Targeted nanotherapeutics for the treatment of Helicobacter pylori infection.

Helicobacter pylori infection is involved in gastric diseases such as peptic ulcer and adenocarcinoma. Approved antibiotherapies still fail in 10 to 40% of the infected patients and, in this scenario, targeted nanotherapeutics emerged as powerful allies for H. pylori eradication. Nano/microparticles conjugated with H. pylori binding molecules were developed to eliminate H. pylori by either (i) blocking essential mechanisms of infection, such as adhesion to gastric mucosa or (ii) binding and killing H. pylori through the release of drugs within the bacteria or at the site of infection. Glycan antigens (as Lewis B and sialyl-Lewis X), pectins, lectins, phosphatidylethanolamine and epithelial cell membranes were conjugated with nano/microparticles to successfully block H. pylori adhesion. Urea-coated nanoparticles were used to improve drug delivery inside bacteria through H. pylori UreI channel. Moreover, nanoparticles coated with antibodies against H. pylori and loaded with sono/photosensitizers, were promising for their application as targeted sono/photodynamic therapies. Further, non-specific H. pylori nano/microparticles, but only active in the acidic gastric environment, coated with binders to bacterial membrane, extracellular polymeric substances or to high temperature requirement A protease, were evaluated. In this review, an overview of the existing nanotherapeutics targeting H. pylori will be given and their rational, potential to counteract infection, as well as level of development will be presented and discussed.

Engineering resveratrol-loaded chitosan nanoparticles for potential use against Helicobacter pylori infection.

Helicobacter pylori (H. pylori) is a microorganism directly linked to severe clinical conditions affecting the stomach. The virulence factors and its ability to form biofilms increase resistance to conventional antibiotics, growing the need for new substances and strategies for the treatment of H. pylori infection. The trans-resveratrol (RESV), a bioactive polyphenol from natural sources, has a potential activity against this gastric pathogen. Here, Chitosan nanoparticles (NP) containing RESV (RESV-NP) were developed for H. pylori management. The RESV-NP were prepared using the ionic gelation method and characterized by Dynamic Light Scattering (DLS), Nanoparticle Tracking Analysis (NTA) and, Cryogenic Transmission Electron Microscopy (Cryo - TEM). The encapsulation efficiency (EE) and in vitro release rate of RESV were quantified using high-performance liquid chromatography (HPLC). RESV-NP performance against H. pylori was evaluated by the quantification of the minimum inhibitory/bactericidal concentrations (MIC/MBC), time to kill, alterations in H. pylori morphology in its planktonic form, effects against H. pylori biofilm and in an in vitro infection model. RESV-NP cytotoxicity was evaluated against AGS and MKN-74 cell lines and by hemolysis assay. Acute toxicity was tested using Galleria mellonella model assays. RESV-NP showed a spherical shape, size of 145.3 ± 24.7 nm, polydispersity index (PDI) of 0.28 ± 0.008, and zeta potential (ZP) of + 16.9 ± 1.81 mV in DLS, while particle concentration was 3.12 x 1011 NP/mL (NTA). RESV-NP EE was 72 %, with full release within the first 5 min. In microbiological assays, RESV-NP presented a MIC/MBC of 3.9 µg/mL, a time to kill of 24 h for complete eradication of H. pylori. At a concentration of 2xMIC (7.8 µg/mL), RESV-NP completely eradicated the H. pylori biofilm, and in an in vitro infection model, RESV-NP (4xMIC - 15.6 µg/mL) showed a significant decrease in bacterial load (1 Log10CFU/mL) when compared to the H. pylori J99 control. In addition, they did not demonstrate a toxic character at MIC concentration for both cell lines. The use of the RESV-NP with mucoadhesion profile is an interesting strategy for oral administration of substances targeting gastric disorders, linked to H. pylori infections.

Impact of Ketamine on Quality of Recovery after Laparoscopic Surgery: A Single-Centre Single-Blinded Trial Using the QoR-15 Questionnaire.

