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1.
Front Mol Biosci ; 11: 1385140, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38745909

RESUMO

Introduction: Although B-cell acute lymphoblastic leukemia (B-cell ALL) survival rates have improved in recent years, Hispanic children continue to have poorer survival rates. There are few tools available to identify at the time of diagnosis whether the patient will respond to induction therapy. Our goal was to identify predictive biomarkers of treatment response, which could also serve as prognostic biomarkers of death, by identifying methylated and differentially expressed genes between patients with positive minimal residual disease (MRD+) and negative minimal residual disease (MRD-). Methods: DNA and RNA were extracted from tumor blasts separated by immunomagnetic columns. Illumina MethlationEPIC and mRNA sequencing assays were performed on 13 bone marrows from Hispanic children with B-cell ALL. Partek Flow was used for transcript mapping and quantification, followed by differential expression analysis using DEseq2. DNA methylation analyses were performed with Partek Genomic Suite and Genome Studio. Gene expression and differential methylation were compared between patients with MRD-/- and MRD+/+ at the end of induction chemotherapy. Overexpressed and hypomethylated genes were selected and validated by RT-qPCR in samples of an independent validation cohort. The predictive ability of the genes was assessed by logistic regression. Survival and Cox regression analyses were performed to determine the association of genes with death. Results: DAPK1, BOC, CNKSR3, MIR4435-2HG, CTHRC1, NPDC1, SLC45A3, ITGA6, and ASCL2 were overexpressed and hypomethylated in MRD+/+ patients. Overexpression was also validated by RT-qPCR. DAPK1, BOC, ASCL2, and CNKSR3 can predict refractoriness, but MIR4435-2HG is the best predictor. Additionally, higher expression of MIR4435-2HG increases the probability of non-response, death, and the risk of death. Finally, MIR4435-2HG overexpression, together with MRD+, are associated with poorer survival, and together with overexpression of DAPK1 and ASCL2, it could improve the risk classification of patients with normal karyotype. Conclusion: MIR4435-2HG is a potential predictive biomarker of treatment response and death in children with B-cell ALL.

2.
Rev Esc Enferm USP ; 58: e20230343, 2024.
Artigo em Inglês, Português | MEDLINE | ID: mdl-38587402

RESUMO

OBJECTIVE: To analyze the evidence of content validity of the Nursing Outcomes "Mechanical Ventilation Response: Adult" and "Mechanical Ventilation Weaning Response: Adult", for patients with severe COVID-19. METHOD: Methodological study developed in two stages: literature review to construct the definitions of the indicators and analysis of the evidence of content validity of the nursing outcomes by a focus group. RESULTS: All the conceptual and operational definitions developed for the 56 indicators were considered clear and precise. However, 17 indicators were excluded because they were deemed not to be relevant. The definitions of the magnitudes for 17 indicators of the Nursing Outcome "Mechanical Ventilation Response: Adult" and 22 indicators "Mechanical Ventilation Weaning Response: Adult" were thus constructed. CONCLUSION: The development of definitions and validation by experts makes the use of these outcomes and their indicators more understandable and precise, favoring their use in clinical practice and providing greater detail in assessment and recording.


Assuntos
COVID-19 , Respiração Artificial , Adulto , Humanos , Grupos Focais , Projetos de Pesquisa
4.
Rev Lat Am Enfermagem ; 32: e4125, 2024.
Artigo em Inglês, Espanhol, Português | MEDLINE | ID: mdl-38511737

