizeram uso de esquema profilático, apenas 6,1%desenvolveram infecção puerperal, prevalência menor que a encontrada entre as mulheres que não fizeram uso do esquema (13,0%) (p=0,012), demonstrando, assim, efetividade da antibioticoprofilaxia na prevenção de infecção puerperal. Conclusão: o uso da antibioticoprofilaxia reduz risco de infecção puerperal grave. A sua interrupção nas gestantes submetidas à cesariana pode aumentar as chances de morbidade grave e até mesmo de mortalidade materna.

Caracterização das mulheres que realizaram o aborto após gravidez indesejada / Characterization of women who carried out abortion after undesirable pregnancy

Objetivo: caracterizar o perfil das mulheres internadas em maternidades de referência após aborto de gravidez indesejada. Método: estudo transversal, de abordagem quantitativa, realizado com 855 puérperas em nove maternidades públicas. Os dados foram processados pelo programa Epi Info, versão 3.2.2, e transportados para um banco de dados do Microsoft Excel 2007. Resultados: com relação à saúde reprodutiva das puérperas pesquisadas, apenas 50,8% delas mencionaram a utilização de algum método contraceptivo, destacando-se os anticoncepcionais orais, com 47,4% de adesão; 73% nunca abortaram. Dentre as que abortaram, constatou-se que, em 75% delas, tal fato ocorreu uma única vez; 33,2% confirmaram ter sido induzido; e 66,8% relataram ser espontâneo. Conclusão: as mulheres que praticam o aborto são mulheres com fator socioeconômico baixo que ainda veem o aborto como forma de planejamento familiar recorrendo a essa prática quando se veem em uma situação em que a gravidez não é desejada.