Background: The quality of recovery is a cluster of patient-related outcomes that emphasise not only pain but different physical and emotional dimensions. Traditionally, ketamine is used to improve postoperative analgesia and avoid opioid consumption and opioid-related side effects. Objective: The present study sought to evaluate if intraoperative ketamine administration (as a part of multimodal analgesia) influences the quality of recovery after laparoscopic surgery. Design: A prospective two-armed, single-blinded trial. Settings. Tertiary single-centre trial between July 2021 and January 2022. Patients. From the 146 patients initially admitted to the study, 127 patients were enrolled, 60 in the ketamine group (group K) and 67 in the control group (group NK). Intervention. Both groups received a rigid intraoperative anaesthesia protocol; furthermore, in group K, 0.5 mg/kg of the ideal body weight of ketamine was administered. Main Outcome Measures. The primary outcome was to evaluate the effect of ketamine administration on the postoperative quality of recovery using the Portuguese version of the Quality of Recovery-15 (QoR-15) Questionnaire 24 h after surgery. The total score and minimal clinically significant difference (MCID) of the QoR-15 were compared. Other variables were also assessed such as the presence of emergence delirium (ED), the Numeric Rating Scale (NRS) for pain, and the presence of postoperative nausea and vomiting (PONV). Results: A total of 127 patients were allocated to the study groups, 60 in group K and 67 in group NK. Regarding the primary outcome, no differences were found in individual categories (15 items) and in the total score of QoR-15 (p=0.214). Concerning improvement (MCID ≥ 8) or worsening (MCID ≤ 8) in quality of recovery, no difference was found between the groups (24 vs. 32 and 6 vs. 6; p=0.776). Finally, no difference was found in secondary postoperative outcomes including ED (p=0.55), NRS (p=0.401), and PONV (p=0.55). Conclusion: In this study, the administration of ketamine in laparoscopic surgery had no impact on the quality of recovery 24 h after surgery. This trial is registered with NCT03724019.

Grafting MSI-78A onto chitosan microspheres enhances its antimicrobial activity.

MSI-78A (Pexiganan A) is one of the few antimicrobial peptides (AMPs) able to kill Helicobacter pylori, a pathogenic bacterium that colonizes the gastric mucosa of half of the world's population. Antibiotics fail in 20-40% of H. pylori-infected patients, reinforcing the need for alternative treatments. Herein, a bioengineered approach was developed. MSI-78A with a C-terminal cysteine was grafted onto chitosan microspheres (AMP-ChMic) by thiol-maleimide (Michael-addition) chemistry using a long heterobifunctional spacer (NHS-PEG113-MAL). Microspheres with ∼4 µm diameter (near H. pylori length) and stable at low pH were produced by spray drying using a chitosan solution with an incomplete genipin crosslinking. A 3 × 10-5 µg AMP/microsphere grafting was estimated/confirmed by UV/Vis and FTIR spectroscopies. AMP-ChMic were bactericidal against H. pylori J99 (highly pathogenic human strain) at lower concentrations than the free peptide (∼277 µg grafted MSI-78A-SH/mL vs 512 µg free MSI-78A-SH/mL), even after pre-incubation in simulated gastric conditions with pepsin. AMP-ChMic killed H. pylori by membrane destabilization and cytoplasm release in a ratio of ∼10 bacteria/microsphere. This can be attributed to H. pylori attraction to chitosan, facilitating the interaction of grafted AMP with bacterium membrane. Overall, it was demonstrated that the peptide-microsphere conjugation chemistry did not compromise the MSI-78A antimicrobial activity, instead it boosted its bactericidal performance against H. pylori. STATEMENT OF SIGNIFICANCE: Half of the world's population is infected with Helicobacter pylori, a gastric bacterium that is responsible for 90% of non-cardia gastric cancers. Therefore, H. pylori eradication is now advocated in all infected individuals. However, available antibiotic therapies fail in up to 40% patients. Antimicrobial peptides (AMPs) are appealing alternatives to antibiotics, but their high susceptibility in vivo limits their clinical translation. AMP immobilization onto biomaterials surface will overcome this problem. Herein, we demonstrate that immobilization of MSI-78A (one of the few AMPs with activity against H. pylori) onto chitosan microspheres (AMP-ChMic) enhances its anti-H. pylori activity even at acidic pH (gastric settings). These results highlight the strong potential of AMP-ChMic as an antibiotic alternative for H. pylori eradication.