RESUMO

OBJECTIVE: to evaluate the evidence of validity of the internal structure and reliability of the Brazilian version of the Smoking Cessation Counseling instrument. METHOD: psychometric study of confirmatory factor analysis and reliability carried out on 250 nurses in clinical practice. For the analysis of the convergent validity of the factor model, Average Variance Extracted values were calculated, and discriminant analysis was carried out using the Fornell-Larcker criterion. Reliability was examined using Cronbach's alpha coefficient and composite reliability. RESULTS: it was necessary to exclude seven items from the Advanced Counseling domain and one item from the Basic Counseling domain in order to properly obtain the Average Variance Extracted values and the Fornell-Larcker criterion. The composite reliability ranged from 0.76 to 0.86 and the overall Cronbach`s alpha coefficient was 0.86, ranging from 0.53 to 0.84 depending on the domain assessed. The final version of the instrument was made up of 16 items divided into 4 domains. CONCLUSION: the Brazilian version of Smoking Cessation Counseling obtained adequate psychometric evidence of validity and reliability. Further studies are needed to refine the instrument. BACKGROUND: (1) Instrument shows adequate internal consistency and validity. BACKGROUND: (2) Evaluate counseling practices and their impact on patient care. BACKGROUND: (3) Instrument for evaluating smoking cessation counseling. BACKGROUND: (4) Provides important information for planning nursing care.


Assuntos
Abandono do Hábito de Fumar , Humanos , Abandono do Hábito de Fumar/psicologia , Brasil , Reprodutibilidade dos Testes , Aconselhamento , Psicometria , Inquéritos e Questionários
5.
Rev Lat Am Enfermagem ; 32: e4119, 2024.
Artigo em Inglês, Espanhol, Português | MEDLINE | ID: mdl-38511736

RESUMO

OBJECTIVE: to test the factorial structure, reliability and convergent validity of the Functional Health Pattern Assessment Screening Tool - Modified Brazilian Version. METHOD: this was a psychometric evaluation of the Functional Health Pattern Assessment Screening Tool - Modified Brazilian Version. Seven hundred and seventeen participants answered the data collection instrument consisting of two parts. Part I included a structured questionnaire to collect sociodemographic data and the participants' perceptions and satisfaction with their current health status. Part II consisted of the tool being tested. The internal structure was assessed using Confirmatory Factor Analysis. Convergent validity was evaluated by the correlation of the tool scores with the rates corresponding to self-perception and satisfaction with current health status. Reliability was assessed using Cronbach's alpha. RESULTS: the Confirmatory Factor Analysis confirmed a three-factor solution. The factor loadings were significant and varied from 0.16 to 0.75; the fit indices suggested moderate fit of the model. Internal consistency for all three components varied between 0.779 and 0.919. CONCLUSION: the findings suggest that the tool is valid and reliable to be used in the Brazilian population, although caution is recommended when interpreting the results due to the moderate fit of the model. BACKGROUND: (1) The FHPAST-BR is a structured, valid and reliable Nursing-driven assessment tool. BACKGROUND: (2) The tool provides a way of organizing clinical data and easing decision-making. BACKGROUND: (3) The FHPAST-BR can be used in clinical practice and research.


Assuntos
Autoimagem , Humanos , Psicometria , Brasil , Reprodutibilidade dos Testes , Inquéritos e Questionários
8.
Biochem Genet ; 62(1): 352-370, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-37347449

RESUMO

Malignant pleural mesothelioma (MPM) is a rare and aggressive neoplasm of the pleural tissue that lines the lungs and is mainly associated with long latency from asbestos exposure. This tumor has no effective therapeutic opportunities nowadays and has a very low five-year survival rate. In this sense, identifying molecular events that trigger the development and progression of this tumor is highly important to establish new and potentially effective treatments. We conducted a meta-analysis of genome-wide expression studies publicly available at the Gene Expression Omnibus (GEO) and ArrayExpress databases. The differentially expressed genes (DEGs) were identified, and we performed functional enrichment analysis and protein-protein interaction networks (PPINs) to gain insight into the biological mechanisms underlying these genes. Additionally, we constructed survival prediction models for selected DEGs and predicted the minimum drug inhibition concentration of anticancer drugs for MPM. In total, 115 MPM tumor transcriptomes and 26 pleural tissue controls were analyzed. We identified 1046 upregulated DEGs in the MPM samples. Cellular signaling categories in tumor samples were associated with the TNF, PI3K-Akt, and AMPK pathways. The inflammatory response, regulation of cell migration, and regulation of angiogenesis were overrepresented biological processes. Expression of SOX17 and TACC1 were associated with reduced survival rates. This meta-analysis identified a list of DEGs in MPM tumors, cancer-related signaling pathways, and biological processes that were overrepresented in MPM samples. Some therapeutic targets to treat MPM are suggested, and the prognostic potential of key genes is shown.


