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Abstract Objective To evaluate whether antimicrobial photodynamic therapy (aPDT) repairs bisphosphonate-related osteonecrosis of the jaw (BRONJ) modulated by the reduction of NF-kB protein in a murine model. Methodology Male Wistar rats (N=30) were divided into the following groups (n=6/group): negative control (NC); experimental osteonecrosis (ONE); ONE + photosensitizer (PS); ONE + photobiomodulation (PBM); and ONE + aPDT. Over 8 weeks, ONE was induced by zoledronic acid 250 µg/kg injections, except in the NC group, which received sterile 0.9% saline, followed by extraction of the lower left first molar. Red light laser irradiation (wavelength ~660 nm, power 50 mW, energy of 2 J, energy dose of 66.67 J/cm2 for 40 s) was performed once a week for 4 weeks. Methylene blue 0.3% was used as PS. The animals were euthanized and examined macroscopically for the presence of exposed bone and epithelial repair and microscopically by histochemical (hematoxylin-eosin and Masson's trichrome staining) and immunohistochemical (anti-NF-kB) methods. Macroscopic and histomorphometric data were analyzed by one-way ANOVA and Tukey's post-test (p<0.05). Results Mucosal repair, viable osteocytes, and NF-kB immunostaining were observed in the NC, ONE+PS, ONE+PBM, and ONE+aPDT groups. The ONE group showed no mucosal repair, showing empty lacunae and multifocal immunostaining for NF-kB. The ONE+PBM and ONE+aPDT groups had greater deposition of extracellular matrix and less necrotic bone tissue (p<0.05). Conclusion PBM and aPDT treatments for BRONJ were effective for bone and epithelial repair, in addition to reducing inflammation mediated by the decrease of NF-kB protein in the irradiated regions.
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Introdução:Às medidas de segurança da COVID-19 direcionaram a adoção do modelo remoto de ensino, inclusive para ações de extensão universitária realizadas no ambiente escolar. A extensão contribui para a promoção da saúde ao abordar temas como a Educação Alimentar eNutricional. Objetivo:O objetivo deste trabalho é relatar a experiência da extensão universitária e a adaptação de ações de Educação Alimentar e Nutricional ao modelo remoto, com escolares de ensino fundamental do interior da Paraíba em 2020. Metodologia:O projeto "#Tecnologias da Informação e da Comunicação: Educação Alimentar e Nutricional em Casa" foi realizado com escolares do ensino infantil ao 5º ano de uma escola pública de Cuité, Paraíba. Utilizou-se o whatsapp como ferramenta para as atividadesbaseadas no incentivo a brincadeiras com movimentação física, o desenvolvimento cognitivo, os vínculos intergeracionais e a alimentação de baixo custo. Foram desenvolvidas 12 ações, adaptadas à idade escolar e de fácil execução no domicílio, através de vídeos explicativos, plataforma de jogos e atividades impressas. Resultados:Observou-se os desafios: desigualdade no acesso à internet, fragilidade na manutenção do vínculo entre a equipe universitária com a comunidade escolar, sobrecarga dos professores e diversos contextos no ambiente familiar como, por exemplo, a vulnerabilidade social e violência doméstica. Conclusão:Contudo, é possível a realização da extensão universitária no modelo remoto a partir da diversificação de estratégias e ferramentas digitais, apesar dos desafios enfrentados para manter o vínculo entre equipe universitária-comunidade escolar (AU).
Introduction:Security measures against COVID-19 led to the adoption of a remote teaching model, including university extension actions carried out in the school environment. The extension contributes to health promotion by addressing topics such as Food and Nutrition Education. Objective:This study aims to report the experience of a university extension and the adaptation of Food and Nutrition Education actions to the remote model applied to elementary school students from the interior of Paraíba in 2020. Methodology:The "#Information and Communication Technologies: Food and Nutrition Education at Home" project was carried out among elementary school students in the fifth grade of a public school in Cuité, Paraíba. Whatsapp was used as a tool for activities that involved encouraging play with physical movement, cognitive development, intergenerational bonds, and low-cost food. Twelve actions were developed and were adapted for school-age students. They were made easy to perform at home through explanatory videos, game platforms, and printed activities.Results:Challenges were observed in terms of unequal internet access, weakness in maintaining the connection betweenthe university team and the school community, overload of teachers, and different contexts in the family environment such as social vulnerability and domestic violence. Conclusions:Despite the challenges faced in maintaining the connection in the universityschool community team, it is possible to carry out university extensions in the remote model based on the diversification of digital strategies and tools (AU).
ntroducción:Las medidas de seguridad del COVID-19 orientaron la adopción del modelo de enseñanza a distancia, incluso para acciones de extensión universitaria realizadas en el ámbito escolar. La extensión contribuye a la promoción de la salud al abordar temas como laEducación Alimentaria y Nutricional. Objetivo:El objetivo de este trabajo es relatar la experiencia de extensión universitaria y la adaptación de las acciones de la Educación Alimentaria y Nutricional al modelo a distancia, con estudiantes de enseñanza básica del interior de Paraíba en 2020.Metodología:El proyecto "#Tecnologías de la Información y la Comunicación: Educación Alimentaria y Nutricional en Casa" fue realizado con alumnos de jardín de infantes a 5o grado de una escuela pública de Cuité, Paraíba. Se utilizó WhatsApp como herramienta para realizar actividades basadas en fomentar el juego con el movimiento físico, el desarrollo cognitivo, los vínculos intergeneracionales y la comida a bajo costo. Se desarrollaron 12 acciones, adaptadas a la edadescolar y fáciles de realizar en casa, através de videos explicativos, una plataforma de juegos y actividades impresas. Resultados:Se observaron desafíos: desigualdad en el acceso a internet, fragilidad en el mantenimiento del vínculo entre el equipo universitario y la comunidad escolar, sobrecarga de docentes y diversos contextos en el entorno familiar, como vulnerabilidad social y violencia intrafamiliar. Conclusiones:Sin embargo, es posible realizar la extensión universitaria en el modelo a distancia a partir de la diversificación de estrategias y herramientas digitales, a pesar de los desafíos que se enfrentan para mantener el vínculo entre el equipo universitario y la comunidad escolar (AU).