Convertirse en madre durante la adolescencia: activación del rol materno en el control prenatal / Become a mother during adolescence: activation of the maternal role during prenatal control

Introducción: Las adolescentes gestantes constituyen un grupo poblacional vulnerable, con limitación en la construcción de la identidad personal frente a la materna e imposibilidad de constitución de una familia estable que afectan su calidad de vida y la del hijo por nacer. El objetivo del artículo es dar a conocer el alcance que tiene la aplicación de una estrategia de cuidado de enfermería que promovió el cuidado integral de la adolescente gestante en la activación del rol materno durante el control prenatal. Materiales y Métodos: Este artículo es el resultado de la aplicación de una estrategia de cuidado de enfermería: programa de atención integral a la adolescente gestante durante el control prenatal, con base en la teoría de Mercer, y estructurado desde el marco lógico; la estrategia contó con la participación de diez adolescentes en gestación y el equipo interdisciplinario. Resultados: Adopción e implementación de la estrategia y apertura Institucional del centro de apoyo y cuidado para adolescentes gestantes “Creciendo Juntos”, que promovió el cuidado integral y permitió la activación del rol materno durante el control prenatal. Discusión: El convertirse en madre adolescente, no se activa sin la influencia del cuidado estructurado brindado por enfermería quien lidera el equipo de salud, quienes permiten a las gestantes, disminuir sus miedos, conocer y vivir el proceso de gestación y aprender las tareas para trascender hacia la activación del rol materno. Conclusiones: La Estrategia valida la visibilidad del cuidado sustentado en una teoría de enfermería, al dar respuesta a las necesidades humanas.

Introduction: Pregnant adolescents are a vulnerable population group, with limitations on the construction of personal identity against maternal and inability to establish a stable family that affect their quality of life and the unborn child. The objective of this article is to present the scope of the application of a strategy for nursing care that promoted the comprehensive care of pregnant adolescent activation of the maternal role during prenatal care. Materials and Methods: This article is the result of the implementation of a strategy for nursing care: comprehensive care program for pregnant adolescent during antenatal care, based on the theory of Mercer, and structured from the logical framework; the strategy counted with the participation of ten adolescent pregnancy and the interdisciplinary team. Results: Adoption and implementation of the strategy and center opening Institutional support and care for pregnant adolescents "Growing Together", which promoted the comprehensive care and allowed the activation of the maternal role during prenatal care. Discussion: Becoming a teenage mother, is not activated without the influence of careful structured provided by nurses who heads the health team, who allow pregnant women to reduce their fears, knowing and living the gestation and learn the tasks to transcend to the activation of the maternal role. Conclusions: The Strategy validates the visibility of sustained care in a nursing theory, to respond to human needs.

Dermatofibroma in a black tattoo: report of a case.

Tattooing has been associated with a variety of complications including inflammatory and granulomatous reactions, transmission of infections, and neoplasms. We report a case of a 24-year-old male who presented with a 2-month history of an erythematous nodule involving a newly made tattoo on the right leg. An excisional biopsy was performed and the histopathological evaluation was consistent with dermatofibroma. Only three cases of dermatofibroma associated with tatooing were reported in literature. We report an additional case and review the literature regarding cutaneous reactions to tattoos.

Dermatofibroma in a black tattoo: report of a case / Dermatofibroma sob pigmento preto de tatuagem: relato de um caso

Tattooing has been associated with a variety of complications including inflammatory and granulomatous reactions, transmission of infections, and neoplasms. We report a case of a 24-year-old male who presented with a 2-month history of an erythematous nodule involving a newly made tattoo on the right leg. An excisional biopsy was performed and the histopathological evaluation was consistent with dermatofibroma. Only three cases of dermatofibroma associated with tatooing were reported in litetature. We report an additional case and review the literature regarding cutaneous reactions to tattoos.

Tatuagens têm sido associadas com uma variedade de complicações incluindo reações inflamatórias e granulomatosas, transmissão de infecções e neoplasias. Relatamos um caso de homem com 24 anos de idade que apresentava há dois meses nódulo eritematoso sob pigmento preto de uma tatuagem na coxa direita. A biópsia excisional foi realizada e a avaliação histológica foi consistente com dermatofibroma. Apenas três casos da associação dermatofibroma e tatuagem foram relatados na literatura. Nós reportamos um caso adicional e revisamos a literatura sobre reações cutâneas em tatuagens.

Multiple cavitary pulmonary nodules in association with pyoderma gangrenosum: case report.

Pyoderma gangrenosum is a rare neutrophilic disease of unknown origin that is associated with systemic diseases in 50% of cases. It is characterized by erythematous-violaceous nodular lesions that quickly progress to painful ulcers, with undermined edges, necrotic-hemorrhagic, varying in size and depth, located mainly in the lower limbs. Extracutaneous locations of pyoderma gangrenosum are rare, usually involving the lungs; the main differential diagnosis in these cases is Wegener granulomatosis. We report a case of pyoderma gangrenosum, which showed multiple cavitary lung nodules, with good response to high doses of steroids. Once excluded the possibility of Wegener granulomatosis, the authors concluded that it was the manifestation of systemic pyoderma gangrenosum with pulmonary involvement.

