Recent Progress of Nano-drug Combined with Chimeric Antigen Receptor T Cell Therapy in the Treatment of Soild Tumors / 中国肺癌杂志

Chimeric antigen receptor T cell (CAR-T) therapy has shown remarkable success in treating hematological malignancies. However, CAR-T therapy for solid tumors is still limited due to the unique solid-tumor microenvironment and heterogeneous target antigen expression, which leads to an urgent need of combining other therapies. At present, nano delivery system has become one of the most promising directions for the development of anti-tumor drugs. Based on the background of CAR-T and tumor treatment, we focus on the research progress of nanomedicine combined with CAR-T therapy, and systematically review the strategies and examples in recent years in the aspects of in vivo delivery of mRNA, regulation of tumor microenvironment, combination with photothermal therapy. And we also look forward to the future direction of this filed.
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Advances of structure and mechanisms of bromodomain-containing protein 4 and its related research in tumors / 生物工程学报

The bromodomain and extraterminal domain (Bet) family are the regulators of the epigenome and also the pivotal driving factors for the expression of tumor related genes that tumor cells depend on for survival and proliferation. Bromodomain-containing protein 4 (Brd4) is a member of the Bet protein family. Generally, Brd4 identifies acetylated histones and binds to the promoter or enhancer region of target genes to initiate and maintain expression of tumor related genes. Brd4 is closely related to the regulation of multiple transcription factors and chromatin modification and is involved in DNA damage repair and maintenance of telomere function, thus maintaining the survival of tumor cells. This review summarizes the structure and function of Brd4 protein and the application of its inhibitors in tumor research.

Research progress on the effect of iron oxide nanoparticles in macrophage polarization / 生物医学工程学杂志

Macrophages are important immune effector cells with significant plasticity and heterogeneity in the body immune system, and play an important role in normal physiological conditions and in the process of inflammation. It has been found that macrophage polarization involves a variety of cytokines and is a key link in immune regulation. Targeting macrophages by nanoparticles has a certain impact on the occurrence and development of a variety of diseases. Due to its characteristics, iron oxide nanoparticles have been used as the medium and carrier for cancer diagnosis and treatment, making full use of the special microenvironment of tumors to actively or passively aggregate drugs in tumor tissues, which has a good application prospect. However, the specific regulatory mechanism of reprogramming macrophages using iron oxide nanoparticles remains to be further explored. In this paper, the classification, polarization effect and metabolic mechanism of macrophages were firstly described. Secondly, the application of iron oxide nanoparticles and the induction of macrophage reprogramming were reviewed. Finally, the research prospect and difficulties and challenges of iron oxide nanoparticles were discussed to provide basic data and theoretical support for further research on the mechanism of the polarization effect of nanoparticles on macrophages.

¿Cuándo el patólogo debe solicitar inmunomarcación con B-Catenina?: una revisión de la literatura a propósito de dos casos / When should the pathologist request immunostaining with B-catenin?: a review of the literature on two cases

For more than 20 years, immunohistochemistry has represented an auxiliary test of great relevance to support pathological work, however, it should be noted that the pillar of diagnosis continues and will continue to be the classic morphological description based on hematoxylin eosin and the trained eye of the specialist. In neoplastic pathologies, whether benign or malignant, it is becoming increasingly necessary to incorporate new tissue biomarkers that help objectify or confirm the diagnosis of each patient, in order to provide better treatment or a more precise diagnosis about the biological nature of their illness. In this line, there has been intense research in relation to the participation of the Wnt/ß-catenin pathway in the development of various types of tumors, including colon adenocarcinoma, some pancreatic neoplasms and even some tumors of mesenchymal origin, as will be seen. in this work. In this context and based on two clinical cases of special interest, we have prepared a brief review of the literature considering the biological aspects of ß-catenin, tumors where there is currently a true relative consensus that its immunolabeling offers a real contribution to the confirmation of the entity and finally a limited exposition regarding the future of this biomarker in the pathology discipline.

Desde hace más de 20 años la inmunohistoquímica ha representado una prueba auxiliar de gran relevancia para apoyar el trabajo anatomopatológico, no obstante, cabe señalar que, aún el pilar del diagnóstico sigue y seguirá siendo la descripción morfológica clásica basada en hematoxilina eosina y el ojo entrenado del especialista. En las patologías neoplásicas, ya sea benignas, como malignas, se hace cada vez más necesario la incorporación de nuevos biomarcadores tisulares que ayuden a objetivar o confirmar el diagnóstico de cada paciente, con objeto de entregar un mejor tratamiento o un diagnóstico más preciso de la naturaleza biológica de su enfermedad. En esta línea, ha habido intensa investigación en relación con la participación de la vía Wnt/ß-catenina en el desarrollo de varios tipos de cáncer, entre ellos el adenocarcinoma de colon, algunas neoplasias pancreáticas e incluso algunos tumores de origen mesenquimal como se verá en este trabajo. En este contexto y partir de dos casos clínicos de especial interés, hemos preparado una breve revisión de la literatura considerando los aspectos biológicos de la ß-catenina, los tumores donde en la actualidad existe verdadero consenso de que su inmunomarcación ofrece un aporte real a la confirmación de la entidad y finalmente una exposición acotada respecto al futuro de este biomarcador en la disciplina de la anatomía patológica.

