Medical cannabis use in oncology and associated outcomes: A scoping review.

BACKGROUND: Natural and synthetic cannabinoids are being used worldwide to treat various symptoms in cancer patients. This study aims to map the therapeutic benefits and adverse effects associated with the use of cannabis-based drugs in these outcomes. METHODS: Following Joanna Briggs Institute guidelines a scoping review was conducted. The study protocol was available in the Open Science Framework public repository. An extensive search strategy involving databases like Cochrane Library, Embase, CINAHL, Medline/PubMed, Lilacs, Google Scholar, and Open Gray for gray literature analysis was executed by a skilled librarian. The inclusion criteria were primary studies (observational and randomized) that evaluated the efficacy and safety of cannabinoids in cancer patients. The review encompassed studies of diverse designs, publication years, and types, as long as they addressed cannabinoids' impact in oncology. RESULTS: Twenty-nine (82.86%) out of total of 35 were randomized and 6 (14.14%) were non-randomized. About 57.1% of studies utilized registered products as interventions, with THC being the most natural cannabinoid cited in variable doses and administration routes. Moreover, 62.85% of studies specified the cancer types (breast, lung, sarcomas, hematological and reproductive system), while only one study detailed cancer staging. The evaluated outcomes encompassed nausea and vomiting (77.14%), appetite (11.43%), pain (8.57%), and tumor regression (2.86%) across different proportions of studies. CONCLUSION: Cannabinoids show promise in managing pain, emesis, and anorexia/cachexia linked to cancer progression. New randomized clinical trials with a larger number of participants and observational studies on long-term safety are crucial to affirm their medicinal utility for cancer patients unresponsive to conventional drugs.

Focal adhesion kinase inhibition decreases cell viability and induces apoptosis of JAK2 V617F positive cells

Abstract Focal Adhesion Kinase (FAK) protein participates in proliferation, migration, cell survival, and apoptosis process. It has been described as overexpressed in several neoplasms being a promising target for therapy. BCR-ABL negative chronic Myeloproliferative Neoplasms (MPN) are clonal disorders characterized by the excess of proliferation and apoptosis resistance. The identification of the acquired JAK2 V617F mutation in MPN patients allowed a better understanding of pathogenesis. However, there is still no pharmacological treatment that leads all patients to molecular remission, justifying new studies. The present study aimed to evaluate FAK involvement in the viability and apoptosis of HEL and SET-2 cells, both JAK2 V617F positive cell lines. The FAK inhibitor PF 562,271 was used. Cell viability was determined using MTT assay and apoptosis verified by cleaved PARP, cleaved Caspase 3 and Annexin-V/PI staining detection. FAK inhibition significantly reduced HEL and SET-2 cells viability and induced apoptosis. Considering the role of JAK/STAT pathway in MPN, further investigation of FAK participation in the MPN cells proliferation and apoptosis resistance, as well as possible crosstalk between JAK and FAK and downstream pathways may contribute to the knowledge of MPN pathophysiology, the discovery of new molecular targets, and JAK inhibitors resistance mechanisms.

Diagnóstico hematológico e molecular das neoplasias mieloproliferativas crônicas BCR-ABL negativas

As neoplasias mieloproliferativas crônicas (NMPC) são doenças hematopoiéticas clonais que acometem a linhagem mieloide. De acordo com a Organização Mundial de Saúde (OMS), a policitemia vera (PV), a trombocitemia essencial (TE) e a mielofibrose (MF) são classificadas como NMPC BCR-ABL negativas. O surgimento dessas doenças está correlacionado com fatores genéticos, como mutações nos genes JAK2, MPL e CALR e outras mutações cooperantes que também podem estar presentes, levando ao aparecimento de diferentes fenótipos e prognósticos. A OMS constantemente revisa e atualiza os critérios de classificação, levando em consideração aspectos clínicos, morfológicos e genéticos. As análises laboratoriais, hematológicas e genéticas são de grande importância para o diagnóstico das neoplasias hematológicas, e devem ser realizadas da forma correta para permitir o diagnóstico diferencial entre outras neoplasias e distúrbios reacionais. O presente trabalho tem como objetivo revisar a fisiopatologia das NMPC e relacionar com os achados clínicos, hematológicos e genéticos, visando instruir e atualizar os analistas clínicos para que possam efetivamente contribuir para o diagnóstico dessas doenças, impactando o prognóstico dos pacientes. Ainda, a discussão sobre diagnóstico molecular tem o intuito de chamar a atenção para a constante evolução da área e importância desta para a hematologia.