Subject(s)
Humans , Male , Female , Child, Preschool , Child , Food and Nutrition Education , Community-Institutional Relations , Information Technology , COVID-19/transmission , Brazil/epidemiology , Social Vulnerability , Health PromotionABSTRACT
Este estudo teve como objetivo identificar os principais desafios enfrentados por pessoas com Transtorno do Espectro Autista (TEA) na vida adulta. Trata-se de uma revisão integrativa abrangendo artigos publicados entre os anos de 2017 e 2022, disponíveis nas bases de dados: Scopus, PubMed e a Biblioteca Virtual em Saúde. Após a seleção e a organização dos estudos, o corpus foi constituído por oito artigos que abordavam esses desafios de pessoas adultas com TEA e suas experiências no âmbito da saúde, polifarmácia, socialização e a correlação com outros transtornos psiquiátricos. Os estudos contribuíram para um entendimento sobre as problemáticas enfrentadas pelo grupo, somado às suas necessidades e percepções, apontando a carência de apoio na transição para a vida adulta, a escassez de qualificação profissional na assistência a pessoas com TEA e a ausência de adaptações do ambiente para com os indivíduos, coadjuvando com o aumento de transtornos mentais e isolamento social.
This study aimed to identify the main challenges faced by people with Autistic Spectrum Disorder (ASD) in adulthood. This is an integrative review covering articles published between the years 2017 and 2022, available in the databases: Scopus, PubMed and the Virtual Health Library. After the selection and organization of the studies, the corpus consisted of eight articles that addressed these challenges of adult people with ASD and their experiences in the realm of health, polypharmacy, socialization, and the correlation with other psychiatric disorders. The studies contributed to an understanding of the problems faced by the group, in addition to their needs and perceptions, pointing out the lack of support in the transition to adulthood, the lack of professional qualification in assisting people with ASD, and the lack of adaptations of the environment for individuals, contributing to the increase of mental disorders and social isolation.
Este estudio tuvo como objetivo identificar los principales desafíos que enfrentan las personas con trastorno del espectro autista (TEA) en la edad adulta. Se trata de una revisión integradora que abarca artículos publicados entre los años 2017 y 2022, disponibles en las bases de datos: Scopus, PubMed y Biblioteca Virtual de Salud. Tras la selección y organización de los estudios, el corpus quedó compuesto por ocho artículos que abordaron estos retos de las personas adultas con TEA y sus experiencias en el contexto de la salud, la polifarmacia, la socialización y la correlación con otros trastornos psiquiátricos. Los estudios contribuyeron para la comprensión de los problemas enfrentados por el grupo, sumados a sus necesidades y percepciones, señalando la falta de apoyo en la transición para la edad adulta, la falta de cualificación profesional en la asistencia a las personas con TEA y la falta de adaptaciones del ambiente para los individuos, contribuyendo para el aumento de los trastornos mentales y del aislamiento social.
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Abstract Background Early rheumatoid arthritis (RA) offers an opportunity for better treatment outcomes. In real-life settings, grasping this opportunity might depend on access to specialized care. We evaluated the effects of early versus late assessment by the rheumatologist on the diagnosis, treatment initiation and long-term outcomes of RA under real-life conditions. Methods Adults meeting the ACR/EULAR (2010) or ARA (1987) criteria for RA were included. Structured interviews were conducted. The specialized assessment was deemed "early" when the rheumatologist was the first or second physician consulted after symptoms onset, and "late" when performed afterwards. Delays in RA diagnosis and treatment were inquired. Disease activity (DAS28-CRP) and physical function (HAQ-DI) were evaluated. Student's t, Mann-Whitney U, chi-squared and correlation tests, and multiple linear regression were performed. For sensitivity analysis, a propensity score-matched subsample of early- vs. late-assessed participants was derived based on logistic regression. The study received ethical approval; all participants signed informed consent. Results We included 1057 participants (89.4% female, 56.5% white); mean (SD) age: 56.9 (11.5) years; disease duration: 173.1 (114.5) months. Median (IQR) delays from symptoms onset to both RA diagnosis and initial treatment coincided: 12 (6-36) months, with no significant delay between diagnosis and treatment. Most participants (64.6%) first sought a general practitioner. Notwithstanding, 80.7% had the diagnosis established only by the rheumatologist. Only a minority (28.7%) attained early RA treatment (≤ 6 months of symptoms). Diagnostic and treatment delays were strongly correlated (rho 0.816; p < 0.001). The chances of missing early treatment more than doubled when the assessment by the rheumatologist was belated (OR 2.77; 95% CI: 1.93, 3.97). After long disease duration, late-assessed participants still presented lower chances of remission/low disease activity (OR 0.74; 95% CI: 0.55, 0.99), while the early-assessed ones showed better DAS28-CRP and HAQ-DI scores (difference in means [95% CI]: −0.25 [−0.46, −0.04] and − 0.196 [−0.306, −0.087] respectively). The results in the propensity-score matched subsample confirmed those observed in the original (whole) sample. Conclusions Early diagnosis and treatment initiation in patients with RA was critically dependent on early access to the rheumatologist; late specialized assessment was associated with worse long-term clinical outcomes.
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Abstract Background Management delays imply worse outcomes in rheumatoid arthritis (RA) and, therefore, should be minimized. We evaluated changes in diagnostic and treatment delays regarding RA in the last decades in Brazil. Methods Adults fulfilling the ACR/EULAR (2010) criteria for RA were assessed. Delays in diagnosis and treatment, and the frequencies of early management initiation within thresholds (windows of opportunity) of 3, 6, and 12 months from symptoms onset were evaluated. The Mann-Kendall trend test, chi-squared tests with Cramer's V effect sizes and analysis of variance were conducted. Results We included 1116 patients: 89.4% female, 56.8% white, mean (SD) age 57.1 (11.5) years. A downward trend was found in diagnostic (tau = - 0.677, p < 0.001) and treatment (tau = - 0.695, p < 0.001) delays from 1990 to 2015. The frequency of early management increased throughout the period, with ascending effect sizes across the 3-, 6-, and 12-month windows (V = 0.120, 0.200 and 0.261, respectively). Despite all improvements, even in recent years (2011-2015) the diagnostic and treatment delays still remained unacceptably high [median (IQR): 8 (4-12) and 11 (5-17) months, respectively], with only 17.2% of the patients treated within the shortest, 3-month window. Conclusion The delays in diagnosis and treatment of RA decreased during the last decades in Brazil. Improvements (effect sizes) were greater at eliminating extreme delays (≥ 12 months) than in attaining really short management windows (≤ 3 months). Very early treatment was still an unrealistic goal for most patients with RA.
