Radiation Therapy Skin Marking with Lancets Versus Electric Marking Pen (COMFORTATTOO)-6 Months Results on Cosmesis, Fading, and Patients' Satisfaction From a Randomized, Double-Blind Trial.

Purpose: Most of radiation oncology centers rely on set-up skin markings for patient setup during treatment delivery. Permanent dark-ink tattooing is the most popular marking method. COMFORTATTOO is a unicentric, randomized trial testing 2 permanent methods: lancets against an electric marking pen (Comfort Marker 2.0, CM). One substudy was undertaken to test if using the CM translates into a cosmesis, fading, or satisfaction benefit compared with the lancets. Methods and Materials: Patients aged 18 years or older referred to our department to receive RT were recruited. They were randomly assigned, in a 1:1 ratio, to receive set-up markings using lancets or CM. This substudy aimed to recruit all the living participants included in the main study. The primary endpoints were tattoos cosmesis, tattoos fading, and patients' satisfaction 6 months after finishing the RT. Cosmetic and fading assessments were scored on a 5-point ascending scale and patients' satisfaction on a 10-point ascending scale. The trial is registered at ClinicalTrials.gov (number NCT05371795). Results: Between April and September 2022, 92 patients were enrolled (45 assigned to lancets and 47 to CM) and assessed for the outcomes. Patients receiving CM had significantly better cosmetic markings, with a median score of 4.4 (vs 3.7 for lancets, P<.001). On the fading assessment, the CM was associated with lower scores compared with the lancets (median score of 1.3 and 3.3, respectively; P<.001). No differences in patients' satisfaction were observed with either method (median score of 10 for both arms, P=.952). Conclusions: Our substudy results demonstrated that, 6 months after the end of RT, the CM produces better cosmetic markings with less fading compared with the lancets. These differences didn't translate into patients' satisfaction superiority toward any method.

Body composition in pediatric patients.

Undernutrition is highly prevalent in children who are critically ill and is associated with increased morbidity and mortality, including a higher risk of infection due to transitory immunological disorders, inadequate wound healing, reduced gut function, longer dependency on mechanical ventilation, and longer hospital stays compared with eutrophic children who are critically ill. Nutrition care studies have proposed that early interventions targeting nutrition assessment can prevent or minimize the complications of undernutrition. Stress promotes an acute inflammatory response mediated by cytokines, resulting in increased basal metabolism and nitrogen excretion and leading to muscle loss and changes in body composition. Therefore, the inclusion of body composition assessment is important in the evaluation of these patients because, in addition to the nutrition aspect, body composition seems to predict clinical prognosis. Several techniques can be used to assess body composition, such as arm measurements, calf circumference, grip strength, bioelectrical impedance analysis, and imaging examinations, including computed tomography and dual-energy x-ray absorptiometry. This review of available evidence suggests that arm measurements seem to be well-established in assessing body composition in children who are critically ill, and that bioelectrical impedance analysis with phase angle, handgrip strength, calf circumference and ultrasound seem to be promising in this evaluation. However, further robust studies based on scientific evidence are necessary.

Simultaneous and Multimodal Antigen-Binding Profiling and Isolation of Rare Cells via Quantitative Ferrohydrodynamic Cell Separation.

Simultaneous cell profiling and isolation based on cellular antigen-binding capacity plays an important role in understanding and treating diseases. However, fluorescence-activated cell sorting (FACS) and magnetic-activated cell sorting (MACS) are not able to meet this need, due to their requirement for a large quantity of target cells and the limitation stemming from bimodal separation. Here we report a microfluidic method, termed quantitative ferrohydrodynamic cell separation (qFCS), that achieved multimodal rare cell sorting and simultaneous antigen profiling at a ∼30,000 cell min-1 throughput with a 96.49% recovery rate and a 98.72% purity of recovered cells. qFCS profiles and sorts cells via cellular magnetic content of the magnetically labeled cells, which correlates to cellular antigen-binding capacity. By integrating cellular magnetophoresis and diamagnetophoresis in biocompatible ferrofluids, we demonstrate that the resulting qFCS device can accurately profile and isolate rare cells even when present at ∼1:50,000 target to background cells frequency. We show that the qFCS device could accurately profile and isolate T lymphocytes based on a low-expression CD154 antigen and allow on-device analysis of cells after processing. This method could address the need for simultaneous and multimodal rare cell isolation and profiling in disease diagnostics, prognostics, and treatment.

Can calf circumference be a viable option for nutritional assessment in the PICU?

BACKGROUND: Children admitted to paediatric intensive care units (PICUs) often need specialised nutritional intervention. Nutritional assessments provide specific data to support such interventions. Body composition measures, such as mid-upper arm circumference (MUAC), can complement nutritional assessment. However, MUAC has limitations. Calf circumference (CC) is an easy and common measure of muscle loss in the elderly; however, there are still very few studies on CC in children. AIMS: To evaluate the viability of using CC for nutritional monitoring of children under intensive care, compared with MUAC and weight. METHODS: Patients aged 2-10 years admitted to the PICU between December 2018 and August 2019 were included in the study. Two MUAC, CC, and weight measurements were performed: one in the first 24 h after PICU admission and another after 7 days. As there are no reference values for CC in children, this measure was used solely to observe the patient's individual progress. The nutritional status, both according to body mass index and MUAC, was used to characterise samples. Percentage changes in these measures were compared using the Wilcoxon signed-rank test for comparison between medians and Spearman's correlation test. Information from medical records regarding hospitalisation was also collected and analysed. RESULTS: Thirty patients were included in the study. During hospitalisation week 1, CC decreased significantly (p = 0.001), whereas MUAC (p = 0.427) and weight (p = 0.315) did not change significantly. Percentage changes in CC and MUAC were statistically different (p = 0.0449), with a positive correlation between the changes in both measures (p = 0.0333; r = 0.3896); conversely, although the percentage changes in CC and weight significantly differed (p = 0.0066), no correlation was found between them (p = 0.9382; r = 0.0148). The percentage changes in MUAC and weight were not different (p = 0.1880) or correlated (p = 0.1691; r = 0.2577). No statistically significant relationship was found between percentage changes in CC and clinical outcomes (length of stay, fasting time, and mechanical ventilation time). CONCLUSIONS: CC appears to be a viable measure for use in PICUs. Although positively correlated with MUAC, a measure proven useful in critically ill children, CC decreased significantly in the first week of intensive care, whereas MUAC remained unchanged, indicating that CC may show signs of depletion earlier than MUAC in these patients. Our study reinforces the importance of alternative measures for anthropometric assessment of critically ill children.