Assuntos
Neoplasias Pulmonares , Mesotelioma Maligno , Mesotelioma , Neoplasias Pleurais , Humanos , Mesotelioma/genética , Mesotelioma/metabolismo , Fosfatidilinositol 3-Quinases , Neoplasias Pleurais/genética , Neoplasias Pleurais/metabolismo , Neoplasias Pulmonares/patologia
9.
Rev. latinoam. enferm. (Online) ; 32: e4125, 2024. tab, graf
Artigo em Inglês | LILACS, BDENF - Enfermagem | ID: biblio-1550984

RESUMO

Objective: to evaluate the evidence of validity of the internal structure and reliability of the Brazilian version of the Smoking Cessation Counseling instrument Method: psychometric study of confirmatory factor analysis and reliability carried out on 250 nurses in clinical practice. For the analysis of the convergent validity of the factor model, Average Variance Extracted values were calculated, and discriminant analysis was carried out using the Fornell-Larcker criterion. Reliability was examined using Cronbach's alpha coefficient and composite reliability Results: it was necessary to exclude seven items from the Advanced Counseling domain and one item from the Basic Counseling domain in order to properly obtain the Average Variance Extracted values and the Fornell-Larcker criterion. The composite reliability ranged from 0.76 to 0.86 and the overall Cronbach`s alpha coefficient was 0.86, ranging from 0.53 to 0.84 depending on the domain assessed. The final version of the instrument was made up of 16 items divided into 4 domains Conclusion: the Brazilian version of Smoking Cessation Counseling obtained adequate psychometric evidence of validity and reliability. Further studies are needed to refine the instrument.


Objetivo: evaluar las evidencias de validez de la estructura interna y de la confiabilidad de la versión brasileña del instrumento Smoking Cessation Counseling. Método: estudio psicométrico de análisis factorial confirmatorio y de confiabilidad realizado en 250 enfermeras de la práctica clínica. Para el análisis de la validez convergente del modelo factorial se calcularon valores de Average Variance Extracted, el análisis discriminante se realizó mediante el criterio de Fornell-Larcker. La confiabilidad se examinó por el coeficiente de alfa de Cronbach y por la confiabilidad compuesta. Resultados: fue necesaria la exclusión de siete ítems del dominio de Asesoramiento avanzado y un ítem del dominio Asesoramiento básico para obtener adecuadamente los valores de Average Variance Extracted y del criterio de Fornell-Larcker. La confiabilidad compuesta varió de 0,76 a 0,86 y el coeficiente de alfa de Cronbach global alcanzado fue de 0,86, variando de 0,53 a 0,84 dependiendo del dominio evaluado. Se obtuvo la versión final del instrumento compuesto de 16 ítems distribuidos en 4 dominios. Conclusión: la versión brasileña de Smoking Cessation Counseling obtuvo adecuadas evidencias psicométricas de validez y confiabilidad. Estudios posteriores serán necesarios para el refinamiento del instrumento.


Objetivo: avaliar as evidências de validade da estrutura interna e da confibialidade da versão brasileira do instrumento Smoking Cessation Counseling Método: estudo psicométrico de análise fatorial confirmatória e de confiabilidade realizado em 250 enfermeiras da prática clínica. Para a análise da validade convergente do modelo fatorial foram calculados valores de Average Variance Extracted , a análise discriminante foi realizada pelo critério de Fornell-Larcker. A confiabilidade foi examinada pelo coeficiente de alfa de Cronbach e pela confiabilidade composta Resultados: foi necessária a exclusão de sete itens do domínio de Aconselhamento avançado e um item do domínio Aconselhamento básico para obtenção adequada dos valores de Average Variance Extracted e do critério de Fornell-Larcker. A confiabilidade composta variou de 0,76 a 0,86 e o coeficiente de alfa de Cronbach global alcançado foi de 0,86, variando de 0,53 a 0,84 a depender do domínio avaliado. Obteve-se a versão final do instrumento composto de 16 itens distribuídos em quatro domínios Conclusão: a versão brasileira da Smoking Cessation Counseling obteve adequadas evidências psicométricas de validade e de confiabilidade. Estudos posteriores serão necessários para o refinamento do instrumento.