Antitumor effect and mechanism of different extracts of cultivated Phellinus vaninii on H22 tumor bearing mice / 生物工程学报

In order to explore the antitumor effect and mechanism of different extracts of cultivated Phellinus vaninii fruit body on H22 tumor bearing mice, 150 ICR mice were randomly divided into blank group, model group, CTX group, P. vaninii water extract group, ethanol extract group, petroleum ether extract group and crude polysaccharide group. H22 liver cancer cells were used to establish a solid tumor model and the mice were sacrificed on the 10th day after administration. The spleen and thymus organ index and tumor inhibition rate were calculated, the serum levels of TNF-α, INF-γ, VEGF, and hematoxylin-eosin were detected, and the immunohistochemical staining method was used to observe the pathological changes of tumor tissues, while Western blotting was used to detect the expression of tumor-related proteins. The high-dose petroleum ether extract group showed the best tumor inhibition rate (73.21%), increased serum levels of TNF-α, IFN-γ, and VEGF, as well as significantly promoted tumor necrosis and ablation. The immunohistochemistry of the water extract group showed negative regulation, indicating an insignificant tumor suppression. Western blotting showed the apoptosis genes Caspase-3, Caspase-9 and pathway genes NF-κB and JAK were all highly expressed in each administration group compared with the model group, and their expression levels gradually decreased with increasing doses. In summary, the petroleum ether extract of P. vaninii fruit body showed a significant anti-tumor effect which is presumably mediated through the mitochondrial pathway. The metabolism of drug in the body induces activation of Caspase-3 and Caspase-9 apoptotic proteins by Bax, Bcl-2, and TNF, which further caused nuclear chromatin or DNA to condense or degrade, and subsequently destroy the normal proliferation of tumor cells, thereby inducing their apoptosis and inhibiting tumor growth.

Innovative pharmaceutical strategies for niclosamide repositioning / Estratégias farmacêuticas inovadoras para o reposicionamento da niclosamida

The antiparasitic niclosamide has shown promising anticancer activity in preclinical studies against several types of cancer, such as colorectal and prostate. Thus, the objective of this work was to develop innovative formulations for the repositioning of niclosamide as an anticancer agent. In chapter I, a critical review of the literature on the physicochemical properties of the drug was carried out, in addition the results of clinical studies against colorectal and prostate cancer. Besides, a review was carried out on studies that developed formulations containing this drug, as well as hypotheses to improve the biopharmaceutical performance of this molecule. In chapter II, the development of solid amorphous dispersion containing niclosamide was carried out. Drug/polymer solutions were acoustic levitated and characterized by synchrotron X-ray light. This set allowed fast, high quality measurements, as well as the identification of niclosamide recrystallization. Plasdone® and Soluplus® demonstrated better properties to form amorphous dispersions, with the latter showing superior solubility enhancement. The study showed that the developed formulation increased the apparent saturation solubility of niclosamide in water by two times. In chapter III the objective was the development, physicochemical characterization and in vitro anticancer activity of a niclosamide nanoemulsion, having HCT-116 cells as a cellular model. Preliminary results indicated Capmul® MCM C8 as the best liquid lipid for the system, but the first nanoemulsions containing this lipid were not stable to justify its usage. On the other hand, Miglyol® 812 indicated to be a suitable liquid lipid for the system. The niclosamide nanoemulsion (~200 nm) with Miglyol® 812 and poloxamer 188 was stable for 56 days, with a monomodal particle size distribution. Cell viability assay against HCT-116 cells demonstrated that niclosamide cytotoxicity is time and concentration dependent. Results herein obtained encourage further research to understand and optimize niclosamide performance as an anticancer drug substance

