Ozonoterapia y cáncer: mito o realidad / Ozone Therapy and Cancer: Myth or Reality

Introducción: El uso clínico de la ozonoterapia se incrementa cada día. Abarca disímiles especialidades médicas como la oncología. En Cuba las investigaciones que evalúan el empleo de la ozonoterapia en pacientes con cáncer son escasas, se precisan estudios científicos que demuestren su eficacia clínica. Objetivo: Explicar los mecanismos farmacológicos y bioquímicos de la ozonoterapia y su uso en el cáncer como terapia complementaria. Métodos: Se consultaron bases de datos disponibles a través de la red de Infomed. Se utilizaron como palabras clave: cáncer, ozonoterapia y estrés oxidativo. Se seleccionaron artículos originales y de revisión sistemáticos de los últimos diez años que evaluaron la utilización de la ozonoterapia en el tratamiento del cáncer. Resultados: El cáncer es per se una enfermedad inductora de estrés oxidativo. La ozonoterapia respalda su utilización como una terapia adyuvante mediante el preacondicionamiento oxidativo que estimula los sistemas antioxidantes de la célula contra la acción de los radicales libres. Así, se logra neutralizar la acción nociva del estrés oxidativo. El ozono incrementa la eficacia de la radio - quimioterapia y ayuda a reducir los efectos secundarios de estos tratamientos al activar los sistemas antioxidantes de la célula. La ozonoterapia se caracteriza por la simplicidad de su aplicación, bajos costos, alta efectividad y prácticamente ausencia de efectos colaterales en comparación con otros tratamientos adyuvantes. Conclusiones: El uso de la ozonoterapia en oncología como una terapia adyuvante representó un recurso terapéutico de gran valor dado por su perfil de efectividad y seguridad. Su uso podría extenderse para disminuir los efectos secundarios y mejorar la calidad de vida de los pacientes(AU)

Introduction: The clinical use of ozone therapy is increasing every day worldwide and it covers different medical specialties, including oncology. However, in Cuba, the investigations that evaluate the use of ozone therapy in cancer patients are scarce, so scientific studies are needed to demonstrate its clinical efficacy. Objective: To explain the pharmacological and biochemical mechanisms of ozone therapy and its use in cancer as a complementary therapy. Methods: Databases available through Infomed Network were consulted. Key words used were cancer, ozone therapy and oxidative stress. Original and systematic review articles from the last ten years that evaluated the use of ozone therapy in the treatment of cancer were selected. Results: Cancer is, as such, a disease that induces oxidative stress. Ozone therapy supports its use as an adjuvant therapy through oxidative pre-conditioning that stimulates the cell's antioxidant systems against the action of free radicals. Thus, it is possible to neutralize the harmful action of oxidative stress. Ozone increases the efficacy of radio-chemotherapy and helps reducing the side effects of these treatments by activating the cell's antioxidant systems. Ozone therapy is characterized by the simplicity of its application, low costs, high effectiveness and with practically no side effects, compared to other adjuvant treatments. Conclusions: The use of ozone therapy in oncology as an adjuvant therapy represented a therapeutic resource of great value given its effectiveness and safety profile. Its use could be extended to improve tissue oxygenation and thus enhance the efficacy of radiochemotherapy, reducing side effects and improving the patients's quality of life(AU)

Proposta de novo protocolo de fotobiomodulação profilática para mucosite oral e orofaríngea induzida por quimioterapia: um estudo clínico randomizado / Proposal of a prophylactic photobiomodulation protocol for chemotherapyinduced oral and oropharyngeal mucositis: a randomized clinical trial

A terapia de fotobiomodulação (TFBM) é amplamente utilizada em contextos oncológicos, mas a falta de padronização das avaliações é a principal barreira para otimizar os protocolos clínicos. Este estudo tem o objetivo de investigar os efeitos clínicos frente a utilização da TFBM na prevenção da mucosite oral e orofaríngea (MO) induzida por quimioterápicos e e/ou transplante de células-tronco hematopoiéticas (TCTH) em pacientes adultos. Foi realizado um ensaio clínico randomizado, no qual os participantes foram designados para três grupos de TFBM. O Grupo 1 recebeu TFBM profilática intraoral, o Grupo 2 recebeu TFBM intraoral e orofaríngea, e o Grupo 3 recebeu TFBM intraoral, orofaríngea e extraoral, desde o primeiro dia da infusão de QT até o dia D+10. Foram avaliadas a ocorrência e gravidade da MO, odinofagia e presença de sinais de infecções na cavidade oral. Também foram avaliadas informações sobre o regime de QT, tipo de TCTH, doença de base, exames hematológicos e dados sociodemográficos. Foram incluídos no estudo 60 pacientes. A distribuição por gênero foi igual (50%) em toda a amostra e a faixa etária variou de 18 a 74 anos. 70% dos indivíduos foram submetidos apenas à QT, enquanto 30% foram submetidos a TCTH. O agente quimioterápico mais utilizado foi a Citarabina (43,3%). A MO foi observada em 43,3% dos pacientes, principalmente nos graus I e II. A odinofagia foi relatada em apenas 23,3% dos indivíduos. A mucosa jugal foi o local mais afetado pela MO (35%). Na análise multivariada, observou-se que o tipo de TCTH influenciou diretamente a ocorrência da MO. Os indivíduos submetidos a TCTH alogênico tiveram 1,93 vezes mais chances de desenvolver MO (p <0,001). O Grupo 3 apresentou uma frequência maior de MO, embora em graus menores. Além disso, esse grupo era composto por metade da população submetida a TCTH, tinha a maior porcentagem de uso de melfalano e a menor contagem média de leucócitos. Todos os três protocolos demonstraram eficácia na prevenção e redução da MO, apresentando boa tolerância e nenhuma toxicidade relatada. Defendemos a utilização da TFBM como uma abordagem segura e eficaz para a profilaxia da MO induzida pela QT em adultos submetidos a QT/TCTH.