Assuntos
Enfermagem em Saúde Pública , Análise Fatorial , Abandono do Uso de Tabaco , Aconselhamento , Estudo de Validação , Métodos
10.
Rev. latinoam. enferm. (Online) ; 32: e4119, 2024. tab
Artigo em Inglês | LILACS, BDENF - Enfermagem | ID: biblio-1550982

RESUMO

Objective: to test the factorial structure, reliability and convergent validity of the Functional Health Pattern Assessment Screening Tool - Modified Brazilian Version. Method: this was a psychometric evaluation of the Functional Health Pattern Assessment Screening Tool - Modified Brazilian Version. Seven hundred and seventeen participants answered the data collection instrument consisting of two parts. Part I included a structured questionnaire to collect sociodemographic data and the participants' perceptions and satisfaction with their current health status. Part II consisted of the tool being tested. The internal structure was assessed using Confirmatory Factor Analysis. Convergent validity was evaluated by the correlation of the tool scores with the rates corresponding to self-perception and satisfaction with current health status. Reliability was assessed using Cronbach's alpha. Results: the Confirmatory Factor Analysis confirmed a three-factor solution. The factor loadings were significant and varied from 0.16 to 0.75; the fit indices suggested moderate fit of the model. Internal consistency for all three components varied between 0.779 and 0.919. Conclusion: the findings suggest that the tool is valid and reliable to be used in the Brazilian population, although caution is recommended when interpreting the results due to the moderate fit of the model.


Objetivo: someter a prueba la estructura factorial, confiabilidad y validez convergente del instrumento Functional Health Pattern Assessment Screening Tool - Versión modificada para Brasil. Método: evaluación psicométrica del instrumento Functional Health Pattern Assessment Screening Tool - Versión modificada para Brasil. Setecientos diecisiete participantes respondieron el instrumento de recolección de datos, compuesto por dos partes. La Parte I incluyó un cuestionario estructurado para recopilar datos sociodemográficos y las percepciones y el nivel de satisfacción de los participantes con respecto a su estado de salud actual. La Parte II consistió en la herramienta sometida a prueba. La estructura interna se evaluó empleando Análisis Factorial Confirmatorio. La validez interna se evaluó por medio de la correlación entre las puntuaciones obtenidas en la herramienta y los índices correspondientes a los niveles de autopercepción y satisfacción con respecto al estado de salud actual. La confiabilidad se evaluó utilizando el coeficiente alfa de Cronbach. Resultados: el Análisis Factorial Confirmatorio confirmó una solución con tres factores. Las cargas factoriales fueron significativas y variaron entre 0,16 y 0.75; los índices de ajuste sugirieron ajuste moderado del modelo. La consistencia interna correspondiente a los tres componentes varió entre 0,779 y 0,919. Conclusión: los hallazgos sugieren que la herramienta es válida y confiable para ser usada en la población de Brasil, aunque se recomienda interpretar los resultados con precaución debido al moderado ajuste del modelo.


Objetivo: testar a estrutura fatorial, a confiabilidade e a validade convergente do Functional Health Pattern Assessment Screening Tool - Versão Brasileira Modificada. Método: avaliação psicométrica do Functional Health Pattern Assessment Screening Tool - Versão Brasileira Modificada. Setecentos e dezessete participantes responderam os itens do instrumento de coleta de dados composto por duas partes. A Parte I incluiu um questionário estruturado contendo dados sociodemográficos e a percepção e satisfação dos participantes com seu estado de saúde atual. A Parte II consistiu no instrumento testado. A estrutura interna foi avaliada por meio de Análise Fatorial Confirmatória. A validade convergente foi avaliada pela correlação dos escores do instrumento com os índices correspondentes à autopercepção e à satisfação com o estado de saúde atual. A confiabilidade foi avaliada pelo alfa de Cronbach. Resultados: a Análise Fatorial Confirmatória confirmou uma solução de três fatores. As cargas fatoriais foram significativas e variaram de 0,16 a 0,75; os índices de ajuste sugeriram ajuste moderado do modelo. A consistência interna dos três componentes variou entre 0,779 e 0,919. Conclusión: os achados sugerem que o instrumento é válido e confiável para ser utilizado na população brasileira, embora seja recomendada cautela na interpretação dos resultados devido ao ajuste moderado do modelo.


