Immunoexpression of PD-L1, CD4+ and CD8+ cell infiltrates and tumor-infiltrating lymphocytes (TILs) in the microenvironment of actinic cheilitis and lower lip squamous cell carcinoma.

OBJECTIVE: Lower lip squamous cell carcinomas (LLSCC) could be associated with a previous history of potentially malignant oral diseases (PMOD), especially actinic cheilitis (AC), with high sun exposure being a well-described risk factor. Immune evasion mechanisms, such as the PD-1/PD-L1 (programmed cell death protein 1/programmed death-ligand 1) pathway has been gaining prominence since immunotherapy with immune checkpoint inhibitors showed a positive effect on the survival of patients with different types of neoplasms. Concomitant with the characterization of the tumor microenvironment, the expression of either or both PD-1 and PD-L1 molecules may estimate mutual relations of progression or regression of the carcinoma and prognostic values of the patient.Considering the importance of tumor microenvironment characterization, this study aims to determine the immunoexpression of PD-L1 and correlate with the frequency of CD4+ and CD8+ cells in AC and LLSCC lesions and with tumor-infiltrating lymphocytes (TILs) in LLSCC and its relationship with histopathological characteristics. METHODOLOGY: This sample includes 33 cases of AC and 17 cases of LLSCC. The cases were submitted to histopathological analysis and to CD4+, CD8+, and PD-L1+ cell determination by immunohistochemistry. RESULTS: There was a significant difference among the frequencies of CD4+, CD8+, and PD-L1+ cells between AC and LSCC cases, higher in the last group. Moreover, histopathological and atypical changes in AC and LLSCC were correlated with the frequencies of PD-L1+, CD4+, and CD8+ cells. In AC, PD-L1+ cases had a low frequency of CD4+ cells, but on the other hand, PD-L1+ cases of LLSCC had a higher frequency of CD4+ and CD8+ cells. CONCLUSION: Therefore, the PD-L1 molecule may be a potential escape route for the immune response in oral lesions, but the mechanisms differ between AC and LLSCC. Future studies related to immune evasion and immunotherapy in oral lesions should consider the analysis of inflammatory infiltrate and TILs.

Immunoexpression of PD-L1, CD4+ and CD8+ cell infiltrates and tumor-infiltrating lymphocytes (TILs) in the microenvironment of actinic cheilitis and lower lip squamous cell carcinoma

Abstract Lower lip squamous cell carcinomas (LLSCC) could be associated with a previous history of potentially malignant oral diseases (PMOD), especially actinic cheilitis (AC), with high sun exposure being a well-described risk factor. Immune evasion mechanisms, such as the PD-1/PD-L1 (programmed cell death protein 1/programmed death-ligand 1) pathway has been gaining prominence since immunotherapy with immune checkpoint inhibitors showed a positive effect on the survival of patients with different types of neoplasms. Concomitant with the characterization of the tumor microenvironment, the expression of either or both PD-1 and PD-L1 molecules may estimate mutual relations of progression or regression of the carcinoma and prognostic values of the patient. Objective: Considering the importance of tumor microenvironment characterization, this study aims to determine the immunoexpression of PD-L1 and correlate with the frequency of CD4+ and CD8+ cells in AC and LLSCC lesions and with tumor-infiltrating lymphocytes (TILs) in LLSCC and its relationship with histopathological characteristics. Methodology: This sample includes 33 cases of AC and 17 cases of LLSCC. The cases were submitted to histopathological analysis and to CD4+, CD8+, and PD-L1+ cell determination by immunohistochemistry. Results: There was a significant difference among the frequencies of CD4+, CD8+, and PD-L1+ cells between AC and LSCC cases, higher in the last group. Moreover, histopathological and atypical changes in AC and LLSCC were correlated with the frequencies of PD-L1+, CD4+, and CD8+ cells. In AC, PD-L1+ cases had a low frequency of CD4+ cells, but on the other hand, PD-L1+ cases of LLSCC had a higher frequency of CD4+ and CD8+ cells. Conclusion: Therefore, the PD-L1 molecule may be a potential escape route for the immune response in oral lesions, but the mechanisms differ between AC and LLSCC. Future studies related to immune evasion and immunotherapy in oral lesions should consider the analysis of inflammatory infiltrate and TILs.

Alkaloid and phenolic compounds of Xylopia aromatica inhibits tumor growth by down-regulating matrix metalloproteinase-2 (MMP-2) expression.

Annonacea species have been reported to possess antitumor properties. However, the in vitro and in vivo antitumor activities of Xylopia aromatica (Annonacea) have not yet been elucidated. This study aimed to investigate the effects of Xylopia aromatica leaves hexane fraction (XaHF) on Ehrlich ascites carcinoma cells lines (EAC), both in vitro and in vivo. In vitro assays revealed a significant cytotoxic effect with the two lower XaHF concentrations (62.5 and 32.3mg/mL). EAC (2.5x106 cells) were inoculated in the right flank of Swiss mice, and the animals were treated intraperitoneally with 32.3mg kg-1 of XaHF daily, for 20 days. Our findings indicate that XaHF suppressed the growth of EAC in vivo, with a significant decrease (46%) in tumor volume. There was also a decrease in the necrosis area (71%), inflammatory infiltrate, and MMP-2 expression. High-Performance Liquid Chromatography with Diode Array Detector (HPLC-DAD) identified secondary metabolites possibly related to phenolic acids, flavonoids, and alkaloids. Thus, the results confirmed the antitumoral activity that may be related to the presence of the identified metabolites in XaHF extract.

