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Background: The mite Tetranychus merganser is considered to be an emerging pest of various crops in tropical countries. It is one of the most detrimental pests in the papaya orchards of some regions of México. The current field control of Tetranychus spp. involves the extensive use of chemicals that have some degree of toxicity to humans or the environment and may cause selective resistance. The use of biological alternatives such as parasitoids and mite predators have limited effectiveness. In order to find effective but non-toxic alternatives for mite pest management, bio-products that are able to be mass produced and applied to large production areas have been sought, including the entomopathogen fungi. B. bassiana and M. anisopliae s.l. are the fungi most extensively used for the biological control of insect pests. Although they do not cause natural epizootic diseases in mites, there are reports that show that they infect T. urticae, and should be evaluated for use in the biological control of papaya's mite pests. Methods: A T. merganser colony was established and the susceptibility of adult females to 30 entomopathogenic fungi strains was evaluated under laboratory conditions with an in vitro mass screening bioassay. Ten strains of Metarhizium anisopliae sensu lato (s.l.), eleven of Beauveria bassiana, nine of Lecanicillium sp. and one of Hirsutella thompsonii var. sinematosa were tested. The infectivity of adult females was evaluated calculating the percentage of mortality. To calculate the LC50 and LT50 of the most virulent strains, a bioassay was performed using serial concentrations (1×104-1×108 conidia/mL) for each strain. Strains showing ability to infect eggs laid were evaluated with a novel egg-infectivity bioassay. The internal transcribed spacer (ITS) region of the more lethal strains were sequenced. Results: T. merganser and T. urticae were found in orchards of Carica papaya (Maradol variety and Tainung hybrid) in Campeche, México. All tested strains of M. anisopliae s.l. and B. bassiana were infectious to the adult female of T. merganser at a concentration of 1×108 conidia/mL. Six strains of M. anisopliae (Ma002, Ma003, Ma004, Ma005, Ma014 and Ma034) caused 100% mortality, and one of B. bassiana (Bb016) caused 95% mortality. The most virulent was Ma034, with an LC50 of 1.73×106 conidia/mL followed by Ma005 and Ma003. Ma005 and Ma034 were the fastest strains to reach LT50,achieving this in less than 3.7 days. Additionally, Ma034 and Ma014 strains were infectious to more than 70% of the eggs. Conclusions: T. merganser and T. urticae are present in the papaya orchards of Campeche, México. The high susceptibility of T. merganser adult females and eggs toward several M. anisopliae s.l. or B. bassiana strains suggests that these fungi are a viable alternative to control this emergent pest. The most virulent strain, Ma034, was also infective to eggs, and is the most promising to be tested in the field.

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Pancreatic ductal adenocarcinoma (PDAC) is one of the most lethal cancer types with a limited overall survival rate due to the asymptomatic progression of symptoms in metastatic stages of the malignancy and the lack of an early reliable diagnostic biomarker. MicroRNAs (miRs/miRNAs) are small (~18-24 nucleotides), endogenous, non-coding RNAs, which are closely linked to the development of numerous malignancies comprising PDAC. Recent studies have described the role of environmental pollutants such as nickel (Ni) in PDAC, but the mechanisms of Ni-mediated toxicity in cancer are still not completely understood. Specifically, Ni has been found to alter the expression and function of miRs in several malignancies, leading to changes in target gene expression. In this study, we found that levels of Ni were significantly higher in cancerous tissue, thus implicating Ni in pancreatic carcinogenesis. Hence, in vitro studies followed by using both normal and pancreatic tumor cell lines and increasing Ni concentration increased lethality. Comparing LC50 values, Ni-acetate groups demonstrated lower values needed than in NiCl2 groups, suggesting greater Ni-acetate. Panc-10.05 cell line appeared the most sensitive to Ni compounds. Exposure to Ni-acetate resulted in an increased phospho-AKT, and decreased FOXO1 expression in Panc-10.05 cells, while NiCl2 also increased PTEN expression in Panc-10.05 cells. Specifically, following NiCl2 exposure to PDAC cells, the expression levels of miR-221 and miR-155 were significantly upregulated, while the expression levels of miR-126 were significantly decreased. Hence, our study has suggested pilot insights to indicate that the environmental pollutant Ni plays an important role in the progression of PDAC by promoting an association between miRs and Ni exposure during PDAC pathogenesis.

