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Targeting tumor vasculature represents an intriguing therapeutic strategy in the treatment of cancer. In an effort to discover new vascular disrupting agents with improved water solubility and potentially greater bioavailability, various amino acid prodrug conjugates (AAPCs) of potent amino combretastatin, amino dihydronaphthalene, and amino benzosuberene analogs were synthesized along with their corresponding water-soluble hydrochloride salts. These compounds were evaluated for their ability to inhibit tubulin polymerization and for their cytotoxicity against selected human cancer cell lines. The amino-based parent anticancer agents 7, 8, 32 (also referred to as KGP05) and 33 (also referred to as KGP156) demonstrated potent cytotoxicity (GI50=0.11-40nM) across all evaluated cell lines, and they were strong inhibitors of tubulin polymerization (IC50=0.62-1.5µM). The various prodrug conjugates and their corresponding salts were investigated for cleavage by the enzyme leucine aminopeptidase (LAP). Four of the glycine water-soluble AAPCs (16, 18, 44 and 45) showed quantitative cleavage by LAP, resulting in the release of the highly cytotoxic parent drug, whereas partial cleavage (<10-90%) was observed for other prodrugs (15, 17, 24, 38 and 39). Eight of the nineteen AAPCs (13-16, 42-45) showed significant cytotoxicity against selected human cancer cell lines. The previously reported CA1-diamine analog and its corresponding hydrochloride salt (8 and 10, respectively) caused extensive disruption (at a concentration of 1.0µM) of human umbilical vein endothelial cells growing in a two-dimensional tubular network on matrigel. In addition, compound 10 exhibited pronounced reduction in bioluminescence (greater than 95% compared to saline control) in a tumor bearing (MDA-MB-231-luc) SCID mouse model 2h post treatment (80mg/kg), with similar results observed upon treatment (15mg/kg) with the glycine amino-dihydronaphthalene AAPC (compound 44). Collectively, these results support the further pre-clinical development of the most active members of this structurally diverse collection of water-soluble prodrugs as promising anticancer agents functioning through a mechanism involving vascular disruption.
Assuntos
Antineoplásicos/uso terapêutico , Bibenzilas/uso terapêutico , Cumarínicos/uso terapêutico , Naftalenos/uso terapêutico , Neoplasias/irrigação sanguínea , Neoplasias/tratamento farmacológico , Pró-Fármacos/uso terapêutico , Aminoácidos/química , Aminoácidos/uso terapêutico , Animais , Antineoplásicos/química , Bibenzilas/química , Mama/irrigação sanguínea , Mama/efeitos dos fármacos , Mama/patologia , Neoplasias da Mama/irrigação sanguínea , Neoplasias da Mama/tratamento farmacológico , Neoplasias da Mama/patologia , Linhagem Celular Tumoral , Cumarínicos/química , Desenho de Fármacos , Feminino , Humanos , Camundongos , Camundongos SCID , Naftalenos/química , Neoplasias/patologia , Imagem Óptica , Pró-Fármacos/química , Solubilidade , Relação Estrutura-Atividade , Tubulina (Proteína)/metabolismo , Água/químicaRESUMO
The discovery of 3-methoxy-9-(30,40,50-trimethoxyphenyl)-6,7-dihydro-5H-benzo[7]annulen-4-ol (a benzosuberene-based analogue referred to as KGP18) was originally inspired by the natural products colchicine and combretastatin A-4 (CA4). The relative structural simplicity and ease of synthesis of KGP18, coupled with its potent biological activity as an inhibitor of tubulin polymerization and its cytotoxicity (in vitro) against human cancer cell lines, has resulted in studies focused on new analogue design and synthesis. Our goal was to probe the relationship of structure to function in this class of anticancer agents. A series of twenty-two new benzosuberene-based analogues of KGP18 was designed and synthesized. These compounds vary in their methoxylation pattern and separately incorporate trifluoromethyl groups around the pendant aryl ring for the evaluation of the effect of functional group modifications on the fused six-membered aromatic ring. In addition, the 8,9-saturated congener of KGP18 has been synthesized to assess the necessity of unsaturation at the carbon atom bearing the pendant aryl ring. Six of the molecules from this benzosuberene-series of compounds were active (IC50 < 5 lM) as inhibitors of tubulin polymerization while four analogues were comparable (IC50 approximately 1 lM) in their tubulin inhibitory activity to CA4 and KGP18. The potency of a bis-trifluoromethyl analogue 74 and the unsaturated KGP18 derivative 73 as inhibitors of tubulin assembly along with their moderate cytotoxicity suggested the potential utility of these compounds as vascular disrupting agents (VDAs) to selectively target microvessels feeding tumors. Accordingly, water-soluble and DMSO-soluble phosphate prodrug salts of each were synthesized for preliminary in vivo studies to assess their potential efficacy as VDAs.