O antiparasitário niclosamida tem apresentado promissora atividade anticâncer em estudos pré- clínicos contra diversos tipos de câncer, como coloretal e próstata. Assim, o objetivo deste trabalho foi desenvolver formulações inovadoras para o reposicionamento da niclosamida como agente anticâncer. No capítulo I foi realizada revisão crítica da literatura sobre as propriedades físico-químicas do fármaco, além de resultados de estudos clínicos da niclosamida contra câncer de coloretal e de próstata. Além disso, foi feita revisão sobre estudos que desenvolveram formulações contendo esse fármaco, bem como hipóteses para melhorar o desempenho biofarmacêutico dessa molécula. No capítulo II foi realizado o desenvolvimento de dispersão solida amorfa contendo niclosamida. Soluções de fármaco/polímero foram levitadas em levitador acústico e caracterizadas por raios-X de luz síncrotron. Este conjunto permitiu medições rápidas e de alta qualidade, bem como identificação de recristalização da niclosamida. Plasdone® e Soluplus® demonstraram melhores propriedades para formar as dispersões amorfas, com o último apresentando aumento de solubilidade superior. O estudo mostrou que a formulação desenvolvida aumentou em duas vezes a solubilidade aparente de saturação da niclosamida em água. No capítulo III o objetivo foi o desenvolvimento, a caracterização físicoquímica e atividade anticâncer in vitro de uma nanoemulsão de niclosamida, tendo células HCT-116 como modelo celular. Resultados preliminares indicaram o Capmul® MCM C8 como o melhor lipídio líquido para o sistema, mas as primeiras nanoemulsões contendo este lipídio não foram estáveis para justificar seu uso. Por outro lado, Miglyol® 812 indicou ser um lipídio líquido adequado para o sistema. A nanoemulsão de niclosamida (~200 nm) com Miglyol® 812 e poloxâmero 188 foi estável por 56 dias, com distribuição monomodal do tamanho de partícula. O ensaio de viabilidade celular contra células HCT-116 demonstrou que a citoxicidade da niclosamida é dependente do tempo e da concentração. Os resultados aqui obtidos encorajam mais pesquisas para entender e otimizar o desempenho da niclosamida como uma substância anticancerígena

Nutritional status at diagnosis among children with cancer referred to a nutritional service in Brazil

ABSTRACT Introduction: Children and adolescents with cancer are particularly vulnerable to malnutrition and require special attention on nutritional assessment. An adequate nutritional status during treatment is essential in reducing morbidity and mortality, being a modifiable risk factor for clinical outcomes. This study aims to determine the nutritional status of pediatric patients with cancer assessed by the nutrition team at diagnosis and evaluate its association with the overall survival. Method: This is a retrospective cross-sectional study of patients at the time of cancer diagnosis who had nutritional assessments when hospitalized or referred to the nutrition outpatient clinic. Nutritional status was classified by the mid-upper arm circumference (MUAC) and body mass index for age z-score (zBMI/A). The Cox regression analysis was used to determine the association between the nutritional status and overall survival, adjusting for gender, tumor group and age. Results: The study included 366 patients. The prevalence of undernutrition varied from 8 to 23% and overweight, from 5 to 20%. The MUAC identified more children as undernourished than the zBMI/A in patients with solid and hematological tumors. There was no significant difference in the overall survival by malnutrition classified by the zBMI/A (p = 0.1507) or MUAC (p = 0.8135). When adjusted for gender, tumor group and age, the nutritional status classification by the zBMI/A (hazard ratio [HR], 1.27; 95% confidence interval [CI], 0.88-1.83; p = 0.209) and MUAC (HR, 0.94; 95% CI, 0.61-1.44; p = 0.773) did not impact overall survival. Conclusion: The nutritional status at diagnosis did not significantly impact the overall survival, which suggests there may have been a protective effect by successful nutritional intervention during the subsequent care.

Updating the role of matrix metalloproteinases in mineralized tissue and related diseases

Abstract Bone development and healing processes involve a complex cascade of biological events requiring well-orchestrated synergism with bone cells, growth factors, and other trophic signaling molecules and cellular structures. Beyond health processes, MMPs play several key roles in the installation of heart and blood vessel related diseases and cancer, ranging from accelerating metastatic cells to ectopic vascular mineralization by smooth muscle cells in complementary manner. The tissue inhibitors of MMPs (TIMPs) have an important role in controlling proteolysis. Paired with the post-transcriptional efficiency of specific miRNAs, they modulate MMP performance. If druggable, these molecules are suggested to be a platform for development of "smart" medications and further clinical trials. Thus, considering the pleiotropic effect of MMPs on mammals, the purpose of this review is to update the role of those multifaceted proteases in mineralized tissues in health, such as bone, and pathophysiological disorders, such as ectopic vascular calcification and cancer.

Farmacogenética, tabaco, alcohol y su efecto sobre el riesgo de desarrollar cáncer / Pharmacogenetics, tobacco, alcohol and its effect on the risk development cancer

El cáncer es la segunda causa de muerte en el mundo, según datos de la Organización Mundial de la Salud (OMS) en el año 2015 ocasionó 8,8 millones de muertes. Dentro de los factores de riesgo para el desarrollo de cáncer se encuentran el tabaquismo y el consumo de alcohol. En Chile el 33,6% de la población fuma y un 21,2 % de los jóvenes. El consumo de alcohol en la población chilena es de 74,5 % y en los jóvenes de un 12,2 %. Entre los factores fisiológicos que influyen en el desarrollo de cáncer, el factor genético juega un rol relevante, habiéndose demostrado que la presencia de polimorfismos genéticos alteran la capacidad del organismo de eliminar contaminantes y aumentan el riesgo de desarrollar cáncer. Lo mismo ocurre con polimorfismos que impiden la reparación de ADN debido a daños producidos por efecto de contaminantes ambientales como el humo de cigarrillo. El objetivo de esta revisión es analizar el estado del arte de la relación entre farmacogenética, tabaco y alcohol como factores de riesgo para el desarrollo de cáncer. Los resultados sugieren que la presencia de po limorfismos que alteran la función de enzimas de biotransformación fase I (CYP1A1, CYP1E1) y fase II (GST), además de polimorfismos en enzimas de reparación del ADN (ERCC1/ERCC2) aumentan el riesgo de cáncer inducido por el hábito tabáquico y alcohólico. Esta asociación es importante, si consideramos que en la población chilena el hábito de fumar y beber alcohol es altamente prevalente.