Photobiomodulation Therapy (PBMT) is widely used in oncological contexts, but the lack of standardized evaluations is the main barrier to optimizing clinical protocols. This study aims to investigate the clinical effects of PBMT in the prevention of oral and oropharyngeal mucositis (OM) induced by chemotherapy and/or hematopoietic stem cell transplantation (HSCT) in adult patients, as well as to explore and correlate potential risk factors associated with this toxicity. A randomized clinical trial was conducted, in which participants were assigned to three PBMT groups. Group 1 received intraoral prophylactic PBMT, Group 2 received intraoral and oropharyngeal PBMT, and Group 3 received intraoral, oropharyngeal, and extraoral PBMT from the first day of chemotherapy infusion until D+10. The occurrence and severity of OM, odynophagia, and the presence of signs of oral cavity infections were evaluated. Information regarding the chemotherapy regimen, type of HSCT, underlying disease, hematological examinations, and sociodemographic data were also assessed. The study included 60 patients. Gender distribution was equal (50%) across the entire sample, and the age range varied from 18 to 74 years. 70% of individuals underwent chemotherapy alone, while 30% underwent HSCT. The most commonly used chemotherapeutic agent was Cytarabine (43.3%). OM was observed in 43.3% of patients, mainly in grades I and II. Odynophagia was reported in only 23.3% of individuals. The buccal mucosa was the most affected site by OM (35%). In the multivariate analysis, it was observed that the type of HSCT directly influenced the occurrence of OM. Individuals undergoing allogeneic HSCT had 1.93 times more chances of developing OM (p <0.001). Group 3 presented a higher frequency of OM, although in milder grades. Additionally, this group consisted of half of the population who underwent HSCT, had the highest percentage of melphalan use, and the lowest mean leukocyte count. All three protocols exhibited efficacy in the prevention and reduction of OM, displaying good tolerance and no reported toxicity. We assert the utilization of PBMT as a safe and effective approach for CT-induced OM prophylaxis in adults undergoing CT/HSCT.

Discovery of drugs to combat covid-19 inspired by traditional Chinese medicine / Descubrimiento de medicamentos para combatir la covid-19 inspirados en la medicina tradicional china

Abstract Contributions from traditional knowledge and history have proven useful in recent years to advance drug discovery. In response to the emergence of covid-19, scientists revisited traditional Chinese medicine. This source of inspiration for drugs to treat this new disease is described here at three different levels: traditional Chinese medicinal herbs, traditional Chinese medical formulas, and traditional Chinese medical texts. Drug discovery inspired by traditional Chinese medicine still faces serious resistance for various reasons, including its system of formulas and clinical trial design. A perspective that includes related issues would benefit the reasonable application of traditional knowledge in drug research and development.

Resumen Las contribuciones del conocimiento tradicional y la historia han demostrado ser útiles en los últimos años para avanzar en el descubrimiento de los medicamentos. En respuesta a la aparición de covid-19, los científicos revisaron la medicina tradicional china. Esta fuente de inspiración de los medicamentos para tratar esta nueva enfermedad se describe aquí en tres niveles diferentes: hierbas medicinales chinas tradicionales, fórmulas médicas chinas tradicionales y textos médicos chinos tradicionales. El descubrimiento de fármacos inspirado en la medicina tradicional china aún enfrenta serias resistencias por varias razones, incluido su sistema de fórmulas y el diseño de ensayos clínicos. Una perspectiva que incluya cuestiones conexas beneficiaría la aplicación razonable de los conocimientos tradicionales en la investigación y el desarrollo de fármacos.

Effect of ginger and P6 acupressure on chemotherapy-induced nausea and vomiting: a randomized controlled study / Efeitos das compressões de acuponto de gengibre e Neiguan sobre náuseas e vômitos induzidos por quimioterapia: um estudo randomizado e controlado / Efecto del jengibre y la acupresión de P6 en las náuseas y vómitos inducidos por la quimioterapia: estudio controlado aleatorizado

ABSTRACT Objective: To evaluate the effect of ginger with P6 acupressure in preventing and treating chemotherapy-induced nausea and vomiting (CINV) in cancer patients. Method: A total of 172 participants were randomly divided into the control, ginger, acupressure, and joint groups, who were hospitalized in the Affiliated Hospital of Xuzhou Medical University from February and September 2022. The baseline characteristics, nausea, vomiting, and retching, benefit finding, functional living index-emesis, treatment satisfaction, and adverse reaction, were used in data collection. Results: No significant difference was found in benefit finding and adverse reactions among the four groups (P > 0.05). Ginger significantly improved delayed CINV and function living index-nausea (P < 0.05) but had no significant effect on acute CINV, retching, and delayed vomiting, functional living index-emesis, and treatment satisfaction (P>0.05). Acute nausea and retching, delayed nausea, vomiting, and retching, functional living index-emesis, and treatment satisfaction were effectively improved in the acupressure and joint groups (P < 0.05). Conclusion: Ginger with P6 acupressure may contribute to improving CINV in patients undergoing chemotherapy.