Assuntos
Antineoplásicos/química , Antineoplásicos/farmacologia , Cumarínicos/farmacologia , Moduladores de Tubulina/química , Moduladores de Tubulina/farmacologia , Tubulina (Proteína)/metabolismo , Animais , Antineoplásicos/uso terapêutico , Linhagem Celular Tumoral , Cumarínicos/uso terapêutico , Humanos , Camundongos SCID , Simulação de Acoplamento Molecular , Neoplasias/irrigação sanguínea , Neoplasias/tratamento farmacológico , Neoplasias/metabolismo , Polimerização/efeitos dos fármacos , Moduladores de Tubulina/uso terapêuticoRESUMO
The natural products colchicine and combretastatin A-4 are potent inhibitors of tubulin assembly, and they have inspired the design and synthesis of a large number of small-molecule, potential anticancer agents. The indole-based molecular scaffold is prominent among these SAR modifications, leading to a rapidly increasing number of agents. The water-soluble phosphate prodrug 33 (OXi8007) of 2-aryl-3-aroylindole-based phenol 8 (OXi8006) was prepared by chemical synthesis and found to be strongly cytotoxic against selected human cancer cell lines (GI50 = 36 nM against DU-145 cells, for example). The free phenol, 8 (OXi8006), was a strong inhibitor (IC50 = 1.1 µM) of tubulin assembly. The corresponding phosphate prodrug 33 (OXi8007) also demonstrated pronounced interference with tumor vasculature in a preliminary in vivo study utilizing a SCID mouse model bearing an orthotopic PC-3 (prostate) tumor as imaged by color Doppler ultrasound. The combination of these results provides evidence that the indole-based phosphate prodrug 33 (OXi8007) functions as a vascular disrupting agent that may prove useful for the treatment of cancer.
Assuntos
Antineoplásicos/síntese química , Antineoplásicos/farmacologia , Bibenzilas/farmacologia , Indóis/síntese química , Indóis/farmacologia , Organofosfatos/síntese química , Organofosfatos/farmacologia , Tubulina (Proteína)/metabolismo , Animais , Antineoplásicos/química , Bibenzilas/química , Colchicina/farmacologia , Ensaios de Seleção de Medicamentos Antitumorais , Humanos , Indóis/química , Concentração Inibidora 50 , Masculino , Camundongos , Estrutura Molecular , Organofosfatos/química , Pró-Fármacos/farmacologia , Neoplasias da Próstata/tratamento farmacológico , Estilbenos , Relação Estrutura-Atividade , Tubulina (Proteína)/efeitos dos fármacosRESUMO
The vascular disrupting activity of a promising tubulin-binding agent (OXi6196) was demonstrated in mice in MDA-MB-231 human breast tumor xenografts growing orthotopically in mammary fat pad and syngeneic RENCA kidney tumors growing orthotopically in the kidney. To enhance water solubility, OXi6196, was derivatized as its corresponding phosphate prodrug salt OXi6197, facilitating effective delivery. OXi6197 is stable in water, but rapidly releases OXi6196 in the presence of alkaline phosphatase. At low nanomolar concentrations OXi6196 caused G2/M cell cycle arrest and apoptosis in MDA-MB-231 breast cancer cells and monolayers of rapidly growing HUVECs underwent concentration-dependent changes in their morphology. Loss of the microtubule structure and increased bundling of filamentous actin into stress fibers followed by cell collapse, rounding and blebbing was observed. OXi6196 (100 nM) disrupted capillary-like endothelial networks pre-established with HUVECs on Matrigel®. When prodrug OXi6197 was administered to mice bearing orthotopic MDA-MB-231-luc tumors, dynamic bioluminescence imaging (BLI) revealed dose-dependent vascular shutdown with >80% signal loss within 2 h at doses ≥30 mg/kg and >90% shutdown after 6 h for doses ≥35 mg/kg, which remained depressed by at least 70% after 24 h. Twice weekly treatment with prodrug OXi6197 (20 mg/kg) caused a significant tumor growth delay, but no overall survival benefit. Similar efficacy was observed for the first time in orthotopic RENCA-luc tumors, which showed massive hemorrhage and necrosis after 24 h. Twice weekly dosing with prodrug OXi6197 (35 mg/kg) caused tumor growth delay in most orthotopic RENCA tumors. Immunohistochemistry revealed extensive necrosis, though with surviving peripheral tissues. These results demonstrate effective vascular disruption at doses comparable to the most effective vascular-disrupting agents (VDAs) suggesting opportunities for further development.
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Introducción: La historia clínica constituye un documento de alto valor para los profesionales. Su correcta gestión contribuye a mejorar la calidad de la atención, proteger intereses legales del paciente, trabajadores y entidades, y proporcionar información con fines de investigación y docencia. Objetivo: Diseñar un modelo de registro de monitorización de enfermería del paciente crítico en la Unidad de Cuidados Intensivos del Hospital Universitario Clínico Quirúrgico Comandante Faustino Pérez Hernández, de Matanzas. Materiales y métodos: Se realizó un estudio analítico, observacional, descriptivo y transversal, entre enero de 2022 y julio de 2023. El universo estuvo conformado por 50 enfermeros, y la muestra por los que se encontraban laborando de manera física en el servicio durante el período de estudio, para un total de 31. Resultados: Se pudo diagnosticar, con el estudio, deficiencias en el registro de las pérdidas insensibles y extraordinarias de agua endógena. Conclusiones: Se logró diseñar un modelo de registro de monitorización de enfermería en la atención al paciente crítico, que cohesiona información científica del monitoreo integral y adecuado del paciente crítico desde el punto de vista fisiológico y terapéutico. El mismo se organizó en una estructura multidimensional, apropiado al contexto cubano que sustenta el proceso del cuidado.
