Prognostic value of overhydration and bioelectrical impedance vector on short- and long-term outcomes in hospitalized patients with cancer.

BACKGROUND & AIMS: Water, an essential component of body composition, appears to be a significant predictor of adverse outcomes in clinical populations, despite being frequently underexplored. Bioelectrical impedance analysis (BIA) and vector analysis (BIVA) are easy and cost-effective bedside tools for estimating body composition, particularly water content. Therefore, our study aimed to assess the impact of hydration and fluid status using both BIA and BIVA on outcomes in hospitalized patients with cancer. METHODS: A prospective cohort study involving hospitalized individuals with cancer was conducted. Total body water (TBW) was estimated using BIA. Extracellular-water/TBW (ECW/TBW) and ECW/intracellular-water (ECW/ICW) ratios were calculated. BIVA ellipses vectors were constructed to enhance our analysis of hydration status. Participants were followed during their hospital stay and up to six months after discharge to assess outcomes, including in-hospital mortality, 6-month non-elective rehospitalization, and 6-month mortality. RESULTS: TBW, ECW/TBW, ECW/ICW ratios, and BIVA plots were not associated with non-elective rehospitalization during the follow-up period. However, TBW and an elevated ECW/ICW ratio were independent predictors of in-hospital mortality [hazard ratio (HR): 1.07 (1.01; 1.13) p = 0.020; HR: 4.23 (1.69; 10.58) p = 0.002]. Elevated ratios ECW/TBW and ECW/ICW were independent predictors of 6-month mortality [HR: 1.87 (1.10; 3.21) p = 0.022; HR: 2.49 (1.37; 4.51) p = 0.003]. BIVA vectors for in-hospital and 6-month mortality shifted significantly to the right, leading to cachexia and overhydration quadrants (p < 0.05). CONCLUSION: Abnormalities related to overhydration were important predictors of short- and long-term mortality in hospitalized patients with cancer.

Impact of chronic diseases on the periapical health of endodontically treated teeth: A systematic review and meta-analysis.

Systemic diseases affecting the immune system can influence the body's response time to endodontic treatment, potentially necessitating a longer duration for the complete resolution of existing infections when compared to healthy controls. This systematic review aims to evaluate the association between the presence of chronic diseases and periapical status after endodontic treatment through a systematic and comprehensive assessment of existing literature on this topic. The search strategy covered seven electronic databases and grey literature, encompassing articles published until October 2023. Two reviewers independently assessed potentially eligible studies based on the following criteria: Included were studies involving populations exposed to pre-existing chronic diseases who underwent endodontic treatment in permanent teeth. These studies evaluated periapical health status, making comparisons with healthy individuals. There were no language or publication date restrictions. Additionally, two reviewers independently extracted data regarding the characteristics of the included studies. The risk of bias was assessed using the Joanna Briggs Institute Critical Assessment Checklist. Meta-analysis was conducted using random effects models. The certainty of evidence was assessed using the GRADE tool. Twenty-three studies were included in the synthesis. Patients with diabetes were found to have about half the odds of having periapical health compared to non-diabetic patients (OR = 0.46; 95% CI = 0.30-0.70%; I2 = 58%) in teeth that underwent endodontic treatment. On the other hand, other systemic diseases like HIV, cardiovascular disease, and rheumatoid arthritis did not demonstrate significant differences concerning the outcome. In conclusion, diabetic patients showed a lower likelihood of maintaining periapical health. Conversely, patients with HIV, cardiovascular disease, and rheumatoid arthritis did not exhibit significant differences, although the existing evidence is still considered limited. It is crucial to manage these patients in a multidisciplinary manner to provide appropriate care for this population.

Impact of dentofacial deformity on the chance of being hired for a job.

Objective: This study aimed to determine the impact of dentofacial deformity on an individual's chances of being hired for a hypothetical job involving customer service. Materials and methods: Face photographs (frontal and lateral) of 15 patients with moderate to severe dentofacial deformity, taken before and after orthodontic-surgical correction, were selected and randomized between two different questionnaires. In addition, five patients without dentofacial deformity were used as controls in both questionnaires. These questionnaires were taken by adults responsible for hiring personnel to work in commerce and business activities, graduates or postgraduates in business administration, with experience in recruiting and hiring personnel. The evaluation took place using a Likert scale with values ranging from 0 to 10 (in which 0 corresponded to complete disagreement and 10 to complete agreement), considering the following variables in a first impression judgment: honesty, intelligence, productivity at work, and hiring chance. Data were tabulated and statistical analysis was performed using a linear regression model for the explanatory variables that showed statistical significance in the analysis of variance (ANOVA). Effect size through Cohen's d has been corrected for all comparisons performed. Results: All re-examined domains demonstrated statistical differences even when included in a multivariate model (p < 0.05), with lower mean values for those requiring pre-treatment (presenting deformity), although the effect size was small for all comparisons. Conclusion: Dentofacial deformity influenced the hiring chance, although not appearing to be a preponderant factor for hiring, acting as a tiebreaker among the candidates adopted.

