Redesign of radiotherapy for prostate cancer: a proposal for universal healthcare systems.

Aim: This study was designed to recommend strategies to improve prostate patients' access to radiotherapy treatment in the Brazilian Unified Health System, along with a cost-tool to support radiotherapy care pathways' lead times and costs. Methods: Data was collected prospectively from patients with prostate cancer receiving radiotherapy in two Brazilian centers to provide data to apply design thinking and process reengineering techniques. The current status of the radiotherapy pathway was determined and the length of time taken for in-hospital activities was measured using data exported from ARIA®. Interviews with patients were used to estimate their waiting periods. This provided the data used to provide recommended strategies and the cost tool based on time-driven activity-based costing. The strategies were classified according to priority. Results: Data from 47 patients were analyzed. The mean interval from diagnosis to start of radiotherapy was 349 days (SD581), and the mean interval from seeking medical attention to starting treatment was 635 days (SD629). Twelve strategies affecting in-hospital processes and 11 impacting patients' care pathways and experiences are recommended, mostly focused on system improvement opportunities. A time-driven activity-based costing monitoring using data extracted from ARIA was coded and can be used by centers as a cost assessment guide. Conclusion: This study uses reengineering and design techniques to introduce priority strategies to allow more efficient and patient-centered radiotherapy.

Late-life drinking and smoking in primary care users in Brazil.

To estimate the prevalence of at-risk drinking and smoking and associated factors among older adults in primary care in Brazil.A cross-sectional study carried out in seven primary care units with 503 older adults (60+), in a city in the state of Sao Paulo, Brazil. At-risk drinking was defined by AUDIT-C and by consumption of units per week. Poisson regression was used to assess the association between the sociodemographic and health characteristics and smoking and at-risk drinking.The median age of the 503 participants was 69.6 (SD ± 6.7; range:60-93). One third of participants (33.6%) were current drinkers, 16% were at-risk drinkers (AUDIT-C), 4% at-risk drinkers (units per week), and 13% of the sample were regular smokers. The prevalence of at-risk drinking (AUDIT-C) was higher for males (RP: 4.89; 95% CI: 2.52-9.49) and for those with higher levels of education (RP: 1,861.85 95% CI: 1.08-3.14), and lower for those over the age of 70 (RP: 0.50; 95% CI: 0.30-0.84). The prevalence of smoking was higher for those with depressive symptoms (RP: 1.95; 95% CI: 1.03-3.66), and lower for those over age 70 (RP: 0.52; 95% CI: 0.29-0.94).The results point to a set of factors associated with at-risk drinking (being male, younger and having a higher education), and with smoking (being younger and having depressive symptoms). Our findings could help health professionals to identify at-risk drinkers and smokers, as well as support strategies for future interventions by the identification of the groups most vulnerable to these behaviors.

La evolución de la crisis ambiental, su efecto en la salud y las posibles soluciones vistos a través del cine: la saga de Mad Max como metáfora / The evolution of the environmental crisis, its impact on health, and possible solutions seen throughcinema: the Mad Max saga as a metaphor / A evolução da crise ambiental, seu impacto na saúde e possíveis soluções vistas através do cinema: a saga Mad Max como metáfora

En el cambiante y complejo panorama de las crisis ambientales que enfrenta nuestro planeta, las películas de la saga "Mad Max" pueden ser empleadas como metáfora, no solo para ilustrar los desafíos ambientales contemporáneos sino también las graves consecuencias futuras que podrían materializarse si no se realiza una acción global decisiva. Desde su debut en la década de 1980 hasta su renovación en 2015 esta saga ha presentado al público preocupaciones sociales globales, recreadas en las intensas luchas, en cada una de las películas, por recursos esenciales y energéticos, desde el petróleo hasta el agua, en un mundo lleno de incertidumbre, colapso y conflictos bélicos internos.

In the changing and complex landscape of environmental crises facing our planet, the films of the "Mad Max" saga can be used as a metaphor, not only to illustrate contemporary environmental challenges but also the serious future consequences that could materialize if decisive global action is not taken. From its debut in the 1980s to its renewal in 2015 this saga has presented the public with global social concerns, recreated in the intense struggles, in each of the films, for essential and energy resources, from oil to water, in a world full of uncertainty, collapse and internal war conflicts.