Matteucinol, isolated from Miconia chamissois, induces apoptosis in human glioblastoma lines via the intrinsic pathway and inhibits angiogenesis and tumor growth in vivo.

Gliomas account for nearly 70% of the central nervous system tumors and present a median survival of approximately 12-17 months. Studies have shown that administration of novel natural antineoplastic agents is been highly effective for treating gliomas. This study was conducted to investigate the antitumor potential (in vitro and in vivo) of Miconia chamissois Naudin for treating glioblastomas. We investigated the cytotoxicity of the chloroform partition and its sub-fraction in glioblastoma cell lines (GAMG and U251MG) and one normal cell line of astrocytes. The fraction showed cytotoxicity and was selective for tumor cells. Characterization of this fraction revealed a single compound, Matteucinol, which was first identified in the species M. chamissois. Matteucinol promoted cell death via intrinsic apoptosis in the adult glioblastoma lines. In addition, Matteucinol significantly reduced the migration, invasion, and clonogenicity of the tumor cells. Notably, it also reduced tumor growth and angiogenesis in vivo. Moreover, this agent showed synergistic effects with temozolomide, a chemotherapeutic agent commonly used in clinical practice. Our study demonstrates that Matteucinol from M chamissois is a promising compound for the treatment of glioblastomas and may be used along with the existing chemotherapeutic agents for more effective treatment.

WIN55,212-2 induces caspase-independent apoptosis on human glioblastoma cells by regulating HSP70, p53 and Cathepsin D.

Despite the standard approaches to treat the highly aggressive and invasive glioblastoma (GBM), it remains incurable. In this sense, cannabinoids highlight as a promising tool, because this tumor overexpresses CB1 and/or CB2 receptors and being, therefore, can be susceptible to cannabinoids treatment. Thus, this work investigated the action of the cannabinoid agonist WIN55-212-2 on GBM cell lines and non-malignant cell lines, in vitro and in vivo. WIN was selectively cytotoxic to GBM cells. These presented blebbing and nuclear alterations in addition to cell shrinkage and chromatin condensation. WIN also significantly inhibited the migration of GAMG and U251 cells. Finally, the data also showed that the antitumor effects of WIN are exerted, at least to some extent, by the expression of p53 and increased cathepsin D in addition to the decreased expression of HSP70.This data can indicate caspase-independent cell death mechanism. In addition, WIN decreased tumoral perimeter as well as caused a reduction the blood vessels in this area, without causing lysis, hemorrhage or blood clotting. So, the findings herein presented reinforce the usefulness of cannabinoids as a candidate for further evaluation in treatment in glioblastoma treatment.

Reduced CD8+ T cells infiltration can be associated to a malignant transformation in potentially malignant oral epithelial lesions.

OBJECTIVE: The aim of this study was to evaluate the immunohistochemical expressions of PD1, CD4+, and CD8+ in premalignant lesions (OPML) that were transformed into oral squamous cell carcinoma OSCC (OPML-OSCC), in OSCC and also in premalignant lesions that were not transformed into OSCC (OPML-NOSSC). MATERIALS AND METHODS: Retrospective analyses were performed in order to verify the demographic characteristics of the patients. CD4, CD8, and PD1 IMH studies were carried out on OPML and OSCC samples from 11 patients with OPML-OSCC and OPML, together with samples from 14 patients with OPML-NOSCC. The differences between OPML-OSCC and OPML-NOSCC were analyzed. RESULTS: Non-homogenous leukoplakia, together with the related oral subsite, and the lack of an exposure to tobacco, were all associated with malignant transformations. There were no statistical differences in the PD1 expression and the CD4+ cells in OPML-OSCC and OPML-NOSCC. A significant increment in the CD8+ cells was noted in the OPML that evolved into carcinomas when compared with OPML-NOSCC (p = 0.05), whereas there were higher CD8+ cells levels in the carcinomas when compared with the OPML that evolved into carcinomas (p = 0.027). CONCLUSIONS: CD8+ cells infiltrate more in OPML-NOSCC than in OPML-OSCC. Carcinoma is more infiltrated by CD8+ cells than its associated OPML. CLINICAL RELEVANCE: Understanding immunological factors associated with malignant transformation of oral premalignant lesions can open a new way to treat this disease.

Adesão de pacientes ao tratamento com antineoplásicos orais: fatores influentes / Adhesión de pacientes al tratamiento con antineoplásicos orales: factores influyentes / Adherence of patients to oral antineoplastic therapy: influential factors

Objetivo avaliar a adesão de pacientes aos tratamentos antineoplásicos orais e identificar os fatores que a influenciam. Método estudo quantitativo, prospectivo, de delineamento não experimental, realizado entre julho de 2013 e janeiro de 2014, em um hospital oncológico no interior do estado de Minas Gerais, Brasil. Os instrumentos utilizados foram: questionário sociodemográfico e clínico, escala Medida de Adesão ao Tratamento e Questionário dos Fatores que podem Influenciar a Adesão ao Tratamento. Os dados foram submetidos a estatística descritiva e testes de correlação entre variáveis. Resultados a média de adesão foi de 6,02 ± 0,8 pontos, e seis (4,9%) pacientes se mostraram não aderentes ao tratamento. Os fatores que mais dificultaram a adesão foram: dificuldade para a aquisição do antineoplásico (36,1%) e utilização de muitos medicamentos (14,8%). Conclusão a taxa de adesão ao uso de antineoplásicos orais é alta, entretanto ainda há muitos fatores que dificultam a adesão e a continuidade do tratamento.