Effect of rapamycin on Cryptococcus neoformans: cellular organization, biophysics and virulence factors.

Background: Cryptococcus neoformans is an opportunistic fungal pathogen that causes infections mainly in immunosuppressed individuals, such as transplant recipients. Aims: This study investigated the effects of rapamycin, an immunosuppressant drug, on the cellular organization, biophysical characteristics, and main virulence factors of C. neoformans. Methods: Morphological, structural, physicochemical and biophysical analyses of cells and secreted polysaccharides of the reference H99 C. neoformans strain were investigated under the effect of subinhibitory concentrations of rapamycin. Results: Rapamycin at a minimum inhibitory concentration of 2.5 µM reduced C. neoformans cell viability by 53%, decreased capsule, increased cell size, chitin and lipid body formation, and changed peptidase and urease activity. Conclusion: Further studies are needed to assess how rapamycin affects the virulence factors and pathogenicity of C. neoformans.

Cryptococcosis is a fungal infection caused by a type of fungus called Cryptococcus. Among the Cryptococcus group, Cryptococcus neoformans is often linked to fungal infections in people who have a weak immune system (known as being immunosuppressed). The main aim of this work was to look at the effect of an immunosuppressant called rapamycin, which is commonly used to prevent organ transplant rejection, on the ability of C. neoformans to cause infection. The results showed that this drug stopped the growth of the fungus, dampening its ability to cause disease.

Assessing the In Vitro Potential of Glatiramer Acetate (Copaxone®) as a Chemotherapeutic Candidate for the Treatment of Cryptococcus neoformans Infection.

Cryptococcosis is a systemic mycosis affecting immunosuppressed individuals, caused by various Cryptococcus species. The current treatment utilizes a combination of antifungal drugs, but issues such as nephrotoxicity, restricted or limited availability in certain countries, and resistance limit their effectiveness. Repurposing approved drugs presents a viable strategy for developing new antifungal options. This study investigates the potential of glatiramer acetate (Copaxone®) as a chemotherapy candidate for Cryptococcus neoformans infection. Various techniques are employed to evaluate the effects of glatiramer acetate on the fungus, including microdilution, XTT analysis, electron and light microscopy, and physicochemical measurements. The results demonstrate that glatiramer acetate exhibits antifungal properties, with an IC50 of 0.470 mg/mL and a minimum inhibitory concentration (MIC) of 2.5 mg/mL. Furthermore, it promotes enhanced cell aggregation, facilitates biofilm formation, and increases the secretion of fungal polysaccharides. These findings indicate that glatiramer acetate not only shows an antifungal effect but also modulates the key virulence factor-the polysaccharide capsule. In summary, repurposing glatiramer acetate as a potential chemotherapy option offers new prospects for combating C. neoformans infection. It addresses the limitations associated with current antifungal therapies by providing an alternative treatment approach.

Development of a Halochromic, Antimicrobial, and Antioxidant Starch-Based Film Containing Phenolic Extract from Jaboticaba Peel.

In this study, the antioxidant, antimicrobial, mechanical, optical, and barrier attributes of Solanum lycocarpum starch bio-based edible films incorporated with a phenolic extract from jaboticaba peel were investigated. Aiming to determine the effect of the polymers and the phenolic extract on the properties of the films, a three-factor simplex-lattice design was employed, and the formulation optimization was based on the produced films' antioxidant potential. The optimized formulation of the starch-PEJP film showed a reddish-pink color with no cracks or bubbles and 91% antioxidant activity against DPPH radical. The optimized starch-PEJP film showed good transparency properties and a potent UV-blocking action, presenting color variation as a function of the pH values. The optimized film was also considerably resistant and highly flexible, showing a water vapor permeability of 3.28 × 10-6 g m-1 h-1 Pa-1. The microbial permeation test and antimicrobial evaluation demonstrated that the optimized starch-PEJP film avoided microbial contamination and was potent in reducing the growth of Escherichia coli, Staphylococcus aureus, and Salmonella spp. In summary, the active starch-PEJP film showed great potential as an environmentally friendly and halochromic material, presenting antioxidant and antimicrobial properties and high UV-protecting activity.

Antioxidant and emulsifying properties of a galactose-rich heteropolysaccharide from Plinia cauliflora peels.