Exposure of workers in tanneries, construction and beauty salons in Armenia to occupational environmental pollution. Case study

The objective of this research was to evaluate the working and health conditions of workers in three sectors of the economy of Armenia, Colombia (tanneries, construction sites, and beauty salons) exposed to chemical and physical agents. A descriptive observational study of the working conditions and health of workers in their work environments was carried out, by visiting 10 companies per sector. The evaluation of working conditions in construction sites gave High (high risk), as well as in tanneries. Beauty salons gave an evaluation of Medium (medium risk).

El objetivo de esta investigación fue evaluar las condiciones de trabajo y salud de los trabajadores, de tres sectores de la economía de Armenia, Colombia (curtiembres, obras de construcción y salones de belleza), expuestos a agentes químicos y físicos. Se realizó un estudio observacional descriptivo de las condiciones de trabajo y salud de los trabajadores en sus entornos laborales, visitando 10 empresas por sector. La evaluación de las condiciones de trabajo en las obras de construcción dio un resultado Alto (riesgo elevado), al igual que en las curtiembres. Los salones de belleza obtuvieron una evaluación Media (riesgo medio).

Percepción de tiempo, salud mental en tiempos de pandemia por COVID-19 y cuarentenas / Perception of time and mental health during COVID-19 pandemic quarantines

Introducción: Debido a la pandemia por COVID-19 fue necesario implementar la cuarentena obligatoria, con el fin de contener la propagación del virus; situación que generó cambios en los estilos de vida y diversas respuestas que incluyen temor, ansiedad, monotonía e incertidumbre. Esto pudo alterar la capacidad en la percepción del tiempo de los individuos, y con ello afectar su salud mental. Objetivo: Sintetizar las bases neurológicas del fenómeno de percepción de tiempo, su importancia y la evidencia científica sobre posibles alteraciones en condiciones de cuarentena. Materiales y métodos: Revisión bibliográfica temática en bases de datos Pubmed, Medline, Scopus, y Google Scholar. Los términos de búsqueda en español e inglés incluyeron: percepción de tiempo, estimación de tiempo, pandemia, cognición, estados emocionales, salud mental. Resultados: Se describe el concepto de percepción del tiempo, sus bases neurológicas y las alteraciones que se pueden generar. Conclusión: La salud mental fue afectada por la pandemia, sin embargo, se desconoce con claridad la forma como se desarrolló dicha afectación a mediano y largo plazo.

Introduction: COVID-19 pandemic made it necessary to implement obligatory quarantine measures in order to contain viral spreading. This situation generated lifestyle changes and diverse responses such as fear, anxiety, monotony, and uncertainty. This affected the people's capacity to perceive time resulting in changes in mental health. Objective: Synthesize the neurological bases of the phenomenon of time perception, its importance and the scientific evidence regarding the possible alterations in the conditions of quarantine. Materials of methods: A thematic bibliographic review was carried out in Pubmed, Medline, Scopus, and Google Scholar databases. The Spanish and English keywords used were: perception of time, estimation of time, pandemic, cognition, emotional states, and mental health. Results: The concept of time perception, its neurological bases and the alterations that can be generated are described. Conclusions: Mental health was affected during pandemic, yet its effects in the short-term and long-term are not understood clearly.

Prognostic Factors for Inguinal Lymph Node Involvement and Tumor Recurrence in Squamous Cell Carcinoma of the Penis / Factores pronósticos de compromiso ganglionar inguinal y recaída tumoral en carcinoma escamocelular de pene

Zoom Image Abstract Introduction Penile carcinoma is an aggressive disease with catastrophic consequences that frequently lead to death. Therefore, further knowledge on the prognostic factors that can help identify patients in need of more aggressive treatments becomes essential. Objective To identify the prognostic factors for lymph node (LN) involvement and tumor recurrence in patients diagnosed with squamous cell carcinoma of the penis (SCCP). Methods A retrospective cohort study was conducted. Patients diagnosed and treated for SCCP at Instituto Nacional de Cancerología between 2008 and 2015 were included in the sample. Cases in which no information on recurrence was available for the follow-up were excluded, as well as patients with no initial pathology and those getting penile reconstructions after cancer. Relevant data was retrieved from the medical records of each patient, and a descriptive analysis was performed. Subsequently, this data was used to apply a logistic regression model to determine the potential clinical and histopathological prognostic factors. Results A total of 104 patients were included in the present study. The average age of the sample was 59 years, while the follow-up averaged 24 months per patient. Inguinal lymphadenectomy was performed on 61 patients (59%) during the follow-up. The logistic regression model showed that lymphovascular invasion (odds ratio [OR]: 6.7; 95% confidence interval [95%CI]: 1.2­35) and poor tumor differentiation (OR: 17; 95%CI: 3.2­92) were associated with tumor recurrence. Likewise, the lymphadenectomy procedures showed that lymphovascular invasion was associated with LN involvement (OR: 3.3; 95%CI: 1.1­10). Conclusion Lymphovascular invasion was the strongest prognostic factor observed in our sample, aiding in the prediction of inguinal LN involvement and tumor recurrence in SCCP patients