Multiple cavitary pulmonary nodules in association with pyoderma gangrenosum: case report / Múltiplos nódulos pulmonares cavitados em associação com pioderma gangrenoso: relato de caso

Pyoderma gangrenosum is a rare neutrophilic disease of unknown origin that is associated with systemic diseases in 50% of cases. It is characterized by erythematous-violaceous nodular lesions that quickly progress to painful ulcers, with undermined edges, necrotic-hemorrhagic, varying in size and depth, located mainly in the lower limbs. Extracutaneous locations of pyoderma gangrenosum are rare, usually involving the lungs; the main differential diagnosis in these cases is Wegener granulomatosis. We report a case of pyoderma gangrenosum, which showed multiple cavitary lung nodules, with good response to high doses of steroids. Once excluded the possibility of Wegener granulomatosis, the authors concluded that it was the manifestation of systemic pyoderma gangrenosum with pulmonary involvement.

Pioderma gangrenoso é doença neutrofílica rara de etiologia desconhecida, que se associa a doenças sistêmicas em 50% dos casos. Caracteriza-se clinicamente por lesão nodular eritematoviolácea ou pústula que progride rapidamente para úlcera dolorosa, de bordas irregulares, fundo necrohemorrágico e localização preferencial nos membros inferiores. Manifestações sistêmicas do Pioderma gangrenoso são raras, envolvem geralmente os pulmões e o principal diagnóstico diferencial nestes casos é a granulomatose de Wegener. Relatamos um caso de paciente portador de pioderma gangrenoso que apresentava múltiplos nódulos pulmonares cavitados, com boa resposta a altas doses de corticoterapia. Uma vez excluída a possibilidade de granulomatose de Wegener, os autores concluíram tratar-se da manifestação sistêmica do pioderma gangrenoso.

Do you know this syndrome? Xeroderma pigmentosum (XP).

Xeroderma pigmentosum is a rare genetic disease characterized by clinical and cellular hypersensitivity to ultraviolet radiation and DNA repair defects. Patients with xeroderma pigmentosum experience sun-induced cutaneous and ocular abnormalities, including cancer. Some develop neurological disorders. We describe the case of a 2 year-old child with DeSanctis-Cacchione's syndrome, with severe neurological deterioration associated with schizencephaly. In the current clinical classification of xeroderma pigmentosum, the term is reserved for cases with severe neurological disorders linked to dwarfism and immature sexual development. The association of xeroderma pigmentosum with schizencephaly has not to date been reported in the literature.

Annular elastolytic giant cell granuloma--case report.

Annular elastolytic giant cell granuloma is a rare granulomatous skin disease characterized histologically by phagocytosis of elastic fibers by multinucleated giant cells and clinically by annular patches with elevated borders and atrophic centers found mainly on sun-exposed skin. The pathogenesis of the disease is controversial. We report the case of a 44-year-old woman with classical clinical and histological findings of the disease whose condition improved when hydroxychloroquine was administered over a four-week period.

Granuloma anular elastolítico gigantocelular: relato de caso / Annular elastolytic giant cell granuloma: case report

O granuloma anular elastolítico gigantocelular é dermatose granulomatosa rara, caracterizada, histologicamente, por fagocitose das fibras elásticas por células gigantes multinucleadas e, clinicamente, por placas anulares com bordas elevadas e centro atrófico, com preferência por áreas expostas. A patogênese é controversa. Descreve-se um caso de mulher de 44 anos, com achados clínicos e histológicos clássicos, que apresentou boa resposta à hidroxicloroquina, após o período de 1 mês.

Annular elastolytic giant cell granuloma is a rare granulomatous skin disease characterized histologically by phagocytosis of elastic fibers by multinucleated giant cells and clinically by annular patches with elevated borders and atrophic centers found mainly on sun-exposed skin. The pathogenesis of the disease is controversial. We report the case of a 44-year-old woman with classical clinical and histological findings of the disease whose condition improved when hydroxychloroquine was administered over a four-week period.