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Pancreatic ductal adenocarcinoma (PDAC) is one of the most fatal and aggressive malignancies with a 5-year survival rate less than 9%. Early detection is particularly difficult due to the lack of symptoms even in advanced stages. microRNAs (miRs/miRNAs) are small (~ 18-24 nucleotides), endogenous, non-coding RNAs, which are involved in the pathogenesis of several malignancies including PDAC. Alterations of miR expressions can lead to apoptosis, angiogenesis, and metastasis. The role of environmental pollutants such as cadmium (Cd) in PDAC has been suggested but not fully understood. This study underlines the role of miRs (miR-221, miR-155, miR-126) in response to cadmium chloride (CdCl2) in vitro. Lethal concentration (LC50) values for CdCl2 resulted in a toxicity series of AsPC-1 > HPNE > BxPC-3 > Panc-1 = Panc-10.5. Following the treatment with CdCl2, miR-221 and miR-155 were significantly overexpressed, whereas miR-126 was downregulated. An increase in epithelial-mesenchymal transition (EMT) via the dysregulation of mesenchymal markers such as Wnt-11, E-cadherin, Snail, and Zeb1 was also observed. Hence, this study has provided evidence to suggest that the environmental pollutant Cd can have a significant role in the development of PDAC, suggesting a significant correlation between miRs and Cd exposure during PDAC progression. Further studies are needed to investigate the precise role of miRs in PDAC progression as well as the role of Cd and other environmental pollutants.

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BACKGROUND: Loxoscelism is an important public health problem in Chile and South America, due to the higher rate of cutaneous-visceral involvement. The diagnosis of loxoscelism is mostly clinical without established diagnostic criteria. There is little evidence to support any treatment used in this condition. AIM: To characterize the clinical features and epidemiology of loxoscelism among patients consulting at the Emergency and Dermatology Services of a clinical hospital between 2013 and 2017. MATERIAL AND METHODS: Review of medical records of patients registered in the electronic clinical record system with a confirmed diagnosis of loxoscelism. Epidemiological, clinical, laboratory tests and treatment variables were analyzed. RESULTS: We reviewed data from 200 patients. Ninety-four percent presented cutaneous loxoscelism and 5.5% cutaneous-visceral loxoscelism. Systemic symptoms were present in 73% of patients with cutaneous-visceral loxoscelism. Patients who developed systemic symptoms had an 18 times higher risk of developing cutaneous-visceral loxoscelism. Laboratory abnormalities were more common in patients with cutaneous-visceral loxoscelism. Not all patients with hematuria had cutaneous-visceral loxoscelism. Most patients required analgesia. Anti-loxosceles serum was not used in any patient. CONCLUSIONS: Many questions remain to be answered regarding the diagnosis and treatment of the disease. Studies are required to validate diagnostic criteria for loxoscelism, predictors for visceral involvement and response to treatment.

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Background: Loxoscelism is an important public health problem in Chile and South America, due to the higher rate of cutaneous-visceral involvement. The diagnosis of loxoscelism is mostly clinical without established diagnostic criteria. There is little evidence to support any treatment used in this condition. Aim: To characterize the clinical features and epidemiology of loxoscelism among patients consulting at the Emergency and Dermatology Services of a clinical hospital between 2013 and 2017. Material and Methods: Review of medical records of patients registered in the electronic clinical record system with a confirmed diagnosis of loxoscelism. Epidemiological, clinical, laboratory tests and treatment variables were analyzed. Results: We reviewed data from 200 patients. Ninety-four percent presented cutaneous loxoscelism and 5.5% cutaneous-visceral loxoscelism. Systemic symptoms were present in 73% of patients with cutaneous-visceral loxoscelism. Patients who developed systemic symptoms had an 18 times higher risk of developing cutaneous-visceral loxoscelism. Laboratory abnormalities were more common in patients with cutaneous-visceral loxoscelism. Not all patients with hematuria had cutaneous-visceral loxoscelism. Most patients required analgesia. Anti-loxosceles serum was not used in any patient. Conclusions: Many questions remain to be answered regarding the diagnosis and treatment of the disease. Studies are required to validate diagnostic criteria for loxoscelism, predictors for visceral involvement and response to treatment.