RESUMEN Objetivo: Evaluar el efecto del jengibre con acupresión P6 en la prevención y tratamiento de las náuseas y vómitos (nviq) inducidos por la quimioterapia en pacientes con cáncer. Método: Se dividió al azar A un total de 172 participantes en los grupos control, jengibre, acupresión y conjunto, que fueron hospitalizados en el Hospital afiliado de la universidad médica Xuzhou entre febrero y septiembre de 2022. En la recolección de datos se utilizaron las características basales: náuseas, vómitos y náuseas, hallazgo de beneficios, índice de vida funcional, satisfacción con el tratamiento y reacciones adversas. Resultados: No se encontró diferencia significativa en el hallazgo del beneficio y las reacciones adversas entre los cuatro grupos (P >0.05). El jengibre mejoró significativamente las nviq diferidas y el índice de vida funcional (nausea) de forma significativa (P < 0.05), pero no tuvo un efecto significativo en las nvi, las náuseas y el vómito diferidos, la emesis del índice de vida funcional y la satisfacción con el tratamiento (P >0.05). Las náuseas agudas y las arcadas, las náuseas, los vómitos y las arcadas tardías, la medida del índice de vida funcional y la satisfacción con el tratamiento mejoraron efectivamente en los grupos de acupresión y articulares (P < 0,05). Conclusión: El jengibre con acupresión P6 puede contribuir a mejorar las nviq en pacientes sometidos a quimioterapia.

RESUMO Objetivo: Avaliar os efeitos da compressão do acuponto gengibre e Neiguan na prevenção e tratamento de náuseas e vômitos induzidos por quimioterapia em pacientes oncológicos. Métodos: Um total de 172 pacientes hospitalizados no Hospital Afiliado da Xuzhou Medical University de fevereiro a setembro de 2022 foram divididos aleatoriamente em grupo controle, grupo gengibre, grupo acuponto e grupo combinado. A recolha de dados incluiu principalmente dados basais, pontuação de náuseas, vómitos e vómitos, sensação de benefício da doença, índice de vida funcional, satisfação com o tratamento e efeitos adversos. Resultados: Não houve diferenças significativas no benefício da doença e efeitos adversos entre os quatro grupos (P >0,05). O gengibre melhorou significativamente o índice de vida funcional tardia e náusea (P < 0,05), mas não melhorou a NVI tardia e vómitos e vómitos retardados, o índice de vida funcional dos vómitos e a satisfação com o tratamento (P >0,05). Ambos os grupos de acuponto e combinação melhoraram náuseas agudas, vómitos, náuseas tardias, vómitos, vómitos, vómitos, índice de vida funcional e satisfação com o tratamento (P < 0,05). Conclusão: A acupuntura de gengibre e neiguan pode ajudar a melhorar a NVIQ em pacientes submetidos a quimioterapia.

Atuação Fisioterapêutica nos Efeitos Adversos da Quimioterapia e Radioterapia em Pacientes Oncológicos: Revisão Sistemática da Literatura / Physiotherapeutic Action on Chemotherapy and Radiotherapy Adverse Effects in Cancer Patients: Systematic Literature Review / Papel Fisioterapéutico en los Efectos Adversos de la Quimioterapia y Radioterapia en Pacientes Oncológicos: Revisión Sistemática de la Literatura

Introdução: O câncer surge a partir de séries de mutações genéticas em razão da exposição a agentes cancerígenos que comprometem a defesa imunológica e, com seu avanço, são utilizados tratamentos como a quimioterapia e a radioterapia. Entretanto, ambos os tratamentos provocam efeitos adversos. Dessa forma, a fisioterapia tem o intuito de reabilitar as disfunções cinético-funcionais provenientes desses efeitos. Objetivo: Sistematizar as condutas fisioterapêuticas mais utilizadas para tratar os principais efeitos adversos oriundos da quimioterapia e radioterapia em pacientes oncológicos. Método: Revisão sistemática nas bases de dados PubMed, LILACS, PEDro e SciELO no período de 2017 a 2022. Resultados: Dos 4.190 artigos, foram selecionados 13 que preencheram os critérios de inclusão e nota 6/10 pela Escala PEDro. As condutas fisioterapêuticas relatadas nos estudos foram acupuntura, laser, led, massagem terapêutica, auriculoterapia, crioterapia e osteopatia, que promoveram diminuição e alívio dos efeitos adversos, podendo atuar como atenuantes na ocorrência desses sintomas. Conclusão: Os efeitos adversos como náuseas e vômitos, mucosite, e fadiga, secundários à quimioterapia e radioterapia, poderão ser tratados com condutas fisioterapêuticas como acupuntura, laser, led, massagem terapêutica, auriculoterapia, crioterapia e osteopatia, que são seguras e efetivas para esse perfil de pacientes, além de proporcionar alívio dos sintomas, prevenir e diminuir os processos inflamatórios, aumentar o apetite, melhorar a função gastrointestinal e o condicionamento físico.

Introduction: Cancer arises from a series of genetic mutations due to exposure to carcinogens that compromise the immune defenses and, as it progresses, treatments as chemotherapy and radiotherapy are adopted. However, both treatments cause adverse effects and physiotherapy has the objective of rehabilitating functional kinetic dysfunctions resulting from these effects. Objective: To systematize the most utilized physiotherapeutic approaches to treat the main adverse effects arising from chemotherapy and radiotherapy in cancer patients. Method: A systematic review was carried out in the PubMed, LILACS, PEDro and SciELO databases from 2017 to 2022. Results: Of the 4,190 articles, 13 were selected that met the inclusion criteria and scored 6/10 on the PEDro Scale. The physiotherapeutic procedures reported in the studies were acupuncture, laser, led, therapeutic massage, auriculotherapy, cryotherapy and osteopathy, which promoted a decrease and relief of adverse effects and could act as mitigating factors in the occurrence of these symptoms. Conclusion: Adverse effects as nausea and vomiting, mucositis and fatigue secondary to chemotherapy and radiotherapy can be treated with physiotherapeutic procedures as acupuncture, laser, led, therapeutic massage, auriculotherapy, cryotherapy and osteopathy, which are safe and effective for this profile of patient, in addition to providing symptoms relief, preventing and reducing inflammatory processes, increasing appetite, improving gastrointestinal function and physical conditioning.