Cancer is the second leading cause of death in the world, causing 8.8 million deaths in 2015 according to the World Health Organization (WHO). Risk factors for cancer include smoking and alcohol con sumption. In Chile, 33.6% of the population and 21.2% of young people smokes. Alcohol consump tion in the Chilean population is 74.5% and 12.2% in young people. Among the physiological factors that influence the development of cancer, the genetic factor plays a relevant role. It has been shown that the presence of genetic polymorphisms that alter the ability of the body to eliminate contami nants increase the risk of developing cancer. The same applies to polymorphisms that prevent DNA repair due to damage caused by environmental pollutants such as cigarette smoke. The objective of this review is to analyze the state of the art of the relationship between pharmacogenetics, smoking, and alcohol consumption as risk factors for the development of cancer. In conclusion, the results suggest that the presence of polymorphisms that alter the function of biotransformation enzymes phase I (CYP1A1, CYP1E1) and phase II (GST), as well as polymorphisms in DNA repair enzymes (ERCC1 / ERCC2), increase the risk of cancer induced by smoking and alcohol consumption. This association is important considering that smoking and drinking alcohol are highly prevalent among the Chilean population.

Combatiendo el metabolismo de las células cancerosas mediante la activación de SIRT3 y el ejercicio físico / Combating tumor cells through SIRT3 activation and exercise

One of the main features of cancer is the high rate of cell proliferation and growth. To do this, cancer cells need to redirect their metabolism mainly towards anaerobic glycolysis and an increased mitochondrial glutamine energy metabolism. Sirtuins are cellular proteins with regulatory functions on metabolic pathways, genomic stability, apoptosis, longevity, inflammation, energy metabolism and oxidative stress. Sirtuins have emerged recently as a potential therapeutic option to treat several chronic diseases including cancer. This review summarizes the tumor suppressor function of Sirtuin 3 (SIRT3), highlighting its repressor effect on glycolytic metabolism, promoting mitochondrial metabolism and oxidative stress reduction. SIRT3 activation by exercise is particularly described since it may represent a potent tool for several types of cancer treatment.

Autophagy and intermittent fasting: the connection for cancer therapy?

Cancer is a leading cause of death worldwide, and its incidence is continually increasing. Although anticancer therapy has improved significantly, it still has limited efficacy for tumor eradication and is highly toxic to healthy cells. Thus, novel therapeutic strategies to improve chemotherapy, radiotherapy and targeted therapy are an important goal in cancer research. Macroautophagy (herein referred to as autophagy) is a conserved lysosomal degradation pathway for the intracellular recycling of macromolecules and clearance of damaged organelles and misfolded proteins to ensure cellular homeostasis. Dysfunctional autophagy contributes to many diseases, including cancer. Autophagy can suppress or promote tumors depending on the developmental stage and tumor type, and modulating autophagy for cancer treatment is an interesting therapeutic approach currently under intense investigation. Nutritional restriction is a promising protocol to modulate autophagy and enhance the efficacy of anticancer therapies while protecting normal cells. Here, the description and role of autophagy in tumorigenesis will be summarized. Moreover, the possibility of using fasting as an adjuvant therapy for cancer treatment, as well as the molecular mechanisms underlying this approach, will be presented.

Lessons and perspectives for applications of stochastic models in biological and cancer research

The effects of randomness, an unavoidable feature of intracellular environments, are observed at higher hierarchical levels of living matter organization, such as cells, tissues, and organisms. Additionally, the many compounds interacting as a well-orchestrated network of reactions increase the difficulties of assessing these systems using only experiments. This limitation indicates that elucidation of the dynamics of biological systems is a complex task that will benefit from the establishment of principles to help describe, categorize, and predict the behavior of these systems. The theoretical machinery already available, or ones to be discovered to help solve biological problems, might play an important role in these processes. Here, we demonstrate the application of theoretical tools by discussing some biological problems that we have approached mathematically: fluctuations in gene expression and cell proliferation in the context of loss of contact inhibition. We discuss the methods that have been employed to provide the reader with a biologically motivated phenomenological perspective of the use of theoretical methods. Finally, we end this review with a discussion of new research perspectives motivated by our results.