The translation initiation factor EIF4E5 from Leishmania: crystal structure and interacting partners.

The mRNA cap-binding protein, eIF4E, mediates the recognition of the mRNA 5' end and, as part of the heterotrimeric eIF4F complex, facilitates the recruitment of the ribosomal subunits to initiate eukaryotic translation. Various regulatory events involving eIF4E and a second eIF4F subunit, eIF4G, are required for proper control of translation initiation. In pathogenic trypanosomatids, six eIF4Es and five eIF4Gs have been described, several forming different eIF4F-like complexes with yet unresolved roles. EIF4E5 is one of the least known of the trypanosomatid eIF4Es and has not been characterized in Leishmania species. Here, we used immunoprecipitation assays, combined with mass-spectrometry, to identify major EIF4E5 interacting proteins in L. infantum. A constitutively expressed, HA-tagged, EIF4E5 co-precipitated mainly with EIF4G1 and binding partners previously described in Trypanosoma brucei, EIF4G1-IP, RBP43 and the 14-3-3 proteins. In contrast, no clear co-precipitation with EIF4G2, also previously reported, was observed. EIF4E5 also co-precipitated with protein kinases, possibly associated with cell-cycle regulation, selected RNA binding proteins and histones. Phosphorylated residues were identified and mapped to the Leishmania-specific C-terminal end. Mutagenesis of the tryptophan residue (W53) postulated to mediate interactions with protein partners or of a neighbouring tryptophan conserved in Leishmania (W45) did not substantially impair the identified interactions. Finally, the crystal structure of Leishmania EIF4E5 evidences remarkable differences in the eIF4G interfacing region, when compared with human eIF4E-1 and with its Trypanosoma orthologue. Mapping of its C-terminal end near the cap-binding site also imply relevant differences in cap-binding function and/or regulation.

Alterações alimentares e hábitos de vida de pacientes com fibrose cística na pandemia de COVID-19 / Dietary changes and life habits of patients with cystic fibrosis in the COVID-19 pandemic / Cambios en la dieta y hábitos de vida de pacientes con fibrosis quística en la pandemia COVID-19

Objetivo: verificar alterações no consumo alimentar e hábitos de vida em pacientes com fibrose cística brasileiros durante o período de isolamento social devido a pandemia de COVID-19. Método: pesquisa transversal com levantamento de dados por meio de questionário elaborado pela equipe de nutricionistas especialistas no tratamento de pacientes com fibrose cística, com questões referentes às manifestações respiratórias recentes de pacientes ou familiares, alterações nos hábitos de aquisição e compras de alimentos e alterações quanto ao consumo de grupos alimentares e suplementos. Os dados foram tabulados e foi realizada uma análise descritiva. Resultados: 40,34% das famílias de pacientes com fibrose cística mudaram os hábitos de compras de alimentos, cerca de 40% dos pacientes diminuíram a prática de atividade física e aumentaram o tempo de uso de telas em mais de 50% durante o período da pandemia de COVID-19. Conclusão: Apesar de algumas dificuldades relacionadas à aquisição dos alimentos e alterações em hábitos de vida, houve manutenção do consumo alimentar da maioria dos grupos alimentares e suplementos pelos pacientes pediátricos com fibrose cística brasileiros durante o isolamento social devido a pandemia de COVID-19.

Objective: to verify changes in food consumption and lifestyle in Brazilian cystic fibrosis patients during the period of social isolation due to the COVID-19 pandemic. Method: cross-sectional survey with data collection through a questionnaire prepared by the team of nutritionists specialized in the treatment of patients with cystic fibrosis, with questions regarding the recent respiratory manifestations of patients or family members, changes in the habits of purchasing food and changes regarding the consumption of food groups and supplements. The data were tabulated and a descriptive analysis was performed. Results: 40.34% of the families of patients with cystic fibrosis changed their food shopping habits, about 40% of the patients decreased their physical activity and increased the time spent using screens by more than 50% during the pandemic COVID-19. Conclusion: despite some difficulties related to the acquisition of food and changes in lifestyle, there was maintenance of the food consumption of most food groups and supplements by Brazilian pediatric patients with cystic fibrosis during social isolation due to the COVID-19 pandemic.