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La sífilis es una enfermedad de transmisión sexual altamente contagiosa con importantes complicaciones, pero con tratamiento efectivo en etapas tempranas. Actualmente, representa un problema de salud pública. La prevalencia reportada en EEUU desde el año 2008 es de 4,5 casos/100.000 habitantes, con una incidencia 10.6 millones de casos cada año, especialmente en hombres que mantienen relaciones sexuales con hombres (HSH) y pacientes portadores de VIH (PVIH). Los métodos diagnósticos basados en test moleculares aún no han sido validados para el diagnóstico de sífilis, lo que ha permitido establecer tres esquemas serológicos con diferentes rendimientos, según prevalencia poblacional. Desde este punto de vista, el screening reverso pareciera ser útil en población de alto riesgo, y el screening tradicional para la población general.

Syphilis is a sexual transmitted disease highly contagious with important complications that can be prevented with an adequate treatment in early stages. Syphilis has become a public health issue, in the USA its incidence has increased from the 2001, with a rate in the 2008 of 4,5 cases/100000 people, with a greater prevalence in men who have sex with men (HSH) and people infected by HIV (PVIH). Despite molecular detection test are used for the diagnostic of many diseases, in syphilis we still using serologist test. There are three different schemes with different per-formance depending in the prevalence of syphilis in the population. In this setting reverse screening is the most adequate method for high prevalence versus traditional method that is better in general population.

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Resumo O diagnóstico de câncer frequentemente suscita a consciência da possibilidade de morte. Admitir a morte na infância implica considerar que o ciclo vital se inverteu e que crianças também morrem. O objetivo deste estudo foi compreender os significados que mães de crianças que terminaram o tratamento oncológico atribuem à morte de outras crianças com câncer vivenciada no contexto hospitalar. Trata-se de uma pesquisa qualitativa com fundamentação fenomenológica. Foram realizadas entrevistas com sete mães cujos filhos haviam concluído tratamento em hospital terciário do interior paulista, audiogravadas e transcritas para análise compreensiva dos relatos. A compreensão do fenômeno estudado evidenciou que, quando as mães recordavam a morte de uma criança com câncer no hospital, significavam esse acontecimento com intensos sentimentos de frustração, tristeza e sofrimento. As participantes relataram de forma explícita que sentiam medo diante da morte de uma criança no hospital, pois isso as fazia pensar na possibilidade de morte do próprio filho ou da recidiva da doença.

Abstract Cancer diagnosis often leads to fear of death. Facing the death of children implies admitting the reversal of life cycle and that children also die. The aim of this study was to understand the significance attributed by mothers whosechildren have completed cancer treatment to the death of other children undergoing cancer treatment at the hospital. This is a qualitative phenomenological research. Individual in-depth interviews were conducted with seven mothers of children who had already completed oncologic treatment at a tertiary hospital in São Paulo State, Brazil. The interviews were audio recorded and transcribed for comprehensive analysis of recorded data. The understanding of the phenomenon studied shows that when the mothers recalled the death of a child with cancer at the hospital, the significance they attributed to that event was expressed with strong feelings of frustration, sorrow, and pain. The participants explicitly reported feeling fear whenever a child died at the hospital because it made them think about the possibility of their own child's death or relapse of the disease.

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Large scale coordination without dominant, consistent leadership is frequent in nature. How individuals emerge from within the group as leaders, however transitory this position may be, has become an increasingly common question asked. This question is further complicated by the fact that in many of these aggregations, differences between individuals are minor and the group is largely considered to be homogeneous. In the simulations presented here, we investigate the emergence of leadership in the extreme situation in which all individuals are initially identical. Using a mathematical model developed using observations of natural systems, we show that the addition of a simple concept of leadership tendencies which is inspired by observations of natural systems and is affected by experience can produce distinct leaders and followers using a nonlinear feedback loop. Most importantly, our results show that small differences in experience can promote the rapid emergence of stable roles for leaders and followers. Our findings have implications for our understanding of adaptive behaviors in initially homogeneous groups, the role experience can play in shaping leadership tendencies, and the use of self-assessment in adapting behavior and, ultimately, self-role-assignment.