The Chronic Myeloproliferative Neoplasms (MPN) are hematopoietic disease that affect the myeloid lineage cells. According to WHO, the Polycythemia vera (PV), Essential Thrombocythemia (ET) and Myelofibrosis (MF) are classified as BCR-ABL negative neoplasms. The occurrence of these diseases is correlated with genetics factors, as mutations in the JAK2, MPL e CALR genes and other cooperative mutations that may also be present, leading to different phenotypes manifestations and prognostics. WHO revises and updates constantly these diseases' classification criteria, considering clinical, morphological and genetic aspects. Laboratory tests, both hematological and genetic, have a key rule at these diseases' diagnosis and must be performed correctly in order to ensure a differential diagnosis from other neoplasms and reactive disorders. This manuscript aims to revise the MPN's physiopathology linking it to clinical, hematological and genetical findings, aiming to instruct and update clinical analysts so they can contribute to those diseases' diagnostic, impacting the patients' prognostics. Furthermore, the considerations about molecular diagnostics have the intention of emphasize the constant evolution of this subject and its importance to hematology.

Evaluation of the Nasopharyngeal Cannula Use After Orthognathic Surgery: Permeability of the Nasal Airways and Discomfort of the Patient With Cleft Lip and Palate.

It is believed that the use of the nasopharyngeal cannula can maintain the patent upper airway in the immediate post-operative period of orthognathic surgery. The present study is a randomized clinical trial with the objective of evaluating the difference in the use of the nasopharyngeal cannula in the post-operative period of orthognathic surgery with respect to permeability and discomfort. The sample was composed of 26 individuals with repaired cleft lip and palate randomly distributed in 2 groups with and without nasopharyngeal cannula. The evaluation was composed by Visual Analogue Scale (VAS), test with Altman mirror in 4 pre-operative periods, 6, 24, 30 hours after the operation. Rhinomanometry was also performed, a flow- pressure technique in 2 distinct moments, 6 and 24 hours after surgery. As a result, greater discomfort, greater obstruction as well as a reduction in the area of bilateral minimum nasal cross-section (ASTM) and increased resistance in the group with nasopharyngeal cannula are observed. In the intra-group comparison with the lowest ASTM values, the test group showed a significant difference between the first and the second moments (P = 0.001). It can be concluded that the nasopharyngeal cannula contributes to increase discomfort, worsens airway permeability by decreasing ASTM and increasing nasal resistance. Regarding the length of stay of the nasopharyngeal cannula, it can be said that from 6 hours onwards it does not contribute to the reduction of discomfort, airway permeability and assist in hemostasis.

As narrativas dos profissionais de saúde na assistência perinatal em tempos de Zika Vírus / The narratives of health professionals in perinatal care in times of Zika Virus