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Abstract The aim of this review was to evaluate the prevalence of dental caries, periodontal disease, malocclusion, and tooth wear in indigenous in Brazil. A systematic review of observational studies was performed according to the PRISMA guidelines (CRD42020218704). The search strategy involved the electronic databases of Embase, LILACS, PubMed, Web of Science, Scopus, and the CAPES Theses and Dissertations for gray literature. The eligibility criteria consisted of publications that assessed the prevalence of oral conditions in indigenous populations in Brazil. Studies with indigenous people living in urban area were excluded. The risk of bias was evaluated by using JBI Critical Appraisal for prevalence studies. Thirty studies were included in the review, and the majority showed a low risk of bias. A meta-analysis of 20 studies was conducted using the random-effects model and a 95% confidence interval. Several ethnicities were studied in isolation or in groups (n = 7,627 for dental caries; n = 2,774 for periodontal disease; n = 1,067 for malocclusion; n = 150 for tooth wear). The prevalence of caries ranged from 50% among indigenous people aged 18-36 months to 100% among those aged 65-74 years. The prevalence of periodontal disease ranged from 58% to 83%. The prevalence of malocclusion was 43%. Tooth wear was assessed in only one ethnic group and showed a prevalence of 100% in indigenous people aged >18 years. The certainty of evidence assessed by the GRADE system ranged from very low to moderate. This systematic review showed significant differences in the prevalence of dental caries, periodontal disease and malocclusion between indigenous population groups and territories in which indigenous people live.
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Introdução: Atualmente, como resultado da globalização, o ambiente de trabalho vem sendo intensificado e sofrendo pressão constante, com isso, a classe dos profissionais de saúde se torna um grupo vulnerável ao desencadeamento de doenças ocupacionais, como a Síndrome de Burnout (SB), caracterizada por etiologia multidimensional: a exaustão emocional, a despersonalização e baixa realização nas atividades. Objetivo: Através das pesquisas à literatura, identificar a frequência da SB nos profissionais de saúde. Metodologia: Trata-se de uma revisão integrativa, segundo os preceitos de estudo exploratórios. Para coleta das fontes de informação foram utilizadas as bases de dados: PubMed, SciELO, Biblioteca Virtual em Saúde (BVS), e Medline, nos idiomas inglês, português e espanhol, dentro do intervalo de 2010 a 2020 e utilizando os seguintes Descritores em Ciências da Saúde (DeCS): Burnout, DORT, saúde do trabalhador. Resultados: Dentre os profissionais de saúde do setor de emergência, relacionados à SB, os médicos se destacaram evidenciando 6 especialidades: Anestesiologistas, Cardiologistas, Intensivistas, Neurologistas, Pediatras e Residentes em cirurgia geral. Conclusão: A partir dos resultados, se faze necessário o desenvolvimento de estudos e pesquisas científicas que investiguem os fatores associados negativamente à Síndrome de Burnout, com o objetivo de preveni-la e proporcionar melhor qualidade de vida a esta população.
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Introdução:As doenças do aparelho respiratório se configuram como o segundo principal motivo de internações hospitalares no Brasil entre 2013 e 2017. Objetivo:Analisar a morbimortalidade de doenças do aparelho respiratório da população brasileira, segundo faixa etária,no período compreendido entre os anos de 2015 a 2019. Metodologia:Trata-se de um estudo do tipo ecológico, retrospectivo, realizado sobre o território brasileiro. Os dados foram coletados a partir do Departamento de Informática do Sistema Único de Saúde, nas seções de Morbidade Hospitalar, de Mortalidade e População Residente. Foram analisados os dados entre 2015 a 2019 e de todas as faixas etárias. Resultados:Ao investigar a mortalidade por doenças do sistema respiratório entre os anos de 2015 e 2019, as cinco causas mais frequentes foram: influenza e pneumonia; doenças crônicas das vias aéreas inferiores; outras doenças do aparelho respiratório; outras doenças respiratórias que afetam principalmente interstício; doenças pulmonares devidas a agentes externos, nessa ordem. Enquanto as cinco causas de morbidades mais frequentes foram: pneumonia; outras doenças do aparelho respiratório; bronquite, enfisema e outras doenças pulmonares obstrutivas crônicas; asma; bronquite aguda e bronquiolite aguda. Conclusões:Verificou-se que a pneumonia, influenza, doenças respiratórias do trato inferior e outras doenças crônicas respiratórias foram as mais prevalentes entre a população respectivamente. Dentre o público mais acometido, foi possível constatar que o público infantil e a população idosa foram os mais atingidos tanto na mortalidade quanto na morbidade (AU).
Introduction:Introduction: Respiratory diseases are the second main reason for hospital admissions in Brazil between 2013 and 2017. Objective:To analyze the morbidity and mortality of respiratory diseases of the Brazilian population, according to age group, in the period from 2015 to 2019. Methodology:This is an ecological, retrospective study conducted on the Brazilian territory. Data were collected from the Informatics Department of the Unified Health System, in the Sections of Hospital Morbidity, Mortality and Resident Population. Data were analyzed between 2015 and 2019 and all age groups. Results:When investigating mortality from respiratory system diseases between 2015 and 2019, the five most frequent causes were: influenza and pneumonia; chronic diseases of the lower airways; other diseases of the respiratory system; other respiratory diseases that mainly affect interstitium; diseases due to external agents, in that order. Conclusions:It was found that pneumonia, influenza, respiratory diseases of the lower tract and other chronic respiratory diseases were the most prevalent among the population, respectively. Among the most affected public, it was possible to observe that the child's public and the elderly population were the most affected in both mortality and morbidity (AU).
Introducción: Las enfermedades respiratorias son la segunda razón principal de los ingresos hospitalarios en Brasil entre 2013 y 2017. Objetivo: Analizar la morbilidad y mortalidad de las enfermedades respiratorias de la población brasileña, según el grupo de edad, en el período comprendido entre 2015 y 2019.Metodología: Se trata de un estudio ecológico y retrospectivo realizado en territorio brasileño. Los datos fueron recogidos del Departamento de Informática del Sistema Unificado de Salud, en las Secciones de Morbilidad Hospitalaria, Mortalidad y Población Residente. Los datos se analizaron entre 2015 y 2019 y todos los grupos de edad. Resultados: Al investigar la mortalidad por enfermedades del sistema respiratorio entre 2015 y 2019, las cinco causas más frecuentes fueron: gripe y neumonía; enfermedades crónicas de las vías respiratorias inferiores; otras enfermedades del sistema respiratorio; otras enfermedades respiratorias que afectan principalmente al intersticio; enfermedades debidas a agentes externos, en ese orden.Mientras que las cinco causas más frecuentes de morbilidad fueron: neumonía; otras enfermedades del sistema respiratorio; bronquitis, enfisema y otras enfermedades pulmonares obstructivas crónicas; asma; bronquiolitis aguda y bronquiolitis aguda. While the five most frequent causes of morbidities were: pneumonia; other diseases of the respiratory system; bronchitis, emphysema and other chronic obstructive pulmonary diseases; asthma; acute bronchitis and acute bronchiolitis. Conclusiones: Se encontróque la neumonía, la influenza, las enfermedades respiratorias de las vías inferiores y otras enfermedades respiratorias crónicas eran las más prevalentes entre la población, respectivamente. Entre el público más afectado, se pudo observar que el público del niño y la población de edad avanzada eran los más afectados tanto en la mortalidad como en la morbilidad (AU).