Objetivo: verificar cambios en el consumo de alimentos y estilo de vida en pacientes brasileños con fibrosis quística durante el período de aislamiento social por la pandemia de COVID-19. Método: encuesta transversal con recolección de datos por medio de un cuestionario elaborado por un equipo de nutricionistas especializados en el tratamiento de pacientes con fibrosis quística, con preguntas sobre las manifestaciones respiratorias recientes de pacientes o familiares, cambios en los hábitos de compra de alimentos y cambios en el consumo de grupos de alimentos y suplementos. Los datos se tabularon y se realizó un análisis descriptivo. Resultados: el 40,34% de los familiares de pacientes con fibrosis quística cambiaron sus hábitos de compra de alimentos, alrededor del 40% de los pacientes disminuyó la práctica de actividad física y aumentó el tiempo de uso de pantallas en más del 50% durante el período pandémico. COVID-19. Conclusión: A pesar de algunas dificultades relacionadas con la adquisición de alimentos y cambios en el estilo de vida, hubo mantenimiento del consumo de alimentos de la mayoría de los grupos de alimentos y suplementos por parte de pacientes pediátricos brasileños con fibrosis quística durante el aislamiento social debido a la pandemia COVID-19.

Projeto piloto de implantação de uma cozinha cetogênica para tratamento de epilepsia refratária / Pilot project of Implementation of a keto-kitchen for the treatment of refractory epilepsy / Proyecto piloto para implementar una cocina cetogénica para el tratamiento de la epilepsia refractaria

Objetivo: verificar alterações no consumo alimentar e hábitos de vida em pacientes com fibrose cística brasileiros durante o período de isolamento social devido a pandemia de COVID-19. Métodos: pesquisa transversal com levantamento de dados por meio de questionário elaborado pela equipe de nutricionistas especialistas no tratamento de pacientes com fibrose cística, com questões referentes às manifestações respiratórias recentes de pacientes ou familiares, alterações nos hábitos de aquisição e compras de alimentos e alterações quanto ao consumo de grupos alimentares e suplementos. Os dados foram tabulados e foi realizada uma análise descritiva. Resultados: 40,34% das famílias de pacientes com fibrose cística mudaram os hábitos de compras de alimentos, cerca de 40% dos pacientes diminuíram a prática de atividade física e aumentaram o tempo de uso de telas em mais de 50% durante o período da pandemia de COVID-19. Conclusões: Apesar de algumas dificuldades relacionadas à aquisição dos alimentos e alterações em hábitos de vida, houve manutenção do consumo alimentar da maioria dos grupos alimentares e suplementos pelos pacientes pediátricos com fibrose cística brasileiros durante o isolamento social devido a pandemia de COVID-19

Objective: This study describes the creation of the first ketogenic diet-teaching kitchen at a ketogenic reference center in Brazil aimed at developing ketogenic recipes and holding keto-culinary workshops with caregivers. Method: In this prospective study, 26 recipes were tested and assessed by sensory panel testing. Eighteen recipes were selected to be prepared in culinary workshops with parents or legal guardians of children with refractory epilepsy receiving the ketogenic diet as outpatients. All recipes were selected, calculated, and approved by registered dietitians. Results: Eight parents or legal guardians participated in four culinary workshops. The activities were extremely satisfactory: participants were able to clear out their doubts, learn, practice recipes, and develop new skills. In general, all participants enjoyed the prepared recipes and praised the culinary workshop. Conclusion: The ketogenic teaching kitchen enabled the development of ketogenic recipes adapted to Brazilian eating habits. Providing alternative meals to children is essential for enhancing compliance with the ketogenic diet because they contribute to expand the dietary repertoire of these patients. Future studies with high methodological quality should test the efficacy of the ketogenic kitchen in increasing compliance with the ketogenic diet in the long term.

Objetivo: Este estudio describe la creación de la primera cocina cetogénica para enseñar dieta cetogénica en un centro de referencia en Brasil, con el objetivo de desarrollar recetas cetogénicas y realizar talleres culinarios con los cuidadores. Método: En este estudio prospectivo, un panel sensorial probó y evaluó 26 recetas. Se seleccionaron dieciocho recetas para ser elaboradas en talleres de cocina con padres o tutores legales de niños con epilepsia refractaria que reciben una dieta cetogénica ambulatoria. Todas las recetas fueron seleccionadas, calculadas y aprobadas por nutricionistas. Resultados: Ocho padres o tutores participaron en cuatro talleres culinarios. Las actividades fueron sumamente satisfactorias: los participantes pudieron despejar sus dudas, aprender, practicar recetas y desarrollar nuevas habilidades. En general, a todos los participantes les gustaron las recetas elaboradas y elogiaron el taller de cocina. Conclusión: La cocina de enseñanza cetogénica permitió el desarrollo de recetas cetogénicas adaptadas a los hábitos alimentarios brasileños. Proporcionar comidas alternativas a los niños es fundamental para mejorar la adherencia a la dieta cetogénica, ya que contribuyen a ampliar el repertorio dietético de estos pacientes. Los estudios futuros con alta calidad metodológica deberían probar la efectividad de la cocina cetogénica para aumentar la adherencia a la dieta cetogénica a largo plazo.

Análise da percepção de risco dos estudantes participantes do Projeto Agente Mirim de Defesa Civil / Risk perception analysis of students participating in the Junior Civil Defense Agent

Atualmente, a Defesa Civil (DC) de Blumenau, em Santa Catarina, na Bacia Hidrográfica do Rio Itajaí (BHRI) realiza ações de educação ambiental para Gestão de Risco de Desastres (GRD) por meio de projetos, dentre eles o Agente Mirim de Defesa Civil (AMDC). O objetivo dessa pesquisa foi analisar como o projeto AMDCsubsidia a implementação da Lei Federal no. 12.608/2012, por meio da análise da percepção de risco dos estudantes durante sua participação. Para isso, foram utilizadas cinco ferramentas aplicadas em sete momentos no decorrer do ano letivo de 2016. Os resultados revelam que os estudantes ao ingressarem no projeto, trazem consigo conceitos básicos sobre ações de defesa civil e constroem novos conhecimentos sobre riscos de desastres. Conclui-se que as práticas educativas empregadas no projeto AMDC possibilitam a construção de conhecimentos, procedimentos e atitudes, capacitando os estudantes nos processos de prevenção, mitigação e preparação frentes aos riscos de desastres conforme enfatizado pela Lei Federal no. 12.608/2012.