Objetivo evaluar la adhesión de pacientes a los tratamientos antineoplásicos orales e identificar los factores que la influyen. Método estudio cuantitativo, prospectivo, de delineado no experimental, realizado entre julio de 2013 y enero de 2014 en hospital oncológico del interior de Minas Gerais, Brasil. Se utilizaron cuestionario sociodemográfico y clínico, escala Medida de Adhesión al Tratamiento y Cuestionario de Factores que pueden influir en la Adhesión al tratamiento. Los datos fueron sometidos a estadística descriptiva y tests de correlación entre variables. Resultados la media de adhesión fue de 6,02 ± 0,8 puntos, y seis (4,9%) pacientes no adhirieron al tratamiento. Los factores que más dificultaron la adhesión fueron: dificultado para adquirir el antineoplásico (36,1%) y utilización de muchos medicamentos (14,8%). Conclusión la tasa de adhesión al uso de antineoplásicos orales es alta, aunque aún existen numerosos factores que dificultan la adhesión y la continuidad del tratamiento.

Objective to evaluate the adherence of patients to oral antineoplastic therapy and identify the factors influencing it. Method quantitative and prospective study with non-experimental design carried out between July 2013 and January 2014 in an oncology hospital in the state of Minas Gerais, Brazil. The instruments used were: questionnaire for socio-demographic and clinical variables, the Therapy Adherence Measurement scale and the Questionnaire on Factors Influencing Medication Adherence. Data were submitted to descriptive statistics and to correlation tests. Results the mean adherence was 6.02 ± 0.8 points and six (4.9%) patients showed to be non-adherent to treatment. The most frequent factors hindering adherence were: difficulty in acquiring the antineoplastic drug (36.1%) and use of many drugs (14.8%). Conclusion the rate of adherence to oral antineoplastic therapy is high, but there are still many factors that hinder adherence and the continuity of care.

Partial laryngectomy in glottic cancer: complications and oncological results / Laringectomia parcial no câncer glótico: complicações e resultados oncológicos

ABSTRACT INTRODUCTION: Most patients with laryngeal carcinoma present tumors in the glottis that can be treated by different treatment modalities. Some authors consider open partial laryngectomy as obsolete, while others still deem this as a viable and cost-efficient option. OBJECTIVES: To compare the oncological and functional results of a series of patients undergoing partial laryngectomy vs. external radiotherapy for the treatment of glottic cancer. METHODS: Historical cohort study with a series of glottic carcinoma patients undergoing partial laryngectomy or external radiotherapy during a period of ten years. RESULTS: Sixty-two patients with glottic carcinoma were included. Group A comprised those submitted to partial laryngectomy (n = 30), and Group B, those who underwent radiotherapy (n = 32). They were homogeneous in the comparison of mean age, 56.4 vs. 60.4 years (p = 0.12) and distribution in pathological stage (p = 0.91). With regard to oncological outcome, there were no differences in distant metastasis rates, or second primary tumor between groups (p = 1.0), as well as in disease-free time, laryngeal rescue-free time, and overall five-year survival. Severe complication rates were also similar between groups. CONCLUSION: Open partial laryngectomy had complication rates and oncological results similar to those of radiotherapy for patients with glottic carcinomas and should still be considered among the main available therapeutic options.

Resumo Introdução: A maioria dos pacientes com carcinoma de laringe apresentam tumores na região glótica suscetíveis a diferentes modalidades de tratamento. Alguns autores consideram a laringectomia parcial aberta em desuso enquanto outros ainda a indicam como uma opção viável e custo eficiente. Objetivos: Comparar os resultados oncológicos e funcionais de uma série de pacientes submetidos à laringectomia parcial versus radioterapia externa para o tratamento do câncer glótico. Método: Estudo tipo coorte histórica com uma série de pacientes com carcinoma glótico submetidos à laringectomia parcial ou radioterapia externa em período de 10 anos. Resultados: Foram incluídos 62 pacientes com carcinoma glótico distribuídos em Grupo A: submetido à laringectomia parcial (n = 30) e Grupo B submetido a radioterapia (n = 32) que se mostraram homogêneos na comparação de média de idade de 56,4 vs. 60,4 (p = 0,12) e distribuição em estadios patológicos (p = 0,91). Com relação ao desfecho oncológico, não foram observadas diferenças nas taxas de metástase à distancia, ou segundo primário entre os grupos (p = 1,0) assim como no tempo livre de doença, tempo livre de resgate laríngeo e sobrevida geral em 5 anos. As taxas de complicações severas também foram semelhantes entre os grupos. Conclusão: A laringectomia parcial aberta apresentou taxas de complicações e resultados oncológicos semelhante àqueles do tratamento radioterápico para pacientes com carcinomas glóticos e ainda deve ser considera entre as principais opções terapêuticas disponíveis.