In this study functional properties of a galactose-rich heteropolysaccharide (GH) were accessed. The bands of a galactose-rich polysaccharide were found in FTIR spectra, including those from the fingerprint region. GH was characterized as a dark-red material (L* 25.86 ± 0.75, a* 9.46 ± 1.01, b* 0.65 ± 0.14, Chroma 9.48 ± 1.02) with antioxidant activity of 21.5 ± 0.08, 12.1 ± 0.06 and 0.46 ± 0.04 mmol Trolox Eq/mg GH in FRAP, DPPH and ABTS, respectively. GH presented 44.9% of esterification degree and 10.73 ± 0. 01 mg of GAE/g. The production parameters of GH emulsions (GH concentration, time and ultrasound power) were optimized using a 23 Central Composite Rotatable Design (CCRD). Emulsion droplets presented particle size (d µm) varying from 0.823 ± 0.065 to 1.926 ± 0.151, polydispersity index (PDI) from 0.10 ± 0.05 to 0.40 ± 0.01 and zeta potential from -29.25 ± 3.98 to -33.75 ± 1.77. Finally, the high emulsifying activity (EA) (96.67%) and emulsion stability (ES) (97.44%) allow suggesting that GH is a promising polysaccharide for food applications.

Epididymo-orchitis caused by Histoplasma capsulatum.

A 66-year-old man presented with asymptomatic right testicular swelling. He was known to be infected with HIV and was non-adherent to treatment. He was recently treated for nasal leishmaniasis. Surgical drainage was performed and eventually, an orchiectomy was required. A post-mortem diagnosis was made of disseminated histoplasmosis. Testicular infection due to H. capsulatum is rare, with only a few cases being reported. Here we present a case of testicular histoplasmosis, followed by a literature review.

Relação Positiva entre o Ângulo de Fase Padronizado e o Estadiamento Clínico em Indivíduos com câncer / Positive Relation between Standardized Phase Angle and Clinical Neoplasm Staging in Individuals with Cancer / Relación Positiva entre Ángulo de Fase y Estadificación Clínica de Neoplasias Individuos con Cáncer

Introdução: O câncer é caracterizado pela multiplicação desordenada de células de um dado tecido, com potencial para invadir outros órgãos e tecidos. O conhecimento da extensão anatômica do câncer e sua capacidade de infiltração são importantes para nortear terapias e prognóstico, e a evolução dessa doença tem forte impacto negativo no estado nutricional do paciente. O ângulo de fase (AF) se apresenta como ótima ferramenta prognóstica para esse grupo. Objetivo: Associar o ângulo de fase padronizado (AFP) com o estadiamento clínico em indivíduos com câncer. Método: Estudo observacional e transversal, realizado com adultos e idosos com câncer não hospitalizados. As informações clínicas e o estadiamento clínico (TNM) do câncer foram obtidos por meio de prontuário eletrônico. Foi realizada a Avaliação Subjetiva Global Produzia pelo Próprio Paciente (ASG-PPP), e calculados o AF, mediante os valores obtidos pela bioimpedância e, em seguida, o AFP. Resultados: Participaram da pesquisa 25 voluntários com média de idade de 58,3 anos (±13,7), sendo 54,8% do sexo feminino e 54,8% idosos. O tipo de câncer mais frequente foi o de estômago (36%); 44% dos participantes tinham estádios clínicos II e 56%, III ou IV. Segundo a ASG-PPP, 74% dos voluntários apresentavam algum grau de comprometimento nutricional (escores B ou C), e foi detectada associação positiva entre o AFP e o estadiamento tumoral (p>0,0414). Conclusão: O AFP se relacionou positivamente com o estadiamento clínico em indivíduos com câncer

Introduction: Cancer is characterized by the abnormal growth of cells in a tissue, with the potential to invade another organs and tissues. The knowledge of the anatomical extent of cancer and its infiltration capacity are important to guide therapies and prognosis, and the evolution of this disease has severe negative impact on the patient's nutritional status. Phase angle (PA) is an excellent prognostic tool for this group. Objective: To associate the standardized phase angle (SPA) with clinical staging in cancer patients. Method: Observational and cross-sectional study with adults and older adults with cancer non-hospitalized. Clinical information and clinical staging (TNM) of cancer were obtained from electronic charts. PatientGenerated Subjective Global Assessment (PG-SGA) was performed, and the PA was calculated using values collected by bioimpedance and then the standardized PA (SPA). Results: 25 volunteers participated, with mean age of 58.3 years (±13.7), 54.8% females and 54.8% older adults. The most frequent tumor site was in the stomach (36%), 44% of the participants were in clinical stages II and 56%, III or IV. According to the PG-SGA, 74% of the volunteers had some degree of nutritional impairment (score B or C), and a positive association was detected between SPA and tumor staging (p>0.0414). Conclusion: SPA was positively related to clinical staging in individuals with cancer