Introducción: El cáncer surge de una serie de mutaciones genéticas debidas a la exposición a agentes cancerígenos que comprometen las defensas inmunitarias, y a medida que avanza se utilizan tratamientos como la quimioterapia y la radioterapia. Sin embargo, ambos tratamientos provocan efectos adversos. De esta forma, la fisioterapia surge con la intención de rehabilitar las disfunciones cinéticas funcionales resultantes de estos efectos. Objetivo: Sistematizar los enfoques fisioterapéuticos más utilizados para tratar los principales efectos adversos derivados de la quimioterapia y radioterapia en pacientes oncológicos. Método: Revisión sistemática en las bases de datos PubMed, LILACS, PEDro y SciELO de 2017 a 2022. Resultados: De los 4190 artículos, solo se seleccionaron 13 que cumplieron con los criterios de inclusión y recibieron una puntuación de 6/10 en la escala PEDro. Los procedimientos fisioterapéuticos reportados en los estudios fueron acupuntura, láser, led, masaje terapéutico, auriculoterapia, crioterapia y osteopatía, que promovieron una disminución y alivio de los efectos adversos y podrían actuar como mitigantes en la aparición de estos síntomas. Conclusión: Los efectos adversos como náuseas y vómitos, mucositis y cansancio secundarios a la quimioterapia y radioterapia pueden ser tratados con procedimientos fisioterapéuticos como acupuntura, láser, led, masaje terapéutico, auriculoterapia, crioterapia y osteopatía, los cuales son seguros y efectivos. en estos perfiles de pacientes, además de proporcionar alivio de síntomas, prevenir y reducir procesos inflamatorios, aumentar el apetito, mejorar la función gastrointestinal y la condición física

Plantas com ação no sistema nervoso central que constam na relação nacional de plantas medicinais de interesse ao sus (RENISUS) / Plants acting on the central nervous system: review plantas com ação no sistema nervoso central que constam na relação nacional de plantas medicinais de interesse ao sus (RENISUS) / Plantas con acción sobre el sistema nervioso central incluidas en la lista nacional de plantas medicinales de interés para sus (RENISUS)

A depressão é uma doença grave que atinge a população em geral, estudos epidemiológicos estimam que a prevalência da depressão ao longo da vida no Brasil está em torno de 15,5%. Os fatores que desencadeiam o aparecimento da depressão incluem fatores sociais, psicológicos, biológicos e também fatores externos específicos como eventos estressantes, solidão, consumo de álcool e drogas, doenças crônicas e dar á luz (depressão pós-parto). O objetivo da presente pesquisa consistiu em realizar uma revisão bibliográfica sobre as principais plantas medicinais com ação antidepressiva. A ansiedade vem se tornando um dos principais problemas da atualidade, sendo intensificada pela pandemia causada pelo coronavírus, onde constatou-se que durante o pico da pandemia onde os casos confirmados de COVID-19 no Brasil ascenderam de 45.757 para 330.890, e as mortes, de 2.906 para 21.048, o sentimento de tristeza/depressão atingiu 40% dos adultos brasileiros. Os sintomas de depressão podem ser amenizados quando a disponibilidade sináptica de monoaminas são aumentadas, e esse aumento pode ocorrer através da diminuição da metabolização desses neurotransmissores. Neste sentido, busca-se através da farmacoterapia a utilização de antidepressivos que disponibilizem as monoaminas na fenda sináptica. A escolha do fármaco é feita com base nos sintomas da depressão e na boa resposta a uma determinada classe de antidepressivos. Em fevereiro de 2009 o Ministério da saúde lançou a Relação Nacional de Plantas Medicinais de Interesse ao SUS (RENISUS), contendo 71 espécies vegetais que são distribuídas de forma in natura nas unidades básicas de saúde (UBS). Destas, somente três espécies apresentam efeito antidepressivo e ansiolítico comprovados na literatura sendo Matricharia chamomilla, Erytrinum mulungu e a Passiflora incarnata que também fazem parte da RENISUS. Além destas, outras espécies como a Melissa officinalis, Lippia alba, Valeriana officinalis e Piper methysticum são utilizadas pela população para tratar ansiedade, insônia e depressão, sugerindo desta forma que estas espécies sejam incluídas na RENISUS.

Depression is a serious disease that affects the general population, epidemiological studies estimate that the prevalence of depression throughout life in Brazil is around 15.5%. The factors that trigger the onset of depression include social, psychological, biological and also specific external factors such as stressful events, loneliness, alcohol and drug consumption, chronic diseases and giving birth (postpartum depression). The objective of the present research was to carry out a literature review on the main medicinal plants with antidepressant action. Anxiety has become one of the main problems of today, being intensified by the pandemic caused by the coronavirus, where it was found that during the peak of the pandemic where confirmed cases of COVID-19 in Brazil rose from 45,757 to 330,890, and deaths, from 2,906 to 21,048, the feeling of sadness/depression reached 40% of Brazilian adults. Symptoms of depression can be alleviated when synaptic availability of monoamines is increased, and this increase can occur through decreased metabolization of these neurotransmitters. In this sense, the use of antidepressants that make monoamines available in the synaptic cleft is sought through pharmacotherapy. The choice of drug is based on symptoms of depression and good response to a particular class of antidepressants. In February 2009, the Ministry of Health launched the National List of Medicinal Plants of Interest to the SUS (RENISUS), containing 71 plant species that are distributed in natura form in basic health units (UBS). Of these, only three species have antidepressant and anxiolytic effects proven in the literature, being Matricharia chamomilla, Erytrinum mulungu and Passiflora incarnata, which are also part of RENISUS. In addition to these, other species such as Melissa officinalis, Lippia alba, Valeriana officinalis and Piper methysticum are used by the population to treat anxiety, insomnia and depression, thus suggesting that these species are included in RENISUS.