Partial laryngectomy in glottic cancer: complications and oncological results.

INTRODUCTION: Most patients with laryngeal carcinoma present tumors in the glottis that can be treated by different treatment modalities. Some authors consider open partial laryngectomy as obsolete, while others still deem this as a viable and cost-efficient option. OBJECTIVES: To compare the oncological and functional results of a series of patients undergoing partial laryngectomy vs. external radiotherapy for the treatment of glottic cancer. METHODS: Historical cohort study with a series of glottic carcinoma patients undergoing partial laryngectomy or external radiotherapy during a period of ten years. RESULTS: Sixty-two patients with glottic carcinoma were included. Group A comprised those submitted to partial laryngectomy (n=30), and Group B, those who underwent radiotherapy (n=32). They were homogeneous in the comparison of mean age, 56.4 vs. 60.4 years (p=0.12) and distribution in pathological stage (p=0.91). With regard to oncological outcome, there were no differences in distant metastasis rates, or second primary tumor between groups (p=1.0), as well as in disease-free time, laryngeal rescue-free time, and overall five-year survival. Severe complication rates were also similar between groups. CONCLUSION: Open partial laryngectomy had complication rates and oncological results similar to those of radiotherapy for patients with glottic carcinomas and should still be considered among the main available therapeutic options.

Increase in perceived stress is correlated to lower heart rate variability in healthy young subjects / Aumento no estresse percebido correlaciona-se com diminuição da variabilidade da frequência cardíaca em indivíduos jovens saudáveis

Emotional stress is a risk factor for cardiovascular disease. Decreased heart rate variability (HRV) is associated to increased mortality rates in certain heart diseases. Current study assessed the co-relation between perceived stress and HRV parameters. The correlation between psychological stress, measured by the perceived stress scale (PSS-14), and HRV parameters obtained during 5 min. at rest was evaluated. Data from 35 healthy young volunteers demonstrated a significant correlation between PSS-14 scores and Low Frequency-LF (ms2) by frequency domain HRV analysis. Other variables such as High Frequency and Standard Deviation of R-R intervals had also negative coefficients but did not have any significant correlation with PSS-14. No correlation between PSS-14 and sympathovagal balance parameters was found. Data interpretation demonstrated that increase in perceived stress was correlated to decrease in heart rate variability, which may point out an important mechanism in cardiovascular pathophysiology that should be further investigated.

O estresse emocional é um fator de risco para doença cardiovascular. A diminuição da Variabilidade da Frequência Cardíaca (VFC) está associada ao aumento da mortalidade em algumas doenças cardíacas. Este estudo teve como objetivo avaliar a correlação entre o estresse percebido e os parâmetros da VFC. Dessa maneira, avaliou-se a correlação existente entre o estresse psicológico mensurado através da escala de estresse percebido (PSS -14) e parâmetros de VFC obtidos durante 5 min. ao repouso. Dados de 35 voluntários jovens e saudáveis demonstraram uma correlação significativa do PSS-14 com os valores de baixa freqüência- LF (ms²) na análise da VFC no domínio frequência. Outras variáveis, tais como alta freqüência e desvio padrão dos intervalos RR, também tiveram coeficientes negativos, mas não se correlacionaram com a PSS-14. Nenhuma correlação entre o PSS-14 e os parâmetros do balanço simpato-vagal foi encontrada. Portanto, a interpretação dos dados demonstra que o aumento no estresse percebido se correlacionou com a diminuição da variabilidade da frequência cardíaca, o que pode ser indicativo de um mecanismo importante na fisiopatologia cardiovascular que deve ser melhor investigado.

Identification of peripheral arterial disease in diabetic patients and its association with quality of life, physical activity and body composition / Identificação de doença arterial obstrutiva periférica e sua associação com a qualidade de vida, a atividade física e a composição corporal em pacientes diabéticos

Diabetes mellitus (DM) is a risk factor for peripheral arterial disease (PAD). Neither the prevalence of PAD in type 2 (T2) DM nor its detrimental effects on quality of life (QoL) or physical activity (PA) have been well described in the Brazilian population. OBJECTIVES: To evaluate the prevalence of newly diagnosed PAD and its associations with QoL, PA and body composition in a sample of T2DM patients from a University Hospital. METHODS: Seventy-three (73) T2DM patients without previous diagnoses of major complications related to T2DM were enrolled. PAD was assessed using the ankle-brachial index (ABI); QoL was measured using a translated and validated SF-36 questionnaire; PA was measured using a modified Baecke questionnaire; and body composition was measured by segmental multi-frequency bioelectrical impedance. RESULTS: PAD prevalence was 13.7%, predominantly of mild severity (ABI between 0.8-0.9). The ABI results correlated with age (ρ=-0.26, P=0.03), DM duration (ρ=-0.28, P=0.02) and systolic and diastolic blood pressure (ρ=-0.33, P=0.007 and ρ=-0.28, P=0.02; respectively). Scores for the SF-36 physical component summary (PCS) were below the normal range, but no negative impact from PAD was identified by the PCS scores (normal-ABI 42.9±11.2 vs. PAD-ABI 38.12±11.07) or the Baecke PA results. Body composition analysis detected excessive body fat, especially in women, but there was no difference between groups. CONCLUSIONS: The prevalence of previously undiagnosed PAD in this population of T2DM patients was 13.7%, predominantly mild and asymptomatic forms, and was not yet associated with worsened QoL, PA levels or body composition variables...