Introducción: El cáncer se caracteriza por la multiplicación desordenada de células en un tejido, con potencial para invadir otros órganos y tejidos. El conocimiento de la extensión anatómica del cáncer y su capacidad de infiltración son importantes para orientar las terapias y el pronóstico, y la evolución de esta enfermedad tiene un fuerte impacto negativo en el estado nutricional del paciente. Y el ángulo de fase (AF) es una excelente herramienta de pronóstico para este grupo. Objetivo: Asociar el ángulo de fase estandarizado con la estadificación en individuos con cáncer. Método: Estudio observacional y transversal, realizado con adultos y ancianos con cáncer no hospitalizados. La información clínica y la estadificación clínica (TNM) del cáncer se obtuvieron a través de registros médicos electrónicos, y se realizó la Valoración Global Subjetiva Generada por el Paciente (VGSGP) y se calculó el AF y AF estandarizado utilizando los valores obtenidos por bioimpedancia y luego el AF estandarizada. Resultados: Participaron 25 voluntarios, con una edad promedio de 58,3 años (±13,7), 54,8% mujeres y 54,8% eran ancianos. El tipo de cáncer más frecuente fue el de estómago (36%), y el 44% de los participantes tenía estadios clínicos II y 56% III o IV. Según la VG-SGP 74% de los voluntarios presentaban algún grado de deterioro nutricional (puntuaciones B o C) y se detectó una asociación positiva entre el AF estandarizado y estadificación tumoral (p>0,0414). Conclusión: El AF estandarizada se relacionó positivamente con la estadificación en personas con cáncer

HLA-E genotyping and its relevance in kidney transplantation outcome.

HLA-E, a class I nonclassical HLA molecule, is expressed in all tissues and is involved in the regulation of both innate (by interaction with the CD94/NKG2 receptor expressed mainly in NK cells) and adaptive immunity (by interaction with T CD8+ cells), suggesting a possible role in the solid organ transplantation context. Transplanted patients with chronic kidney disease and their respective donors (N = 107 pairs) were genotyped for exons 2 and 3 of the HLA-E locus by sequence-based typing (SBT). Groups' genotype frequencies were compared regarding episodes of clinical rejection by global G test, and binary logistic regression was made to demonstrate the contribution of genetic variables vs epidemiological variables. Comparisons of donors' genotype frequencies showed significant differences (P = .0230), revealing a protective profile of E*01:01/*01:01 compared to the other genotypes (P = .0099; OR = 0.3088; CI [95%] = 0.1333-0.7157). The same happened when the aforementioned genotype was combined with the E*01:01/*01:01 recipients' genotype (P = .0065; OR = 0.1760; CI [95%] = 0.0517-0.5987). A binary logistic regression analysis was performed, and, of all variables considered, only two were included in the resulting model (P = .007; R2 Cox and Snell = 0.243; R2 Nagelkerke = 0.328)- "End-Stage Renal Disease" and "HLA class II Mismatches." A protective profile (E*01:01/*01:01) was observed between the recipients and donors, suggesting a possible impact of the HLA-E genotype in rejection episodes.

Associação entre endocardite bacteriana e procedimento de cirurgia e traumatologia bucomaxilofacial / Association between bacterial endocardite and procedure of bucomaxilofacial surgery and traumatology / Asociación entre endocardite bacteriana y procedimiento de cirugía y traumatología bucomaxilofacial

Introdução: Pacientes com condições cardíacas de risco submetidos a procedimentos de cirurgia e traumatologia bucomaxilo faciais estão expostos à endocardite infecciosa, sujeitos a morbidade e mortalidade por esta grave doença. Objetivo: O presente artigo de revisão busca trazer informação adicional sobre endocardite bacteriana e procedimentos de Cirurgia e Traumatologia Bucomaxilofaciais, bem como principais microrganismos envolvidos neste feito, fatores e condições de risco e a antibioticoprofilaxia. Material e Método: Realizou-se uma revisão bibliográfica, onde foram analisados artigos científicos obtidos da base de dados PubMed, Cochrane, Biblioteca Virtual de Saúde e Scielo. Foram pesquisados estudos de 2000 a 2018 e incluídos estudos do período de 2013 a 2018, de acordo com os descritores: Endocardite Bacteriana ­ Prevalência ­ Profilaxia -Bacteriana, bem como a associação dos termos pesquisados nas línguas inglês, espanhol e português. Totalizando-se 189 estudos para realização da pesquisa e incluídos 13 artigos. Os dados foram analisados a partir de estatística descritiva. Conclusão: Mediante informações exportas nestes trabalhos, pode-se concluir que a melhor maneira de se prevenir uma endocardite infecciosa é conhecendo o paciente por meio de uma anamnese bem feita, onde se conheça toda a história médica odontológica pregressa do paciente para que se possam identificar de forma individualizada os pacientes de risco, bem como a exposição desnecessária de antibióticos a este paciente. Sendo a antibioticoprofilaxia recomendada para todos os pacientes odontológicos de risco eminente, assim como procedimentos de cirurgia e traumatologia bucomaxilofacial mais invasivo(AU)