Los estudios epidemiológicos estiman que la prevalencia de la depresión a lo largo de la vida en Brasil es de alrededor del 15,5%. Los factores que desencadenan la aparición de la depresión son sociales, psicológicos, biológicos y también factores externos específicos, como los acontecimientos estresantes, la soledad, el consumo de alcohol y drogas, las enfermedades crónicas y el parto (depresión posparto). El objetivo de esta investigación fue realizar una revisión bibliográfica sobre las principales plantas medicinales con acción antidepresiva. La ansiedad se ha convertido en uno de los principales problemas de la actualidad, intensificándose por la pandemia causada por el coronavirus, donde se encontró que durante el pico de la pandemia donde los casos confirmados de COVID-19 en Brasil aumentaron de 45.757 a 330.890, y las muertes, de 2.906 a 21.048, el sentimiento de tristeza/depresión alcanzó el 40% de los adultos brasileños. Los síntomas de la depresión pueden aliviarse cuando se aumenta la disponibilidad sináptica de las monoaminas, y este aumento puede producirse mediante una disminución de la metabolización de estos neurotransmisores. En este sentido, se busca a través de la farmacoterapia el uso de antidepresivos que hagan disponibles las monoaminas en la hendidura sináptica. La elección del fármaco se hace en función de los síntomas de la depresión y de la buena respuesta a una clase concreta de antidepresivos. En febrero de 2009, el Ministerio de Salud lanzó la Lista Nacional de Plantas Medicinales de Interés para el SUS (RENISUS), que contiene 71 especies de plantas que se distribuyen in natura en unidades básicas de salud (UBS). De ellas, sólo tres especies tienen efectos antidepresivos y ansiolíticos probados en la literatura: Matricharia chamomilla, Erytrinum mulungu y Passiflora incarnata, que también forman parte del RENISUS. Además de éstas, otras especies como Melissa officinalis, Lippia alba, Valeriana officinalis y Piper methysticum son utilizadas por la población para tratar la ansiedad, el insomnio y la depresión, lo que sugiere que estas especies se incluyan en el RENISUS.

Questioning Established Theories and Treatment Methods Related to Iron and Other Metal Metabolic Changes, Affecting All Major Diseases and Billions of Patients.

The medical and scientific literature is dominated by highly cited historical theories and findings [...].

Degradable mesoporous semimetal antimony nanospheres for near-infrared II multimodal theranostics.

Metallic and semimetallic mesoporous frameworks are of great importance owing to their unique properties and broad applications. However, semimetallic mesoporous structures cannot be obtained by the traditional template-mediated strategies due to the inevitable hydrolytic reaction of semimetal compounds. Therefore, it is yet challenging to fabricate mesoporous semimetal nanostructures, not even mention controlling their pore sizes. Here we develop a facile and robust selective etching route to synthesize monodispersed mesoporous antimony nanospheres (MSbNSs). The pore sizes of MSbNSs are tunable by carefully controlling the partial oxidation of Sb nuclei and the selective etching of the as-formed Sb2O3. MSbNSs show a wide absorption from visible to second near-infrared (NIR-II) region. Moreover, PEGylated MSbNSs are degradable and the degradation mechanism is further explained. The NIR-II photothermal performance of MSbNSs is promising with a high photothermal conversion efficiency of ~44% and intensive NIR-II photoacoustic signal. MSbNSs show potential as multifunctional nanomedicines for NIR-II photoacoustic imaging guided synergistic photothermal/chemo therapy in vivo. Our selective etching process would contribute to the development of various semimetallic mesoporous structures and efficient multimodal nanoplatforms for theranostics.

Coping and adaptation of adults with cancer: the art of nursing care / Afrontamiento y adaptación del adulto con cáncer: el arte del cuidado de enfermería / Enfrentamento e adaptação do adulto com câncer: a arte do cuidado de enfermagem

Objective: To determine the coping and adaptive capabilities in patients with cancer undergoing treatment. Methodology: This was a quantitative and descriptive cross-sectional study; the sample consisted of 100 patients with a cancer diagnosis who received chemotherapy and/or radiotherapy treatment between June and August 2019, meeting the inclusion criteria. The Coping and Adaptation Processing Scale (CAPS) was used. Results: 53 % of the patients participating in the study presented high coping and adaptive capabilities; 40 % presented medium capabilities, and 7 % presented low capabilities. Conclusion: Continuous follow-up is extremely important throughout the disease process; having a romantic partner becomes a protective factor since patients feel heard and cared for, which motivates them to follow through with the treatment. In the nursing field, knowing the experience of those who live with an illness allows for transcending and impacting care by providing holistic attention to patients.

Objetivo: determinar la capacidad de afrontamiento y adaptación en personas con cáncer en tratamiento. Metodología: estudio cuantitativo y descriptivo de corte transversal; la muestra fue conformada por 100 pacientes con diagnóstico de cáncer que asistieron a tratamiento de quimioterapia y/o radioterapia entre junio y agosto del 2019, cumpliendo los criterios de inclusión. Se utilizó la Escala de Medición del Proceso de Afrontamiento y Adaptación (ESCAPS). Resultados: 53% de los pacientes estudiados poseen una capacidad de afrontamiento y adaptación alta; 40% obtuvo capacidad media y 7% una capacidad baja. Conclusión: el acompañamiento continuo es de gran importancia en todo el proceso de la enfermedad; tener una pareja sentimental se convierte en un factor protector pues los pacientes se sienten escuchados y atendidos, lo cual los motiva a continuar con el tratamiento. En el área de enfermería, conocer la experiencia de quienes viven una enfermedad permite trascender e impactar el cuidado brindando una atención holística.