O Diabetes Mellitus (DM) é fator de risco para a doença arterial obstrutiva periférica (DAOP). A prevalência de DAOP no DM tipo 2 (T2) e o prejuízo adicional causado por esta na qualidade de vida (QoL) e na atividade física (AF) não são bem descritos na população brasileira. OBJETIVOS: Avaliar a prevalência e a associação da DAOP recém-diagnosticada com a QoL, a AF e a composição corporal em pacientes T2DM provenientes de um hospital universitário. MÉTODOS: Setenta e três pacientes T2DM, sem complicações maiores relacionadas ao T2DM, foram incluídos. A DAOP foi avaliada pelo índice tornozelo-braquial (ITB); a QoL, pelo questionário traduzido e validado SF-36, e a AF, pelo questionário modificado de Baecke. A composição corporal foi avaliada pela impedância bioelétrica segmentar multifrequencial. RESULTADOS: A prevalência de DAOP foi 13,7%, predominantemente de severidade leve (ITB entre 0,8-0,9). O ITB correlacionou-se com a idade (ρ= -0,26; P= 0,03), a duração do DM (ρ=-0,28; P=0,02) e a pressão arterial sistólica e diastólica (ρ= -0,33; P= 0,007 e ρ= -0,28; P= 0,02; respectivamente). O sumário de saúde física (PCS) do questionário SF-36 estava abaixo da variação normal; contudo, nenhum impacto negativo da DAOP foi identificado no PCS (ABI normal = 42,9±11,2 vs. ABI-DAOP = 38,12±11,07) ou no nível de AF. A análise da composição corporal demonstrou gordura corporal excessiva, especialmente em mulheres; contudo, sem diferenças entre grupos. CONCLUSÃO: A prevalência de DAOP sem diagnóstico prévio nesta amostra de pacientes T2DM foi de 13,7%, predominantemente assintomática e leve, e ainda não associada com piores índices de QoL, nível de AF e composição corporal...

Effects of digoxin and Na, K-ATPase immunoexpression on human oral squamous carcinomas.

AIM: The present study evaluated the expression of α1 and ß1 Na,K-ATPase, as well as the effects of digoxin (DGX) on oral squamous cell carcinomas (OSCCs). PATIENTS AND METHODS: Immunohistochemical expression of α1 and ß1 Na,K-ATPase were evaluated in 60 patients who underwent treatment at the São João de Deus Hospital. SCC-25 viability was assessed by the colorimetric assay. Chi-square or Fisher's exact tests were used to analyze the association of α1 and ß1 Na,K-ATPase expression with the variables. RESULTS: Immunoexpression of α1 and ß1 Na,K-ATPase were observed in 28% and 55% of the tumors, however these proteins were not significant prognostic factors. Tobacco was significantly associated with α1 expression. SCC-25 viability decreased significantly after treatment with 1 µM DGX at 24 h. CONCLUSION: The smoking status of OSCC patients was significantly associated with α1 expression and DGX affected the SCC-25 viability in a dose- and duration-dependent manner.

Perfil sociodemográfico e clínico das participantes de um curso para gestantes / Socio-demographic and clinical profiles of participants in a course for pregnant women

O objetivo deste estudo foi identificar a clientela assistida em um Curso para Gestantes e observar a qualidade de vida dessas mulheres. Estudo descritivo no qual foi aplicado um questionário semiestruturado, abordando os aspectos socioeconômicos e culturais, bem como o protocolo Medical Outcomes Study 36-item Short-form Health Survey (SF-36) para a análise da qualidade de vida. O grupo de participantes constou de 41 gestantes com idades entre 19 e 38 anos, em sua maioria primigestas (95%), casadas (85,4%), empregadas (70,7%) e sedentárias (80,5%), com idade gestacional média de 21 semanas e nível superior de escolaridade (65,9%) e estado nutricional adequado (58,6%). A amostra apresentou média acima do escore médio do protocolo SF-36, com exceção do domínio aspectos físicos (46,95 ±37,58). Em relação à população feminina geral, considerada em outros estudos, as participantes também apresentaram pontuação média significativamente maior em seis dos oito domínios: saúde geral (81,21±16,45), capacidade funcional (66,09±21,98), aspectos emocionais (67,47±43,13), dor (63,58 ±24,30), função social (76,52 ±18,37) e saúde mental (71,70 ±14,32). As mulheres que procuram o Curso para Gestantes são, em sua grande maioria, adultas, casadas, com nível superior de escolaridade, empregadas e relatam renda familiar alta. Apresentam escores de qualidade de vida acima da população feminina em geral, com exceção dos domínios aspectos físicos e vitalidade, que parecem estar comprometidos nesse período.