Currently the Civil Defense (CD) of Blumenau, Santa Catarina, in the Itajaíriver basin conducts environmental education actions for Disaster Risk Management (DRM) through projects, among them the "Junior Civil Defense Agent" (JCDA). The objective of this research was to analyze how the JCDA project subsidizes the implementation of Federal Law nº. 12.608/2012, by analyzing the students' perception of risk during their participation. To this end, five tools were applied at seven times during the 2016 school year. The results show that students entering the project bring with them basic concepts about civil defense actions and build new knowledge about disaster risks. It is concluded that the educational practices employed in the JCDA project enable the construction of knowledge, procedures and attitudes, enabling students in disaster prevention, mitigation and preparedness processes as emphasized by Federal Law nº. 12.608/2012.

Ferramenta gerencial para integração dos serviços de saúde na gestão de riscos de desastres: o caso de Blumenau, SC / Management tool for the integration of health services in disaster risk management: the case of Blumenau, SC

RESUMO No âmbito dos desastres, os planos de contingência em saúde costumam limitar-se aos aspectos de resposta e emergência. Propõe-se que, em uma perspectiva holística, os municípios formulem planos que contemplem também aspectos de prevenção e redução de riscos. Nesse contexto, objetivou-se desenvolver e aplicar um instrumento técnico para a formulação de um plano de ação dos serviços da saúde voltado à Gestão de Riscos de Desastres (GRD). As bases conceituais apresentadas fundamentaram a elaboração do instrumento levando-se em conta uma gestão integral, integrada e participativa. Programas, projetos, ações, agentes e instrumentos jurídicos são descritos a partir dos diversos processos da GRD do município de Blumenau, Santa Catarina. Os resultados revelaram um diagnóstico das políticas do município. As ações existentes concentram-se em processos de preparação e resposta. O Programa Vigidesastres não se encontra operante. Novas ações também são propostas com o intuito de fortalecer ações de prevenção e redução de riscos. Espera-se que o estudo possa subsidiar políticas públicas que considerem os serviços de saúde sob uma perspectiva integral, reduzindo as vulnerabilidades sociais e promovendo a saúde da população.

ABSTRACT Health contingency plans are usually limited to response and emergency aspects in the context of disasters. It is proposed that, in a holistic perspective, the municipalities formulate plans that also include prevention and reduction of risks. Thus, the aim of this study was to develop and apply a technical instrument for the formulation of a health services action plan for Disaster Risk Management (GRD). The conceptual bases were used for the elaboration of the instrument, taking into account integral, integrated, and participative management. Programs, projects, actions, agents and legal instruments are described from the various GRD processes in the municipality of Blumenau, Santa Catarina. The results revealed a diagnosis of municipal policies. The actions are limited to the preparation and response processes and the 'Vigidesastres' Program is not operational. New actions are also proposed to improve public health policies in your prevention and mitigation processes. It is hoped that the study can subsidize public policies that consider health services from an integral and integrated perspective, reducing social vulnerabilities and promoting populational health.

Platelet Rich Plasma (PRP) Produces an Atherofibrotic Histophenotype During Craniofacial Bone Repair Due to Changes of Immunohistochemical Expression of Erk1/2, p38α /β, Adiponectin and Elevated Presence of Cells Exhibiting B-scavenger Receptor (CD36+)

Abstract The platelet-extracellular matrix interaction in platelet rich plasma (PRP) through thrombospondin receptor-CD36 induces the secretion of growth factors responsible for cellular proliferation and differentiation during the repair process. Since CD36 also acts as a class B-scavenger-receptor for development of foam-like cells and mitogen-activated kinases, such as Erk1/2 and p38α/β, are important proteins activated by platelet growth factor, the aim of this study was to evaluate the immunohistochemical presence of CD36, Erk1/2, p38α/β during the bone repair treated and non-treated with PRP and to compare these results with the histomorphometry of repair. Simultaneously, the immunopresence of adiponectin was analyzed, which may contribute to osteogenesis at the same time it inhibits fibrosis and impairs adipogenesis and foam cell formation in the medullary area. An artificial bone defect measuring 5×1 mm was produced in the calvaria of 56 Wistar rats. The defects were randomly treated with autograft, autograft+PRP, PRP alone and sham. The animals were euthanized at 2 and 6 weeks post-surgery. Data were analyzed by ANOVA followed by non-parametric test Student Newman-Keuls (p<0.05) for histomorphometric and immunohistochemical interpretation. The results revealed that in specimens that received PRP the immunopositivity for Erk1/2, p38α/β and CD36 proteins increased significantly while the immunohistochemical expression of adiponectin decreased simultaneously. There was also an accentuated reduction of bone matrix deposition and increase of the medullary area represented by fibrosis and/or presence of foam-like cells, which exhibited immunophenotype CD36+adiponectin. The findings of this study suggest that PRP acted as an inhibitor of osteogenesis during the craniofacial bone repair and induced a pathological condition that mimics an atherofibrotic condition.