Introduction: The clinical record is a document of high value for professionals. Its correct management contributes to improving the quality of care, protecting the legal interests of the patient, workers and entities; in addition it provides information for research and teaching purposes. Objective: To design a nursing monitoring record model of the critical patients in the Intensive Care Unit of the Clinical Surgical University Hospital Comandante Faustino Pérez of Matanzas. Materials and methods: An analytical, observational, descriptive and cross-sectional study was carried out between January 2022 and July 2023. The universe was made up of 50 nurses and the sample was made up of those who were physically working in the service during the study period, for a total of 31. Results: It was possible to diagnose, with the study, deficiencies in the recording of insensible and extraordinary losses of endogenous water. Conclusions: It was possible to design a nursing monitoring record model in the care of critical patients, which brings together scientific information on the comprehensive and adequate monitoring of critical patients from the physiological and therapeutic point of view. It was organized in a multidimensional structure, appropriate to the Cuban context that supports the care process.
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La enfermería puede definirse como una profesión científica de marcado carácter humanista, la cual asume el rol del cuidado de las personas, con el fin de dominar el "arte de cuidar". El objetivo de este trabajo es describir la enfermería como modelo de evaluación neurológica del traumatismo craneoencefálico en pediatría, lo cual implica una atención sistematizada, integral y eficaz, realizando una evaluación neurológica detallada que permita observar las alteraciones, estructuras y funciones comprometidas. Los profesionales de enfermería, como miembros activos del equipo de salud, desempeñan un papel fundamental durante el cuidado de estos pacientes. El cuidado de enfermería en el contexto del traumatismo craneoencefálico en la población pediátrica juega un papel crucial en la mejora de los resultados clínicos y la calidad de vida de estos pacientes. La evaluación neurológica especializada, respaldada por modelos y guías de cuidados, permite una atención individualizada y de calidad. La aplicación de la sistematización de la atención de enfermería en las unidades de cuidados intensivos unifica criterios y garantiza una atención basada en protocolos específicos.
Nursing can be defined as a scientific profession with a strong humanistic character, which assumes the role of caring for people, with the aim of mastering the "art of caring". The objective of this work is to describe nursing as a as neurological assessment model of the crania-encephalic trauma in pediatrics, which implies a systematic, comprehensive, and effective care, carrying out a detailed neurological assessment that allows to observe the compromised alterations, structures, and functions. Nursing professionals, as active members of the health team, play a fundamental role during the care of these patients. Nursing care in the context of the crania-encephalic trauma in the pediatric population plays a crucial role in improving clinical outcomes and patients' quality of life. Specialized neurological evaluation, backed by models and care guides, allows for individualized and quality care. The application of the systematization of nursing care in the intensive care units unifies criteria and ensures care based on specific protocols.
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The natural products colchicine and combretastatin A-4 (CA4) have provided inspiration for the discovery and development of a wide array of derivatives and analogues that inhibit tubulin polymerization through a binding interaction at the colchicine site on ß-tubulin. A water-soluble phosphate prodrug salt of CA4 (referred to as CA4P) has demonstrated the ability to selectively damage tumor-associated vasculature and ushered in a new class of developmental anticancer agents known as vascular disrupting agents (VDAs). Through a long-term program of structure activity relationship (SAR) driven inquiry, we discovered that the dihydronaphthalene molecular scaffold provided access to small-molecule inhibitors of tubulin polymerization. In particular, a dihydronaphthalene analogue bearing a pendant trimethoxy aryl ring (referred to as KGP03) and a similar aroyl ring (referred to as KGP413) were potent inhibitors of tubulin polymerization (IC50 = 1.0 and 1.2 µM, respectively) and displayed low nM cytotoxicity against human cancer cell lines. In order to enhance water-solubility for in vivo evaluation, the corresponding phosphate prodrug salts (KGP04 and KGP152, respectively) were synthesized. In a preliminary in vivo study in a SCID-BALB/c mouse model bearing the human breast tumor MDA-MB-231-luc, a 99% reduction in signal was observed with bioluminescence imaging (BLI) 4 h after IP administration of KGP152 (200 mg kg-1) indicating reduced tumor blood flow. In a separate study, disruption of tumor-associated blood flow in a Fischer rat bearing an A549-luc human lung tumor was observed by color Doppler ultrasound following administration of KGP04 (15 mg kg-1).
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RESUMEN Introducción: El asma es una enfermedad psicosomática que reduce la calidad de vida de quien la padece, y tiene el riesgo de progresar en intensidad hasta producir daño e incapacidad permanente. Este texto recoge las experiencias de un estudio cuyo objetivo estuvo orientado a identificar las necesidades de aprendizaje de los licenciados en Enfermería del Policlínico Docente Reinol García, del consejo popular Versalles, perteneciente al municipio Matanzas, de la provincia cubana de igual nombre; acerca del manejo del paciente con asma bronquial. Método: El estudio mencionado tuvo carácter exploratorio descriptivo, desplegado como parte del Programa Nacional de Prevención del asma bronquial durante el período 2019-2020, acerca de las necesidades de aprendizaje de este personal para el manejo de tal situación de salud. El universo fue constituido por 31 licenciados, que laboran en los consultorios médicos y en el policlínico implicado en la investigación. Se aplicó un instrumento diseñado por un grupo de expertos y aplicado a la manera de un examen o prueba escrita por personal calificado, con carácter anónimo y previo consentimiento informado, sobre aspectos epidemiológicos, epistemológicos y teóricos prácticos. Resultados: Se constataron carencias y vacíos de conocimientos relacionados con el tema, de lo cual derivaronestrategias de superación profesional. Discusión: Los hallazgos constatados en la etapa experimental se corroboran con los resultados y criterios emitidos por especialistas y académicos que han profundizado en el tratamiento del tema.