Identify the clients assisted in a course for pregnant women and observe the quality of life of these women. A descriptive study in which a semi-structured questionnaire was applied, addressing socio-economic and cultural aspects, as well as the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36) protocol for analyzing quality of life. The participants were 41 pregnant women with ages between 19 and 38 years, mostly primigravida (95%), married (85,4%), employed (70,7%), and sedentary (80,5%), with a mean gestational age of 21 weeks and a higher education level (65,9%), and an adequate nutritional status (58,6%). The sample presented a mean above the SF-36 protocol mean score, except for the physical aspects domain (46.95 ±37.58). With respect to the general female population, seen in other studies, the participants also had a significantly higher average score in six of eight domains: general health (81.21 ±16.45), functional capacity (66.09 ± 21.98), emotional aspects (67.47 ± 43.13), pain (63.58 ± 24.30), social functioning (76.52 ± 18.37), and mental health (71.70 ± 14.32). The women who seek the Course for Pregnant Women are mostly adults, married, with a college education, employed, and report high family income. They present quality of life scores above the general female population, with the exception of the physical aspects and vitality domains, which appear to be impaired during this period.

Padrão de uso de álcool e outras drogas por trabalhadores de obras públicas / Pattern of use of alcohol and other drugs by construction workers hired by a municipality in Minas Gerais, Brazil / Patrón de consumo de alcohol y otras drogas por los empleados de obras públicas

O consumo de álcool e outras drogas interfere nas atividades laborais. Esta pesquisa teve como propósito verificar o padrão de uso de substâncias psicoativas entre trabalhadores de obras públicas. Trata-se de estudo exploratório e transversal cuja coleta de dados foi realizada pelo questionário Triagem do Uso de Álcool, Tabaco e Outras Substâncias (ASSIST) aplicado para 200 trabalhadores da Empresa Municipal de Obras Públicas de Divinópolis (MG), no período de março a setembro de 2011. Os resultados indicam que os trabalhadores são predominantemente do sexo masculino (73,5%). Foi constatado elevado consumo de álcool e outras drogas com prejuízos sociais, familiares e de saúde. Concluiu-se que é necessária a implantação e o desenvolvimento de breves intervenções para minimizar os agravos para o grupo investigado, suas famílias e a sociedade.

The consumption of alcohol and other drugs interfere with work activities. This research aimed to assess the pattern of psychoactive substance use among construction workers hired by a municipality. This is a cross-sectional exploratory study whose data collection was conducted by the questionnaire Screening for Alcohol Use, Tobacco, and Other Substances (ASSIST) answered by 200 construction workers hired by the Municipal Building Construction Company in Divinópolis (MG), from March to September 2011. The results indicate that workers are predominantly male (73.5%). It was found out a high consumption of alcohol and other drugs that cause social, family and health disruption. It could be concluded that it is necessary the implementation and development of brief interventions to minimize the problems for the group investigated, their families and society.

El consumo de alcohol y otras drogas interfiere en las actividades laborales. Esta investigación tuvo como objetivo verificar el patrón de uso de sustancias psicoactivas entre los trabajadores de obras públicas. Se trata de un estudio con enfoque exploratorio y transversal cuya recolecta de datos se realizó mediante el cuestionario Triado del Uso del Alcohol, Tabaco y Otras Sustancias (ASSIST) aplicado a 200 trabajadores de la Empresa Municipal de Obras Públicas de Divinópolis (MG), de marzo a septiembre de 2011. Los resultados indican que los trabajadores son en su mayoría varones (73,5%). Se encontró un alto consumo de alcohol y otras drogas con trastornos sociales, familiares y de salud. Se concluye que se hace necesaria la implementación y desarrollo de intervenciones breves para reducir los agravios del grupo investigado, sus familias y la sociedad.

Avaliação da indução, recuperação, agitação ao despertar e consumo com uso de duas marcas de sevoflurano para anestesia ambulatorial / Assessment of induction, recovery, agitation upon awakening, and consumption with the use of two brands of sevoflurane for ambulatory anesthesia / Evaluación de la inducción, recuperación, agitación al despertar y consumo con el uso de dos marcas de sevoflurano para la anestesia ambulatorial

JUSTIFICATIVA E OBJETIVOS: O sevoflurano por suas características farmacológicas é o anestésico ideal para procedimentos de curta duração. Existem duas marcas de sevoflurano no mercado brasileiro, o Sevocris® e Sevorane®, com diferentes formulações e envasamento. O objetivo deste estudo foi analisar se existem diferenças entre os dois anestésicos na indução, manutenção, recuperação e consumo. MÉTODO: Foram incluídas 130 crianças dividas em dois grupos segundo a marca do agente utilizado: Grupo 1 sevoflurano da Cristália® e Grupo 2 da Abbott®. Foram analisados os seguintes parâmetros: frequência cardíaca, pressão arterial sistólica e diastólica, fração inspirada e expirada de sevoflurano, valores de BIS, temperatura timpânica, tempos de indução e recuperação, agitação ao despertar pela escala PAED e consumo do anestésico por pesagem dos vaporizadores. A indução foi realizada com 1 CAM e incrementadas a cada três movimentos respiratórios em 0,5 CAM, até no máximo 3 CAM. RESULTADO: Não houve diferença entre os grupos quanto ao tempo de procedimento e de anestesia e nos parâmetros avaliados na indução. No Grupo 1, o número de crianças que necessitaram bolus adicionais de sevoflurano na manutenção da anestesia foi maior que no 2 (p < 0,05). A fração inspirada e expirada de sevoflurano no final do procedimento foi menor no Grupo 1 (p < 0,001). No momento do despertar o valor do BIS foi menor no Grupo 1 (p = 0,045). Outros parâmetros avaliados na recuperação não mostraram diferença entre os grupos. O consumo de anestésico foi semelhante entre os grupos.