Cambios de comportamiento, uso y beneficios de un programa comunitario para la promoción de la actividad física / Behavioral changes, used and benefits of a community program for the promotion in physical activity / Mudanças de comportamento, uso e benefícios de um programa comunitário para a promoção da atividade física

Objetivo: Determinar el cambio de comportamiento frente a la actividad física y las características relacionadas con el uso y los beneficios del Centro Local de Actividad Física (CLAF), en la población de la localidad de Santa Fe de la ciudad de Bogotá. Materiales y métodos: Se realizó un estudio longitudinal de antes y después, donde se evaluó, al ingreso y a los tres meses de estar en el programa de intervención en actividad física del CLAF, el cambio de comportamiento frente a la actividad física de los usuarios. Los criterios de inclusión fueron: ser usuario activo del CLAF, tener edad de entre 15 y 65 años y manifestar voluntariamente su participación en el estudio. El criterio de exclusión era: diligenciamiento incompleto de los instrumentos de medición utilizados. Del marco muestral del usuarios del CLAF, se seleccionaron n= 55 sujetos que cumplieron los criterios de selección. Para la recolección de la información se diseñó un cuestionario que contenía los estadios de cambio de comportamiento frente a la actividad física; también se realizó una encuesta semiestructurada donde se determinaron características acerca de los beneficios y uso del CLAF. Resultados: El total de los participantes del estudio fue n= 55, el promedio de edad fue 40.4 ± 15.3 años, con una mínima de 15 y una máxima de 64 años; el 83.6% fueron mujeres. El 78.2% desconoce el propósito del Centro Local de Actividad Física. La estrategia de divulgación que más llegó al grupo fue la de tipo verbal con un 58.2%. El tiempo de vinculación al CLAF de más frecuencia en el grupo evaluado fue de 1 a 6 meses, con un 36.4%. La motivación para asistir regularmente al CLAF, en la mayoría, fue la de mejorar la salud física y/o mental, con un 74.5%. El 89.1% estaría dispuesto a recomendar a otras personas el uso del CLAF. Un 81.8% de la población realizaba actividad física por más de 150 min/semana a intensidad moderada. Post intervención del CLAF, en los sujetos del estudio se evidenciaron cambios significativos en el nivel de actividad física (p<0.001, Test de Wilcoxon) y en el estado de comportamiento (p<0.001, Test de Wilcoxon).

Objective: To determine the change of behavior in physical activity and the characteristics associated with the use and benefits of Local Physical Activity Center (CLAF) in the population of the town of Santa Fe de Bogota. Materials and methods: We conducted a longitudinal study before and after, which was assessed at admission and 3 months in the intervention program CLAF physical activity, behavior change compared to the physical activity of users. Inclusion criteria: were being active user of CLAF, aged between 15 and 65 years and voluntarily express their participation in the study. Exclusion criteria: Fill incomplete measurement instruments used. The sampling frame of CLAF users, we selected n=55 subjects. To gather information, a questionnaire, which contained the behavioral stages of change, also conducted a survey which determined semistructured features about the benefits and use of CLAF. Results: The total study participants was n = 55, mean age was 40.4 ± 15.3 years, with a minimum 15 and maximum of 64 years, 83.6% were women. 78.2% do not know the purpose of the Local Centre for Physical Activity. The outreach strategy that most came to the group was 58.2 with a verbal type. The time for links to CLAF more frequently in the group evaluated was 1 to 6 months 36.4. The motivation to regularly attend the CLAF in the majority was to improve the physical and / or a 74.5% mental. 89.1% would be willing to recommend to others the use of CLAF. A 81.8% of the population physical activity performed by more than 150 min / wk at moderate intensity; Post CLAF intervention in the subjects showed positive changes in the level of physical activity (p<0.001, Test de Wilcoxon) and behavioral state (p<0.001, Test de Wilcoxon).

Objetivo: Determinar a mudança de comportamento frente á atividade física e as características relacionadas com o uso e os benefícios do Centro Local de Atividade Física (CLAF), na população da localidade de Santa Fe da cidade de Bogotá. Materiais e métodos: Realizou-se um estudo longitudinal de antes e depois, onde se avaliou, ao ingresso e aos três meses de estar no programa de intervenção em atividade física do CLAF, a mudança de comportamento a atividade física dos usuários. Os critérios de inclusão foram: ser usuário ativo do CLAF, ter idade entre 15 e 65 anos, e manifestar voluntariamente sua participação no estudo. O critério de exclusão era: preenchimento incompleto dos instrumentos de medição utilizados. Da base de amostragem dos usuários do CLAF, se selecionaram n= 55 sujeitos que cumpriram os critérios de seleção. Para a colheita da informação desenho-se um questionário que continha os estádios de mudança de comportamento frente á atividade física; também se realizou uma enquete semi-estruturada onde se determinaram características com respeito aos benefícios e uso do CLAF. Resultados: O total dos participantes do estudo foi n= 55, a média de idade foi 40.4 ± 15.3 anos, com uma mínima de 15 e uma máxima de 64 anos; o 83,6% foram mulheres. O 78,2% desconhece o propósito do Centro Local de Atividade Física. A estratégia de divulgação que funcionou com o grupo foi a de tipo verbal com um 58,2%. O tempo de vinculação ao CLAF de maior freqüência no grupo avaliado foi de 1 a 6 meses, com um 36,4%. A motivação para assistir regularmente ao CLAF, na maioria, foi a de melhorar a saúde física e/ou mental, com um 74,5%. O 89,1% estaria disposto a recomendar a outras pessoas o uso do CLAF. Um 81,8% da população realizava atividade física por mais de 150 min./semana a intensidade moderada. Pós-ão do CLAF, nos sujeitos de estudo se evidenciaram mudanças significativas no nível de atividade física (p<0.001, Test de Wilcoxon) e no estado de comportamento (p<0.001, Test de Wilcoxon).