ABSTRACT Introduction: Asthma is a psychosomatic disease that reduces the quality of life of those who suffer from it, and has the risk of progressing in intensity until it produces damage and permanent disability. This text collects the experiences of a study whose objective was aimed at identifying the learning needs of the Nursing graduates of the Educational Polyclinic Reinol García, of the Versalles popular council, belonging to the Matanzas municipality, of the Cuban province of the same name; about the management of the patient with bronchial asthma. Method: The aforementioned study had a descriptive exploratory nature, deployed as part of the National Program for the Prevention of bronchial asthma during the 2019-2020 period, about the learning needs of these personnel for the management of such health situation. The universe was made up of 31 graduates, who work in the medical offices and in the polyclinic involved in the research. An instrument designed by a group of experts was applied in the manner of an exam or written test by qualified personnel, with an anonymous character and with prior informed consent, on epidemiological, epistemological and practical theoretical aspects. Results: There were deficiencies and gaps in knowledge related to the subject, from which professional improvement strategies were derived. Discussion: The findings found in the experimental stage are corroborated with the results and criteria issued by specialists and academics who have delved into the treatment of the subject.
RESUMO
Vascular disrupting agents (VDAs) have been proposed as an effective broad spectrum approach to cancer therapy, by inducing ischemia leading to hypoxia and cell death. A novel VDA (OXi8007) was recently reported to show rapid acute selective shutdown of tumor vasculature based on color-Doppler ultrasound. We have now expanded investigations to noninvasively assess perfusion and hypoxiation of orthotopic human MDA-MB-231/luc breast tumor xenografts following the administration of OXi8007 based on dynamic bioluminescence imaging (BLI) and magnetic resonance imaging (MRI). BLI showed significantly lower signal four hours after the administration of OXi8007, which was very similar to the response to combretastatin A-4P (CA4P), but the effect lasted considerably longer, with the BLI signal remaining depressed at 72 hrs. Meanwhile, control tumors exhibited minimal change. Oximetry used (19)F MRI of the reporter molecule hexafluorobenzene and FREDOM (Fluorocarbon Relaxometry using Echo Planar Imaging for Dynamic Oxygen Mapping) to assess pO2 distributions during air and oxygen breathing. pO2 decreased significantly upon the administration of OXi8007 during oxygen breathing (from 122 ± 64 to 34 ± 20 Torr), with further decrease upon switching the gas to air (pO2 = 17 ± 9 Torr). pO2 maps indicated intra-tumor heterogeneity in response to OXi8007, though ultimately all tumor regions became hypoxic. Both BLI and FREDOM showed the efficacy of OXi8007. The pO2 changes measured by FREDOM may be crucial for future study of combined therapy.
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This study describes the vascular disrupting ability and the mechanism of action of the indole-based tubulin-binding compound, OXi8006, and its water-soluble phosphate prodrug OXi8007. Treatment of rapidly proliferating human umbilical vein endothelial cells (HUVECs), used as a model for the tumor vasculature, with OXi8006 or OXi8007, caused potent microtubule disruption followed by extensive reorganization of the cytoskeletal network. The mechanism of action involved an increase in focal adhesion formation associated with an increase in phosphorylation of both non-muscle myosin light chain and focal adhesion kinase. These effects were dramatically diminished by an inhibitor of RhoA kinase, a downstream effector of RhoA. Cell cycle blockade at G2/M and cytotoxicity toward rapidly proliferating HUVECs were also observed. Capillary-like networks of HUVECs were disrupted by the action of both OXi8006 and OXi8007. The prodrug OXi8007 exhibited potent and rapid dose-dependent antivascular activity assessed by dynamic bioluminescence imaging (BLI) in an MDA-MB-231-luc breast cancer xenograft mouse model. By 6 hours post treatment, over 93% of the BLI signal was abolished with only a slight recovery at 24 hours. These findings were confirmed by histology. The results from this study demonstrate that OXi8007 is a potent vascular disrupting agent acting through an anti-microtubule mechanism involving RhoA.