Assuntos
Humanos , Psicometria , Estudo de Validação , Raciocínio Clínico , Avaliação em Enfermagem , Processo de Enfermagem
11.
Life (Basel) ; 13(9)2023 Aug 31.
Artigo em Inglês | MEDLINE | ID: mdl-37763245

RESUMO

Anti-CD38 monoclonal antibody (MoAB) therapy has significantly improved the prognosis of patients with multiple myeloma. However, not all patients sustain durable responses. We aimed to describe the natural history of patients relapsed or refractory (R/R) to CD38 MoAB therapy. We performed a single-center, retrospective analysis of the clinical characteristics and outcomes of 81 patients with multiple myeloma who progressed after treatment with daratumumab. Our cohort was heavily pretreated, with a median of two lines prior to daratumumab and only 17 patients received daratumumab as a first line. A total of 38.2% had received a previous autologous stem cell transplantation (ASCT), and 61.7% had received both an immunomodulatory drug (IMID) and a proteasome inhibitor (PI). The median overall survival (OS) was 21 months for the global cohort but it decreased to 14 months for triple-class refractory patients and 5 months for penta-refractory patients. Most of the patients (83.9%) received treatment after daratumumab progression, in many cases with second generation IMID or PI, but seven patients were treated with anti-BCMA therapy and three patients received CART therapy within a clinical trial. In conclusion, patients R/R to daratumumab represent an unmet clinical need with poor prognosis and in need of incorporation of new treatments.

12.
Rev Gaucha Enferm ; 44: e20220328, 2023.
Artigo em Inglês, Português | MEDLINE | ID: mdl-37672404

RESUMO

OBJECTIVE: To analyze the evidence of content validity of telephone messages regarding preventive measures against COVID-19. METHOD: Methodological study, in which messages containing text and image were developed through a narrative literature review and whose content was evaluated by eight judges in terms of clarity, practical relevance, theoretical relevance and vocabulary. The content validity index (CVI) was calculated, and messages that reached levels above 90% were considered to have adequate evidence of validity. RESULTS: Eighteen text messages/images were developed containing information about COVID-19, hand hygiene, use and handling of masks and the importance of social distancing. After second round of evaluation, a content validity index above 90% was obtained in all evaluated indicators. CONCLUSION: The telephone messages were developed and showedadequate evidence of content validity.


Assuntos
COVID-19 , Higiene das Mãos , Humanos , COVID-19/prevenção & controle , Máscaras , Distanciamento Físico , Telefone
13.
Arch. latinoam. nutr ; 73(supl. 2): 140-150, sept. 2023. tab
Artigo em Espanhol | LILACS, LIVECS | ID: biblio-1537269

RESUMO

Introducción. Las máquinas expendedoras de bebidas y alimentos (MEBA) ganan presencialidad en universidades, lo que potencia aumento de peso en adultos jóvenes. Objetivo. reconocer la configuración de las MEBA para la construcción del ambiente alimentario saludable en una universidad de Colombia. Materiales y métodos. Diseño descriptivo multimodos, con aproximación empírica de: entrevista a tomadores de decisión (n=6) de la institución educativa; análisis de ventas durante un año (n=12.955) en las MEBA (n=12); caracterización por densidad nutricional de la oferta (n=152) y rastreo a comunicaciones circulantes asociadas con alimentación. El análisis consideró cuatro momentos: I-Relaciones; II-Canal MEBA; III-Nutrición y IV-Interacción. Los I y II se enfocaron en los componentes político, sociocultural, físico y económico. El III estudió el aporte nutricional de bebidas y alimentos para integrar resultados en el IV. Resultados. La ausencia de política sobre alimentación institucional como la visibilización comunicativa parecen potenciar condiciones sociales que refuerzan lógicas de: "mal necesario", "perfil de consumo ya existente", "ausencia de ejercicios académicos" y "experiencias negativas con alimentación saludable". Cimientos para ofertar con mayor demanda bebidas como refrescos y agua y, en alimentos, chocolate en diferentes formulaciones. En la clasificación por densidad nutricional se encontró que las bebidas fueron clasificadas como "no saludable" (51,6%); "algo saludable" (28,1%) y "saludable" (20,3%). Los alimentos "algo saludable" (44,9%); "no saludable" (32,2%) y "saludable" (22,9%). Conclusiones. la universidad, espacio de formación, requiere realizar esfuerzos de comprensión sociocultural, gerencia alineada a normativas de promoción de salud para incidir en la calidad nutricional ofertada a la comunidad universitaria(AU)