Em março de 2015 ocorreu no Brasil uma das maiores epidemias do ZIKV já registradas no mundo. Neste período surgiu o termo Síndrome da Zika Congênita (SZC) para diagnosticar os fetos/RNs portadores de diversas malformações ocasionadas pela exposição ao vírus. Neste cenário o conhecimento obstétrico não era de todo suficiente, visto que as anormalidades nos exames eram uma surpresa. A emergência sanitária do ZIKV gerou um novo cenário também para as unidades intensivas neonatais. Mesmo sendo este um setor já acostumado a fornecer más notícias e lidar com o atendimento de bebês com malformações congênitas, havia, nestes casos, o desconhecimento sobre as causas e prognósticos da doença. Esta pesquisa pretendeu investigar as narrativas dos profissionais de saúde sobre suas experiências na assistência perinatal durante o surto inicial da infecção pelo Zika Vírus. foi realizada em uma maternidade pública referência em alto risco fetal e uma maternidade privada referência no cuidado perinatal. a coleta de dados foi realizada de outubro a dezembro de 2018, utilizando a técnica de entrevista semi-estruturada. foram entrevistados 19 profissionais de saúde entre médicos e enfermeiros que prestaram assistência a gestantes e recém-nascidos no período da epidemia. o tratamento dos dados obtidos foi realizado através de análise de conteúdo. esta pesquisa foi aprovada pelo comitê de ética em pesquisa do Instituto Nacional de Saúde da mulher, da criança e do adolescente Fernandes Figueira sob o número 94448318.6.0000.5269. Após a análise dos resultados, se chegou a três temáticas: 1) Mudanças e pressões nos atendimentos em função do ZIKV: estresse do profissional; 2) Empatia e impotência dos profissionais ante à suspeita ou confirmação da síndrome congênita pelo ZIKV; 3) Comunicar o que não se sabe: impasses e entraves da comunicação de más notícias durante a epidemia do ZIKV. Concluiu-se que o profissional de saúde deve ter uma capacitação técnica atrelada ao cuidado com sua saúde física e mental. Desta forma a segurança e o acolhimento farão com que a equipe esteja preparada para lidar com atendimentos excepcionais como os que ocorrem em epidemias.

In March of 2015, Brazil faced one of the largest epidemics of the Zika Virus (ZIKV) registered in the world. During this period, the term Congenital Zika Syndrome (SZC) appeared to diagnose the fetuses/newborns that had several malformations caused by virus exposal. In this setting, there was a lack of knowledge from the obstetrics professionals, since the abnormalities in the exams were a diagnostic novelty. The health emergency of the ZIKV also foresaw a new scenario for neonatal intensive units. Even though the professionals are already accustomed to providing bad news and dealing with the care of babies with congenital malformations, there were, in these cases, a lack of knowledge about the etiology and prognoses of the disease. The present work aimed to investigate the histories of health professionals about their experiences in perinatal care during the initial outbreak of Zika virus infection. It was carried out in a public maternity reference in high-risk fetal and a private maternity reference in perinatal care. The data was collected between October and December of 2018, using the technique of semi-structured interviews. In total, 19 health professionals were interviewed. Among them, there were physicians and nurses who assisted pregnant women and newborns during the epidemic period. The treatment of the obtained data was performed through content analysis. This research was approved by the research ethics committee of the "Instituto Nacional de Saúde da mulher, da criança e do adolescente Fernandes Figueira" under the number 94448318.6.0000.5269. After data analysis three main categories were observed: 1) Changes and pressures in attendance due to ZIKV: professional stress; 2) Empathy and impotence of the professionals before the suspected or confirmation of congenital syndrome by the ZIKV; 3) Communicate what is not known: impasses and obstacles to the communication of bad news during the ZIKV epidemic. In conclusion, it was observed that the health professional should have a technical training in accordance to the care of his physical and mental health. In this fashion, the certainty and initial hospital care will allow the team to be prepared to deal with exceptional services such as those occurring in epidemics.

Results from portable and of low cost equipment developed for detection of milk adulterations

Abstract This work presents the results of a device, MilkTech, developed to detect milk tampering, based on electrical measurements. The device indicates possible frauds by water, sodium chloride, caustic soda, ethyl alcohol and sodium bicarbonate. The advantages in relation to traditional methods are portability, low cost and detection of mixed frauds. The experiments were conducted in dairy plants at Governador Valadares, in Brazil. The results were compared with cryoscopy and chloride tests. It is demonstrated there is high correlation between MilkTech and Cryoscopy. For instance, the detection limit of the equipment for water addition with the set of analyzed data was 0.78% with precision of 1.1%. Adulterations with sodium chloride, caustic soda, ethyl alcohol and sodium bicarbonate are detected qualitatively, even when added with water, and MilkTech indicates "SUSPECT" milk.