BACKGROUND AND OBJECTIVES: Due to its pharmacological characteristics, sevoflurane is the ideal anesthetic for short-duration procedures. There are two brands of sevoflurane in the Brazilian market, Sevocris® and Sevorane®, with different formulations and packaging. The objective of this study was to assess whether there are differences between the two anesthetics regarding induction, maintenance, recovery, and consumption. METHODS: One hundred and thirty children were included, divided into two groups according to the brand used: Group 1 was assigned to sevoflurane Cristália® and Group 2 to sevoflurane Abbott®. The following parameters were assessed: heart rate, systolic and diastolic blood pressure, fraction of inspired and expired sevoflurane, BIS values, tympanic temperature, induction and recovery time, agitation upon awakening measured by the PAED scale, and anesthetic consumption by weighing the vaporizers. Anesthesia was induced with 1 MAC and increased every three breaths at 0.5 MAC, up to 3 MAC. RESULTS: There was no difference between groups regarding the duration of the procedure, the anesthesia, and the parameters evaluated at induction. In Group 1, the number of children who required additional bolus of sevoflurane for anesthesia maintenance was higher than in Group 2 (p < 0.05). The fraction of inspired and expired sevoflurane at the end of the procedure was lower in Group 1 (p < 0.001). Upon awakening, BIS value was lower in Group 1 (p = 0.045). Other parameters evaluated in recovery showed no difference between groups. The use of anesthesia was similar between groups.

JUSTIFICATIVA Y OBJETIVOS: El sevoflurano, por sus características farmacológicas, es el anestésico ideal para procedimientos de corta duración. Existen dos marcas de sevoflurano en el mercado brasileño, el Sevocris® y el Sevorane®, con diferentes formulaciones y envases. El objetivo de este estudio, fue analizar si existen diferencias entre los dos anestésicos en la inducción, mantenimiento, recuperación y consumo. MÉTODO: Se incluyeron 130 niños divididos en dos grupos según la marca del agente utilizado: Grupo 1 sevoflurano de Cristália® y Grupo 2 de Abbott®. Se analizaron los siguientes parámetros: frecuencia cardíaca, presión arterial sistólica y diastólica, fracción inspirada y espirada de sevoflurano, valores de BIS, temperatura timpánica, tiempos de inducción y recuperación, agitación al despertar por la escala PAED, y consumo del anestésico por pesaje de los vaporizadores. La inducción fue realizada con 1 CAM e incrementada a cada tres movimientos respiratorios en 0,5 CAM, hasta el máximo de 3 CAM. RESULTADO: No hubo diferencia entre los grupos en cuanto al tiempo de procedimiento y de anestesia y en los parámetros evaluados en la inducción. En el Grupo 1, el número de niños que necesitaron bolos adicionales de sevoflurano en el mantenimiento de la anestesia, fue mayor que en el 2 (p < 0,05). La fracción inspirada y espirada de sevoflurano al final del procedimiento fue menor en el Grupo 1 (p < 0,001). Al momento del despertar, el valor del BIS fue menor en el Grupo 1 (p = 0,045). Otros parámetros evaluados en la recuperación no arrojaron diferencia entre los grupos. El consumo de anestésico fue similar entre los grupos.

Assessment of induction, recovery, agitation upon awakening, and consumption with the use of two brands of sevoflurane for ambulatory anesthesia.

BACKGROUND AND OBJECTIVES: Due to its pharmacological characteristics, sevoflurane is the ideal anesthetic for short-duration procedures. There are two brands of sevoflurane in the Brazilian market, Sevocris® and Sevorane®, with different formulations and packaging. The objective of this study was to assess whether there are differences between the two anesthetics regarding induction, maintenance, recovery, and consumption. METHODS: One hundred and thirty children were included, divided into two groups according to the brand used: Group 1 was assigned to sevoflurane Cristália® and Group 2 to sevoflurane Abbott®. The following parameters were assessed: heart rate, systolic and diastolic blood pressure, fraction of inspired and expired sevoflurane, BIS values, tympanic temperature, induction and recovery time, agitation upon awakening measured by the PAED scale, and anesthetic consumption by weighing the vaporizers. Anesthesia was induced with 1 MAC and increased every three breaths at 0.5 MAC, up to 3 MAC. RESULTS: There was no difference between groups regarding the duration of the procedure, the anesthesia, and the parameters evaluated at induction. In Group 1, the number of children who required additional bolus of sevoflurane for anesthesia maintenance was higher than in Group 2 (p<0.05). The fraction of inspired and expired sevoflurane at the end of the procedure was lower in Group 1 (p<0.001). Upon awakening, BIS value was lower in Group 1 (p=0.045). Other parameters evaluated in recovery showed no difference between groups. The use of anesthesia was similar between groups.