Introduction: Patients with cardiac conditions at risk submitted to facial or buccomaxial surgery and trauma procedures are exposed to infective endocarditis, subject to morbidity and mortality from this serious disease. Purpose: This review article seeks to provide additional information on bacterial endocarditis and procedures of Buccomaxillofacial Surgery and Traumatology, as well as the main microorganisms involved in this work, risk factors and conditions and antibiotic prophylaxis. Material and Method: A bibliographic review was carried out, where scientific articles were obtained from the PubMed, Cochrane, Virtual Health Library and Scielo databases. Studies were conducted from 2000 to 2018 and included studies from the period 2013 to 2018, according to the descriptors: Bacterial Endocarditis - Prevalence - Bacterial Prophylaxis, as well as the association of terms searched in the English, Spanish and Portuguese languages. A total of 189 studies were carried out to carry out the research and 13 articles were included. Data were analyzed from descriptive statistics. Conclusion: Through information exported in these works, it can be concluded that the best way to prevent an infective endocarditis is to know the patient through a well-made anamnesis, where the patient's previous medical history is known, so that they can identify patients at risk as well as unnecessary exposure of antibiotics to this patient. Since antibiotic prophylaxis is recommended for all dental patients of imminent risk, as well as more invasive surgery procedures and buccomaxillofacial traumatology(AU)

Introducción: Pacientes con condiciones cardiacas de riesgo sometidos a procedimientos de cirugía y traumatología bucomaxilo faciales están expuestos a la endocarditis infecciosa, sujetos a morbilidad y mortalidad por esta grave enfermedad. Objetivo: El presente artículo de revisión busca traer información adicional sobre endocarditis bacteriana y procedimientos de Cirugía y Traumatología Bucomaxilofaciales, así como principales microorganismos involucrados en este hecho, factores y condiciones de riesgo y la antibioticoprofilaxis. Material y método: Se realizó una revisión bibliográfica, donde fueron analizados artículos científicos obtenidos de la base de datos PubMed, Cochrane, Biblioteca Virtual de Salud y Scielo. 2000 estudios fueron encuestados para 2018 y 2013 incluyen periodo de 2018 estudios, de acuerdo con los descriptores: La endocarditis bacteriana - Prevalencia - Profilaxis-bacteriana, así como la asociación de los términos de búsqueda en el idioma Inglés, español y portugués. Totalizándose 189 estudios para la realización de la investigación e incluidos 13 artículos. Los datos fueron analizados a partir de estadística descriptiva. Conclusión: Mediante informaciones exportas en estos trabajos, se puede concluir que la mejor manera de prevenir una endocarditis infecciosa es conocer al paciente por medio de una anamnesis bien hecha, donde se conozca toda la historia médica odontológica anterior del paciente para que se puedan identificar de forma individualizada los pacientes de riesgo, así como la exposición innecesaria de antibióticos a este paciente. Siendo la antibioticoprofilaxia recomendada para todos los pacientes odontológicos de riesgo eminente, así como procedimientos de cirugía y traumatología bucomaxilofacial más invasiva(AU)

The association of HLA-G polymorphisms and the synergistic effect of sMICA and sHLA-G with chronic kidney disease and allograft acceptance.

The HLA-G and MICA genes are stimulated under inflammatory conditions and code for soluble (sMICA and sHLA-G) or membrane-bound molecules that exhibit immunomodulatory properties. It is still unclear whether they would have a synergistic or antagonistic effect on the immunomodulation of the inflammatory response, such as in chronic kidney disease (CKD), contributing to a better prognosis after the kidney transplantation. In this study, we went from genetic to plasma analysis, first evaluating the polymorphism of MICA, NKG2D and HLA-G in a cohort from Southern Brazil, subdivided in a control group of individuals (n = 75), patients with CKD (n = 94), and kidney-transplant (KT) patients (n = 64). MICA, NKG2D and HLA-G genotyping was performed by polymerase chain reaction with specific oligonucleotide probes, Taqman and Sanger sequencing, respectively. Levels of soluble forms of MICA and HLA-G were measured in plasma with ELISA. Case-control analysis showed that the individuals with haplotype HLA-G*01:01/UTR-4 have a lower susceptibility to develop chronic kidney disease (OR = 0.480; p = 0.032). Concerning the group of kidney-transplant patients, the HLA-G genotypes +3010 GC (rs1710) and +3142 GC (rs1063320) were associated with higher risk for allograft rejection (OR = 5.357; p = 0.013 and OR = 5.357, p = 0.013, respectively). Nevertheless, the genotype +3010 GG (OR = 0.136; p = 0.041) was associated with kidney allograft acceptance, suggesting that it is a protection factor for rejection. In addition, the phenotypic analysis revealed higher levels of sHLA-G (p = 0.003) and sMICA (p < 0.001) in plasma were associated with the development of CKD. For patients who were already under chronic pathological stress and underwent a kidney transplant, a high sMICA (p = 0.001) in pre-transplant proved to favor immunomodulation and allograft acceptance. Even so, the association of genetic factors with differential levels of soluble molecules were not evidenced, we displayed a synergistic effect of sMICA and sHLA-G in response to inflammation. This increase was observed in CKD patients, that when undergo transplantation, had this previous amount of immunoregulatory molecules as a positive factor for the allograft acceptance.

