Relationship Among Treatment Adherence, Family Functioning, and Self-Care Agency in Colombian Patients With Cardiovascular Disease.

BACKGROUND: Multiple factors affect treatment adherence in individuals with cardiovascular disease. However, information on the relationships among treatment adherence, family functioning, and self-care agency in these patients and their families is limited. PURPOSE: This study was developed to determine the relationships among treatment adherence, family functioning, self-care agency, and sociodemographic variables in patients with cardiovascular disease. Self-care agency, as defined by Orem, is the dynamic process patients use to engage in their own healthcare that involves discerning and addressing factors that allow their making decisions that improve self-care abilities. METHODS: This cross-sectional, observational-analytical study enrolled 151 adult patients with cardiovascular diseases who had undergone pharmacological and nonpharmacological treatments and 108 family members of these patients who had consented to participate. Measurements were performed using the "Questionnaire for measuring treatment adherence in patients with cardiovascular disease," the "Family Functioning Assessment Scale," and the "Self-care Agency Scale." RESULTS: Of the 151 patients, 119 (78.8%) were assessed as having a low risk of nonadherence, 60 (39.7%) as having low family functioning, and 131 (86.8%) as having high self-care agency. Treatment adherence and self-care agency showed a moderate and significant correlation ( r = .66, p < .001). Similarly, treatment adherence and family functioning showed a low but significant correlation ( r = .35, p < .001). Moreover, significant multivariate associations were found among the variables of interest. Patients with a low risk of nonadherence were found to be more likely to have a secondary or postsecondary education, not to have vision or hearing problems, and to have a contributory affiliation mode with the health system or private health insurance. In addition, participants with moderate or high levels of family functioning were less likely to be workers or to not have hearing or vision problems. Finally, significant differences were noted between patients with low self-care agency and those with high self-care agency in terms of kinship relationship with family members and affiliation mode with the health system. CONCLUSIONS/IMPLICATIONS FOR PRACTICE: The results of this research help clarify the issue of treatment adherence in patients with cardiovascular disease. Although family functioning and self-care agency were found to be low to moderately correlated with treatment adherence, relevant information regarding these variables and sociodemographic variables is presented in this study. Nurses may use these results as a reference to design nursing care plans and interventions to address the conditions of their patients more appropriately.

Photoresponsive miR-34a/Nanoshell Conjugates Enable Light-Triggered Gene Regulation to Impair the Function of Triple-Negative Breast Cancer Cells.

Triple-negative breast cancer (TNBC) is an aggressive disease that requires new interventions. A promising approach to improve patient prognosis is to introduce tumor suppressive miR-34a into TNBC cells. Unfortunately, naked miR-34a is not effective therapeutically because it is degraded by nucleases and cannot passively enter cells. Nanocarriers designed to increase miR-34a stability and cellular entry have lacked specificity and potency. To overcome these limitations, we conjugated miR-34a to photoresponsive gold nanoshells (NS), which can release tethered miR-34a upon excitation with continuous wave (CW) or nanosecond (ns) pulsed near-infrared light to facilitate on-demand gene regulation. We demonstrate that miR-34a/NS can regulate downstream miR-34a targets following irradiation to reduce TNBC cell viability, proliferation, and migration. Further, we show ns pulsed light releases miRNA more effectively than CW light, and that released miR-34a is as potent as transfected miR-34a. These findings signify miR-34a/NS as promising tools for precisely controlled gene regulation of TNBC.

State of the art: pediatric brain stem gliomas / Estado del arte: Gliomas del tronco encefálico en pediatría

Abstract Brain stem are a heterogeneous group of tumors regarding both clinical gliomas; presentation and prognosis. They can be classified on the basis of their biological behaviour, anatomical location and radiographic appearance on MRI. The choice of treatment depends largely on whether the tumor is a diffuse intrinsic pontine glioma or not. A better understanding of the biology of these tumors can be the key for progress in treatment. The purpose of this article is provide updated information to enable a detailed understanding of this group of tumors and thus help to optimize the management of this condition in the pediatric population.

Resumen Los gliomas del tronco encefálico son un grupo heterogéneo de tumores tanto en la presentación clínica como en el pronóstico. Se pueden clasificar en función de su compor tamiento biológico, localización anatómica y la apariencia radiográfica en la RM. La elección del tratamiento depende en gran medida de si el tumor es un glioma intrínseco difuso del puente o no. Una mejor comprensión de la biología de estos tumores puede ser la clave para el pro greso en el tratamiento. El propósito de este artículo es proporcionar información actualizada que permita una comprensión detallada de este grupo de tumores y así ayudar a optimizar el tratamiento de esta condición en la población pediátrica.

Cobertura de examen clínico y mamografía de tamización para cáncer de mama en mujeres bogotanas / Breast Cancer Screening Coverage with clinical examination and Mammography Among insured women in Bogota

Objetivo: Determinar la cobertura de examen clínico y mamografía de tamización para cáncer de mama en un grupo de mujeres bogotanas afiliadas a seguros de salud. Métodos: Se realizó una encuesta telefónica a 4.526 mujeres entre 50 y 69 años, residentes en Bogotá y en municipios vecinos, afiliadas a tres compañías de seguros de salud. Se excluyeron las mujeres con antecedente personal de cáncer de mama. La cobertura de tamización se valoró como la proporción de mujeres con antecedente de mamografía y examen clínico de la mama. Se estimó la frecuencia en la vida, en los últimos dos años y en el último año. Se analizaron factores asociados a la práctica de tamización, mediante el cálculo de OR ajustados. Resultados: La frecuencia de vida de uso del examen clínico y mamografía fue de 59,3% y 79,8% respectivamente; el 49,7% y el 65,6% de las mujeres se realizó los exámenes con fines de tamización; el resto, con fines diagnósticos (sintomáticas). El 34,2% tenía examen clínico en el último año, y el 54%, mamografía en los últimos dos años. La educación y el antecedente familiar de cáncer de mama estuvieron asociados a la práctica de tamización. Conclusiones: La cobertura de examen clínico de la mama como método de tamización es baja. Las coberturas de mamografía son superiores a lo exigido por el sistema colombiano, pero inferiores a las coberturas útiles reportadas en países desarrollados.

Objectives: To determine the coverage of clinical breast examination (CBE) and mammography for screening of breast cancer among a group of insured women in Bogotá. Methods: A telephone survey was carried out with 4,526 women between the ages of 50 and 69, residing in Bogotá or its suburbs, who were insured by one of three commercial health plans. Women with a history of breast cancer were excluded. Screening coverage was estimated as the proportion of women who had had a mammography or CBE. Estimates were established for lifetime frequency, two years prior the survey, and one year prior the survey. Factors associated with screening procedures were analyzed with calculations based on adjusted OR. Results: Lifetime frequency of CBE was 59.3% and 79.8% for mammography; and 49.7% and 65.6% of women respectively underwent the tests for screening purposes; the remainder, for diagnostic purposes (breast symptoms). CBE reported a 34.2% one year coverage and mammography reported a 54% two years coverage. Screening was associated to cancer education and family history of breast cancer. Conclusion: Coverage of CBE for screening purposes is low. Mammography coverage is above that required by the Colombian Health Ministry, but below that reported by developed countries.