Avaliação da adaptação psicossocial na gravidez em gestantes brasileiras / Assessment of psychosocial adaptation to pregnancy in brazilian pregnant women

RESUMO OBJETIVO: avaliar a adaptação psicossocial na gravidez, por intermédio da tradução e adaptação de instrumento específico, para ser usado em gestantes brasileiras. MÉTODOS: estudo observacional de corte transversal. Foi realizada a tradução e adaptação transcultural do PSeQ (Prenatal Self-evaluation Questionnaire) seguindo todas as etapas metodológicas exigidas. aplicou-se um questionário contendo perguntas abertas e fechadas de forma a caracterizar os dados sócio-demográficos e clínicos das gestantes (n=36). a análise estatística constou de média, desvio padrão (DP), freqüência absoluta e relativa. Para análise da consistência interna utilizou-se o coeficiente alfa de Cronbach, por meio do SPSS versão 17.0. RESULTADOS: as voluntárias apresentaram baixo nível sócio-econômico, média de idade de 25,1 anos ( 5,5), idade gestacional média de 25,9 semanas ( 8,1). Destas, 58,3 por cento não haviam planejado a atual gravidez. O pré-teste mostrou que 75 por cento das gestantes consideraram o questionário de fácil entendimento. Quanto ao instrumento PSEQ, a identificação com o papel materno foi a sub-escala que apresentou maior média 24,8 ( 5,6), enquanto o relacionamento com a mãe apresentou a menor média 15,4 ( 7,7). a consistência interna variou entre 0,52-0,89. CONCLUSÃO:a avaliação psicossocial materna no pré-natal mostra-se importante no acompanhamento da progressão da gestação e permite a intervenção mediante ações de promoção e prevenção no bem-estar materno-infantil.

PURPOSE:to evaluate psychosocial adaptation to pregnancy by translating and cross-culturally adapting a specific assessment instrument to be used with Brazilian women. METHODS: this was a cross-sectional observational study. the translation and cross-cultural adaptation and of the Prenatal Self-evaluation Questionnaire (PSeQ) was performed following all the required methodological steps. another questionnaire was applied to characterize the sociodemographic and clinical status of the pregnant women (n=36). Statistical analysis consisted of the determination of the mean and standard deviation (SD) and of absolute and relative frequency. the statistical test used for the analysis of internal consistency was Cronbach's alpha coefficient, using SPSS version 17.0. RESULTS: the volunteers were of low socioeconomic status, aged on average 25.1 years ( 5.5), and had an average gestational age of 25.9 weeks ( 8.1). 58.3 percent of these volunteers had not planned their current pregnancy. the pretest showed that 75 percent of the pregnant women found the questionnaire easy to understand. Regarding the PSeQ instrument, the identification with the maternal role was the subcategory which showed the highest average, 24.8 ( 5.6), while the relationship with the mother had the lowest average 15.4 ( 7.7). the internal consistency ranged from 0.52 to 0.89. CONCLUSION: the assessment of psychosocial adaptation to pregnancy in pregnant women is very important during the progress of pregnancy and permits intervention through obstetric-neonatal actions of promotion and prevention regarding the well-being of mother and child.

Interleukin-4 blocks thapsigargin-induced cell death in rat rod photoreceptors: involvement of cAMP/PKA pathway.

Although the photoreceptors cell death is the main cause of some retinopathies diseases, the mechanisms involved in this process are poorly understood. The neuroprotective effects of interleukin-4 (IL-4) have been shown in several tissues, including retina. We demonstrate that treatment of rat retinal explants with IL-4 completely inhibited the thapsigargin-induced rod photoreceptor cell death after 24 hr in culture. We also showed that IL-4 receptor alpha subunit (IL-4Ralpha) is abundantly present in retina. Colocalization of IL-4Ralpha and rhodopsin indicate a direct effect of this cytokine in rod photoreceptor cells. Moreover, IL-4 increased the intracellular levels of cAMP in 7.4-fold, indicating that the neuroprotective effect of this cytokine was completely blocked by RpcAMP, an inhibitor of protein kinase (PKA). Our data demonstrate, for the first time, the neuroprotective effect of IL-4 through cAMP/PKA pathway in thapsigargin-induced photoreceptor cell death.

Interleukin-4 blocks proliferation of retinal progenitor cells and increases rod photoreceptor differentiation through distinct signaling pathways.

Interleukin-4 (IL-4), an anti-inflammatory cytokine, has been related to the differentiation of the rodent retina in vitro, but constitutive presence of either IL-4 or of IL-4 receptor in the retina has not been reported. In this work we examined the expression of IL-4 and its specific receptor alpha subunit (IL-4Ralpha). IL-4Ralpha is expressed both in neural retina and non-neural ocular tissue, while IL-4 was found mainly in non-neural tissue. We characterized a novel trophic effect of IL-4 upon the retina. We showed that IL-4 can inhibit the proliferation of retinal cells (approximately 40%) through the cAMP-PKA pathway and associated with a reduction of cyclin D1 and increase of p27(kip1). IL-4 also promotes the differentiation of rod photoreceptors. Activation of tyrosine kinases, protein kinase C, and mitogen-activated kinases of the Erk family were required for IL-4-induced rod photoreceptor differentiation, independent of the release of other trophic factors in culture. Taken together, our results show, for the first time, that IL-4 directly modulates proliferation of retinal cells and rod photoreceptor differentiation, through distinct signaling pathways.