High-resolution characterization of 12 classical and non-classical HLA loci in Southern Brazilians.

The human leukocyte antigen (HLA) are the most polymorphic genes in the human genome. Because of their importance for antigen recognition, HLA molecules play a central role in host defense and graft rejection upon transplantation. The aim of this study was to characterize allelic diversity of the classical HLA genes HLA-A, -B, -C, -DRA, -DRB1, -DQA1, -DQB1, -DPA1, -DPB1, and the non-classical class I genes HLA-E, -F and -G at high-resolution for a population of predominantly European ancestry from Curitiba, Brazil. Genotyping of 108 individuals was performed by next-generation sequencing on the MiSeq platform and also by Sanger sequencing. The genotype distributions of all loci were in accordance with Hardy-Weinberg equilibrium (P > 0.05) and a total of 202 HLA variants at second field resolution were observed for the 12 loci. The strongest linkage disequilibrium (r2 = 1.0, P < 10-5 ) was observed for the following pairs of alleles: HLA-B*42:01:01 ~ HLA-DRB1*03:02:01; HLA-B*14:02:01 ~ HLA-C*08:02:01; B*42:01:01 ~ HLA-C*17:01:01; HLA-DRB1*03:01:01 ~ HLA-DQB1*02:01:01 ~ DRB1*03:01:01 ~ HLA-DQB1*02:01:01; DRB1*13:01:01~ HLA-DQB1*06:03:01 and HLA-DRB1*09:01:02 ~ HLA-DQA1*03:02. This is the first study to characterize all 12 HLA genes at high resolution in a single population. On the basis of the allelic frequencies of worldwide populations and principal component analysis, we confirmed the similarity of the study population to European and other Euro-descendant populations.

Prática educativa nutricional como ação de cuidado em uma instituição de longa permanência para idosos: relato de experiência / Nutritional educational practice as caregiving in a long-term institution stay for the elderly: report of experience

A proposta da ação de educação em saúde, surge como estratégia de cuidado para contribuir com os idosos a desenvolver sua autonomia considerando suas necessidades e vontades dentro da realidade em que vivem. Por fim, verificou-se a necessidade de compartilhar com os idosos as questões sobre hábitos alimentares saudáveis, pois foram observadas as reais condições do estoque de alimentos, desde a segunda visita. Considerando que a instituição é categorizada como filantrópica, sem fins lucrativos e vinculada a entidade religiosa, recebem recursos financeiros por meio de doações e parte das aposentadorias dos idosos residentes, deste modo tornando restrita a variabilidade de alimentos oferecidos aos residentes. Espera-se que o estudo traga implicações reflexivas sobre a importância da nutrição da pessoa idosa e possíveis adequações do cardápio habitual, levando em consideração os mantimentos que são, na grande maioria, doações

Women's knowledge of methods for secondary prevention of breast cancer. / O conhecimento de mulheres sobre os métodos para prevenção secundária do câncer de mama.

The objective of this study was to evaluate women's knowledge of methods for screening breast cancer. The study was done on a population of women aged 18 or over in the city of Rio Grande between April and November 2011. Interviewers used questionnaires on all of the women at selected households. Models were developed for every type of screening (self-examination of breasts, mammography, and clinical exams) that were analyzed through the use of Poisson regression. Out of the 1596 women interviewed, 1355 reported self-examination, 456, mammography, and only 191, clinical examination of the breast, performed by a health professional, as important for the prevention of breast cancer. White women with 11 years or more worth of schooling had a greater probability of having mammography exams and clinical examinations as methods for screening. We noted, linked to the aforementioned, that there was a linear tendency whereby there was a greater probability for those with high incomes to undergo one of the above interventions. The study noted that there was a need for more detailed information aimed at the population on prevention methods in order to avoid late diagnosis. We noted that non-white women with little education and on low incomes showed less knowledge of clinical examination methods and mammographies.

Objetivou-se avaliar o conhecimento das mulheres sobre métodos de rastreamento do câncer de mama. Estudo de base populacional com mulheres de 18 anos ou mais em Rio Grande, entre abril e novembro de 2011. Entrevistadoras aplicavam questionário pré-codificado em todas as mulheres do domicílio selecionado. Construiuse um modelo para cada forma de rastreamento (autoexame das mamas, mamografia e exame clínico), analisados por regressão de Poisson. Das 1596 mulheres entrevistadas, 1355 referiram o autoexame, 456, a mamografia e, apenas 191, o exame clínico da mama, realizado por um profissional de saúde, como importantes para a prevenção do câncer de mama. As mulheres brancas, e com 11 anos ou mais de escolaridade, tiveram maior probabilidade de referirem a mamografia e o exame clínico como métodos de rastreamento. Para esses dois desfechos, também se observou uma tendência linear, sendo que a probabilidade de referir uma dessas formas de rastreamento se incrementou na medida em que aumentaram os quartis de renda. O estudo aponta para a necessidade de maior esclarecimento da população sobre os métodos de prevenção, evitando, assim, o diagnóstico tardio. Evidenciou-se que as mulheres não brancas e as de baixa escolaridade e renda, demonstraram menos conhecimentos sobre os métodos de exame clínico e mamografia.