Assuntos
Antineoplásicos/farmacologia , Neoplasias da Mama/tratamento farmacológico , Células Endoteliais da Veia Umbilical Humana/efeitos dos fármacos , Indóis/farmacologia , Animais , Antineoplásicos/uso terapêutico , Neoplasias da Mama/irrigação sanguínea , Adesão Celular/efeitos dos fármacos , Linhagem Celular Tumoral , Citoesqueleto/efeitos dos fármacos , Citoesqueleto/patologia , Feminino , Adesões Focais/metabolismo , Células Endoteliais da Veia Umbilical Humana/patologia , Humanos , Indóis/uso terapêutico , Camundongos SCID , Fosforilação , Processamento de Proteína Pós-Traducional , Transdução de Sinais , Ensaios Antitumorais Modelo de XenoenxertoRESUMO
OBJETIVO: describir los hábitos del sueño en la población infantil de entre 8 y 12 años escolarizados; y estudiar la influencia de factores sociodemográficos y de los hábitos de sueño en el sobrepeso y la obesidad. MÉTODO: estudio descriptivo transversal en niños y niñas de 8 a 12 años, escolarizados entre 3º y 6º de Educación Primaria (EP) del barrio de La Mina de Sant Adrià de Besòs (Barcelona). Recogida de los datos: cuestionario Children Sleep Habits Questionnaire (CSHQ). Se calculó el percentil IMC (pIMC) según las curvas y tablas de crecimiento de Orbegozo. Tratamiento de los datos: pruebas de contraste de hipótesis (Chi cuadrado, U de Mann-Whitney y Kruskall Wallis). RESULTADOS: se estudiaron 337 niños/as. Un 4,2% de los escolares tenía sobrepeso y un 23,7% obesidad. El 55,9% de quienes tenían normopeso habitualmente estaba preparado para ir a dormir, en contraposición del 42,5% de quienes presentaban obesidad (p= 0,02). El 29,5% se mantenía despierto/a en la cama mientras sus padres creían que estaba durmiendo (aumenta el porcentaje a medida que aumenta el curso (p= 0,03), en los varones (p= 0,01) y en con obesidad (p= 0,04). Existía diferencia estadísticamente significativa entre las escuelas y la puntuación de la dimensión relacionada con los trastornos del sueño y la puntuación total de la suma de todas las dimensiones (p< 0,01); se obtuvieron mejores puntuaciones en el colegio concertado. CONCLUSIONES: los escolares de mayor edad y las niñas siguen mejores hábitos del sueño. Atendiendo a las puntuaciones obtenidas en el CSHQ, quienes estaban en la escuela concertada reflejaron mejores hábitos del sueño. Los escolares con normopeso tienen mejores hábitos de sueño
OBJECTIVE: to describe the sleep habits in a population of 8-to-12-year-old school children, and to study the influence of sociodemographical factors and sleep habits upon excess weight and obesity. METHOD: a descriptive transversal study in 8-to-12-year-old boys and girls, attending from 3rd to 6th term of Primary Education (PE), at the La Mina de Sant Adrià de Besòs neighbourhood in Barcelona. Data collection: Children Sleep Habits Questionnaire (CSHQ). The BMI rate was calculated according to growth curves and tables by Orbegozo. Data treatment: hypothesis contrast tests (Chi Square, Mann-Whitney's U-Test, and Kruskall Wallis). RESULTS: the study included 337 boys and girls; 4.2% of them had excess weight, and 23.7% suffered obesity. From those school children with normal weight, 55.9% were usually ready to go to sleep, unlike the 42.5% who presented obesity (p= 0.02). 29.5% stayed awake in bed while their parents believed they were sleeping; the rate increased for latter terms (p= 0.03), for boys (p= 0.01) and for those with obesity (p= 0.04). There was a statistically significant difference between schools and the score in the dimension associated with sleep disorders and the total score for the sum of all dimensions (p< 0.01); there were better scores in the private school with public funding. CONCLUSIONS: older school-children and girls presented better sleep habits. According to the scores from the CSHQ, those attending the private school with public funding showed better sleep habits. Schoolchildren with normal weight have better sleep habits
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Humanos , Masculino , Feminino , Criança , Adolescente , Transtornos do Sono-Vigília/epidemiologia , Obesidade Infantil/epidemiologia , Sobrepeso/epidemiologia , Hábitos , Estudos TransversaisRESUMO
Se realizó una investigación descriptiva transversal en el Hospital Universitario Clínico-Quirúrgico Cmte. Faustino Pérez Hernández, de Matanzas, en un período comprendido entre enero y mayo de 2008, acerca del comportamiento de la violencia intrafamiliar en pacientes que asistieron a la consulta de psicología. Tuvo como objetivos principales caracterizar el comportamiento de la violencia intrafamiliar en estos pacientes, e identificar las manifestaciones más comunes de la misma. La muestra se seleccionó por el método aleatorio simple, quedando constituida por 75 pacientes que cumplieron con los criterios de inclusión. Para la recogida de la información se utilizó una encuesta semiestructurada y previamente validada, que medía las variables edad, género, grado de escolaridad, si había sido maltratado, repercusión emocional que provocó la acción violenta y algunos factores propiciadores de maltratos familiares. Los resultados más relevantes arrojaron que la totalidad del grupo estudiado había sido maltratado en una o reiteradas ocasiones, las consecuencias psicológicas en los individuos fueron inolvidables, y por último, los conflictos familiares estuvieron favorecidos por la ingestión de bebidas alcohólicas, conflictos de parejas y hacinamiento familiar. Se concluyó con la evidencia de que la violencia familiar traspasa todas las dimensiones, dejando huellas difíciles de borrar, y por tal razón los pacientes acuden a consulta de psicología en busca de ayuda especializada...(AU)
We carried out a descriptive transversal study at the Clinico-surgical Teaching Hospital Comandante Faustino Perez Hernández, Matanzas, in a period from January to May 2008, on the behavior of intrafamilial violence in patients assisting to Psychological consultation. It has, as main objective, characterizing intrafamilial violence behavior in these patients, and identifying its most common manifestations. The sample was selected using the simple random method, and was formed by 75 patients fulfilling the inclusion criteria. To collect the information we used a previously validated semistructured questionnaire, measuring such variables as age, genre, scholarship, if the patients was abused, emotional repercussion of the violent action and some factors propitiating familial abuse. The most relevant outcomes showed that the totality of the group had been abused one or more times, the psychological consequences were unforgettable for individuals, and last, that familial conflicts were favoured by alcoholic beverage drinking, mates' conflicts and familial overcrowding. We concluded that familial violence crosses over all dimensions, leaving marks that are difficult to remove. For that reason patients assist the Psychology consultation looking for specialized help...(AU)