Introduccion El cáncer de pene es una enfermedad agresiva con consecuencias catastróficas que frecuentemente llevan a la muerte. Por lo tanto, es esencial un mayor conocimiento sobre los factores pronósticos que pueden ayudar a identificar a los pacientes que necesitan tratamientos más agresivos. Objetivo Identificar los factores pronósticos patológicos de compromiso ganglionar inguinal y recaída tumoral en pacientes con carcinoma escamocelular de pene. Métodos Se realizó un estudio de cohorte retrospectivo. Se incluyeron en la muestra pacientes diagnosticados y tratados por carcinoma escamocelular de pene (SCCP) en el Instituto Nacional de Cancerología entre 2008 y 2015. Los casos en los que no había información sobre la recurrencia en el seguimiento fueron excluidos, así como los pacientes sin patología inicial y aquellos que reciben reconstrucciones del pene después del cáncer. Se recuperaron los datos relevantes de los registros médicos de cada paciente, y una descripción fue realizada. Posteriormente, estos datos se utilizaron para aplicar un modelo de regresión logística para determinar los posibles factores pronósticos clínicos e histopatológicos. Resultados Un total de 104 pacientes fueron incluidos en el estudio. La edad promedio de la muestra fue de 59 años, mientras que el seguimiento promedió fue de 24 meses por paciente. La linfadenectomía inguinal se realizó en 61 pacientes (59%) durante el seguimiento. El modelo de regresión logística mostró que la invasión linfovascular (odds ratio [OR]: 6,7; intervalo de confianza del 95% [IC 95%]: 1,2­35) y la pobre diferenciación tumoral (OR: 17; IC 95%: 3,2­92) se asociaron con recurrencia tumoral. Así mismo, los procedimientos de linfadenectomía mostraron que la invasión linfovascular se asoció con afectación de LN. (OR: 3,3; IC 95%: 1,1-10). Conclusión La invasión linfovascular es el factor pronóstico independiente más importante que se asocia de manera independiente con compromiso ganglionar inguinal positivo y recaída tumoral.

Papel de los profesionales de la salud en el diseño, obtención y entendimiento del consentimiento informado: Una revisión / Role of health professionals in the design, obtention and understanding of informed consent: A review

RESUMEN El consentimiento informado es un proceso que tiene la intención de autorizar o llegar a un acuerdo con el profesional para la realización de un procedimiento en el área de la salud o en el campo de la investigación, que se formaliza con la firma de un documento. Este consentimiento refleja la voluntad y la autonomía de dicho individuo y su capacidad, una vez ilustrado en detalle sobre la intervención, para entender los resultados principales y los potenciales riesgos de dicha intervención y su voluntad de asumirlos, sin presión externa. Aunque esto parece trivial, la historia muestra que voluntad y autonomía no han sido valores tenidos en cuenta en el área de la salud y menos en el campo de la investigación, de manera intencional o por omisión. Para la presente revisión, se realizó una búsqueda bibliográfica en las bases de datos PubMed, Medline, Scielo y Google Académico. Se utilizaron los siguientes descriptores: historia de la investigación, ética, consentimiento informado, investigación, enfermería y comprensión, encontrando 2.800 artículos, en idiomas inglés, portugués y español, sin restricción de un límite de tiempo; luego, se efectuó la lectura del resumen de los artículos, seleccionando los 80 que más se acercaban al tema y se emplearon. Como resultado del análisis de la información, se generaron algunas pautas orientadas a mejorar el proceso de consentimiento informado, a través de técnicas que mejoren la explicación por parte del profesional de salud y la comprensión del participante o paciente.