Introduction. Food and beverage vending machines (MEBA) are gaining presence in universities, which promotes weight gain in young adults. Objective. to recognize the configuration of the MEBA for the construction of a healthy food environment in a university in Colombia. Materials and methods. multimodal descriptive design, with an empirical approach of: interview with decision makers of the educational institution (n=6); analysis of sales during one year (n=12,955) in the MEBAs (n=12); characterization by nutritional density of the offer (n=152) and tracking of circulating communications associated with food. The analysis considered four moments: I-Relationships; II-MEBA Channel; III-Nutrition and IV-Interaction. I and II focused on the political, sociocultural, physical and economic components. The III studied the nutritional contribution of drinks and foods to integrate results in the IV. Results. the absence of a policy on institutional food such as communicative visibility seems to enhance social conditions that reinforce logics of: "necessary evil", "already existing consumption profile", "absence of academic exercises" and "negative experiences with healthy eating". Foundations to offer with greater demand drinks such as soft drinks and water and, in food, chocolate in different formulations. In the classification by nutritional density, it was found that the drinks were classified as "unhealthy" (51.6%); "something healthy" (28.1%) and "healthy" (20.3%). "Somewhat healthy" foods (44.9%); "unhealthy" (32.2%) and "healthy" (22.9%). Conclusions. the university, a training space, requires efforts at sociocultural understanding, management aligned with health promotion regulations to influence the nutritional quality offered to the university community(AU)


Assuntos
Humanos , Qualidade dos Alimentos , Ingestão de Alimentos , Distribuidores Automáticos de Alimentos
14.
Surg Neurol Int ; 14: 225, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37404501

RESUMO

Background: Gliomas represent almost 30% of all primary brain tumors and account for 80% of malignant primary ones. In the last two decades, significant progress has been made in understanding gliomas' molecular origin and development. These advancements have demonstrated a remarkable improvement in classification systems based on mutational markers, which contribute paramount information in addition to traditional histology-based classification. Methods: We performed a narrative review of the literature including each molecular marker described for adult diffuse gliomas used in the World Health Organization (WHO) central nervous system 5. Results: The 2021 WHO classification of diffuse gliomas encompasses many molecular aspects considered in the latest proposed hallmarks of cancer. The outcome of patients with diffuse gliomas relies on their molecular behavior and consequently, to determine clinical outcomes for these patients, molecular profiling should be mandatory. At least, the following molecular markers are necessary for the current most accurate classification of these tumors: (1) isocitrate dehydrogenase (IDH) IDH-1 mutation, (2) 1p/19q codeletion, (3) cyclin-dependent kinase inhibitor 2A/B deletion, (4) telomerase reverse transcriptase promoter mutation, (5) α-thalassemia/ mental retardation syndrome X-linked loss, (6) epidermal growth factor receptor amplification, and (7) tumor protein P53 mutation. These molecular markers have allowed the differentiation of multiple variations of the same disease, including the differentiation of distinct molecular Grade 4 gliomas. This could imply different clinical outcomes and possibly impact targeted therapies in the years to come. Conclusion: Physicians face different challenging scenarios according to the clinical features of patients with gliomas. In addition to the current advances in clinical decision-making, including radiological and surgical techniques, understanding the disease's molecular pathogenesis is paramount to improving the benefits of its clinical treatments. This review aims to describe straightforwardly the most remarkable aspects of the molecular pathogenesis of diffuse gliomas.