Objetivo: determinar a capacidade de enfrentamento e adaptação em pessoas com câncer em tratamento. Materiais e método: estudo quantitativo e descritivo, de corte transversal; a amostra foi conformada de 100 pacientes com diagnóstico de câncer que passaram por tratamento de quimioterapia e/ou radioterapia entre junho e agosto de 2019, cumprindo com os critérios de inclusão. Foi utilizada a Escala de Medição do Processo de Enfrentamento e Adaptação. Resultados: 53 % dos pacientes estudados apresentaram capacidade de enfrentamento e adaptação alta; 40 % obtiveram capacidade média e 7 %, capacidade baixa. Conclusões: o acompanhamento contínuo é de grande importância em todo o processo da doença; ter um parceiro(a) sentimental se torna um fator protetor, pois os pacientes se sentem escutados e atendidos, o que os motiva a continuar com o tratamento. Na área de enfermagem, conhecer a experiência de quem vive uma doença permite transcender e impactar o cuidado, oferecendo uma atenção holística.

Custos e benefícios da atenção domiciliar para pessoas com condições crônicas complexas: revisão integrativa / Costos y beneficios de la atención domiciliaria para personas con condiciones crónicas complejas: revisión integrativa / Costs and benefits of home care for people with complex chronic conditions: an integrative review

RESUMO Objetivo: analisar os custos e benefícios da atenção domiciliar de adultos ou idosos com condições crônicas complexas (CCC). Método: revisão integrativa, relatada segundo o Preferred Reporting Items for Syste matic reviews and Meta-Analyses. Os resultados foram submetidos à análise narrativa. Resultados: A amostra final foi de 18 estudos, publicados no período de 2008 a 2021.As CCC identificadas foram insuficiência cardíaca grave, doença renal crônica, doença pulmonar obstrutiva crônica,múltiplas condições crônicas, pacientes sob quimioterapia e em cuidados paliativos. A modalidade de atenção domiciliar prevalente foi o monitoramento adistância. Conclusão: Identificou-se redução de custos entre 23,9% e 67,1%, com variações entre os componentes analisados e as metodologias utilizadas para o cálculo. Os benefícios incluem diminuição de hospitalizações; redução de exacerbações de sintomas e do uso de serviços de saúde, melhoria na qualidade de vida e controle mais eficaz das condições crônicas complexas com autocuidado e autogerenciamento.

RESUMEN Objetivo: analizar los costos y beneficios de la atención domiciliaria a adultos o ancianos con condiciones crónicas complejas (CCC). Método: revisión integrativa, relatada según el PreferredReportingItemsforSysteMaticReviews and Meta-Analyses. Los resultados fueron sometidos al análisis narrativo. Resultados: la muestra final fue de 18 estudios, publicados en el período de 2008 a 2021. Las CCC identificadas fueron insuficiencia cardíaca grave, enfermedad renal crónica, enfermedad pulmonar obstructiva crónica, múltiples condiciones crónicas, pacientes bajo quimioterapia y en cuidados paliativos. La modalidad de atención domiciliaria prevalente fue el monitoreo a distancia. Conclusión: se identificó reducción de costos entre el 23,9% y el 67,1%, con variaciones entre los componentes analizados y las metodologías utilizadas para el cálculo. Los beneficios incluyen disminución de hospitalizaciones; reducción de exacerbaciones de síntomas y del uso de servicios de salud, mejora en la calidad de vida y un control más eficaz de las condiciones crónicas complejas con autocuidado y autogestión.

ABSTRACT Objective: To analyze the costs and benefits of home care for adults or elderly with complex chronic conditions (CCC). Method: Integrative Review, reported according to the Preferred Reporting Items for Systematic reviews. The results were submitted to the Narrative analysis final sample was 18 studies, published from 2008 to 2021. The CCC identified were severe heart failure, chronic kidney disease, chronic obstructive pulmonary disease, multiple chronic conditions, patients undergoing chemotherapy and palliative care. The prevalent mode of home care was remote monitoring. Conclusion: Cost reduction was identified between 23.9% and 67.1%, with variations between the components analyzed and the methodologies used for the calculation. The benefits include decreased hospitalizations; reduced exacerbations of symptoms and use of health services, improved quality of life and more effective control of complex chronic conditions with self-care and self-management.

Significado do relaxamento com visualização guiada para o paciente em tratamento oncológico / Significado de relajación con visualización guiada para pacientes en tratamiento oncológico / Meaning of guided imagery relaxtion for patients undergoing cancer treatment

Objetivo: compreender o significado do relaxamento com visualização guiada para o paciente em tratamento oncológico. Método: estudo qualitativo, realizado com 11 pacientes em tratamento oncológico, no período de janeiro a março de 2020. Foram aplicados questionários sociodemográfico e clínico, em forma de entrevista, seguidos de uma sessão de terapia complementar e alternativa de relaxamento com visualização guiada Os depoimentos foram gravados e submetidos a análise de conteúdo, proposta por Bardin. Resultados: identificou-se três categorias: Relaxamento como elo corpo e mente; Relaxamento como aliado na redução dos sintomas; e Relaxamento como reforço de convicções positivas. Considerações finais: o relaxamento com visualização guiada foi significado pelo paciente oncológico como um processo válido na assistência e recuperação.