ABSTRACT Informed consent is a legal document signed by an individual who will undergo an intervention in the health area, or in the research field. This informed consent reflects the individual wellbeing and autonomy and his / her capacity, once he or she has been illustrated in detail about the intervention, to understand its main results and its potential risks of said intervention and his / her willingness to assume it without external pressure. Although this seems trivial, history shows that wellbeing and autonomy have not been considered values in the health area and lesser in research, intentionally or by omission. For the present review, a bibliographic search was carried out in PubMed, Medline, Scielo and Google Scholar databases. The following descriptors were used: history of research, ethics, informed consent, research, nursing and comprehension. We found 2800 articles, in English, Portuguese and Spanish, without time limit. Then after reading abstract of the Articles it was selected 80 articles that were close to the subject and there were used. As a result of the analysis of the information, some guidelines were generated aimed to improve the informed consent process through techniques that improve the explanation by the health professional and the understanding of the participant or patient.

Low-frequency electromagnetic fields as an alternative to sanitize water of drinking systems in poultry production?

Low-frequency electromagnetic fields (LF-EMF) may present an alternative to conventional sanitation methods of water supply lines in animal production. The objective of this study was to evaluate the effect of the application of LF-EMF on bacterial concentrations and biofilms at scale-models of different drinking systems (circulating and non-circulating) conventionally used in poultry holdings. Treated systems were equipped with commercial devices producing pulsed electromagnetic signals of low frequency up to 10,000 Hz; max. 21 mT. Exposure of water to LF-EMF resulted in changes of the culturable bacterial counts, although with high standard deviations. Differing between systems types, LF-EMF treatment seemed to be responsible either for a limitation or for an increase of colony forming unit counts, with partly statistically significant differences, especially in early stages of treatment. In contrast, neither biofilm formation nor counts of cells suspended in water differed between treated and control lines over 28 days of experiment, as determined by fluorescence microscopy. Although this study indicates that LF-EMF may influence culturability of water microorganisms, no clear inhibitory effects on bacterial biofilm formation or on planktonic microbes by LF-EMF treatment were confirmed in the experiments.

Effectiveness of sampling methods employed for Acanthamoeba keratitis diagnosis by culture.

PURPOSE: This retrospective, observational study was designed to evaluate the effectiveness of the sampling methods commonly used for the collection of corneal scrapes for the diagnosis of Acanthamoeba keratitis (AK) by culture, in terms of their ability to provide a positive result. METHODS: A total of 553 samples from 380 patients with suspected AK received at the Parasitology Section of the Public Health Institute of Chile, between January 2005 and December 2015, were evaluated. A logistic regression model was used to determine the correlation between the culture outcome (positive or negative) and the method for sample collection. The year of sample collection was also included in the analysis as a confounding variable. RESULTS: Three hundred and sixty-five samples (27%) from 122 patients (32.1%) were positive by culture. The distribution of sample types was as follows: 142 corneal scrapes collected using a modified bezel needle (a novel method developed by a team of Chilean corneologists), 176 corneal scrapes obtained using a scalpel, 50 corneal biopsies, 30 corneal swabs, and 155 non-biological materials including contact lens and its paraphernalia. Biopsy provided the highest likelihood ratio for a positive result by culture (1.89), followed by non-biological materials (1.10) and corneal scrapes obtained using a modified needle (1.00). The lowest likelihood ratio was estimated for corneal scrapes obtained using a scalpel (0.88) and cotton swabs (0.78). CONCLUSION: Apart from biopsy, optimum corneal samples for the improved diagnosis of AK can be obtained using a modified bezel needle instead of a scalpel, while cotton swabs are not recommended.

Rare variation of the right internal jugular vein: a case study / Variação rara da veia jugular interna direita: um estudo de caso

This study reports on a rare variation of the right internal jugular vein (IJV) identified during routine anatomic dissection of a male cadaver. The right IJV had a tributary located parallel and medially to the IJV itself. This branch of the IJV emerged between the transverse processes of the 3rd and 4th cervical vertebrae and drained into the junction between the right internal jugular and brachiocephalic veins. The present study described a rare branch of the right IJV, which is important knowledge for surgeons, in order to prevent accidental injury and bleeding during surgical procedures

O presente estudo demonstrou uma variação rara da veia jugular interna direita (VJI), identificada durante uma dissecção de rotina de um cadáver masculino. A VJI direita apresentou uma tributária localizada paralelamente e medialmente à referida veia. Essa tributária da VJI emergiu entre os processos transversos das 3ª e 4ª vértebras cervicais e drenou para a junção entre as veias jugular interna e braquiocefálica direita. O conhecimento da variação anatômica demonstrado no presente estudo é importante para os cirurgiões, a fim de prevenir lesões acidentais e sangramento durante procedimentos cirúrgicos

All with You: a new method for developing compassionate communities-experiences in Spain and Latin-America.