Hospitalizations for cancer in international migrants versus local population in Chile / Hospitalizaciones por cáncer en migrantes internacionales y población local en Chile

ABSTRACT OBJECTIVE To compare cancer hospital morbidity among the local population and the immigrant population in Chile. METHODS This is a prevalence study based on the analysis of hospital discharges of all the health centers of Chile. Cancer hospital discharges were characterized in 2012 according to the migratory status. The crude and specific rates of hospital morbidity for this cause were estimated for the analysis of their association with migratory status using zero-inflated negative binomial regression, adjusted for sociodemographic variables. RESULTS The neoplasms were the third cause of hospital discharges for immigrants and the seventh one for Chileans. The adjusted rate of cancer hospital discharges was higher for Chileans than immigrants, and the latter had fewer days of hospitalization and greater proportion of surgical interventions. In the group of immigrants, cancer hospital discharges mainly corresponded to patients belonging to the private system (46%), and in the group of Chileans they mainly corresponded to patients in the public system (71.1%). We observed a large difference in the proportion of cancer hospital discharges for patients with no health insurance between the two populations (22.6%: immigrants, 1.0%: Chileans). In both populations, the three most frequent types of cancer were: (i) lymphoid tissue, hematopoietic organs, and related tissues, (ii) digestive organs, and (iii) breast cancer. CONCLUSIONS Models of differentiated care should be considered for immigrants, with the creation of specific programs of information, coverage, and protection against cancer. More information on this problem must be generated at the local and international level.

RESUMEN OBJETIVO Comparar la morbilidad hospitalaria por cáncer entre población local e inmigrante en Chile. MÉTODOS Estudio de prevalencia basado en el análisis de egresos hospitalarios de todos los centros de Chile. Se caracterizaron los egresos hospitalarios por cáncer en 2012 según condición migratoria. Se estimaran las tasas brutas y específicas de morbilidad hospitalaria por esta causa, para finalmente analizar su asociación con el estatus migratorio mediante una regresión binomial negativa inflada por ceros ajustada por variables sociodemográficas. RESULTADOS Las neoplasias fueron la tercera causa de egresos hospitalarios en inmigrantes y la séptima en chilenos. La tasa ajustada de egresos hospitalarios por cáncer fue mayor en chilenos que en inmigrantes, y estos presentaron menor cantidad de días de hospitalización y mayor proporción de intervenciones quirúrgicas. En el grupo de inmigrantes, los egresos hospitalarios por cáncer corresponderán principalmente a pacientes pertenecientes al sistema privado (46%) y en chilenos a pacientes en el sistema público (71,1%). Se observó una amplia diferencia en la proporción de egresos hospitalarios por cáncer correspondientes a pacientes sin previsión de salud entre ambas poblaciones (22,6%: inmigrantes, 1,0%: chilenos). En ambas poblaciones, los tres cánceres que se presentaron con mayor frecuencia fueron: (i) tejidos linfáticos, órganos hematopoyéticos y tejidos afines, (ii) órganos digestivos y (iii) cáncer de mama. CONCLUSIONES Se deben considerar modelos de atención diferenciada en inmigrantes, creando programas específicos de información, cobertura y protección frente al cáncer. Es necesario generar más información sobre esta problemática a nivel local e internacional.

Concepções de idosos sobre vulnerabilidade ao HIV/Aids para construção de diagnósticos de enfermagem / Las concepciones de ancianos sobre vulnerabilidad al VIH/Sida para la construcción de diagnósticos de enfermeira / Beliefs of older adults about their vulnerability to HIV/Aids, for the construction of nursing diagnoses

RESUMOObjetivo:conhecer concepções de idosos sobre vulnerabilidade ao HIV/Aids e identificar diagnósticos de enfermagem.Método:pesquisa de campo desenvolvida em Unidades de Saúde da Família, João Pessoa. A amostra compreendeu 250 idosos de ambos os sexos com coleta de dados de abril a julho, 2011. Aplicou-se um Teste da Associação Livre de Palavras utilizando o termo: HIV/Aids. Realizou-se análise de conteúdo e mapeamento cruzado dos termos mais frequentes com os da Classificação Internacional para a Prática de Enfermagem, 2011.Resultados:identificaram-se 202 termos, numa frequência total de 1156. Dos 202 termos, 16 foram mais frequentes e utilizados para a construção de diagnósticos de enfermagem. Identificaram-se os diagnósticos conhecimento sobre comportamento sexual adequado, capacidade para proteção parcial, medo da morte e desesperança.Conclusão:compreender essas concepções trouxe conhecimentos acerca de fatores de vulnerabilidades ao HIV/Aids tendo em vista o planejamento de ações de saúde para esse segmento populacional.