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Adolescente , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , /psicologia , /classificação , Pacientes Ambulatoriais/psicologia , Entrevista Psicológica/métodos , Epidemiologia Descritiva , Estudos Transversais , Psicologia , Hospitais , CubaRESUMO
Se realizó una investigación descriptiva transversal en el Hospital Universitario Clínico-Quirúrgico Cmte. Faustino Pérez Hernández, de Matanzas, en un período comprendido entre enero y mayo de 2008, acerca del comportamiento de la violencia intrafamiliar en pacientes que asistieron a la consulta de psicología. Tuvo como objetivos principales caracterizar el comportamiento de la violencia intrafamiliar en estos pacientes, e identificar las manifestaciones más comunes de la misma. La muestra se seleccionó por el método aleatorio simple, quedando constituida por 75 pacientes que cumplieron con los criterios de inclusión. Para la recogida de la información se utilizó una encuesta semiestructurada y previamente validada, que medía las variables edad, género, grado de escolaridad, si había sido maltratado, repercusión emocional que provocó la acción violenta y algunos factores propiciadores de maltratos familiares. Los resultados más relevantes arrojaron que la totalidad del grupo estudiado había sido maltratado en una o reiteradas ocasiones, las consecuencias psicológicas en los individuos fueron inolvidables, y por último, los conflictos familiares estuvieron favorecidos por la ingestión de bebidas alcohólicas, conflictos de parejas y hacinamiento familiar. Se concluyó con la evidencia de que la violencia familiar traspasa todas las dimensiones, dejando huellas difíciles de borrar, y por tal razón los pacientes acuden a consulta de psicología en busca de ayuda especializada.
We carried out a descriptive transversal study at the Clinico-surgical Teaching Hospital Comandante Faustino Perez Hernández, Matanzas, in a period from January to May 2008, on the behavior of intrafamilial violence in patients assisting to Psychological consultation. It has, as main objective, characterizing intrafamilial violence behavior in these patients, and identifying its most common manifestations. The sample was selected using the simple random method, and was formed by 75 patients fulfilling the inclusion criteria. To collect the information we used a previously validated semistructured questionnaire, measuring such variables as age, genre, scholarship, if the patients was abused, emotional repercussion of the violent action and some factors propitiating familial abuse. The most relevant outcomes showed that the totality of the group had been abused one or more times, the psychological consequences were unforgettable for individuals, and last, that familial conflicts were favoured by alcoholic beverage drinking, mates' conflicts and familial overcrowding. We concluded that familial violence crosses over all dimensions, leaving marks that are difficult to remove. For that reason patients assist the Psychology consultation looking for specialized help.
Assuntos
Adolescente , Adulto , Pessoa de Meia-Idade , Idoso de 80 Anos ou mais , Entrevista Psicológica/métodos , Pacientes Ambulatoriais/psicologia , Violência Doméstica/classificação , Violência Doméstica/psicologia , Cuba , Epidemiologia Descritiva , Estudos Transversais , Hospitais , PsicologiaRESUMO
We carried out a descriptive longitudinal study, in the Teaching Clinic Surgical Hospital Comandante Faustino Pérez, of the province of Matanzas, in the period from June 2008 to June 2009, on the behavior of intra familial violence in elder patients, entering the services of Geriatrics, Internal Medicine and Urology for health reasons. The general objective of this study was diagnosing the main characteristics and manifestations of the intra familial violence. The sample was formed by 50 patients, fulfilling the selection criteria that are, being elder patients entering the before-mentioned services because of different somatic alterations, and giving their verbal and written consent to participate in the investigation. The sample selection criteria answered the objective of the study and the characteristics of the investigation. We used the non probabilistic method intentionally, based on the willfulness, confidentiality and anonymity, because of the special characteristics of the subjects of the study. Currently, the intra familial violence is a serious social and health problem, because its sequels affect the physical and psychological health of the people, being children, women and elder people the most vulnerable social groups. That was the reason of this research, showing the magnitude of this problem and its social repercussion, and also the disturbances it causes in human health. The method used to collect the information was a questionnaire validated by other authors. The results demonstrated that all the studied patients showed manifestations of intra familial violence, and that its consequences have influence on their physical and psychological health. The conclusions were based in the form violence takes, with a predominance of the psychological one. Besides that, it was stated the necessity of developing diagnostic studies on this problem among this vulnerable group, to prevent and adequately attend this phenomena when it is discovered...(AU)
Assuntos
Humanos , Idoso , Violência Doméstica/ética , Violência Doméstica/prevenção & controle , Violência Doméstica/psicologia , Qualidade de Vida , Abuso de Idosos/diagnóstico , Abuso de Idosos/prevenção & controle , Abuso de Idosos/psicologia , Estudos Longitudinais , Epidemiologia DescritivaRESUMO
