Validação das competências do enfermeiro nos cuidados com portadores de marca-passo / Validation of core nursing competencies in the management of care for patients with pacemakers / Validacíon de las competencias de enfermería en el cuidado de pacientes con marcapasos

Objetivo: validar competências de enfermeiros atuantes nos cuidados com portadores de marca-passo. Método: tratase de estudo de validação de conteúdo, realizado entre março e novembro de 2017, pela técnica Delphi, sob protocolo CAAE nº 63940217.3.0000.5462. A apreciação das competências foi realizada por sete juízes enfermeiros, doutores e experts em cardiologia, que consideraram o índice para validação de conteúdo (IVC) superior a 70%. Resultados: foram validados 119 itens de cuidado do total de 133, distribuídos em nove competências, com média geral de cada competência (AVE) e de concordância dos juízes (UA) com IVC>0,7. Dos 14 itens não validados após segunda rodada de avaliação, foram validados com AVE geral de 0,9 e UA de 1. Observouse relevância da competência sobre os conhecimentos de enfermagem para promoção da assistência segura aos familiares e à ação educativa ao paciente. Conclusão: As competencias foram validadas quanto à relevância e confiabilidade pelos juízes.(AU)

Aim: To validate nursing core competencies in the care management of patients with pacemakers. Methods: We conducted a single-center content validation study from March through November, 2017, using the Delphi e approval CAAE 63940217.3.0000.5462. Competency assessment was performed by seven judges (nurses with PhD degree and specialty in cardiology), who considered the content validation index (CVI) greater than 70%. Results: 119 care items out of the total number of 133 were distributed in nine competencies, with an average of each competence (AVE) and concordance of the judges (UA) with CVI>0.7. 14 items which had not been validated after the second round of evaluation were validated with an AVE =0.9 and AU = 1. Competence relevance on nursing knowledge was identified for the support in safe care by the patient's relatives and the education training for the patient. Conclusion: The competencies were validated as to relevance and reliability by the judges.(AU)

Objetivo: validar las competencias de las enfermeras que trabajan en el cuidado de pacientes con marcapasos. Método: estudio de validación de contenido, realizado entre marzo y noviembre de 2017, mediante la técnica Delphi, aprobación el protocolo CAAE 63940217.3.0000.5462. La evaluación de la competencia fue realizada por siete enfermeras, doctor y expertos en cardiología, quienes consideraron que el índice del validación de contenido (IVC) era superior al 70%. Resultados: se distribuyeron 119 ítems de 133, distribuidos en nueve competencias, con un promedio general de cada competencia (AVE) y concordancia de los jueces (AU) con IVC> 0.7. De los 14 ítems no validados después de la segunda ronda, se validaron con un golpe general de 0,9 y una UA de 1. Se observó relevancia para promover la atención y la acción segura de la familia al paciente. Conclusión: las competencias fueron validadas en cuanto a la relevancia y confiabilidad de los jueces.(AU)

Qualidade de vida relacionada à saúde e fatores psicossociais após prostatectomia radical / Calidad de vida relacionada a la salud y factores psicosociales después de prostatectomía radical / Health-related quality of life and psychosocial factors after radical prostatectomy

Resumo Objetivo: Investigar a qualidade de vida relacionada à saúde e correlações com fatores psicossociais (ansiedade, depressão e autoestima) em homens prostatectomizados. Métodos: Estudo descritivo correlacional realizado com 85 homens submetidos a prostatectomia radical há no mínimo três meses e no máximo cinco anos. Foram utilizados o European Organization for Research and Treatment of Cancer- QLQ C30 e European Organization for Research and Treatment of Cancer "Prostate Cancer" 25 items - EORTC QLQ-PR25; Escala de Autoestima de Rosenberg e Hospital Anxiety and Depression Scale. Resultados: Os participantes mostraram comprometimento da qualidade de vida no que se refere a prejuízos da função sexual e presença de sintomas urinários. Houve correlação entre os aspectos psicossociais e algumas escalas de avaliação da qualidade de vida, principalmente as escalas funcionais e de sintomas. Conclusão: Evidenciou-se que a prostatectomia radical causa prejuízo na qualidade de vida dos homens, demandando assistência dos profissionais de saúde para minimizar os efeitos das complicações mais comuns. Recomenda-se a implementação de intervenções educativas e apoio multiprofissional pautados em melhor compreensão das implicações físicas e psicossociais para ajudar a melhorar a qualidade de vida dos homens após a prostatectomia radical.

Resumen Objetivo: Investigar la calidad de vida relacionada a la salud y correlación con factores psicosociales (ansiedad, depresión y autoestima) en hombres prostatectomizados. Métodos: Estudio descriptivo correlacional realizado con 85 hombres sometidos a prostatectomía radical hace al menos tres meses y máximo cinco años. Se utilizó el European Organization for Research and Treatment of Cancer- QLQ C30 y European Organization for Research and Treatment of Cancer "Prostate Cancer" 25 items - EORTC QLQ-PR25; Escala de Autoestima de Rosenberg y Hospital Anxiety and Depression Scale. Resultados: Los participantes mostraron su calidad de vida comprometida con relación al detrimento de la función sexual y presencia de síntomas urinarios. Hubo correlación entre los aspectos psicosociales y algunas escalas de evaluación de calidad de vida, principalmente las escalas funcionales y de síntomas. Conclusión: Quedó en evidencia que la prostatectomía radical perjudica la calidad de vida de los hombres y demanda asistencia de los profesionales de la salud para minimizar los efectos de las complicaciones más comunes. Se recomienda la implementación de intervenciones educativas y de apoyo multiprofesional para una mejor comprensión de las consecuencias físicas y psicosociales para ayudar a mejorar la calidad de vida de los hombres después de la prostatectomía radical.