RESUMENObjetivo:conocer concepciones de ancianos sobre vulnerabilidad a HIV/Sida y identificar de diagnósticos de enfermería.Método:investigación de campo desarrollado en Unidades de Salud de Familia, João Pessoa. La muestra incluyó 250 ancianos de ambos sexos con recogida de datos de abril a julio, 2011. Se aplicó prueba de asociación de palabras el uso del término: HIV/Sida. Tenido análisis de contenido de proceder cruzar términos más frecuentes con la Clasificación Internacional para la Práctica de Enfermería, 2011.Resultados:202 términos fueron identificados en frecuencia 1156. De los 202 términos, 16 fueron más frecuentes y utilizados para construcción de diagnósticos de enfermería. Se identificaron conocimiento sobre comportamiento sexual apropiado, capacidad de protección parcial, miedo a la muerte y desesperanza.Conclusión:La comprensión de conceptos trajo reflexiones sobre factores de vulnerabilidad ante el HIV/Sida en vista de planificación de acciones la salud para este segmento de población.

ABSTRACTObjective:to know the beliefs of older adults about their vulnerability to HIV/Aids, and to identify nursing diagnoses.Method:a field research implemented in Family Health Units, in João Pessoa, Brazil. The sample included 250 older adults of both genders with data collected from April to July of 2011. A Test of Free Word Association was applied using the term HIV/Aids. A content analysis and cross-mapping of the most frequent terms with the International Classification for Nursing Practice, 2011 were performed.Results:202 terms were identified in terms, with an overall frequency of 1156. Of the 202 terms, 16 were more frequent and were used to construct the nursing diagnoses. The diagnoses identified were knowledge about appropriate sexual behavior, ability for partial protection, fear of death and hopelessness.Conclusion:understanding these beliefs drew from knowledge about factors related to, vulnerability to HIV/Aids aimed at planning health care actions for this population segment.

Prevalência e fatores associados ao tabagismo entre fumicultores na região Sul do Brasil / Prevalencia y factores asociados al hábito de fumar entre los cultivadores de tabaco en el sur de Brasil / Prevalence and factors associated with smoking among tobacco growers in southern Brazil

RESUMOObjetivo:identificar a prevalência e fatores associados ao tabagismo em fumicultores.Método:estudo descritivo, do tipo transversal. A coleta de dados ocorreu em 2012 por inquérito domiciliar e entrevistas, incluindo aplicação de instrumento estruturado e escala de Fargeström.Resultados:foram incluídos 100 fumicultores, média de idade 46,9±10,8 anos; 90 (90%) casados; 72 (72%) cor branca; composição familiar de 3,7±1,1 pessoas, mediana de filhos de 3(1-3) e média tempo de estudo 6±2,5 anos. Obteve-se prevalência de 17% de fumantes, os quais apresentaram menor escolaridade (p=0,010) e menor número de pessoas no domicílio (p=0,049).Conclusão:a prevalência do tabagismo entre fumicultores foi maior que a média nacional, porém, com baixa dependência da nicotina, o que pode facilitar o processo de cessação do tabagismo. Destaca-se a necessidade de implantar um programa para o controle do tabagismo junto a este grupo.

RESUMENObjetivo:identificar la prevalencia y factores asociados con el consumo de tabaco en el cultivo del tabaco.Método:estudio descriptivo, transversal. Los datos fueron recolectados por medio de entrevistas en el 2012, que incluye la aplicación de un instrumento estructurado y escala Fargeström.Resultados:100 cultivadores se incluyeron, la edad media 46,9±10,8 años; 90(90%) se casó; 72(72%) blanco, la composición familiar de 3,7±1,1 personas, mediana de 3 niños (1-3) y el tiempo promedio de estudio de 6±2,5 años. La prevalencia de tabaquismo fue del 17%, que tenía menos educación (p=0,010) y un menor número de personas en hogar (p=0,049).Conclusión:la prevalencia de tabaquismo entre los productores de tabaco fue mayor que el promedio nacional, pero la dependencia de la nicotina fue baja, lo que puede facilitar el proceso de dejar de fumar. Destaca la necesidad de implementar un programa de control del tabaquismo entre los cultivadores de tabaco.

ABSTRACTObjective:identify the prevalence and factors associated with smoking in tobacco growers.Method:descriptive, cross-sectional research. Data collection occurred in 2012 through household survey and interviews, including application of a structured instrument and scale Fargeström.Results:there were 100 growers included, average age of 46,9 ± 10,8 years; 90(90%) married; 72(72%) white, average family composition 3,7±1,1 people; median number of children 3(1-3), and the average study time 6±2,5. The prevalence of smoking among tobacco growers was 17%, which had less education (p=0.010) and fewer people in the household (p=0.049).Conclusion:the prevalence of smoking among tobacco growers was higher than the national average, but the nicotine dependence was low, which can facilitate the smoking cessation process. Highlights the need to implement a program to control smoking among tobacco growers.