15.
Biomolecules ; 13(7)2023 07 19.
Artigo em Inglês | MEDLINE | ID: mdl-37509183

RESUMO

Uveal melanoma (UVM) is a highly aggressive ocular cancer with limited therapeutic options and poor prognosis particularly for patients with liver metastasis. As such, the identification of new prognostic biomarkers is critical for developing effective treatment strategies. In this study, we aimed to investigate the potential of an ultraviolet light response gene signature to predict the prognosis of UVM patients. Our approach involved the development of a prognostic model based on genes associated with the cellular response to UV light. By employing this model, we generated risk scores to stratify patients into high- and low-risk groups. Furthermore, we conducted differential expression analysis between these two groups and explored the estimation of immune infiltration. To validate our findings, we applied our methodology to an independent UVM cohort. Through our study, we introduced a novel survival prediction tool and shed light on the underlying cellular processes within UVM tumors, emphasizing the involvement of immune subsets in tumor progression.


Assuntos
Melanoma , Neoplasias Uveais , Humanos , Raios Ultravioleta , Melanoma/patologia , Neoplasias Uveais/genética , Neoplasias Uveais/metabolismo , Neoplasias Uveais/patologia , Olho/metabolismo
16.
Am J Gastroenterol ; 118(11): 2014-2024, 2023 11 01.
Artigo em Inglês | MEDLINE | ID: mdl-37307528

RESUMO

INTRODUCTION: In the treatment of upper GI endoscopy-negative patients with heartburn and epigastric pain or burning, antacids, antireflux agents, and mucosal protective agents are widely used, alone or as add-on treatment, to increase response to proton-pump inhibitors, which are not indicated in infancy and pregnancy and account for significant cost expenditure. METHODS: In this randomized, controlled, double-blind, double-dummy, multicenter trial assessing the efficacy and safety of mucosal protective agent Poliprotect (neoBianacid, Sansepolcro, Italy) vs omeprazole in the relief of heartburn and epigastric pain/burning, 275 endoscopy-negative outpatients were given a 4-week treatment with omeprazole (20 mg q.d.) or Poliprotect (5 times a day for the initial 2 weeks and on demand thereafter), followed by an open-label 4-week treatment period with Poliprotect on-demand. Gut microbiota change was assessed. RESULTS: A 2-week treatment with Poliprotect proved noninferior to omeprazole for symptom relief (between-group difference in the change in visual analog scale symptom score: [mean, 95% confidence interval] -5.4, -9.9 to -0.1; -6.2, -10.8 to -1.6; intention-to-treat and per-protocol populations, respectively). Poliprotect's benefit remained unaltered after shifting to on-demand intake, with no gut microbiota variation. The initial benefit of omeprazole was maintained against significantly higher use of rescue medicine sachets (mean, 95% confidence interval: Poliprotect 3.9, 2.8-5.0; omeprazole 8.2, 4.8-11.6) and associated with an increased abundance of oral cavity genera in the intestinal microbiota. No relevant adverse events were reported in either treatment arm. DISCUSSION: Poliprotect proved noninferior to standard-dose omeprazole in symptomatic patients with heartburn/epigastric burning without erosive esophagitis and gastroduodenal lesions. Gut microbiota was not affected by Poliprotect treatment. The study is registered in Clinicaltrial.gov (NCT03238534) and the EudraCT database (2015-005216-15).


Assuntos
Antiulcerosos , Dispepsia , Esofagite , Úlcera Péptica , Humanos , Omeprazol/uso terapêutico , Azia/tratamento farmacológico , Azia/etiologia , Antiulcerosos/uso terapêutico , Esofagite/induzido quimicamente , Inibidores da Bomba de Prótons/uso terapêutico , Dispepsia/tratamento farmacológico , Úlcera Péptica/complicações , Dor Abdominal/tratamento farmacológico , Resultado do Tratamento , Método Duplo-Cego
17.
Nurs Sci Q ; 36(3): 264-272, 2023 07.
Artigo em Inglês | MEDLINE | ID: mdl-37309148

RESUMO

This situation-specific theory was developed by linking concepts from Orem's Self-Care Deficit Nursing Theory and standardized nursing languages with the purpose of explaining and describing the health management of outpatients with heart failure. This theory suggests that the health management of these patients is influenced by basic conditioning factors, which may affect individuals' health management capability and may interfere with the ability to present health management behaviors. Knowing the ability of these patients to manage their health will allow nurses to plan their interventions, which will reflect directly on a patient's quality of life, and reduce the chances of hospitalization and health costs.


