Immuno-oncology in head and neck squamous cell carcinoma - a narrative review

Immuno-oncology studies the immune system in cancer. In recent decades, immunotherapy has shown a good response to the treatment of various locally advanced and metastatic cancers. The main mechanisms of action include stimulation of the patient's own immune system to enhance immune responses acting in tumor escape pathways. This review examined the literature related to immune system mechanisms in head and neck squamous cell carcinoma (HNSCC) and their application in immunotherapy using biomarkers. The PUBMED, LILACS, MEDLINE, WHOLIS, and SCIELO databases were searched using the terms squamous cell carcinoma, head and neck, immuno-oncology, immunotherapy, and immunology. The main drugs currently available for clinical use in patients diagnosed with HNSCC include pembrolizumab and nivolumab, both classified as check-point inhibitors. These immunobiological agents improve patient survival and quality of life. Many authors and clinical trials point out that the recommendation of these agents is linked to the dose of PD-L1 (ligand expressed primarily by tumor cells), which proved to be an unreliable biomarker in the patient selection. Recommendation of immunotherapy depends on reliable biomarkers that must be identified in order to achieve good therapeutic results.

Efficacy of cognitive behavioral therapy in reducing psychiatric symptoms in patients with implantable cardioverter defibrillator: an integrative review

This article is a systematic review of the available literature on the benefits that cognitive behavioral therapy (CBT) offers patients with implanted cardioverter defibrillators (ICDs) and confirms its effectiveness. After receiving the device, some patients fear that it will malfunction, or they remain in a constant state of tension due to sudden electrical discharges and develop symptoms of anxiety and depression. A search with the key words “anxiety”, “depression”, “implantable cardioverter”, “cognitive behavioral therapy” and “psychotherapy” was carried out. The search was conducted in early January 2013. Sources for the search were ISI Web of Knowledge, PubMed, and PsycINFO. A total of 224 articles were retrieved: 155 from PubMed, 69 from ISI Web of Knowledge. Of these, 16 were written in a foreign language and 47 were duplicates, leaving 161 references for analysis of the abstracts. A total of 19 articles were eliminated after analysis of the abstracts, 13 were eliminated after full-text reading, and 11 articles were selected for the review. The collection of articles for literature review covered studies conducted over a period of 13 years (1998-2011), and, according to methodological design, there were 1 cross-sectional study, 1 prospective observational study, 2 clinical trials, 4 case-control studies, and 3 case studies. The criterion used for selection of the 11 articles was the effectiveness of the intervention of CBT to decrease anxiety and depression in patients with ICD, expressed as a ratio. The research indicated that CBT has been effective in the treatment of ICD patients with depressive and anxiety symptoms. Research also showed that young women represented a risk group, for which further study is needed. Because the number of references on this theme was small, further studies should be carried out.

Spatial patterns of a tropical tree species growing under an eucalyptus plantation in South-East Brazil / Padrões espaciais de uma espécie arbórea tropical crescendo sob o dossel de um plantio de eucalipto no Sudeste brasileiro

The objectives of this study were to evaluate the influence of propagules source and the implication of tree size class on the spatial pattern of Xylopia brasiliensis Spreng. individuals growing under the canopy of an experimental plantation of eucalyptus. To this end, all individuals of Xylopia brasiliensis with diameter at soil height (dsh) > 1 cm were mapped in the understory of a 3.16 ha Eucalyptus spp. and Corymbia spp. plantation, located in the municipality of Lavras, SE Brazil. The largest nearby mature tree of X. brasiliensis was considered as the propagules source. Linear regressions were used to assess the influence of the distance of propagules source on the population parameters (density, basal area and height). The spatial pattern of trees was assessed through the Ripley K function. The overall pattern showed that the propagules source distance had strong influence over spatial distribution of trees, mainly the small ones, indicating that the closer the distance from the propagules source, the higher the tree density and the lower the mean tree height. The population showed different spatial distribution patterns according to the spatial scale and diameter class considered. While small trees tended to be aggregated up to around 80 m, the largest individuals were randomly distributed in the area. A plausible explanation for observed patterns might be limited seed rain and intra-population competition.

Os objetivos deste estudo foram avaliar a influência da fonte de propágulo e a implicação de diferentes classes de tamanho sobre o padrão de distribuição espacial de indivíduos de Xylopia brasiliensis Spreng. crescendo sob o dossel de um plantio experimental de eucalipto. Para isso, todos os indivíduos de X. brasiliensis com diâmetro à altura do solo (das) > 1 cm foram mapeados em uma área de 3,16 ha no sub-bosque de um plantio de Eucalyptus ssp. e Corymbia spp., localizado no município de Lavras, MG. O maior e mais próximo indivíduo reprodutivo de X. brasiliensis foi considerado como fonte de propágulos. Foram utilizadas regressões lineares para avaliar a influência da fonte de propágulos sobre parâmetro populacionais (densidade, área basal e altura). O padrão de distribuição espacial das árvores foi avaliado por meio da função K de Ripley. O padrão geral demonstrou que a distância da fonte de propágulo teve forte influência sobre a distribuição espacial das árvores, principalmente as menores, indicando que quanto mais próximo à fonte de propágulos, maior a densidade e menor a altura das árvores. A população demonstrou diferentes distribuições espaciais de acordo com a escala analisada. Enquanto árvores menores tenderam a estar agregadas até uma escala de 80 m, os maiores indivíduos estavam aleatoriamente distribuídos na área. Uma explicação plausível para os padrões observados poderia ser a limitação espacial da chuva de sementes e a competição intraespecífica.