Abstract Objective: To investigate quality of life and its correlations with psychosocial factors (anxiety, depression and low self-esteem) in men who underwent prostatectomy. Methods: A descriptive, correlational study with 85 men who underwent radical prostatectomy at least three months and at most five years prior to the survey. The instruments used were the European Organization for Research and Treatment of Cancer- QLQ C30, the European Organization for Research and Treatment of Cancer "Prostate Cancer" 25 items - EORTC QLQ-PR25; the Rosenberg Self-Esteem Scale and the Hospital Anxiety and Depression Scale. Results: Participants showed impairment of quality of life associated with impairment of sexual function and presence of urinary symptoms. There was a correlation between the psychosocial aspects and some quality of life assessment scales, mainly the functional and symptom scales. Conclusion: It was shown that radical prostatectomy causes impairment in the quality of life of men, requiring care from health professionals to minimize the effects of the most common complications. Educational interventions and multi-professional support based on a better understanding of the physical and psychosocial implications are recommended to help improve the quality of life of men after radical prostatectomy.

Alternagin-C binding to 21 integrin controls matrix metalloprotease-9 and matrix metalloprotease-2 in breast tumor cells and endothelial cells

Background Matrix metalloproteinases (MMPs) are key players in tumor progression, helping tumor cells to modify their microenvironment, which allows cell migration to secondary sites. The role of integrins, adhesion receptors that connect cells to the extracellular matrix, in MMP expression and activity has been previously suggested. However, the mechanisms by which integrins control MMP expression are not completely understood. Particularly, the role of 21 integrin, one of the major collagen I receptors, in MMP activity and expression has not been studied. Alternagin-C (ALT-C), a glutamate-cysteine-aspartate-disintegrin from Bothrops alternatus venom, has high affinity for an 21 integrin. Herein, we used ALT-C as a 21 integrin ligand to study the effect of ALT-C on MMP-9 and MMP-2 expression as well as on tumor cells, fibroblats and endothelial cell migration. Methods ALT-C was purified by two steps of gel filtration followed by anion exchange chromatography. The 21, integrin binding properties of ALT-C, its dissociation constant (Kd) relative to this integrin and to collagen I (Col I) were determined by surface plasmon resonance. The effects of ALT-C (10, 40, 100 and 1000 nM) in migration assays were studied using three human cell lines: human fibroblasts, breast tumor cell line MDA-MB-231, and microvascular endothelial cells HMEC-1, considering cells found in the tumor microenvironment. ALT-C effects on MMP-9 and MMP-2 expression and activity were analyzed by quantitative PCR and gelatin zymography, respectively. Focal adhesion kinase activation was determined by western blotting. Results Our data demonstrate that ALT-C, after binding to 21 integrin...

Alternagin-C binding to α2ß1 integrin controls matrix metalloprotease-9 and matrix metalloprotease-2 in breast tumor cells and endothelial cells

Background: Matrix metalloproteinases (MMPs) are key players in tumor progression, helping tumor cells to modify their microenvironment, which allows cell migration to secondary sites. The role of integrins, adhesion receptors that connect cells to the extracellular matrix, in MMP expression and activity has been previously suggested. However, the mechanisms by which integrins control MMP expression are not completely understood. Particularly, the role of α2ß1 integrin, one of the major collagen I receptors, in MMP activity and expression has not been studied. Alternagin-C (ALT-C), a glutamate-cysteine-aspartate-disintegrin from Bothrops alternatus venom, has high affinity for an α2ß1 integrin. Herein, we used ALT-C as a α2ß1 integrin ligand to study the effect of ALT-C on MMP-9 and MMP-2 expression as well as on tumor cells, fibroblats and endothelial cell migration. Methods: ALT-C was purified by two steps of gel filtration followed by anion exchange chromatography. The α2ß1, integrin binding properties of ALT-C, its dissociation constant (Kd) relative to this integrin and to collagen I (Col I) were determined by surface plasmon resonance. The effects of ALT-C (10, 40, 100 and 1000 nM) in migration assays were studied using three human cell lines: human fibroblasts, breast tumor cell line MDA-MB-231, and microvascular endothelial cells HMEC-1, considering cells found in the tumor microenvironment. ALT-C effects on MMP-9 and MMP-2 expression and activity were analyzed by quantitative PCR and gelatin zymography, respectively. Focal adhesion kinase activation was determined by western blotting. Results: Our data demonstrate that ALT-C, after binding to α2ß1 integrin, acts by two distinct mechanisms against tumor progression, depending on the cell type: in tumor cells, ALT-C decreases MMP-9 and MMP-2 contents and activity, but increases focal adhesion kinase phosphorylation and transmigration; and in endothelial cells, ALT-C inhibits MMP-2, which is necessary for tumor angiogenesis. ALT-C also upregulates c-Myc mRNA level, which is related to tumor suppression. Conclusion: These results demonstrate that α2ß1 integrin controls MMP expression and reveal this integrin as a target for the development of antiangiogenic and antimetastatic therapies.(AU)