Se realizó un estudio descriptivo longitudinal, en el Hospital Universitario Clínico Quirúrgico Comandante Faustino Pérez Hernández, de la provincia de Matanzas, en un período comprendido de junio de 2008 a junio de 2009, sobre el comportamiento de la violencia intrafamiliar en pacientes adultos mayores que ingresaron por razones de salud en los servicios de Geriatría, Medicina Interna y Urología. Dicho estudio tuvo como objetivo general diagnosticar las principales características y manifestaciones de la violencia intrafamiliar. La muestra quedó constituida por 50 pacientes, que cumplieron con los criterios de selección, o sea, pacientes adultos mayores que ingresaron por diferentes alteraciones somáticas en los servicios antes mencionados, y que dieron su consentimiento verbal y escrito de participar en la investigación. El criterio de selección de la muestra respondió al objeto de estudio y a las características de la investigación. Se utilizó el método no probabilístico de forma intencional, basado en la voluntariedad, confidencialidad y anonimato, por las características especiales de los sujetos a estudiar. En la contemporaneidad se expresa la violencia intrafamiliar como un grave problema social y de salud, puesto que sus secuelas afectan la salud física y psicológica de las personas, siendo los niños, las mujeres y los ancianos las personas más vulnerables. Por esta razón fue necesario realizar este estudio, que demostró la magnitud de esta problemática y su repercusión social, así como las afectaciones que provoca a la salud humana. Los métodos empleados para la recolección de la información fue una encuesta validada por otros autores. Los resultados demostraron que en todos los pacientes estudiados existían manifestaciones de violencia familiar, y que sus consecuencias influyen en la calidad de su salud, tanto física como psicológica. Las conclusiones se basaron en la forma de violencia (prevaleciendo la psicológica), además de quedar demostrada la necesidad de estudios de diagnóstico sobre esta problemática en este grupo vulnerable, a fin de poder prevenir y brindar la atención adecuada a este fenómeno.
We carried out a descriptive longitudinal study, in the Teaching Clinic Surgical Hospital Comandante Faustino Pérez, of the province of Matanzas, in the period from June 2008 to June 2009, on the behavior of intra familial violence in elder patients, entering the services of Geriatrics, Internal Medicine and Urology for health reasons. The general objective of this study was diagnosing the main characteristics and manifestations of the intra familial violence. The sample was formed by 50 patients, fulfilling the selection criteria that are, being elder patients entering the before-mentioned services because of different somatic alterations, and giving their verbal and written consent to participate in the investigation. The sample selection criteria answered the objective of the study and the characteristics of the investigation. We used the non probabilistic method intentionally, based on the willfulness, confidentiality and anonymity, because of the special characteristics of the subjects of the study. Currently, the intra familial violence is a serious social and health problem, because its sequels affect the physical and psychological health of the people, being children, women and elder people the most vulnerable social groups. That was the reason of this research, showing the magnitude of this problem and its social repercussion, and also the disturbances it causes in human health. The method used to collect the information was a questionnaire validated by other authors. The results demonstrated that all the studied patients showed manifestations of intra familial violence, and that its consequences have influence on their physical and psychological health. The conclusions were based in the form violence takes, with a predominance of the psychological one. Besides that, it was stated the necessity of developing diagnostic studies on this problem among this vulnerable group, to prevent and adequately attend this phenomena when it is discovered.
RESUMO
Se realizó una investigación de desarrollo tecnológico en la ciudad de Matanzas, acerca del nivel de conocimientos que tenían los profesionales de enfermería de esta ciudad en el manejo de la violencia intrafamiliar. Para llevar a cabo dicho estudio se diseñó un instrumento evaluativo que exploraba temáticas como conceptos, causas, consecuencias, factores propiciatorios y posibles estrategias a utilizar en el manejo de la violencia familiar por parte de los profesionales de enfermería. El grupo muestral estuvo integrado por 80 enfermeras pertenecientes a 3 policlínicas de la ciudad de Matanzas.A dicho grupo muestral se le aplicó el instrumento evaluativo donde se pudo constatar que los conocimientos respecto a este tema no eran suficientes para lograr una mejora en el manejo de la violencia familiar. A partir de los resultados obtenidos se diseñó una figura académica tipo diplomado, que contaba con seis módulos que incluían temáticas relacionadas con todo lo anteriormente explorado en el instrumento, además de estrategias definidas a utilizar por los profesionales de enfermería frente a la violencia familiar. Se implantó en un período de 12 semanas, posteriormente se evaluaron los contenidos impartidos durante el desarrollo del programa con un instrumento similar al anteriormente aplicado, donde se pudo constatar que aumentaron los conocimientos del grupo muestral en cuanto al manejo de la violencia familiar por parte de estos profesionales de enfermería, cumpliéndose el objetivo central del estudio
Assuntos
Humanos , Violência Doméstica , Serviços de Enfermagem , Relações Enfermeiro-PacienteRESUMO
Se realizó una investigación de desarrollo tecnológico en la ciudad de Matanzas, acerca del nivel de conocimientos que tenían los profesionales de enfermería de esta ciudad en el manejo de la violencia intrafamiliar. Para llevar a cabo dicho estudio se diseñó un instrumento evaluativo que exploraba temáticas como conceptos, causas, consecuencias, factores propiciatorios y posibles estrategias a utilizar en el manejo de la violencia familiar por parte de los profesionales de enfermería. El grupo muestral estuvo integrado por 80 enfermeras pertenecientes a 3 policlínicas de la ciudad de Matanzas.A dicho grupo muestral se le aplicó el instrumento evaluativo donde se pudo constatar que los conocimientos respecto a este tema no eran suficientes para lograr una mejora en el manejo de la violencia familiar. A partir de los resultados obtenidos se diseñó una figura académica tipo diplomado, que contaba con seis módulos que incluían temáticas relacionadas con todo lo anteriormente explorado en el instrumento, además de estrategias definidas a utilizar por los profesionales de enfermería frente a la violencia familiar. Se implantó en un período de 12 semanas, posteriormente se evaluaron los contenidos impartidos durante el desarrollo del programa con un instrumento similar al anteriormente aplicado, donde se pudo constatar que aumentaron los conocimientos del grupo muestral en cuanto al manejo de la violencia familiar por parte de estos profesionales de enfermería, cumpliéndose el objetivo central del estudio.