Incidentes críticos en los docentes de enfermería: descubriendo una nueva identidad / Incidentes críticos em docentes de enfermagem: descobrindo uma nova identidade / Critical incidents in nursing academics: discovering a new identity

RESUMEN Objetivo: estudio cualitativo que siguió los principios de la teoría fundamentada con el fin de analizar la identidad profesional de docentes de enfermería por medio del análisis de incidentes críticos que más las desestabilizaban. Método: entrevistas semi-estructuradas fueron realizadas a siete enfermeras que actúan como docentes e investigadoras en una universidad privada de Barcelona. Resultados: el material empírico resultante fue organizado en dos categorías: caracterización de los incidentes críticos y reacción de las enfermeras frente a ellos. Conclusión: se concluye que la identidad profesional de estas enfermeras en el campo académico está aún en construcción y que la inexperiencia es el mayor obstáculo que enfrentan para gestionar los incidentes críticos en el trabajo docente. .

RESUMO Objetivo: estudo qualitativo que seguiu os princípios da teoria fundamentada em dados com o objetivo de analisar a identidade profissional de docentes de enfermagem por meio da análise de incidentes críticos que mais as desestabilizaram. Método: entrevistas semiestruturadas foram realizadas com sete enfermeiras que atuam como docentes e pesquisadoras em uma universidade privada de Barcelona. Resultados: o material empírico resultante foi organizado em duas categorias: caracterização dos incidentes críticos e reação das enfermeiras frente a eles. Conclusão: concluiu-se que identidade profissional dessas enfermeiras no campo acadêmico está ainda em construção e a que inexperiência é o maior obstáculo que enfrentam para gerenciar incidentes críticos no trabalho docente. .

ABSTRACT Objective: a qualitative study that followed the principles of the grounded theory in order to analyze the professional identity of nursing academics through the analysis of the most disturbing critical incidents. Method: semi-structured interviews were conducted with seven nurses who worked as professors and researchers in a private university in Barcelona. Results: the resulting empirical material was organized into two categories: characterization of critical incidents and responsiveness to the incident. Conclusion: the professional identity of nurses regarding the academic area is still under construction and inexperience is the major obstacle in the management of critical incidents in the teaching career. .

Alterations in plaque accumulation and gingival inflammation promoted by treatment with self-ligating and conventional orthodontic brackets

OBJECTIVE: The aim of the present study was to evaluate, comparatively, the periodontal response during orthodontic treatment performed with self-ligating and conventional brackets. METHODS: Sixteen Caucasian individuals of both sexes, aged between 12 and 16 years old and in permanent dentition were selected. Eight individuals were treated with conventional brackets installed on the lower dental arch and self-ligating brackets on the upper arch. Another eight individuals received self-ligating brackets in the lower arch and conventional brackets in the upper arch. The subjects received material and instructions for oral hygiene. Visible plaque index (VPI), gingival bleeding index (GBI) and clinical attachment level (CAL) were evaluated just after installation of orthodontic appliances, and 30, 60 and 180 days later. Mann-Whitney test was used to compare differences between groups (self-ligating and conventional), two-way ANOVA followed by Tukey's test was used to assess CAL at each site of each tooth. Significance level was set at 5%. RESULTS: No significant changes were found with regard to the assessed parameters (VPI, GBI and CAL) in either one of the systems. CONCLUSION: No significant changes were found with regard to the periodontal response to orthodontic treatment for the variables assessed and between subjects receiving passive self-ligating and conventional brackets. All individuals had received oral hygiene instructions and had their periodontal conditions monitored. .

OBJETIVO: o objetivo do presente estudo foi avaliar, comparativamente, a resposta periodontal durante o tratamento ortodôntico realizado com braquetes autoligáveis e convencionais. MÉTODOS: dezesseis indivíduos, leucodermas, em dentição permanente, de ambos os sexos, com idades de 12 a 16 anos, foram selecionados. Oito foram tratados com braquetes convencionais instalados na arcada inferior, e braquetes autoligáveis na arcada superior. Os outros oito indivíduos receberam braquetes autoligáveis na arcada inferior e braquetes convencionais na arcada superior. Os pacientes receberam materiais e instruções sobre higiene bucal. O índice de placa visível (IPV), o índice de sangramento gengival (ISG) e o nível de inserção clínica (NIC) foram avaliados logo após a instalação do aparelho e 30, 60 e 180 dias mais tarde. Para comparar as diferenças entre os grupos (braquetes autoligáveis e convencionais), foi utilizado o teste Mann-Whitney; para analisar o NIC em cada local de cada dente, foi utilizada a análise de variância de duas vias, seguida do teste de Tukey, com nível de significância a 5%. RESULTADOS: não houve alteração significativa nos parâmetros avaliados (IPV, ISG e NIC), em nenhum dos dois sistemas. CONCLUSÃO: a resposta periodontal ao tratamento ortodôntico não apresentou diferenças significativas, para nenhuma das variáveis analisadas, entre os indivíduos tratados com braquetes autoligáveis passivos e braquetes convencionais, os quais receberam instruções quanto à adequada higienização bucal e foram submetidos ao monitoramento das condições periodontais. .