Objetivo: comprender el significado de la relajación con visualización guiada para el paciente en tratamiento oncológico. Método: estudio cualitativo, realizado con 11 pacientes en tratamiento oncológico, de enero a marzo de 2020. Se aplicaron cuestionarios sociodemográficos y clínicos, en forma de entrevista, seguida de una sesión de terapia de relajación complementaria y alternativa con visualización guiada. y sometido al análisis de contenido propuesto por Bardin. Resultados: se identificaron tres categorías: La relajación como vínculo entre el cuerpo y la mente; La relajación como aliada en la reducción de síntomas; y Relajación como refuerzo de creencias positivas. Consideraciones finales: la relajación con visualización guiada fue considerada por el paciente oncológico como un proceso válido en el cuidado y la recuperación.

Objective: to understand the meaning of guided imagery relaxation for the patient undergoing cancer treatment. Method: qualitative study performed with 11 patients undergoing cancer treatment, from January to March 2020. Sociodemographic and clinical questionnaires were applied in the form of an interview, followed by a complementary and alternative relaxation therapy session with guided imagery relaxation. The statements were recorded and submitted to content analysis, proposed by Bardin. Results: three categories were identified: Relaxation as a body and mind connection; Relaxation as an ally in the reduction of symptoms; and Relaxation as reinforcement of positive beliefs. Final considerations: guided imagery relaxation was meant by the cancer patient as a valid process in care and recovery.

Flavonoids Synergistically Enhance the Anti-Glioblastoma Effects of Chemotherapeutic Drugs.

Flavonoids are polyphenolic plant secondary metabolites with pleiotropic biological properties, including anti-cancer activities. These natural compounds have potential utility in glioblastoma (GBM), a malignant central nervous system tumor derived from astrocytes. Conventional GBM treatment modalities such as chemotherapy, radiation therapy, and surgical tumor resection are beneficial but limited by extensive tumor invasion and drug/radiation resistance. Therefore, dietary flavonoids-with demonstrated anti-GBM properties in preclinical research-are potential alternative therapies. This review explores the synergistic enhancement of the anti-GBM effects of conventional chemotherapeutic drugs by flavonoids. Primary studies published between 2011 and 2021 on flavonoid-chemotherapeutic synergy in GBM were obtained from PubMed. These studies demonstrate that flavonoids such as chrysin, epigallocatechin-3-gallate (EGCG), formononetin, hispidulin, icariin, quercetin, rutin, and silibinin synergistically enhance the effects of canonical chemotherapeutics. These beneficial effects are mediated by the modulation of intracellular signaling mechanisms related to apoptosis, proliferation, autophagy, motility, and chemoresistance. In this light, flavonoids hold promise in improving current therapeutic strategies and ultimately overcoming GBM drug resistance. However, despite positive preclinical results, further investigations are necessary before the commencement of clinical trials. Key considerations include the bioavailability, blood-brain barrier (BBB) permeability, and safety of flavonoids; optimal dosages of flavonoids and chemotherapeutics; drug delivery platforms; and the potential for adverse interactions.

Effects of virtual reality v. biophilic environments on pain and distress in oncology patients: a case-crossover pilot study.

This pilot study aimed to determine if a biophilic Green Therapy or Virtual Reality environment can decrease an oncology patient's pain and distress while receiving chemotherapy. A case-crossover pilot study was conducted in a comprehensive cancer infusion center. 33 participants with breast, gynecologic, gastrointestinal, pancreatic and prostate cancers were all included in three rooms in a random order at different cycles: control room, Green Therapy room, and Virtual Reality room to receive chemotherapy, respectively. Participants' pain, distress, heart rate, blood pressure, and saliva cortisol were measured before and after infusion in each room. No statistical significance differences were shown in the changes of heart rate, systolic, or diastolic blood pressure, saliva cortisol, pain, or distress before and after infusion between the control, Green Therapy, and Virtual Reality rooms. However, more patients reported the experience as "fun" and "enjoyable" when they were in Green Therapy or Virtual reality room as compared to in the control room. Additionally, since participating in the study, 14 patients reported spending at least 30 min or more outside in nature. In this study, we found that patients' heart rate, blood pressure, and self-reported distress levels were reduced after each biophilic intervention although results are not statistically significant. The study also suggested that biophilic interventions are safe and feasible and may complement the standard of care for oncology patients.

A triple-stimulus responsive melanin-based nanoplatform with an aggregation-induced emission-active photosensitiser for imaging-guided targeted synergistic phototherapy/hypoxia-activated chemotherapy.

Multimodal synergistic therapy has gained increasing attention in cancer treatment to overcome the limitations of monotherapy and achieve high anticancer efficacy. In this study, a synergistic phototherapy and hypoxia-activated chemotherapy nanoplatform based on natural melanin nanoparticles (MPs) loaded with the bioreduction prodrug tirapazamine (TPZ) and decorated with hyaluronic acid (HA) was developed. A self-reporting aggregation-induced emission (AIE)-active photosensitizer (PS) (BATTMN) was linked to the prepared nanoparticles by boronate ester bonds. The MPs and BATTMN-HA played roles as quenchers for PS and cancer targeting/photodynamic moieties, respectively. As a pH sensitive bond, the borate ester bonds between HA and BATTMN are hydrolysed in the acidic cancer environment, thereby separating BATTMN from the nanoparticles and leading to the induction of fluorescence for imaging-guided synergistic phototherapy/hypoxia-activated chemotherapy under dual irradiation. TPZ can be released upon activation by pH, near-infrared (NIR) and hyaluronidase (Hyal). Particularly, the hypoxia-dependent cytotoxicity of TPZ was amplified by oxygen consumption in the tumor intracellular environment induced by the AIE-active PS in photodynamic therapy (PDT). The nanoparticles developed in our research showed favorable photothermal conversion efficiency (η = 37%), desired cytocompatibility, and excellent synergistic therapeutic efficacy. The proposed nanoplatform not only extends the application scope of melanin materials with AIE-active PSs, but also offers useful insights into developing multistimulus as well as multimodal synergistic tumor treatment.