Assuntos
Insuficiência Cardíaca , Qualidade de Vida , Humanos , Custos de Cuidados de Saúde , Hospitalização , Idioma
19.
Rev Bras Enferm ; 76(3): e20220366, 2023.
Artigo em Inglês, Português | MEDLINE | ID: mdl-37377315

RESUMO

OBJECTIVES: to identify the effect on satisfaction and self-confidence of undergraduate nursing students after using a validated bed bath video during the simulation. METHODS: blinded parallel randomized clinical trial. Participants were allocated to the control group (simulation with tutor) or intervention (simulation with video). After the interventions, the Student Satisfaction and Self Confidence with Learning Scale was used to assess satisfaction and self-confidence. The study was approved by the Ethics Committee and Brazilian Registry of Clinical Trials. Mann Whitney, Fisher Exact and Student t statistical tests were used. A significance level of 5% was adopted. Results: fifty eight students (30, control; and 28, intervention) were evaluated. There was no significant difference between the groups regarding satisfaction (p=0.832) and self-confidence (p>0.999). CONCLUSIONS: satisfaction and self-confidence were similar between the groups, and the two strategies could be used in the simulated practice of bed bathing.


Assuntos
Bacharelado em Enfermagem , Treinamento por Simulação , Estudantes de Enfermagem , Humanos , Competência Clínica , Autoimagem , Satisfação Pessoal
20.
Acta neurol. colomb ; 39(2)jun. 2023.
Artigo em Espanhol | LILACS | ID: biblio-1533487

RESUMO

Introducción: La enfermedad de Pompe (EP) o glucogenosis tipo II es una enfermedad autosómica recesiva causada por mutaciones en el gen GAA que codifica para la proteína alfa-1,4-glucosidasa. Su deficiencia lleva a un almacenamiento anormal de glucógeno en los lisosomas de varias células, a través de los diferentes tejidos, lo que causa un compromiso musculoesquelético predominante. Contenidos: Los fenotipos de la enfermedad dependen de las variantes genéticas y de los niveles de la actividad enzimática residual. La enfermedad se presenta como EP de inicio infantil, EP de inicio tardío y EP intermedio, por lo que es de suma importancia su diagnóstico temprano, por medio de estudios moleculares como la secuenciación de Sanger y la secuenciación de nueva generación. Conclusiones: Se ha demostrado, mediante diferentes estudios, que las variaciones genéticas pueden diferir entre etnias, y es importante su caracterización molecular para determinar el tratamiento más adecuado, de acuerdo con el estado del material inmunológico de reacción cruzada (CRIM).


Introduction: Pompe disease (PD) or Glycogenosis Type II is a rare autosomal recessive disease caused by mutations in the GAA gene that codes for the alpha-1,4-glucosidase protein. Its deficiency leads to abnormal glycogen storage in the lysosomes of various cells throughout the different tissues causing a predominant musculoskeletal compromise. Contents: The phenotypes of the disease depend on the genetic variants and the levels of residual enzyme activity, presenting as infantile-onset PD, late-onset PD, and intermediate PD; Therefore, early diagnosis of the disease through molecular studies such as Sanger sequencing and new generation sequencing is of utmost importance. Conclusions: It has been shown through different studies that genetic variations can vary between ethnic groups and the molecular characterization of the variants is important to determine the most appropriate treatment depending on the state of the cross-reactive immunological material (CRIM)


Assuntos
Doença de Depósito de Glicogênio Tipo II , Técnicas de Diagnóstico Molecular , Fibroblastos , Leucócitos , Microscopia Eletrônica
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