Postoperative Orthognathic Surgery Edema Assessment With and Without Manual Lymphatic Drainage.

OBJECTIVE: To evaluate the effects of manual lymphatic drainage (MLD) on facial edema and pain in patients who underwent orthognathic surgery from patient and professional perspectives and clinical measures. METHODS: It is a randomized double-blind clinical trial, where 30 patients who underwent bimaxillary orthognathic surgery were divided into 2 groups (treatment and placebo). One group (treatment) received MLD from 2nd postoperative day, besides cryotherapy and postoperative medications. The other group (placebo) received cryotherapy, medications, and manual superficial sliding movements as placebo. For edema evaluation, facial measurements with tape and photographs were used. To evaluate patients' perception, visual analog scale for pain and edema was used. In statistical analysis, quantitative data were analyzed using Student t test for normally distributed variables and Mann-Whitney test for non-normal to find differences between groups; 5% significance level was adopted. RESULTS: No difference was found between groups in the amount of maximum developed edema (P = 0.290) nor on what day the edema peak occurred (P = 0.091). However, it was found that treatment group showed faster and greater regression of swelling compared with placebo (P < 0.001). Manual lymphatic drainage was not effective in relieving pain in these patients and nor in edema perception (P = 0.784 and P = 0.946, respectively). CONCLUSION: Manual lymphatic drainage was effective in reducing facial measurements in orthognathic surgery postoperatory. When considering patient's pain and swelling perception, no difference was found between groups.

A new methodology for sampling blackflies for the entomological surveillance of onchocerciasis in Brazil.

The effectiveness of the MosqTent® trap was evaluated in endemic area to onchocerciasis in Brazil. This study seeks to provide subsidies for the monitoring of the onchocerciasis transmission in the country. The study was carried out at the Homoxi and Thirei villages, located in the Yanomami Indigenous Land, in the state of Roraima. This area presents hyperendemicity, high blackflies densities, large population migrations and mining activities. The Homoxi and Thirei villages are assisted by the Brazilian Ministry of Health. To conduct the present study, the village leader, health leaders and the Brazilian Ethics Committee were consulted. Blackflies captures were carried out simultaneously at the Homoxi and Thirei, using systematized methods to allow for comparisons between the traditional Human Landing Catch (HLC) and HLC protected by the MosqTent®. The female blackflies were captured at two equidistant capture stations per locality, by two collectors per station, for five consecutive days. Individuals captured by interval/station/day were counted, identified and maintained at -20°C. The underlying probability distributions and the differences between the methods for the independent sample data were verified in a comparative statistical analysis between the use of the MosqTent® and the HLC. A total of 10,855 antropophilic blackflies were captured by both methodologies. A total of 7,367 (67.87%) blackflies belonging to seven species were captured by MosqTent® -Simulium incrustatum s.l (99.06%); S. guianense s.l (0.74%), S. oyapockense s.l (0.01%), S. exiguum (0.10%), S. metallicum (0.05%), S. ochraceum (0.03%) and S. minusculum s.l (0.01%). Moreover, 3,488 (32.14%) blackflies belonging to four species were captured by HLC-S. incrustatum s.l (98.33%); S. guianense s.l (1.38%), S. oyapockense s.l (0.26%) and S. metallicum (0.03%). The MosqTent® was more effective and efficient when compared to HLC. When comparing total blackflies captured/day, the MosqTent® was more efficient than HLC (p = 0.031) with a means of 799.4 blackflies/day versus 217.6 blackflies/day by HLC. The results demonstrated improved performance and high reliability of the MosqTent® compared to the traditional HLC method.