Subject(s)
Humans , Male , Female , Respiratory System/anatomy & histology , Respiratory Tract Diseases/pathology , Brazil/epidemiology , Indicators of Morbidity and Mortality , Retrospective Studies , Data Interpretation, Statistical , Ecological Studies , Age GroupsABSTRACT
Objetivo: Este artigo visa relatar a experiência da construção e implementação de ações de Educação Alimentar e Nutricional (EAN) transversais aos componentesdo currículo escolar do ensino fundamental.Método:As ações foram realizadas entre agosto e dezembro de 2020 em uma escola pública na Paraíba, com base em conteúdos previstos no Marco de EAN para as políticas públicas e no Guia alimentar para a população brasileira, transversalmente associados ao desenvolvimento cognitivo e conteúdosde português e matemática. Resultados: Nos resultados foram descritas as estratégias aplicadas nas ações de EAN e na articulação com componentes curriculares da escola,segundo a idade escolar dos alunos. Com a vivência observou-se, no recurso lúdico, como jogos e contação de histórias, uma estratégia necessária ao engajamento dos alunos nas ações. A articulação entre EAN e o currículo escolar foi viável devido à disponibilização do planejamento pedagógico em curso por todos os professores da escola. O desenvolvimento de ações de EAN adaptadas à idade escolar do aluno garantiram melhor aprendizado e participação dos escolares. Conclusão: As ações transversais de EAN são desafiadoras e demandam criatividade, vínculo entre os educadores e a equipe da escola e planejamento adequado à realidade territorial e das turmas.
Objective: This study aims to report the experience of the construction and implementation of school-based food and nutrition education (SFNE) transversal actions to an elementary school curriculum. Method: The actions were conducted between August and December 2020 in a public school in the state of Paraíba, in Brazil, based on the content of the Brazilian Food and Nutrition Education Framework for Public Policies and on the Dietary Guidelines for the Brazilian population transversally associated to cognitive development and topics in Portuguese and Mathematics classes. Results: In the results, the strategies of the Food and Nutrition Education (FNE) actions executed were described, as well as the articulations to the school's curricular components, according to the school age of the students. With the experience, ludic resources, such as games and story-telling, were observed as a strategy necessary to the engagement of students in the actions. The articulation of FNE with the school curriculum was viable due to the availability of the current pedagogic planning by all teachers in the school. The conduction of the FNE actions adapted by school age granted a more satisfactory learning and better participation of the students. Conclusion: The transversal FNE actions were challenging and demanded creativity, rapport between educators and the school's management team, as well as planning adequately done considering territorial singularities and those of each school cohort.
Subject(s)
Humans , Child , Students , School Feeding , Food and Nutrition Education , Curriculum , Play and Playthings , BrazilABSTRACT
Abstract Background: Rheumatoid arthritis (RA) is a common autoimmune systemic inflammatory disease. In addition to joint involvement, RA patients frequently have other comorbidities, such as cardiovascular diseases. Drugs used for RA treatment may increase or decrease the risk of a cardiovascular event. This study aims to analyze cardiovascular risk comorbidities in patients with RA and the correlation with the use of anti-rheumatic drugs. Methods: Cross-sectional study conducted based on the real-life rheumatoid arthritis study database - REAL, a prospective observational cohort study. Associations between the use of anti-rheumatic drugs and the presence of comorbidities were represented by their prevalence ratio and evaluated using the Chi-square or Fisher's Exact tests. Results: We assessed 1116 patients, 89.4% women, mean age of 55.15 years and predominance of seropositive disease. 63.3% had some cardiovascular comorbidity, predominantly hypertension (49.9%). The use of glucocorticoids was observed in 47.4% of patients and there was a significant tendency of lower use of these drugs in the presence of dyslipidemia (PR: 0.790; p = 0.007). We observed that the presence of cardiovascular comorbidities was associated with higher use of bDMARDs (PR:1.147; p = 0.003). Conclusions: The presence of cardiovascular risk comorbidities was confirmed to be higher in RA patients. Different treatment strategies using less glucocorticoids in the presence of dyslipidemia and more common use of bDMARDs in patients with cardiovascular comorbidities suggest that rheumatologists are aware of the potential influence of the DMARDs in the risk of cardiovascular event. Reinforcing these results, we highlight the need for a better baseline assessment to guide the choice of anti-rheumatic drugs in RA patients who have comorbidities.
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Resumo Cuidados paliativos visam amenizar o sofrimento de pacientes com doenças crônicas e ameaçadoras da vida nas dimensões: física, social, psicológica e espiritual. Na dimensão espiritual, procura-se imbuir de sentido aspectos transcendentais, como vida e morte. Conhecer esses sentidos é o objetivo deste estudo, que se trata de pesquisa qualitativa de caráter exploratório e faz uso de entrevistas semiestruturadas para a coleta de dados e análise do discurso. Foram entrevistados quatro pacientes e identificadas três categorias de significado: recursos de enfrentamento relativos à finitude; sofrimentos relativos à finitude; sentidos atribuídos à vida e à morte. Percebeu-se como maior sofrimento não a finitude em si, mas o que decorre dela, como perda funcional, preocupação com a família e ameaça de valores. A dificuldade em se falar sobre a morte não necessariamente se encontra em si mesma, mas em identificar o sentido que ela tem para a pessoa e os sofrimentos subjacentes.
Resumen Los cuidados paliativos se proponen mitigar el sufrimiento de pacientes con enfermedades crónicas y amenazadoras de vida en cuatro dimensiones: física, social, psicológica y espiritual. En la dimensión espiritural se pretende llenar de sentido con aspectos trascendentales, como vida y muerte. Este estudio tiene como objetivo conocer estos sentidos. Para ello, se utilizó el método cualitativo de carácter exploratorio y aplicó entrevistas semiestructuradas para recopilar los datos y el análisis del discurso. Se entrevistaron a cuatro pacientes, y se identificó tres categorías de significado: recursos de afrontamiento relacionados con la finitud, sufrimientos relacionados con la finitud y sentidos atribuidos a la vida y la muerte. Se observó que el mayor sufrimiento no era la finitud en sí, sino lo que deriva de ella, como la pérdida funcional, la preocupación por la familia y la amenza de valores. La dificultad de hablar acerca de la muerte no reside necesariamente en sí misma, sino en identificar el sentido que tiene para la persona y los sufrimientos subyacentes.