[Development of a laminar bioadsorbent with hypertolerant Phanerochaete chrysosporium to Cd, Ni and Pb for wastewater treatment]. / Desarrollo de un bioadsorbente laminar con Phanerochaete chrysosporium hipertolerante al cadmio, al níquel y al plomo para el tratamiento de aguas.

BACKGROUND: The use of basidiomycetes for metal removal is an alternative to traditional methods. In this, the biomass acts as a natural ionic exchanger removing metals from solution. OBJECTIVE: To develop a laminar biosorbent using a basidiomycete fungus resistant to high Cd, Ni and Pb concentrations. METHODS: The tolerance of Trametes versicolor, Pleurotus ostreatus and Phanerochaete chrysosporium was evaluated using increasing concentrations of the heavy metal salts, cadmium sulphate, lead acetate and nickel chloride. A biosorbent system was developed based on polyethylene sheets with a fungal biomass. It was evaluated in bubble columns using synthetic wastewater with the 3 metal salts at a rate of 300 mg/l. Finally, in a complementary experiment using shake flasks, the effect of a higher amount of biomass related to the metal removal efficiency was evaluated. RESULTS: P. chrysosporium strain was more tolerant to C4H6O4Pb (10,000mg/l), Cl2Ni (300mg/l) and CdSO4·8H2O (1,500 mg/l). In a reactor, under non-ligninolytic conditions, the fungus removed 69% of the chemical oxygen demand and produced enzymes such as LiP (0.01 U/l) and MnP (0.6 U/l.). An accumulation of metals in the wall was observed. By increasing the biomass to 1.6 (w/v), the metal biosorption was favored in the mixture (57% Pb, 74% Cd, and 98% Ni) and separately (95% Pb, 60% Cd, and 56% Ni). Competition between Ni and Pb by ligands of the wall was observed. CONCLUSION: A novel laminar system based on P. chrysosporium viable biomass was developed. It has a large surface area and tolerance to high concentrations of Cd, Ni and Pb. It seems to be an alternative for the removal of metals from water.

Interrelationship between MYC gene numerical aberrations and protein expression in individuals from northern Brazil with early gastric adenocarcinoma.

Gastric cancer is the second leading cause of death by cancer in Brazil. Early gastric cancer represents approximately 10% of gastric cancer cases in some services of Brazil, which underscores the need for early gastric cancer diagnosis that could lead to better prognosis. There are few published studies of cytogenetic alterations in early gastric cancer. To evaluate MYC copy number and its protein expression, we performed fluorescence in situ hybridization and immunohistochemical analyses in five early gastric adenocarcinomas in individuals from northern Brazil. Three signals of MYC and MYC immunoreactivity were observed in all five samples, regardless of histologic type, tumor extension, or lymph nodal status. These novel findings concerning MYC copy number alteration in early gastric cancer suggest that MYC alteration is observed in the beginning of gastric carcinogenesis and could be used as a therapeutic target.

Crianças em perigo: o papel das Comissões de Proteção de Menores em Portugal / Children at risk: the role of Commissions for the Protection of Minors in Portugal

Since children have been acknowledged as an autonomous social group, it has become necessary to create adequate laws to protect their fundamental rights, including the right to education, health, and affection. However, despite significant progress for childhood worldwide, children's fundamental rights are still not ensured. It is thus important to reflect on the way laws for the protection of children have developed, analyzing their original objectives and principles and the means used in their enforcement. This article discusses the role of the Commissions for the Protection of Minors at Social Risk in Portugal.