BACKGROUND: In recent years, compassion has motivated the development of programs oriented to create communities and societies involved in the relief of suffering. The development of compassionate communities and cities begins in each one of us, though it relies on organizations, providers and societies as a whole who need tools and methodologies as a part of a set of actions to help compassionate communities and cities to become a reality rooted widely in social values. In order to describe the "All with You®" methodology and its components: a method designed to develop compassionate communities and cities at the end of life that can be extended to organizations, communities, municipalities, cities or countries. In addition, this article tries to describe several experiences from applying the method in different cities and contexts. METHODS: A search of models for the development of compassionate communities was carried out initially to guide the elements and phases that could help to create a systematized method that will help organizations to create compassionate communities. After analysing the results, alliances were established with some of the main promoters at the time in the development of compassionate communities to validate the designed method. The city of Seville (Spain) was selected to validate the phases of the method and analyse the results based on a series of indicators. Finally, the methodology is being spread throughout cities in various countries, and the experiences are being evaluated with common indicators. RESULTS: The "All with You®" method (Todos Contigo® in Spanish) has been developed as a systematic approach that enables anyone interested in building compassionate communities or cities to include all of the elements outlined in the Compassionate City Charter. All with You® is a method that includes eight phases that allows organizations to be guided in the development of compassionate communities and cities towards a certification process that is evaluated through a series of structures, process and results indicators. The main actions of this method are based on social awareness, training, and the implementation of networks of care using innovative elements like Community Promoters and the RedCuida protocol to provide support, backing and care for those who face advanced chronic disease and end of life situations. Several cities in Spain and Latin America have already joined the movement of compassionate cities using this method, including four in Spain (Seville, Badajoz, Getxo and Pamplona), four in Colombia (Cali, Medellin, Fusagasugá and Bogotá) and one in Argentina (Buenos Aires). CONCLUSIONS: The All with You® method has made the development of compassionate communities and cities possible, aligning organizations and cities to promote compassionate acts, and to start creating networks involved in a global community united by a vocation for caring.

Effects of overfeeding and high-fat diet on cardiosomatic parameters and cardiac structures in young and adult zebrafish.

Obesity is a complex global health problem because it is a risk factor for multiple chronic pathologies such as cardiovascular, endocrine, metabolic, and neoplastic diseases. It is considered a multicausal disease, and one of the determining factors is nutritional imbalances, which include high-fat diets. In this paper, we use the zebrafish model to assess the impact of overfeeding and a high-fat diet in somatic and cardiac parameters in young and adult zebrafish. The results show that fish receiving a high-fat diet showed greater weight gain compared to fish receiving a standard fat diet. Additionally, changes in the heart, including increases in size, a change in the triangular shape of the ventricle to a globular shape, and an increase in the thickness of the trabeculae of the spongy myocardium were observed. These changes could be indicators of cardiovascular overload. The results show that there is a direct relationship between the intake of a high-fat diet and obesity, which in turn can induce cardiac changes, supporting the hypothesis of the relationship between high-fat diets and cardiovascular risk factors. Given the genetic similarity between zebrafish and humans, these results could be extrapolated to human beings, and the findings similarly highlight the importance of incorporating a balanced diet from the early life stages to reduce the risk of cardiovascular disease.

Metastasectomy of Abdominal Wall Lesions due to Prostate Cancer Detected Through PET/CT Gallium 68-PMSA: First Case Report.

Introducing the topic of abdominal wall metastasis secondary to prostate cancer with a reminder of the disease's rarity, being the first published case. This article is about a 66 year old patient diagnosed with prostate cancer [cT2aNxMx iPSA: 5,6 ng/ml Gleason 3+3, (Grade 1 Group)], treated with radical prostatectomy as well as accompanied with amplified pelvic lymphadenectomy, who subsequently presented metastatic lesions to the abdominal wall diagnosed with PET/CT Gallium 68-PMSA technique and treated with abdominal metastasectomy with adequate short term results.