Résumé Les soins palliatifs visent à soulanger les souffrances des patients atteints de maladies chroniques et potentiellement mortelles dans quatre domaines: physique, social, psychologique et spirituel. Ce dernier renvoie au sens que l'on peut donner à des aspects transcendants tels que la vie et la mort. Explorer ces différentes facettes est l'objective de cette étude. Il s'agit d'une recherche qualitative de nature exploratoire, menée à partir d'entretiens semi-directifs pour la collecte de données et l'analyse du discours. Quatre patients ont été interrogés et trois catégories de signification ont été identifiées: les ressources d'adaptation liées à la finitude, la souffrance associées à la finitude, et les sens attribué à la vie et à la mort. Il en ressort que la plus grande souffrance n'est pas l'idée de finitude en soi, mais ce qui en découle, comme la perte d'autonomie fonctionnelle, l'anxiété à l'égard de la famille et la remise en question des valeurs. La difficulté de parler de la mort ne réside cependant pas nécessairement dans le fait de parler de la mort elle-même, mais dans l'identification du sens qu'elle revêt pour la personne concernée et dans l'identification des souffrances sous-jacentes.
Abstract Palliative care seeks to alleviate the suffering of patients with chronic and life-threatening diseases in the physical, social, psychological and spiritual dimensions. In the spiritual dimension, it seeks to imbue transcendental aspects, such as life and death, with meaning. Knowing these senses is the objective of this study, which is a qualitative research of exploratory character, and uses semi-structured interviews for data collection and discourse analysis. Four patients were interviewed and three categories of meaning were identified: finitude coping resources; sufferings related to finitude; meanings attributed to life and death. We noticed the greater suffering was not the finitude itself, but what arises from it, such as functional loss, concern for the family and threat of values. The difficulty in talking about death is not necessarily in itself, but in identifying the meaning it has for the person and the underlying sufferings.
Subject(s)
Humans , Male , Female , Middle Aged , Aged , Palliative Care/psychology , Spirituality , Psychological DistressABSTRACT
Introdução: Nas situações da vida diária, frequentemente, é necessário reconhecer a fala em ambientes com ruído competitivo, sendo que dificuldades neste reconhecimento é uma queixa comum de pessoas com transtornos do processamento auditivo central (TPAC). O Teste de Dígitos no Ruído (TDR), desenvolvido para triagem de perdas auditivas em adultos e idosos, apresenta vantagens que o tornam promissor para triagem em crianças com TPAC. Objetivo: Verificar o desempenho de crianças com TPAC no TDR baseado em software para o Português brasileiro. Método: A amostra de conveniência foi constituída por 31 crianças (8-12 anos), sendo 23 com TPAC, alocadas no G1, e oito sem o transtorno, que compuseram o G2. Todas realizaram avaliação audiológica básica, timpanometria, reconhecimento numérico visual e aleatório, aplicação do TDR e avaliação comportamental do processamento auditivo central (PAC) para determinar presença ou não do TPAC. Na análise foi utilizado Teste de Mann-Whitney no comparativo entre G1 e G2 e correlação de Sperman entre os testes de PAC e a média da relação S/R (RSR) do TDR. Resultados: G1 e G2 apresentaram desempenhos significativamente diferentes nos testes fala filtrada (orelha direita), dicótico de dígitos (orelha esquerda), fusão binaural e gaps-in-noise de ambas as orelhas e no teste de padrões de frequência. A média da relação sinal/ruído (RSR) do TDR foi de -7,29 dB (dp ± 4,76) nos sujeitos do G1 e de -8,42 dB (dp ± 2,93) no G2. Não houve diferença estatisticamente significante entre G1 e G2 no comparativo das médias de RSR final (p = 0,227). Não foi evidenciada correlação na maior parte dos testes de PAC e o TDR, exceto correlação negativa no FBOE e DDIOD. Conclusão: O desempenho das crianças com TPAC é similar ao de crianças sem TPAC no teste de dígitos no ruído em Português Brasileiro.
Speech recognition on noise is an auditory processing skill, important for children in contexts with competitive noise and reverberation and can test their functional capacity. The Digits-in-Noise (DIN) Test, developed for hearing screening in adults and the elderly, has advantages that make it promising for screening children with central auditory processing disorders (CAPD). Objective: Verify the performance of children with central auditory processing disorder in a software-based DIN Test for Brazilian Portuguese. Methods: The convenience sample comprised 31 children (8 to 12 years), 23 with CAPD placed in G1, and eight without the disorder that composed G2. All children underwent basic audiological assessment and tympanometry, visual and random numerical recognition, use of DIN and auditory processing behavioral assessment to determine the presence or absence of APD. We used the Mann-Whitney test to compare G1 and G2. Results: G1 and G2 presented different performances in the filtered speech (right ear), dichotic digits (left ear), binaural fusion and gaps-in-noise tests of both ears and in the frequency pattern test. We observed that the average DIN signal-to-noise ratio (SNR) was -7.29 dB (SD ± 4.76) in G1 subjects, and -8.42 dB (SD ± 2.93) in G2 subjects. There was no statistically significant difference between G1 and G2 in comparison of average final SNR (p = 0.227). Conclusion: Considering the average values of the final SNR, we found that the children's performance in the DIN test was similar between both groups.
Introducción: Reconocimiento de habla en ruido es una habilidad del procesamiento auditivo, importante para chicos en contextos con ruido competitivo y reverberación, y puede ser evaluada para determinar su capacidad funcional. La Prueba de Dígitos en Ruido (PDR), desarrollada para detectar pérdida de audición en adultos y ancianos, presentado ventajas que lo hacen prometedor para detección en niños con trastorno del procesamiento auditivo central (TPAC). Objetivo: Verificar el rendimiento de niños conTPAC en PDR basado en software en portugués brasileño. Metodos: La muestra de conveniencia consistió en 31 niños entre 8-12 año, 23 chicos con TPAC, asignado en G1, y ocho sin trastorno, que componen G2. Todos realizaron evaluación audiológica básica, timpanometría, reconocimiento numérico visual y aleatorio, aplicación del PDR y evaluación comportamental del procesamiento auditivo, aplicación del PDR e del comportamiento del procesamiento auditivo para determinar la presencia o ausencia de TPAC. Se utilizó la prueba de Mann-Whitney para análisis entre G1 y G2. Resultados: G1 y G2 presentaron diferentes rendimientos en pruebas de habla filtrada (oído derecho), dígitos dicóticos (oído izquierdo), fusión binaural y gaps-in-noise en ambos oídos y en la prueba del patrón de frecuencia. La Relación Señal/Ruido (S/R) del PDR fue -7.29 dB (sd ± 4.76) en chicos del G1 y -8.42 dB (sd ± 2.93) en G2. No hubo diferencias estadísticamente significativas entre G1 y G2 al comparar las medias finales de RSR (p = 0.227). Conclusión: Teniendo en cuenta valores de la media S/R final, hubo similitud de rendimiento en PDR en ambos grupos.