Traditional herbal medicine combined with first-line platinum-based chemotherapy for advanced non-small-cell lung cancer: A PRISMA-compliant systematic review and meta-analysis.

BACKGROUND: Non-small-cell lung cancer (NSCLC) is a major health burden in many countries. This review aimed to evaluate the efficacy of traditional herbal medicine (THM) combined with first-line platinum-based chemotherapy (PBCT) for the treatment of advanced NSCLC. METHODS: From inception to April 2021, relevant studies were retrieved from 9 electronic databases. Randomized controlled trials (RCTs) comparing survival outcomes of THM + PBCT treatment with PBCT treatment in patients with advanced NSCLC were reviewed. The risk of bias was evaluated using the Cochrane Risk of Bias Tool. Overall survival, 1-year survival, progression-free survival or time to progression, tumor response rate, and adverse effects were analyzed. RESULTS: Sixteen RCTs comprising 1445 patients were included. The meta-analysis indicated that THM + PBCT treatment, compared to PBCT alone, could improve overall survival (median survival ratio = 1.24, 95% confidence intervals [CI] [1.11, 1.39], P < .001), progression-free survival/time to progression (median survival ratio = 1.22, 95% CI [1.09, 1.37], P < .001), and the 1-year survival rate (risk ratio [RR] = 1.56, 95% CI [1.31, 1.86], P < .001). THM + PBCT also led to a higher tumor response rate (RR = 1.39, 95% CI [1.22, 1.59], P < .001) and lower incidence of thrombocytopenia (RR = 0.72, 95% CI [0.56, 0.92], P = .009) and nausea/vomiting (RR = 0.35, 95% CI [0.21, 0.57], P < .001), while there was no significant effect observed on leukopenia (RR = 0.68, 95% CI [0.34, 1.36], P = .27). CONCLUSION: THM, when used in combination with PBCT, might increase survival and the tumor response rate while decreasing the side effects caused by chemotherapy in patients with advanced NSCLC. However, considering the limited methodological qualities of the included trials, more rigorous RCTs are needed.

A multifunctional nano-delivery system enhances the chemo-co-phototherapy of tumor multidrug resistance via mitochondrial-targeting and inhibiting P-glycoprotein-mediated efflux.

Despite the excellent progress of chemotherapy and phototherapy in tumor treatment, their effectiveness on multidrug-resistant (MDR) tumors is still unsatisfactory. One of the main obstacles is drug efflux caused by P-glycoprotein in MDR cells. Herein, we developed a nano-delivery system that combines a P-glycoprotein inhibitor with chemotherapy and phototherapy to overcome MDR. Briefly, the system is prepared by the self-assembly of a ROS-triggered doxorubicin prodrug (PTD) and mitochondrial-targeted D-α-tocopherol polyethyleneglycol succinate (TPP-TPGS), in which a photoactive drug, IR780, is encapsulated (PTD/TT/IR780). PTD/TT/IR780 can target the release of TPP-TPGS, doxorubicin and IR780 at the mitochondrial site of MDR cells through ROS trigger. D-α-Tocopherol polyethyleneglycol succinate (TPGS) is a P-glycoprotein inhibitor, which will reduce the efflux of doxorubicin and IR780 from MDR cells. Under irradiation of an 808 nm near-infrared laser, IR780 generates heat and ROS, causing mitochondrial damage and prompting MDR cell apoptosis. At the same time, ROS can reduce the ATP content, which inhibits the P-glycoprotein function. In addition, an increase in the ROS generates positive feedback, allowing more nanoparticles to be cleaved and further promoting payload release in MDR cells, thereby enhancing the synergistic efficacy of chemotherapy and phototherapy. The in vitro cellular assay showed that PTD/TT/IR780 significantly inhibited MDR cell proliferation at a very low drug concentration (IC50 = 0.27 µg mL-1 doxorubicin-equivalent concentration). In vivo animal experiments based on BALB/c nude mice bearing MCF-7/ADR tumors confirmed a superior antitumor efficacy and an excellent biosafety profile. These findings demonstrate that this multifunctional nanoplatform provides a new approach for the treatment of MDR tumors.

Black Phosphorus Nanosheet Encapsulated by Zeolitic Imidazole Framework-8 for Tumor Multimodal Treatments.

Black phosphorus (BP) nanosheet is easily oxidized by oxygen and water under ambient environment, thus, reliable BP passivation techniques for biomedical applications is urgently needed. A simple and applicable passivation strategy for biomedical applications was established by encapsulating BP nanosheet into zeolitic imidazole framework-8 (ZIF-8). The resulted BP nanosheet in ZIF-8 (BP@ZIF-8) shows not only satisfied chemical stability in both water and phosphate buffered saline (PBS), but also excellent biocompatibility. Notably, BP nanosheet endows the prepared BP@ZIF-8 with prominent photothermal conversion efficiency (31.90%). Besides passivation BP, ZIF-8 provides the BP@ZIF-8 with high drug loading amount (1353.3 mg g-1). Moreover, the loaded drug can be controlled release by pH stimuli. Both in vitro and in vivo researches verified the resulted BP@ZIF-8 an ideal candidate for tumor multimodal treatments.