Inclusão de alunos com deficiência em uma Universidade particular de Curitiba / Inclusion of students with disabilities in a particular university of Curitiba / Inclusión de estudiantes con discapacidad en una universidad privada de Curitiba

Discussões e questionamentos comprometidos com a democratização do ensino superior têm ocupado importante espaço nos debates educacionais, tanto para garantir o ingresso de pessoas em tal nível de ensino, quanto à melhoria da qualidade do mesmo. Objetivo: descrever e analisar as diretrizes e ações que direcionam o Programa Incluir e a Comissão de Educação Inclusiva de uma universidade privada de Curitiba, bem como a visão de alunos com deficiência acerca de sua experiência acadêmica, no tocante à infraestrutura, às relações interpessoais e aos aspectos pedagógicos pertinentes à sua formação. Método: estudo de caso do tipo qualitativo. Foram realizadas entrevistas semiestruturadas com a presidente da Comissão e 5 graduandos que se autodenominam deficientes. A análise dos dados baseou-se na análise de conteúdo. Os enunciados produzidos pelos participantes foram analisados a partir dos seguintes eixos temáticos: comissão de Educação Inclusiva; relações interpessoais e experiências pedagógicas e a visão dos alunos sobre mudanças necessárias. Resultado: Embora os estudantes possuam uma visão positiva sobre as atividades desenvolvidas pela comissão, fica evidenciado que a mesma tem uma ação restrita no que tange aos aspectos relacionais e pedagógicos da vivência acadêmica dos alunos. Conclusão: No que se refere à Comissão Inclusiva da universidade e ao Programa Incluir, ambos possuem objetivos focados no trabalho para questões funcionais de acessibilidade. Quanto aos aspectos pedagógicos e relacionais, seu alcance apresenta-se frágil. Sugere-se o implemento de estudos que analisem os aspectos singulares das pessoas com deficiência e os determinantes sociais e históricos que perpassam o sistema educacional brasileiro.

Discussions on the democratization of higher education have occupied an important place in the Brazilian educational debates, both to ensure that an increasing number of people enter this level of education, as well as regarding its quality. Objective: to analyze the guidelines of the Programa Incluir as well as the work of the Inclusive Education Commission (IEC) of a university thereby analyzing the vision of a group of such students on their academic experience in terms of infrastructure, interpersonal relations and pedagogical aspects relevant to their training. Method: case study of the qualitative type. Semi-structured interviews were conducted with the president of the Commission and 5 graduates who call themselves disabled. Data analysis was based on content analysis. The statements produced by the participants were analyzed from the following thematic axes: Inclusive Education Committee; interpersonal relationships and pedagogical experiences, and students' view of necessary changes. Results: Although the students have a positive view on the activities developed by the commission, it is evidenced that it has a restricted action regarding the relational and pedagogical aspects of student's academic experience. Conclusion: With regard to the University's Inclusive Commission and the Include Program, both have work-focused objectives for functional accessibility issues. As for the pedagogical and relational aspects, its scope is fragile. It is suggested the implementation of studies that analyze the unique aspects of people with disabilities and the social and historical determinants that permeate the Brazilian educational system.

Las discusiones y cuestionamientos comprometidos con la democratización de la enseñanza superior han ocupado un importante espacio en los debates educativos brasileños, tanto para garantizar el ingreso de un número cada vez mayor de personas en dicho nivel de enseñanza, en cuanto a la mejora de la calidad del mismo. Objetivo: analizar las directrices que orientan el Programa Incluir, así como el funcionamiento de la Comisión de Educación Inclusiva (CEI) de una universidad privada de Curitiba y analizar la visión de un grupo de estudiantes acerca de su experiencia académica, en lo que se refiere a la infraestructura, Las relaciones interpersonales y los aspectos pedagógicos pertinentes a su formación. Método: estudio de caso del tipo cualitativo. Se realizaron entrevistas semiestructuradas con la presidenta de la Comisión y 5 graduados que se autodenominan discapacitados. El análisis de los datos se basó en el análisis de contenido. Los enunciados producidos por los participantes fueron analizados a partir de los siguientes ejes temáticos: comisión de Educación Inclusiva; relaciones interpersonales y experiencias pedagógicas y la visión de los alumnos sobre cambios necesarios. Resultado: Aunque los estudiantes tienen una visión positiva sobre las actividades desarrolladas por la comisión, queda evidenciado que la misma tiene una acción restringida en lo que se refiere a los aspectos relacionales y pedagógicos de la vivencia académica de los alumnos. Conclusión: En lo que se refiere a la Comisión Inclusiva de la Universidad y al Programa Incluir, ambos tienen objetivos enfocados en el trabajo para cuestiones funcionales de accesibilidad. En cuanto a los aspectos pedagógicos y relacionales, su alcance se presenta frágil. Se sugiere el implemento de estudios que analizan los aspectos singulares de las personas con discapacidad y los determinantes sociales e históricos que atravesan el sistema educativo brasileño.