Resumo A interação da matriz extracelular-plaquetas no plasma rico em plaquetas (PRP) através de receptor trombospondina CD36 induz a secreção de fatores de crescimento responsáveis pela proliferação e diferenciação celular durante o processo de reparo. Uma vez que o CD36 também age como receptor scavenger de classe B para o desenvolvimento de células do tipo espuma, e as quinases ativadas por mitógenos, tais como ERK1/2 e p38α/β, são importantes proteínas ativadas por fator de crescimento das plaquetas, o objetivo deste estudo foi avaliar a presença imunoistoquímica de CD36, ERK1/2, p38α/β durante o reparo ósseo tratado e não-tratado com PRP e comparar estes resultados com a histomorfometria do reparo. Simultaneamente, analisou-se a imunopresença da adiponectina, que pode contribuir para osteogênese ao mesmo tempo que inibe a fibrose e prejudica a formação de células tipo espuma/xantomatosas na área medular. Um defeito artificial de osso medindo 5×1 mm foi produzido na calvária de 56 ratos Wistar. Os defeitos foram tratados aleatoriamente com auto-enxerto, enxerto autógeno+PRP, PRP apenas e sham. Os animais foram sacrificados 2 e 6 semanas pós-cirurgia. Os dados foram examinados por meio de ANOVA, seguido pelo teste não-paramétrico Student Newman-Keuls (p<0,05) para a interpretação histomorfométrica e imunoistoquímica. Os resultados revelaram que as amostras que receberam PRP aumentaram significativamente a imunopositividade para as proteínas ERK1/2, p38α/β e CD36, simultaneamente à diminuição de expressão imunoistoquímica da adiponectina. Houve também expressiva redução de deposição de matriz óssea e aumento da área medular representada por fibrose e/ou presença de células do tipo espuma que apresentaram imunofenótipo CD36 + adiponectina. Estes resultados sugerem que o PRP atuou como um inibidor da osteogênese durante o reparo ósseo craniofacial e induziu uma condição patológica que mimetiza uma condição aterofibrótica.

Platelet Rich Plasma (PRP) Produces an Atherofibrotic Histophenotype During Craniofacial Bone Repair Due to Changes of Immunohistochemical Expression of Erk1/2, p38α/ß, Adiponectin and Elevated Presence of Cells Exhibiting B-scavenger Receptor (CD36+).

The platelet-extracellular matrix interaction in platelet rich plasma (PRP) through thrombospondin receptor-CD36 induces the secretion of growth factors responsible for cellular proliferation and differentiation during the repair process. Since CD36 also acts as a class B-scavenger-receptor for development of foam-like cells and mitogen-activated kinases, such as Erk1/2 and p38α/ß, are important proteins activated by platelet growth factor, the aim of this study was to evaluate the immunohistochemical presence of CD36, Erk1/2, p38α/ß during the bone repair treated and non-treated with PRP and to compare these results with the histomorphometry of repair. Simultaneously, the immunopresence of adiponectin was analyzed, which may contribute to osteogenesis at the same time it inhibits fibrosis and impairs adipogenesis and foam cell formation in the medullary area. An artificial bone defect measuring 5×1 mm was produced in the calvaria of 56 Wistar rats. The defects were randomly treated with autograft, autograft+PRP, PRP alone and sham. The animals were euthanized at 2 and 6 weeks post-surgery. Data were analyzed by ANOVA followed by non-parametric test Student Newman-Keuls (p<0.05) for histomorphometric and immunohistochemical interpretation. The results revealed that in specimens that received PRP the immunopositivity for Erk1/2, p38α/ß and CD36 proteins increased significantly while the immunohistochemical expression of adiponectin decreased simultaneously. There was also an accentuated reduction of bone matrix deposition and increase of the medullary area represented by fibrosis and/or presence of foam-like cells, which exhibited immunophenotype CD36+adiponectin. The findings of this study suggest that PRP acted as an inhibitor of osteogenesis during the craniofacial bone repair and induced a pathological condition that mimics an atherofibrotic condition.

Mechanisms of environmental chemicals that enable the cancer hallmark of evasion of growth suppression.

As part of the Halifax Project, this review brings attention to the potential effects of environmental chemicals on important molecular and cellular regulators of the cancer hallmark of evading growth suppression. Specifically, we review the mechanisms by which cancer cells escape the growth-inhibitory signals of p53, retinoblastoma protein, transforming growth factor-beta, gap junctions and contact inhibition. We discuss the effects of selected environmental chemicals on these mechanisms of growth inhibition and cross-reference the effects of these chemicals in other classical cancer hallmarks.

A educação permanente em saúde na perspectiva do enfermeiro na estratégia de saúde da família / Permanent health education in the perspectiveof nurses infamily health strategy / Educación permanente para la salud en la perspectiva de enfermeros en la estrategia de salud familiar

Trata-se de um estudo descritivo com abordagem qualitativa com o objetivo de compreender a Educação Permanente em Saúde na perspectiva dos enfermeiros na Estratégia de Saúde da Família. Os dados foram coletados por meio de uma entrevista semiestruturada, analisados e organizados em duas categorias: “Desafios para realização da Educação Permanente” e “Modos de conceber e intervir na Educação Permanente”. Os resultados revelam a percepção dosprofissionais sobre a importância da realização da Educação permanente para a assistência de qualidade, e que ela acontece parcialmente, mesmo diante dos entraves apontados para sua realização. Esses achados apontam arelevância da necessidade de consolidação da Política de Educação Permanente em Saúde para o processo de trabalho do enfermeiro e contribui para torná-la uma realidade...

Se trata de un estudio descriptivo con enfoque cualitativo con el fin de entender la educación permanente en salud desde la perspectiva de los enfermeros de la Estrategia de Salud Familiar en una ciudad de Minas Gerais. Los datos se recolectaron a través de una entrevista semiestructurada, analizados y organizados en dos categorías: “Desafíos a la conclusión de Educación Continua” y “Modos de concebir e intervenir en la Educación Continua”. Los resultadosmuestran la percepción de la importancia de la realización de la formación permanente para la atención de calidad y que aun sucede parcialmente, a pesar de los obstáculos señalados para su realización. Estos resultados indican laimportancia de la consolidación de la política para el proceso de EP para el proceso de trabajo de los enfermeros yayuda a que sea una realidad...