Aspectos bioecológicos de Simuliidae em área sob influência de empreendimento hidroenergético: aproveitamento múltiplo de Manso, MT, Brasil / Bioecology of Simuliidae in area under influence of hydropower development: multiple uses of Manso, MT, Brazil

Devido às condições hidrogeográficas brasileiras favoráveis a instalação de hidrelétricas, este tipo de empreendimento é responsável pela maior parte da produção de energia do País. Estas hidrelétricas impactam diretamente os criadouros de insetos aquáticos, inclusive os de simulídeos. O monitoramento de Simuliidae, em especial em áreas com alto grau de biodiversidade e com fauna ainda pouco estudada, como o Bioma Cerrado, é de extrema importância para a prospecção de dados relevantes para o conhecimento da biodiversidade alinhado com a saúde pública. O Aproveitamento Múltiplo de Manso está localizado em área de Cerrado no município de Chapada dos Guimarães, atingindo também Cuiabá e Nova Brasilândia, MT. Para o monitoramento de Simuliidae, foram realizadas 13 coletas bimestrais em períodos de seca e chuva de maio/2009 a julho/2011. Do total de pontos selecionados na área sob influência direta, 11 pontos foram a montante e 03 a jusante da barragem e 05 pontos, aparentemente, sem influência direta do APM Manso. De maneira geral, percebe-se que o número total de exemplares coletados é inversamente proporcional à precipitação acumulada do período. No total, foram encontradas 28 espécies: Simulium brunnescens, S. pertinax, S. (Chirostilbia) sp, S. spinibranchium, S. dekeyseri, S. subpallidum, S. perflavum, S. (Psilopelmia) sp, S. rorotaense, S. incrustatum sl, S. quadrifidum, S. jujuyense, S. incrustatum s.s., S. limbatum, S. minusculum sl, S. oyapockense, S. (Psaroniocompsa) sp, S. cuasiexiguum, S. (Notolepria) sp, S. guianense, S. nigrimanum, S. rubrithorax, S. (Trichodagmia) sp, S. inaequale, S. clavibranchium sl, S. (Inaequalium) sp, S. subclavibranchium e S. subnigrum. Todas as espécies, com a exceção de S. quadrifidum e S. clavibranchium, já haviam sido registradas para o estado do Mato Grosso. S. perflavum, S. subnigrum e S. subclavibranchium foram encontradas em todas as campanhas...

Simulium (Chirostilbia) brunnescens (Diptera: Simuliidae) - new species from the Brazilian cerrado, Manso Dam, state of Mato Grosso, Brazil.

A new species of Simuliidae, Simulium (Chirostilbia) brunnescens, was discovered at Chapada dos Guimarães, state of Mato Grosso, Brazil, and nearby municipalities (Paranatinga, Rosário do Oeste and Nobres). This species is described here based on the adults, pupae and larvae. This species is closely related to Simulium (C.) subpallidum Lutz, but could be differentiated in all stages: females, leg colour pattern and frontal dilatation size; males, gonostyle shape; pupae, number of gill filaments; larvae, body size and colour, postgenal cleft, ratio between antenna and stalk of labral fan.

Simulium (Chirostilbia) brunnescens (Diptera: Simuliidae) - new species from the Brazilian cerrado, Manso Dam, state of Mato Grosso, Brazil

A new species of Simuliidae, Simulium (Chirostilbia) brunnescens, was discovered at Chapada dos Guimarães, state of Mato Grosso, Brazil, and nearby municipalities (Paranatinga, Rosário do Oeste and Nobres). This species is described here based on the adults, pupae and larvae. This species is closely related to Simulium (C.) subpallidum Lutz, but could be differentiated in all stages: females, leg colour pattern and frontal dilatation size; males, gonostyle shape; pupae, number of gill filaments; larvae, body size and colour, postgenal cleft, ratio between antenna and stalk of labral fan.