Autism in Brazil: a systematic review of family challenges and coping strategies / Autismo no Brasil, desafios familiares e estratégias de superação: revisão sistemática

OBJECTIVE: To describe the challenges faced by families caring for children with autism spectrum disorder (ASD) in Brazil and the coping strategies employed. SOURCES: Systematic review of articles published until September of 2013, without language restrictions, using quality appraisal (AMSTAR and CASP/Oxford instruments). SUMMARY OF THE FINDINGS: The literature shows parental emotional overload as one of the main challenges faced by families, especially mothers. The main stressors were diagnostic postponement, difficulty dealing with the diagnosis and associated symptoms, and poor access to health services and social support. The predominant coping strategies found included information exchange between affected families and integrated healthcare network for patient and family support. CONCLUSION: ASD exerts strong influence on family dynamics, resulting in caregiver overload, especially in mothers. The Brazilian Unified Health System needs to provide comprehensive, continuous, and coordinated care to strengthen the patient-family dyad and promote the full development and societal inclusion of children with ASD. .

OBJETIVO: Descrever os desafios encontrados pelas famílias na convivência com crianças portadoras de transtorno do espectro autista (TEA) no Brasil e as estratégias de superação empregadas. FONTE DOS DADOS: Revisão sistemática da literatura com inclusão de artigos publicados até setembro de 2013, sem restrições de idioma. Os artigos incluídos foram submetidos à avaliação de qualidade metodológica por meio do Amstar e Casp/Oxford. SÍNTESE DOS DADOS: Incluem-se estudos provenientes de São Paulo e Rio Grande do Sul com alta e moderada qualidade metodológica. A literatura mostra sobrecarga emocional dos pais como um dos principais desafios encontrados pelas famílias, inclusive com grande tensão sobre as mães. Dentre os fatores relacionados ao estresse estão: postergação diagnóstica, dificuldade de lidar com o diagnóstico e com os sintomas associados, acesso precário ao serviço de saúde e apoio social. Dentre as estratégias de superação destacaram-se: troca de informações entre as famílias afetadas e assistência integralizada da rede de saúde no atendimento do paciente e suporte à família. CONCLUSÃO: Observou-se que o TEA exerce forte influência na dinâmica familiar com sobrecarga dos cuidadores, geralmente da mãe. O Sistema Único de Saúde necessita prover cuidado integral, longitudinal e coordenado com vistas ao fortalecimento do binômio paciente-família e o pleno desenvolvimento e a plena inserção dessas crianças na sociedade. .

Waiting times for surgical and diagnostic procedures in public hospitals in Mexico / Tiempos de espera para procedimientos quirúrgicos y diagnósticos en hospitales públicos de México

Objective. A retrospective evaluation of waiting times for elective procedures was conducted in a sample of Mexican public hospitals from the following institutions: the Mexican Institute for Social Security (IMSS), the Institute for Social Security and Social Services for Civil Servants (ISSSTE) and the Ministry of Health (MoH). Our aim was to describe current waiting times and identify opportunities to redistribute service demand among public institutions. Materials and methods. We examined current waiting times and productivity for seven elective surgical and four diagnostic imaging procedures, selected on the basis of their relative frequency and comparability with other national health systems. Results. Mean waiting time for the seven surgical procedures in the three institutions was 14 weeks. IMSS and ISSSTE hospitals showed better performance (12 and 13 weeks) than the MoH hospitals (15 weeks). Mean waiting time for the four diagnostic procedures was 11 weeks. IMSS hospitals (10 weeks) showed better average waiting times than ISSSTE (12 weeks) and MoH hospitals (11 weeks). Conclusion. Substantial variations were revealed, not only among institutions but also within the same institution. These variations need to be addressed in order to improve patient satisfaction.

Objetivo. Se llevó a cabo una evaluación retrospectiva de los tiempos de espera para procedimientos electivos en una muestra de hospitales públicos en México de las siguientes instituciones: Instituto Mexicano del Seguro Social (IMSS), Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado (ISSSTE) y Secretaría de Salud (SS). El propósito era describir la situación actual en materia de tiempos de espera e identificar oportunidades de redistribución de la demanda de servicios entre instituciones públicas. Material y métodos. Se analizaron los tiempos de espera y la productividad para siete procedimientos quirúrgicos y cuatro procedimientos diagnósticos seleccionados sobre la base de su frecuencia relativa y comparabilidad con otros sistemas de salud nacionales. Resultados. El tiempo de espera promedio para los siete procedimientos quirúrgicos en las tres instituciones fue de 14 semanas. Los hospitales del IMSS y el ISSSTE mostraron un mejor desempeño (12 y 13 semanas) frente a los hospitales de la SS (15 semanas). El tiempo de espera promedio para los cuatro procedimientos diagnósticos fue de 11 semanas. Los hospitales del IMSS mostraron un tiempo de espera promedio mejor (10 semanas) que los hospitales del ISSSTE (12 semanas) y la SS (11 semanas). Conclusión. Se identificaron variaciones importantes no sólo entre instituciones sino también al interior de cada una de ellas. Estas variaciones deben atenderse para así mejorar la satisfacción de los usuarios de los servicios.