This is a descriptive and qualitative study with the goal of understanding Permanent Health Education from the point of view of nurses from the Family Health Strategy program in a city in the State of Minas Gerais, Brazil. Data were collected through a semi-structured interview, and then analyzed and organized into two categories: “Challenges for Permanent Education” and “Ways of conceiving and intervening in Permanent Education”. The results reveal the perception by professionals on the importance of Permanent Education for quality care, and that PermanentEducation happens partially, even in the face of the obstacles pointed out. These findings indicate the relevance of the need for a consolidation of the Health Permanent Education Policy for the nurses’ work process and contribute to bring it to reality...

Pre-clinical study of drug combinations that reduce breast cancer burden due to aberrant mTOR and metabolism promoted by LKB1 loss.

Cancer therapies that simultaneously target activated mammalian target of rapamycin (mTOR) and cell metabolism are urgently needed. The goal of our study was to identify therapies that effectively inhibited both mTOR activity and cancer cell metabolism in primary tumors in vivo. Using our mouse model of spontaneous breast cancer promoted by loss of LKB1 expression in an ErbB2 activated model; referred to as LKB1-/-NIC mice, we evaluated the effect of novel therapies in vivo on primary tumors. Treatment of LKB1-/-NIC mice with AZD8055 and 2-DG mono-therapies significantly reduced mammary gland tumorigenesis by inhibiting mTOR pathways and glycolytic metabolism; however simultaneous inhibition of these pathways with AZD8055/2-DG combination was significantly more effective at reducing tumor volume and burden. At the molecular level, combination treatment inhibited mTORC1/mTORC2 activity, selectively inhibited mitochondria function and blocked MAPK pro-survival signaling responsible for the ERK-p90RSK feedback loop. Our findings suggest that loss of LKB1 expression be considered a marker for metabolic dysfunction given its role in regulating AMPK and mTOR function. Finally, the outcome of our pre-clinical study confirms therapies that simultaneously target mTORC1/mTORC2 and glycolytic metabolism in cancer produce the best therapeutic outcome for the treatment of patients harboring metabolically active HER2 positive breast cancers.

Fatores associados ao comportamento alimentar de frequentadores de academias de Taubaté - SP / Factors associated with eating behavior in users of fitness centers of Taubaté city SP

A relação da atividade física e da alimentação com a saúde é estudada há muitos anos e os resultados confirmam que a prática regular de exercício físico e uma alimentação equilibrada atuam diretamente na prevenção de doenças. Objetivo - Identificar os fatores associados ao comportamento alimentar dos frequentadores de academias de ginástica do município de Taubaté, SP, segundo idade, gênero e estado nutricional. Métodos - Estudo transversal, quantitativo e com uma amostra não probabilística, constituída por 160 frequentadores de academias do município de Taubaté-SP. Para a obtenção dos dados utilizou-se questionário padronizado de múltipla escolha com questões demográficas, socioeconômicas, comportamentais, nutricionais e sobre saúde; o teste Como está a sua alimentação? do Guia Alimentar de bolso do Ministério da Saúde; o Questionário Internacional de Atividade Física IPAQ; e para avaliação do estado nutricional, informações do peso e da altura para cálculo do IMC (índice de massa corporal) e aferição de dobras cutâneas para a estimativa do percentual de gordura corporal ( por cento GC). Empregou-se análise descritiva, teste do qui-quadrado de Pearson para avaliar associação e análise de cluster. Resultados - A idade média dos frequentadores é de 39,4 anos (DP = ±13,1 anos). Há uma predominância do gênero feminino, alto grau de escolaridade e elevada renda familiar. O IMC médio é de 25,5 kg/m², a maioria encontra-se eutrófico e apresenta por cento GC normal...

The relationship between physical activity and food with health have been studied for many years and the results confirm that the regular practice of physical activity and a balanced diet influence directly in disease prevention. Objective - To identify the factors associated with eating behavior of users of fitness centers from Taubaté city, SP, according to age, gender and nutritional status. Methods - There was a cross-sectional study with a non-probabilistic sample involving 160 users of fitness centers from Taubaté city, SP. Data were collected using a questionnaire containing demographic, socioeconomic, behavioral, nutritionals and about health multiple choice questions. Furthermore, they were used the test Whats your diet like?, present in the pocket edition of the Brazilian Dietary Guideline from the Health Ministry, and the International Physical Activity Questionnaire IPAQ. For anthropometric assessment were used weight and height to calculate the BMI (Body Mass Index) and skinfolds thicknesses to estimate the percentage of body fat ( per cent BF). It was used the chi-square test to determine the association and cluster analysis. Results - The average age users of fitness centers was 39.4 years old (SD = 13.1). There was predominance of the feminine gender, high schooling and high family income. The averages of BMI was 25.5 kg/m2, the most of them were found eutrophic and presents normal per cent BF. They use nutritional complements and the younger...

Omega-3 polyunsaturated fatty acid promotes the inhibition of glycolytic enzymes and mTOR signaling by regulating the tumor suppressor LKB1.