The transformation process for palliative care professionals: The metamorphosis, a qualitative research study.

BACKGROUND: Palliative care professionals are exposed daily to high levels of suffering. This makes them particularly vulnerable to suffering from stress, which can lead to burnout and/or compassion fatigue. AIMS: To analyse the professional trajectory of palliative care workers over time and the factors which influence this trajectory. DESIGN: A qualitative study was designed based on the Grounded Theory approach, using semi-structured individual interviews. Interviews were recorded audio-visually and transcribed verbatim for subsequent analysis using the procedure described by Miles and Huberman. This process was supported using ATLAS.ti 6 software. SETTING/PARTICIPANTS: A total of 10 palliative care professionals from Extremadura (Spain) took part in the study. RESULTS: The analysis revealed a common trajectory followed by participants in their working lives: pre-palliative care/honeymoon/frustration/maturation. In addition, factors which influence this trajectory were identified. Details of the self-care strategies that these professionals have developed are described. The result of this process, which we have metaphorically termed 'metamorphosis', is the formation of a professional who can work satisfactorily within a palliative care context. CONCLUSION: During their professional activity, palliative care professionals go through a series of phases, depending on the relationship between the cost of caring and the satisfaction of caring, which can influence both the care provided to patients and families and their own personal circumstances. Being aware of this risk, and implementing self-care strategies, can protect professionals and enable them to conduct their work in an optimal manner. Reflecting on the experiences of these professionals could be useful for other health professionals.

Morphometric study of the corpus cavernosum after anabolic androgenic steroid administration in pubertal and adult rats

PURPOSE: To evaluate the penile morphological modifications of pubertal and adult rats chronically treated with supra-physiological doses of anabolic androgenic steroids. METHODS: Forty-eight male Wistar rats were distributed into four groups: two control groups, 105- and 65-day-old (C105 and C65, respectively) injected with peanut oil (vehicle); and two treated groups, 105- and 65-day-old (T105 and T65, respectively) injected with nandrolone decanoate at a dose of 10 mg Kg-1 of body weight. The rats were injected once a week for eight weeks. The rats were then killed and their penises were processed for histomorphometric analyses. The mean of each parameter was statistically compared. RESULTS: A corpus cavernosum reduction of 12.5% and 10.9% was observed in the T105 and T65 groups, respectively, when compared with their respective control groups. The cavernosum smooth muscle surface density diminished by 5.6% and 12.9% in the T65 and T105 groups, respectively, when compared with their controls. In contrast, the sinusoidal space increased by 17% in the T105 group and decreased by 9.6% in the T65 group. CONCLUSION: The use of supra-physiological doses of AAS promotes structural changes in the rat penis, by altering the proportions of corpus cavernosum tissues, in both pubertal and adult treated animals. .

A randomized crossover clinical trial to evaluate the efficacy of oral transmucosal fentanyl citrate in the treatment of dyspnea on exertion in patients with advanced cancer.

BACKGROUND: Morphine is the only opioid which has been clearly demonstrated as effective in the treatment of dyspnea. The role of other opioids has not been sufficiently substantiated. OBJECTIVE: To evaluate the efficacy of oral transmucosal fentanyl citrate (OTFC) in the treatment of dyspnea on exertion in patients with advanced cancer. DESIGN: This is a randomized, double-blind crossover clinical trial to evaluate the efficacy of OTFC in dyspnea on exertion after the completion of a 6-minute walk test (6MWT). All patients were attended in 2011 by the Palliative Care Supportive Team from Badajoz. In visit 1, patients were randomly assigned to 1 of the 2 treatment groups. In visit 2, the patients who had been receiving the investigational product were given placebos and vice versa. RESULTS: Thirteen patients were recruited (26 6MWT), with a mean age of 65 years. Of the patients, 11 (76%)were males and lung cancer was the most frequently represented etiology. The patients were classified into 3e categories: better response in the first period, the same response in both the periods, and better response in the second period. No differences between the treatments were demonstrated (P: 1). There were no differences in changes in oxygen saturation (P: .7541) nor in the distance walked in the different sequences (P: .6550). No significant differences were found in relation to the Edmonton Symptom Assessment System, either before or after the 6MWT (P: .1234). No secondary effects associated with the medication were observed. CONCLUSION: It could not be demonstrated that the OTFC improved exertion dyspnea in patients with advanced cancer. A placebo effect was observed in all the patients.