We made an investigation of technology development in the city of Matanzas , on the knowledge level the nursing professionals of this city had in the management of intrafamiliar violence. To carry out this study we designed an evaluative instrument exploring themes like concepts, causes, consequences, favouring facts and possible strategies to use in the management of familiar violence by nursing professionals. The sample group was formed by 80 nurses of three policlinics of the city of Matanzas. The evaluative instrument was applied to the sample group and we could arrive to the conclusion that knowledge about this theme is insufficient to achieve a better management of the familiar violence. Beginning with the obtained results we designed an academic figure, kind of diplomat, counting with six modules that included themes related with everything explored before in the instrument, and also defined structures to use by nursing personnel against familiar violence. It was implanted in a period of 12 weeks, and them the contents imparted were evaluated with an instrument similar to the one applied before, so we could conclude that the sample group knowledge about the management of familiar violence by these nursing professionals increased, fulfilling the central objective of the study.
Assuntos
Humanos , Relações Enfermeiro-Paciente , Serviços de Enfermagem , Violência DomésticaRESUMO
El presente trabajo consistió en insertar la Terapia Floral como alternativa de tratamiento en personas que sufren las secuelas psicológicas que trae apareada la violencia familiar. Partiendo de consideraciones generales que hoy en día se expresan como una epidemia galopante que contamina la humanidad y sus secuelas psicológicas pueden llevar incluso al suicidio, siendo el manejo de este fenómeno en cuanto a alternativas de mejora un tanto difícil. Se implantó esta modalidad de tratamiento en pacientes que acudían al servicio de Medicina Natural y Tradicional del Hospital Faustino Pérez Hernández, de Matanzas, refiriendo que presentaban insomnio, miedo, preocupación, tristeza, decepción, baja autoestima, entre otros síntomas. Se trabajó con una muestra de 20 pacientes del municipio de Matanzas, se aplicó una metodología integrada por cuestionarios, análisis de documentos y la entrevista floral, lo que permitió seleccionar las esencias casuísticamente, arribando a importantes resultados
Assuntos
Humanos , Violência Doméstica/psicologia , Estresse Psicológico/tratamento farmacológicoRESUMO
El presente trabajo consistió en insertar la Terapia Floral como alternativa de tratamiento en personas que sufren las secuelas psicológicas que trae apareada la violencia familiar. Partiendo de consideraciones generales que hoy en día se expresan como una epidemia galopante que contamina la humanidad y sus secuelas psicológicas pueden llevar incluso al suicidio, siendo el manejo de este fenómeno en cuanto a alternativas de mejora un tanto difícil. Se implantó esta modalidad de tratamiento en pacientes que acudían al servicio de Medicina Natural y Tradicional del Hospital Faustino Pérez Hernández, de Matanzas, refiriendo que presentaban insomnio, miedo, preocupación, tristeza, decepción, baja autoestima, entre otros síntomas. Se trabajó con una muestra de 20 pacientes del municipio de Matanzas, se aplicó una metodología integrada por cuestionarios, análisis de documentos y la entrevista floral, lo que permitió seleccionar las esencias casuísticamente, arribando a importantes resultados.
This work consisted in insert the floral therapy as an alternative treatment in persons suffering the psychological sequels of the familiar violence. Beginning with the particular considerations that nowadays familiar violence is an increasing epidemic contaminating the human being, and its psychological sequels could lead even to the suicide, the management of this phenomenon is a little difficult, according to the ameliorating alternatives. We implanted this treatment modality in patients assisting to the Traditional and Natural Medicine Service at the Hospital Faustino Perez, of Matanzas They referred insomnia, fear, preoccupation, sadness, deception, low selfsteem, and other symptoms. We worked with a sample of 20 patients from the municipality of Matanzas , an applied a methodology integrated by questionnaires, documents analyses and the floral enquiry, which allowed us to select casuistically the essences. We achieved important results.