The omega-3 polyunsaturated fatty acids (ω3PUFAs) are a class of lipids biologically effective for the treatment of inflammatory disorders, cardiovascular disease and cancer. Patients consuming a high dietary intake of ω3PUFAs have shown a low incidence of metabolic disorders, including cancer. Although the effects of ω3PUFAs intake was shown to be involved in the prevention and treatment of these diseases, the underlying molecular mechanisms involved are not well understood. Here, we show that ω3PUFA, docosahexaenoic acid (DHA) enhanced the tumor suppressor function of LKB1. We observed that when LKB1 expressing cells are treated with DHA, there is an increase in LKB1 activity leading to phosphorylation of AMPK and inhibition of mTOR signaling. Abrogation of LKB1 in MCF-7 cells by siRNA reversed this phenotype. Furthermore, cellular metabolism was altered and ATP levels were reduced in response to DHA treatment, which was further attenuated in cells expressing LKB1. More importantly, in mammary epithelial cells expressing LKB1, the rate of glycolysis was decreased as a result of diminished expression of glycolytic enzymes. Functionally, these events lead to a decrease in the migration potential of these cells. Overall, our discovery shows for the first time that LKB1 function is enhanced in response to ω3PUFA treatment, thereby resulting in the regulation of cell metabolism.

Loss of LKB1 expression reduces the latency of ErbB2-mediated mammary gland tumorigenesis, promoting changes in metabolic pathways.

The tumor suppressor kinase LKB1 is mutated in a broad range of cancers however, the role of LKB1 mammary gland tumorigenesis is not fully understood. Evaluation of human breast cancer tissue microarrays, indicate that 31% of HER2 positive samples lacked LKB1 expression. To expand on these observations, we crossed STK11 (fl/fl) mice with mice genetically engineered to express activated Neu/HER2-MMTV-Cre (NIC) under the endogenous Erbb2 promoter, to generate STK11 (-/-/) NIC mice. In these mice, the loss of lkb1 expression reduced the latency of ErbB2-mediated tumorigenesis compared to the latency of tumorigenesis in NIC mice alone. Analysis of STK11(-/-/)NIC mammary tumors revealed hyperactivation of mammalian target of rapamycin (mTOR) through both mTORC1 and mTORC2 pathways as determined by the phosphorylation status of ribosomal protein S6 and AKT. Furthermore, STK11(-/-/)NIC mammary tumors had elevated ATP levels along with changes in metabolic enzymes and metabolites. The treatment of primary mammary tumor cells with specific mTOR inhibitors AZD8055 and Torin1, that target both mTOR complexes, attenuated mTOR activity and decreased expression of glycolytic enzymes. Our findings underscore the existence of a molecular interplay between LKB1-AMPK-mTORC1 and ErbB2-AKT-mTORC2 pathways with mTOR at its epicenter, suggestive that loss of LKB1 expression may serve as a marker for hyperactivated mTOR in HER2 positive breast cancer and warranting further investigation into therapeutics that target LKB1-AMPK-mTOR and glycolytic pathways.

Prevalência das injúrias orofaciais e uso de protetores bucais em uma população de atletas que praticam futebol e jiu-jitsu / Prevalence of orofacial injury and use of mouthguard in soccer and jiu-jitsu athletes

Este estudo epidemiológico teve por objetivo investigar a prevalência de injúria orofacial em dois grupos de atletas. O primeiro grupo foi de atletas integrantes do Fluminense Futebol Clube, em Xerém, e o segundo de atletas praticantes do jiu-jitsu em diferentes academias ou que participaram do Campeonato Brasileiro em 2011, no Rio de Janeiro. Um examinador calibrado, auxiliado por um assistente, preencheu os questionários com todos os atletas, seguido do exame clínico de todos. Grupo I: 260 atletas do Fluminense Futebol Clube com idade média de 14,08 (DP ± 2,71) anos de idade, todos do gênero masculino. Grupo II: 315 atletas de diversas academias de jiu-jitsu com idade média de 26,86 (DP ± 8,99), dentre esses indivíduos, apenas 10 eram do gênero feminino. A prevalência de injúrias orofaciais encontrada para o Grupo I foi de 47% (n=122; IC 95% 40,94% a 52,99%) e no Grupo II de 74,6% (n=235; IC 95% 69,52% a 79,09%). Considerando-se a prevalência de trauma apenas no elemento dentário, a prevalência diminuiu de 147 injúrias para 57 traumas dentais no futebol e de 289 injúrias para 93 traumas dentais no jiu-jitsu. Foi observada uma menor prevalência de injúria orofacial nos goleiros quando comparados aos outros jogadores de futebol. A maior parte das injúrias ocorreu durante o período do treino (n=42; IC 95% 26,59% a 43,22%) e apenas 4 desses atletas usavam protetor bucal. Por outro lado, no jiu-jitsu, a prevalência de injúria variou de acordo com a cor da faixa do uniforme do atleta. Os atletas da faixa preta exibiram mais injúrias (n=83). Atletas que treinavam de 7 a 15 horas por semana, sofreram mais injúria (n=109). A maioria das injúrias ocorreu durante o treino. Somente 28,57% dos atletas (IC 95% 23,86% a 33,79%) usavam protetor bucal. Nos dois esportes, a maioria dos atletas sofreu apenas uma injúria, sendo o tipo mais frequente em tecido mole. O dente mais atingido foi o incisivo central superior. Estes dados ressaltam ...