Subject(s)
Humans , Male , Female , Child , Audiometry, Speech/methods , Auditory Perceptual Disorders , Hearing Tests , Mass Screening , Cross-Sectional Studies , Prospective Studies , Hearing , NoiseABSTRACT
RESUMO Este estudo avaliou a toxicidade e a atividade antimicrobiana frente a Escherichia coli e Staphylococcus aureus dos óleos essenciais de Pimenta dioica Lindl. e Citrus sinensis L. Os óleos essenciais (OE) foram extraídos por hidrodestilação, com caracterização química através de cromatografía gasosa acoplada a espectrometria de massas (CG-EM). Os parâmetros físico-químicos foram determinados de acordo com a Farmacopeia Brasileira. O ensaio de toxicidade seguiu o bioensaio com Artemia salina Leach, os OE aprovados neste ensaio seguiram para avaliação das suas propriedades biológicas. A atividade antimicrobiana seguiu a metodologia descrita pelo Clinical and Laboratory Standards Institute utilizando o método de difusão de disco, diluição em caldo para concentração inibitória mínima (CIM) e posterior concentração bactericida mínima para avaliar a ação dos OE frente a Escherichia coli e Staphylococcus aureus. Ambos os OE apresentaram toxicidade baixa, e assim foram avaliados quanto as propriedades biológicas antimicrobianas. Ambos os OE apresentaram potenciais bactericidas frente aos microrganismos testados, exibindo resultados satisfatórios para a ação deles. Os resultados indicam que os OE avaliados são compostos por substâncias que propiciam e incentivam sua aplicação em virtude de seus potenciais para atividade biológicas moluscicida e antimicrobiana.
SUMMARY This study evaluated the toxicity and antimicrobial activity in the face of Escherichia coli and Staphylococcus aureus of essential oils of Pimenta dioica Lindl. and Citrus sinensis L. The essential oils (EO) were extracted by hydrodistillation, with chemical characterization by gas chromatography coupled and mass spectrometry (GC-MS). Physicochemical parameters were determined according to the Brazilian Pharmacopeia. The toxicity test followed the bioassay with Artemia salina Leach, the EO approved in this assay followed to evaluate its biological properties. The antimicrobial activity followed the methodology described by the Clinical and Laboratory Standards Institute using the disc diffusion method, broth dilution for minimum inhibitory concentration (MIC) and subsequent minimum bactericide concentration for to evaluate the action of EO against Escherichia coli and Staphylococcus aureus. Both OE showed low toxicity, and thus were evaluated for the biological antimicrobial properties. Both OE presented bactericidal potential against the microorganisms tested, showing satisfactory results for their action. The results indicate that the evaluated OE are composed of substances that provide and encourage their application due to their potentials for biological molluscicide and antimicrobial activity.
ABSTRACT
Abstract Background: Last decades witnessed great technological advances in rheumatoid arthritis (RA) management, but their implementation in clinical practice might prove difficult. Despite the efficacy demonstrated in controlled trials this information needs to be confirmed by real life data. This study assessed real-life treatment among RA patients. Methods: REAL study included Brazilian RA patients from eleven centers. Interview and medical records were performed. Continuous variables were compared using Student's t or Mann-Whitney and categorical variables were assessed with chi-square or Fisher's exact tests. Results: 1115 patients were included, women 89.5%. Median age 56.6 years, disease duration 152.5 months; 78.7% were rheumatoid fator positive; 55.2% had erosive disease; DAS28 (disease activity index-28 joints) = 3.5, HAQ (health assessment questionnaire) =0.875. The median duration of symptoms until the start of first DMARD was 12 months. A total of 529 (47.2%) patients used corticosteroids; 1022 (90.8%) were on conventional synthetic (cs) DMARDs and 406 (36.1%) on biological (b) DMARDs. Methotrexate (MTX) was the most frequent csDMARD: 748 (66.5%) patients, followed by leflunomide (LFN), used by 381 (33.9%) of patients. MTX was associated to LFN in 142 (12.6%) patients. Only five (0.4%) patients used triple therapy (MTX + hydroxychloroquine + sulfasalazine) or sulfasalazine in monotherapy. Conclusions: Despite advances in therapeutic resources, roughly half RA patients failed achieve T2T goals and 55.2% developed erosive disease. The frequent use of corticosteroids and delay in initiating DMARDs were demonstrated. Issues concerning timely access to medical care are crucial for effective management.(AU)
Subject(s)
Humans , Arthritis, Rheumatoid/drug therapy , Brazil , Methotrexate/therapeutic use , Adrenal Cortex Hormones/therapeutic useABSTRACT
Abstract Background: In Brazil, socioeconomic differences in the incidence of rheumatoid arthritis (RA) have been demonstrated, which are important in the formulation of hypotheses regarding the association between environmental factors, lifestyle and the risk of disease development. This study examines how the socioeconomic condition of the patient with RA in Brazil, assessed according to social class, educational level, employment situation and use of caregivers, affects the times between the beginning of symptoms and diagnosis and the beginning of the use of disease-modifying antirheumatic drugs, as well as the presence of erosive disease and functional status. Methods: This work is part of a multicentric study called REAL - Rheumatoid Arthritis in Real Life in Brazil, which is a prospective observational cohort study. Results: As described in the REAL study, we included a total of 1115 patients. It was noted that patients with an educational classification of up to second grade incomplete presented with erosion percentages above those with a higher grade complete. Patients with caregivers presented a higher percentage of erosion than patients without caregivers. We verified that patients from economic classes above B2 presented fewer occurrences of erosion than those from classes C2, D-E. We also analyzed the average time differences from the beginning of symptoms and diagnosis and the beginning of treatment, according to academic level, erosion and economic classification. Patients with first grade complete showed an HAQ-DI averages higher than those with second grade complete. The patients who had employment showed lower HAQ-DI averages than patients who were not employed. The patients with erosion showed an HAQ-DI value higher than those without erosion. Patients with caregivers showed an HAQ-DI average higher than that of without caregivers. Conclusion: This study showed that the therapeutic window of RA is not being reached, and therefore we should have a policy to expand and ensure access to public health for all patients, especially those with lower levels of education and income. Trial registration: This study was approved by the National Commission of Ethics in Research.(AU)