The prostate after administration of anabolic androgenic steroids: a morphometrical study in rats

Purpose Many adverse effects have been associated with abuse of anabolic-androgenic steroids (AAS), including disorders of the urogenital tract. The objective of this study is to analyze the morphological modifications in the prostate ventral lobe of pubertal and adult rats chronically treated with AAS, using morphometric methods. Materials and Methods: We studied 39 male Wistar rats weighing between 400 g and 550 g. The rats were divided into four groups: (a) control rats, with 105 days of age (C105) (n = 7); (b) control rats with 65 days of age (C65) (n = 9), injected only with the vehicle (peanut oil); (c) treated rats, with 105 days of age (T105) (n = 10) and (d) treated rats with 65 days of age (T65) (n = 13). The treated rats were injected with nandrolone decanoate at a dose of 10 mg.Kg-1 body weight. The steroid hormone and the vehicle were administered by intramuscular injection once a week for eight weeks. The rats were killed at 161 days of age (C105 and T105) and 121 days of age (C65 and T65) and the ventral prostate lobe was dissected and processed for histology. The height of the acinar epithelium, the surface densities of the lumen, epithelium and stroma were observed with X400 magnification using an Olympus light microscope coupled to a Sony CCD video camera, and the images transferred to a Sony monitor KX14-CP1. The selected histological areas were then quantified using the M42 test-grid system on the digitized fields. The data were analyzed with the Graphpad software. To compare the quantitative data in both groups (controls and treated) and the outcomes, Student's t-test was used (p < 0.05 was considered significant). Results: The weight (p < 0.001) and volume (p = 0.004) of the prostate ventral lobe showed differences between C65 and T65 groups and between C105 and T105 groups. The epithelium height showed no difference between groups C65 and T65 (p = 0.8509), but the T105 group showed an increase of 32% compared ...

Atención y motivación ante estímulos afectivos en personas con ansiedad social / Attention and motivation to affective stimuli in people with social anxiety

El objetivo de esta investigación fue identificar las diferencias en el tiempo de respuesta ante una tarea tipo stroop emocional entre sujetos con y sin ansiedad social. Se utilizó un diseño descriptivo comparativo y participaron 63 personas divididas en dos grupos según las puntuaciones en el instrumento FNE. Todos los participantes de ambos grupos debieron resolver tres tareas tipo stroop: una tradicional, otra neutral y una emocional. Se evidenciaron diferencias significativas en los tiempos de ejecución en todas las tareas tipo stroop, siendo siempre mayor el tiempo de ejecución en las personas con ansiedad social. Todas las diferencias fueron estadísticamente significativas, aunque la que obtuvo lamayor significancia fue la tarea de stroop emocional. Estos resultados son analizados a partir de los procesos atencionales y motivacionales.

The purpose of this research was to identify differences in response time to an emotional stroop task in subjects with and without social anxiety. A comparative descriptive design was used in a sample of 63 participants, which were divided into two groups according to the scores on the FNE instrument. All of them were measured by three different Stroop type tasks: the traditional, the neutral and the emotional. It was found, significant differences in execution times in the Stroop type tasks, and the greatest executive time was presented by people with social anxiety. All differences were statistically relevant, although the emotional Stroop task got the highest significance. The results were analyzed from attentional and motivational processes.

Dyspnea--a bad prognosis symptom at the end of life.

PURPOSES: Dyspnea as refractory symptom leading to sedation at the end of life and the place of death. Survival study in population with dyspnea. METHODS: Longitudinal study of terminally ill patients in a year (n = 195). We divided populations as (a) population with dyspnea: prevalent and incident dyspnea and (b) population without dyspnea. We used the statistical program Stata9 (Kaplan-Meier and Cox logistic regression models). RESULTS: The probability of being sedated was 5 times higher in population with dyspnea. Dying in hospital odds ratio was 2.13 in patients with dyspnea. The average survival time was 52 days in patients with dyspnea and 69 in non-dyspnea patients. The average survival was similar between both groups. Patients with incident dyspnea showed a higher average survival than those with prevalent dyspnea. CONCLUSIONS: The connection between dyspnea and sedation was clearly shown. There were significant differences between prevalent dyspnea and incident dyspnea groups.