O conhecimento de mulheres sobre os métodos para prevenção secundária do câncer de mama / Women's knowledge of methods for secondary prevention of breast cancer

Resumo Objetivou-se avaliar o conhecimento das mulheres sobre métodos de rastreamento do câncer de mama. Estudo de base populacional com mulheres de 18 anos ou mais em Rio Grande, entre abril e novembro de 2011. Entrevistadoras aplicavam questionário pré-codificado em todas as mulheres do domicílio selecionado. Construiuse um modelo para cada forma de rastreamento (autoexame das mamas, mamografia e exame clínico), analisados por regressão de Poisson. Das 1596 mulheres entrevistadas, 1355 referiram o autoexame, 456, a mamografia e, apenas 191, o exame clínico da mama, realizado por um profissional de saúde, como importantes para a prevenção do câncer de mama. As mulheres brancas, e com 11 anos ou mais de escolaridade, tiveram maior probabilidade de referirem a mamografia e o exame clínico como métodos de rastreamento. Para esses dois desfechos, também se observou uma tendência linear, sendo que a probabilidade de referir uma dessas formas de rastreamento se incrementou na medida em que aumentaram os quartis de renda. O estudo aponta para a necessidade de maior esclarecimento da população sobre os métodos de prevenção, evitando, assim, o diagnóstico tardio. Evidenciou-se que as mulheres não brancas e as de baixa escolaridade e renda, demonstraram menos conhecimentos sobre os métodos de exame clínico e mamografia.

Abstract The objective of this study was to evaluate women's knowledge of methods for screening breast cancer. The study was done on a population of women aged 18 or over in the city of Rio Grande between April and November 2011. Interviewers used questionnaires on all of the women at selected households. Models were developed for every type of screening (self-examination of breasts, mammography, and clinical exams) that were analyzed through the use of Poisson regression. Out of the 1596 women interviewed, 1355 reported self-examination, 456, mammography, and only 191, clinical examination of the breast, performed by a health professional, as important for the prevention of breast cancer. White women with 11 years or more worth of schooling had a greater probability of having mammography exams and clinical examinations as methods for screening. We noted, linked to the aforementioned, that there was a linear tendency whereby there was a greater probability for those with high incomes to undergo one of the above interventions. The study noted that there was a need for more detailed information aimed at the population on prevention methods in order to avoid late diagnosis. We noted that non-white women with little education and on low incomes showed less knowledge of clinical examination methods and mammographies.

Atuais diretrizes do rastreamento do câncer colorretal: revisão de literatura / Current guidelines for screening colorectal cancer: a review of the literature

O câncer colorretal (CCR) é atualmente considerado uma neoplasia com alta taxa de incidência e de mortalidade na população, sendo o terceiro tipo de câncer mais prevalente no mundo e a segunda causa de mortes por câncer. Devido à importância de amenizar estas taxas, foram avaliados diversos métodos existentes nos Estados Unidos, na Europa e no Brasil para o rastreio do câncer colorretal, sendo notável a variedade de opções de exames disponíveis, além dos fatores de risco mundialmente difundidos. Foi observado que a mudança do estilo de vida é de difícil adesão, tornando assim imprescindível a adoção de um método de rastreio eficaz para detecção precoce e remoção de lesões pré-malignas e de neoplasias em estágio inicial, visando reduzir a incidência e a mortalidade do CCR e os gastos despendidos com o tratamento no caso de uma neoplasia avançada. No entanto, ainda não há um consenso acerca de um método de rastreio altamente qualificado e utilizado mundialmente de maneira unânime (AU)

Colorectal cancer (CRC) is currently considered a neoplasm with a high rate of incidence and mortality in the population, being the third most prevalent type of cancer in the world and the second cause of cancer deaths. Due to the importance of mitigating these rates, several methods for the screening of colorectal cancer used in the United States, Europe and Brazil were assessed, being noteworthy the variety of options for tests available, in addition to the risk factors broadcast worldwide. It has been observed that lifestyle changes are difficult to implement, thus making it imperative to adopt an effective screening method for the early detection and removal of premalignant lesions and early stage neoplasms in order to reduce the incidence and mortality of CRC and the costs incurred with treatment in case of advanced neoplasia. However, there is as yet no consensus on a highly qualified screening method used universally worldwide (AU)