Subject(s)
Humans , Arthritis, Rheumatoid/epidemiology , Social Class , Demographic Indicators , Public Policy , Brazil/epidemiology , Cohort Studies , Life StyleABSTRACT
Objetivo Descrever o perfil epidemiológico da hanseníase em Campinas através do levantamento do número de casos da doença, registrados de 2011 a agosto de 2018 no município. Métodos Tratou-se de uma pesquisa com abordagem transversal retrospectiva, quantitativa do tipo descritiva com a coleta de dados registrados no Sistema de Informação de Agravos de Notificação (Sinan) a respeito dos casos de hanseníase notificados no período de agosto de 2011 a agosto de 2018. Resultados Foram encontrados 213 novos casos de hanseníase em Campinas no período estudado, com uma taxa de incidência de 2,47 casos para cada 100 mil habitantes. A população masculina apresentou-se com 57% dos casos registrados e a população feminina com 43%. A hanseníase mostrou-se prevalente em populações com idade acima de 14 anos com 96% das notificações. As formas clínicas iniciais mais encontradas foram a Virchowiana e a Dimorfa, com 31% e 26% respectivamente. O distrito residencial com o maior número de casos foi o Sul, com 28% dos casos registrados e o grau de incapacidade mais prevalente no momento do diagnóstico, foi o grau 0 da patologia com 59% dos casos notificados. Quanto a classificação operacional da notificação, notou-se que a classificação multibacilar apresentou 69% dos casos. Conclusão Conclui-se que apesar da taxa de incidência da hanseníase no município de Campinas estar em declínio nas últimas décadas, é necessário manter o afinco dos órgãos de saúde do município na luta contra a doença, pois esta, ainda é considerada como um grave problema de saúde pública
Objective To describe the epidemiological profile of leprosy in Campinas by surveying the number of cases of disease, recorded from 2011 to August 2018 in the city. Methods This is a cross-sectional, quantitative, descriptive retrospective research with data collection recorded in the Notification Recording Information System (Sinan) and respect for unreported leprosy cases from August 2011 to August 2018. Results A total of 213 new leprosy cases were found in Campinas during the study period, with an incidence rate of 2.47 cases per 100,000 inhabitants. The male population shows up with 57% of registered cases and the female population with 43%. Leprosy was prevalent at ages over 14 years with 96% of notifications. The most recent clinical forms found were Virchowiana and Dimorfa, with 31% and 26%, respectively. The residential district with the largest number of cases was the South, with 28% of the cases registered and the most prevalent degree of disability at the time of diagnosis, was the degree 0 pathology with 59% of the reported cases. Regarding the operational classification of the notification, there is no multibacillary classification Displaying 69% of cases. Conclusion It was concluded that, although leprosy incidence rates in the city of Campinas have been declining in the last decades, it is necessary to maintain the commitment of public agencies of the city in the fight against the disease, since it is still considered as a serious public health problem.
Subject(s)
Humans , Male , Female , Public Health , Epidemiology , Communicable Diseases , Leprosy , Mycobacterium leprae , Health Profile , Incidence , Drug Therapy, CombinationABSTRACT
Objetivo Realizar análise microbiológica de escovas dentais utilizadas por moradores da cidade de Sumaré e ainda analisar seus hábitos de higiene e cuidados com a escova de dente. Métodos Foram selecionados 100 voluntários aleatoriamente, com idade a partir de 18 anos para responder um questionário sobre hábitos de higiene e cuidados com as suas escovas dentais e desses voluntários 20 escovas foram coletadas de forma aleatória para análise microbiológica e de desgaste das cerdas, no laboratório de análises clínicas da Universidade Paulista. Resultados Verificou-se que a maioria (56%) escovam os dentes duas vezes ao dia, que 44% (44/100) trocam as escovas no período de 2 a 3 meses, porém a maior parte não apresentava conhecimento em relação aos métodos de desinfecção para escova de dentes. Com relação a análise de desgastes das cerdas, 50% apresentavam a maioria dos tufos das cerdas divergentes, com tufos cobrindo outros tufos. Quanto a análise microbiológica 85% (17/20) das escovas de dentes apresentou crescimento microbiano, no qual a maior parte (75%) compreendia em Staphylococcus spp., seguido por 30% de enterobactérias, 5% de bacilo gram-positivo,15% Streptococcus spp. e 10% diplococos gram-negativo. Conclusão Nesta perspectiva percebe-se que existe uma necessidade de conscientizar a população em relação à manutenção adequada das escovas de dentes. Quanto a contaminação nas escovas, observamos que não está necessariamente relacionada ao tempo de uso e desgaste das cerdas da escova dental.
Objective The objective of this study is to verify the presence of bacteria in the toothbrush and to evaluate the knowledge of the residents of the Sumaré city about toothbrush care. Methods Were selected 100 volunteers randomly, aged 18 years and older to answer a questionnaire, and of theses 20 brushes were randomly collected for microbiological and bristle wear analyzes in the toothbrush at the clinical analyzes laboratory of Universidade Paulista. Results Most (56%) brush their teeth twice a day, 44% (44/100) changes their brushes within 2 to 3 months, but most respondents do not know disinfection methods for toothbrush. In relation the toothbrush bristle wear analysis, 50% presented the majority of divergent bristle, with tufts, covering other tufts. Regarding the microbiological analysis, 85% (17/20) of the toothbrushes showed a microbial growth, where the most (75%) comprised of Staphylococcus spp., followed by 30% enterobacteria, 5% bacilli gram positive, 15% Streptococcus spp. and 10% diplococci gram negative. Conclusion In this perspective, it is observed that there is a need to make the population aware of the maintenance of toothbrushes. About contamination in the brushes, we observed that not necessarily it is associate to time of use and wear of toothbrush bristles.