This epidemiological study aimed to investigate the prevalence of orofacial injury of two groups of athletes. The first group included athletes who were part of the Fluminense Soccer Club in Xerém, and the second group included athletes from different brazilian jiu-jitsu academies or who participated in the Brazilian Championship in 2011, in Rio de Janeiro. One calibrated examiner, with the help of the assistant, completed the forms of all athletes followed by the clinical examination of them. Group I: 260 male athletes from the Fluminense Soccer Club, mean age of 14.08 (SD ± 2.71). Group II: 315 athletes from a variety of brazilian jiu-jitsu academies, mean age of 26.86 (SD ± 8.99), among these individuals, only 10 of them were female. The prevalence of orofacial injuries found for Group I was 47% (n=122; IC 95% 40,94%; 52,99%) and for Group II was 74,6% (n=235; IC 95% 69,52%, 79,09%). When the prevalence of trauma was evaluated individually per tooth, it decreased from 147 injuries to 57 dental traumas in soccer and from 289 injuries to 93 dental traumas in brazilian jiu-jitsu. A lower prevalence of orofacial injuries in goalkeepers was observed when compared to the others soccer players. Most injuries occurred during the training period (n=42; IC 95% 26,59%; 43,22) and only 4 athletes used to wear mouthguard. The prevalence of injury in brazilian jiu-jitsu varied according to their uniform belt colour. Black belt athletes suffered more injuries (n=83). Athletes who trained between 7 to 15 hours per week experienced more injury (n=109). Most injuries occurred during training. Only 28,57% of the athletes (IC 95% 23,86%; 33,79%) used to wear mouthguard. In both sports, most of the athletes have suffered only one injury, and the most frequent type was in soft tissue. The tooth that was injured the most was the maxillary central incisor. These data reveal the importance of encouraging the use of mouthguards ...

Levantamento epidemiológico de hipersensibilidade dentinária e trauma dental em crianças e atletas dos Jogos Pan-americanos e Parapan-americanos de 2007 / Epidemiologial survey of dentin hypersensitivity and dental trauma in children and athletes of the Pan American Games and Parapan 2007

O objetivo deste trabalho é realizar um levantamento epidemiológico observacional transversal de trauma dental e hipersensibilidade dentinária em quatro populações diferentes: crianças inseridas em um projeto social esportivo, em Guadalupe, chamado Bola para Frente (BPF); crianças da Escola República Argentina (ERA), em Vila Isabel; e atletas participantes dos jogos Pan-americanos (PAN) e Parapan-americanos (PARAPAN) de 2007, no Rio de Janeiro. A avaliação foi feita através do preenchimento de um questionário, seguido de exame clínico em cadeira odontológica, realizado por três examinadores calibrados. As populações examinadas foram: a) no BPF 294 indivíduos de 6 a 17 anos, sendo 57,48% do sexo masculino; b) no ERA, foram examinadas 281 crianças, entre 6 e 18 anos, sendo 48,75% do sexo masculino; c) no PAN, 424 atletas, sendo 55,42% homens, com idade de 13 a 49 anos; d) no PARAPAN, 121 atletas, sendo 78,15% homens, com idade de 13 a 58 anos. As prevalências de hipersensibilidade no BPF, ERA, PAN e PARAPAN, foram respectivamente de 41%, 43%, 40% e 54% através do questionário, e 7% , 7%, 17% e 27 % através do teste do jato de ar. Não houve diferença estatisticamente significativa entre sexos com relação à hipersensibilidade. Na população adulta, no PAN e PARAPAN, 47,79% (IC 95% ± 8,4) e 73,24% (IC 95% ± 10,3) dos dentes com sensibilidade tinham algum grau de recessão. Em relação ao trauma as prevalências foram de 27,21% (IC 95% ± 5,09) no BPF, 28,11% (IC 95% ± 5,26) no ERA, 49,63% (IC 95% ± 4,85) no PAN e 47,50% (IC 95% ± 8,93) no PARAPAN. Dentre os atletas de alto rendimento, participantes do PAN, a maior prevalência de trauma estava associada ao treinamento ou competição. As modalidades com maior prevalência foram basquete (70,59%; IC 95% ± 21,66), lutas (83,33%; IC 95% ± 21,09) e boxe (73,68%; IC 95% ± 19,8)...

The aim of this study was to do a cross-sectional epidemiological survey on dental trauma and dentine hypersensitivity in four distinct populations: children who are enrolled in a social project, in Guadalupe, Bola para Frente (BPF); children who attend the Escola República Argentina (ERA); and athletes competing at the Pan American Games (PAN) and the Parapanamerican Games (PARAPAN), that took place in Rio de Janeiro in 2007. The evaluation was done through a questionnaire filled in by the participant, followed by a clinical exam, performed by three calibrated examiners at a dental chair. The examined populations were: a) at BPF, 294 volunteers aged from 6 to 17, being 57,48% male; b) at ERA, were examined 281 children, aged from 6 to 18, being 48,75% male; c) at PAN, 424 athletes, being 55,42% male, aged from 13 to 49; d) at PARAPAN, 121 athletes, being 78,15% male, aged from 13 to 58. The prevalences of hypersensitivity obtained with questionnaire at BPF, ERA, PAN and PARAPAN, were, respectively, 41%, 43%, 40% and 54%, and with the clinical exam , 7% , 7%, 17% and 27 %. There was not a statistically significant difference between males and females concerning hypersensitivity. 47,79% (CI 95% ± 8,4) and 73,24% (CI 95% ± 10,3) of the athletes at PAN and PARAPAN showed hypersensitive teeth with some degree of recession. In relation to trauma, the prevalences were 27,21% (CI 95% ± 5,09) at BPF, 28,11% (CI 95% ± 5,26) at ERA, 49,63% (CI 95% ± 4,85) at the PAN and 47,50% (CI 95% ± 8,93) at the PARAPAN. Among high performance athletes competing at PAN, most of the injuries were related to the sport, either during training or competition. The sports with higher prevalence were basketball (70,59%; CI 95% ± 21,66), wrestling (83,33%; CI 95% ± 21,09) and boxing (73,68%; CI 95% ± 19,8). In all four populations, the most common injury was enamel fracture and the most affected teeth were the upper central incisors...