Subject(s)
Humans , Male , Female , Adult , Oral Hygiene , Oral Health , Microbiological Techniques , Periodontal Diseases , Toothbrushing , MouthABSTRACT
Abstract Background Benzbromarone is a uricosuric drug that has been used in the treatment of gout over the last 30 years. Due to its potent inhibition of the dominant apical (luminal) urate exchanger in the human proximal tubule URAT1, it reduces the urate reabsorption, diminishing serum urate levels and therefore preventing gout flares. Main body of the abstract Through several clinical trials, Benzbromarone has been proved effective and safe, inclusive in patients with chronic kidney disease and as combination therapy with allopurinol. Due to hepatotoxicity reports, it was withdrawn from the European market by the manufacturer, however many authors have questioned the product's withdrawal due to a lack of clinical evidence in order to support its hepatotoxicity. Benzbromarone is still available in several European countries, New Zealand, Brazil and several other countries. Despite the product's marketing over more than 20 years after the first hepatotoxicity reports, we have found only five reports in our literature search, and no prospective or retrospective study correlating hepatotoxicity with benzbromarone use. Short conclusion Benzbromarone is a safe and effective molecule for the treatment of gout. However, due to in vitro and in vivo data related to hepatotoxicity, it is prudent to prescribe it with some caution, especially for patients with an already known liver condition.
Subject(s)
Humans , Benzbromarone/therapeutic use , Gout/drug therapy , Allopurinol/administration & dosage , Drug Combinations , Drug-Related Side Effects and Adverse ReactionsABSTRACT
Objetivo Avaliar a evolução da infecção e a ocorrência de doenças oportunistas e sexualmente transmissíveis em indivíduos diagnosticados com HIV na cidade de Indaiatuba, visando divulgação de informações e resultados que poderão estimular criação de projetos relevantes para a prevenção do agravo de HIV e para a garantia de melhor expectativa de vida nesta população. Métodos Coleta de dados em 40 prontuários médicos de pacientes infectados pelo HIV atendidos no Hospital Dia de Indaiatuba. Os dados obtidos através de análise retrospectiva foram utilizados para o preenchimento de planilhas que dispunham as informações mais relevantes para a pesquisa. Análises estatísticas foram utilizadas para demonstrar diferenças significantes entre grupo de indivíduos assintomáticos ou com sintomas leves e grupo de indivíduos em estágio avançado da doença. Resultados A análise dos dados mostrou que 60% dos pacientes diagnosticados estavam em estágio assintomático/moderado da infecção pelo HIV, enquanto que outros 40% estavam em estágios avan- çados da AIDS. Houve mais infecções oportunistas do que DST de modo geral. Entretanto, pacientes em estágio avançado da doença, grupo definido como AIDS, apresentaram mais infecções oportunistas do que os pacientes assintomáticos ou com sintomas moderados. Os pacientes em estágio assintomático/moderado apresentaram poucas doenças concomitantes. As doenças de maior frequência nos pacientes avaliados neste presente estudo foram candidíase, sífilis, pneumocistose, HPV, entre outros. Conclusão Pacientes em estágio avançado da doença apresentaram maior número de doenças oportunistas e sexualmente transmissíveis em relação aos pacientes em estágio assintomático/moderado, revelando que a imunossupressão está associada à maior suscetibilidade do paciente ao desenvolvimento destas doenças. Esta suscetibilidade às doenças contribui para o agravamento da doença e torna o paciente mais debilitado. Sendo assim, é necessário adequado acompanhamento médico e clínico-laboratorial ao paciente portador de HIV para monitoramento da evolução da doença e garantia de melhor qualidade e expectativa de vida.
Objective Evaluate the evolution of the infection and the occurrence of opportunistic and sexually transmitted diseases in HIV diagnosed individuals in Indaiatuba, aiming at disseminating information and results that can stimulate creation of relevant projects for the prevention of HIV grievance and better life expectation guarantee in this population. Methods Data collection in 40 medical records of HIV-infected patients treated at Indaiatuba Day Hospital. The data obtained from retrospective analysis were used for filling out spreadsheets that had the most relevant information for the research. Statistical analyzes were made to demonstrate significant differences between the group of asymptomatic or mildly symptomatic individuals and group of individuals at an advanced stage of the disease. Results Data analysis showed that 60% of diagnosed patients were in asymptomatic/moderate stage of HIV infection, while the other 40% were in advanced stages of AIDS. There were more opportunistic infections than STDs in general. However, patients with advanced disease, group defined as AIDS, showed more opportunistic infections than patients asymptomatic or with mild symptoms. Patients in asymptomatic/moderate stage presented few concomitant diseases. The most frequent diseases in patients evaluated in this study were candidiasis, syphilis, pneumocystosis, HPV, among others. Conclusions Patients with advanced stage of disease showed a higher number of opportunistic and sexually transmitted diseases compared to patients in an asymptomatic/moderate stage, showing that immunosuppression is associated with higher susceptibility of the patient to the development of these diseases. This susceptibility to diseases contributes to the aggravation of the disease and makes the patient weeker. Therefore, it is necessary an appropriate medical follow-up to the HIV-infected patient for monitoring the disease progression and guarantee best quality and life expectancy.
Subject(s)
Humans , Male , Female , Acquired Immunodeficiency Syndrome , HIV , Infections , Opportunistic InfectionsABSTRACT
O câncer de colo do útero é a segunda causa de câncer mais comum entre as mulheres em todo o mundo, sendo precedido por lesões precursoras denominadas neoplasias intraepiteliais cervicais (NICs), de grau 1, 2 e 3. A relação entre o papilomavírus humano (HPV) e o câncer de colo uterino já está bem estabelecida. O ciclo de vida do HPV, assim como seu mecanismo de ação sobre o ciclo celular da célula hospedeira, causam a transformação neoplásica e progressão das lesões precursoras para o câncer de colo uterino. Tal transformação está associada principalmente à expressão de dois genes do HPV: o E6 e o E7, cujos produtos interferem no controle do ciclo celular, tendo como alvos principais as proteínas p53 e pRB. Esta revisão de literatura pretende fornecer ao leitor conhecimento da ação do HPV sobre o ciclo celular, visando identificar potenciais marcadores biológicos da evolução das lesões precursoras ao câncer de colo uterino.
Cervical cancer is the second most common malignant disease in women worldwide and is preceded by cervical intraepithelial neoplasia (CIN) grades 1, 2 and 3. The relationship between human papillomavirus (HPV), cervical CIN and cervical cancer is well established. The HPV life cycle cause neoplastic transformation and CIN progression for cervical cancer. This transformation is associated with E6 and E7 HPV genes, whose products interfere with cell cycle control, mainly through action on p53 and pRB proteins. This review aims to provide to the reader an update for the understanding of the HPV effects on the cell cycle, attempting to identify potential biological markers for the evolution of precursor lesions to cervical cancer.