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In Mexico Agave angustifolia has traditionally been used to treat inflammation. The aim of this study was to measure the anti-inflammatory effect of the extract of A. angustifolia, the isolation and identification of active compounds. From the acetone extract two active fractions were obtained, (AsF13 and AaF16). For the characterization of pharmacological activity, the acute inflammatory model of mouse ear edema induced with TPA was used. The tissue exposed to TPA and treatments were subjected to two analysis, cytokine quantification (IL-1ß, IL-6, IL-10 and TNF-α) and histopathological evaluation. The active fraction (AaF16) consisted principally of 3-O-[(6'-O-palmitoyl)-ß-D-glucopyranpsyl] sitosterol. In AaF13 fraction was identified ß-sitosteryl glucoside (2) and stigmasterol (3). The three treatments tested showed a concentration-dependent anti-inflammatory effect (AaAc Emax = 33.10%, EC50 = 0.126 mg/ear; AaF13 Emax = 54.22%, EC50 = 0.0524 mg/ear; AaF16 Emax = 61.01%, EC50 = 0.050 mg/ear). The application of TPA caused a significant increase on level of IL-1ß, IL-6 and TNFα compared with basal condition, which was countered by any of the experimental treatments. Moreover, the experimental treatments induced a significant increase in the levels of IL-4 and IL-10, compared to the level observed when stimulated with TPA. Therefore, the anti-inflammatory effect of Agave angustifolia, is associated with the presence of 3-O-[(6'-O-palmitoyl)-ß-D-glucopyranosyl] sitosterol.

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Há algumas décadas, o câncer infantil era considerado uma doença fatal. Com a melhora nos procedimentos terapêuticos e nos métodos de detecção precoce, o número de crianças que sobrevivem vem aumentando, ocorrendo um direcionamento da atenção para o viver com câncer assim como para as necessidades desses sobreviventes. O presente estudo teve por objetivo compreender, por meio de uma análise fenomenológica, o sentido que a criança que está finalizando seu tratamento contra o câncer atribui ao próprio futuro. Foram realizadas seis entrevistas com crianças entre oito e treze anos e, a partir das convergências e divergências encontradas em seus relatos, emergiram as categorias de análise. A análise de conteúdo dos relatos revelou que, quando o tratamento está terminando e a criança já se encontra sem os sintomas da doença, permanecem ainda por algum período as antigas referências utilizadas na época do tratamento. As crianças falam de seu passado e fazem suposições do que poderá acontecer. Expressam o desejo de retomar sua aparência física anterior e as atividades interrompidas ou dificultadas pela doença. Ao longo de todo esse processo, elas se defrontam com o paradoxo vida e morte e conseguem manter uma visão positiva de futuro, almejando a retomada do projeto de vida e amplitude de possibilidades com a retomada da saúde.(AU)

For some decades childhood cancer has been considered a fatal disease. However, with improvements in therapeutic procedures and early detection methods, the number of children who survive is increasing, with the care becoming directed toward living with cancer as well as toward the needs of these survivors. This study aimed to comprehend, through phenomenological analysis, the feelings that children, who are finishing their cancer treatment, attributed to their future. Six interviews were conducted with children aged eight to thirteen years and from the convergences and divergences in their reports the categories of analysis emerged. The content analysis of the reports revealed that when the treatment is finished and the child has no disease symptoms the old references used at the time of treatment still remain for some time. The children spoke about their past and made assumptions regarding what might happen. They expressed the desire to regain their prior physical appearance, and resume the activities that were interrupted or impeded by the disease. Throughout this process they were faced with the life and death paradox, yet managed to maintain a positive outlook for the future, aiming to resume the life project and enjoy a range of possibilities with the return to health.(AU)

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Há algumas décadas, o câncer infantil era considerado uma doença fatal. Com a melhora nos procedimentos terapêuticos e nos métodos de detecção precoce, o número de crianças que sobrevivem vem aumentando, ocorrendo um direcionamento da atenção para o viver com câncer assim como para as necessidades desses sobreviventes. O presente estudo teve por objetivo compreender, por meio de uma análise fenomenológica, o sentido que a criança que está finalizando seu tratamento contra o câncer atribui ao próprio futuro. Foram realizadas seis entrevistas com crianças entre oito e treze anos e, a partir das convergências e divergências encontradas em seus relatos, emergiram as categorias de análise. A análise de conteúdo dos relatos revelou que, quando o tratamento está terminando e a criança já se encontra sem os sintomas da doença, permanecem ainda por algum período as antigas referências utilizadas na época do tratamento. As crianças falam de seu passado e fazem suposições do que poderá acontecer. Expressam o desejo de retomar sua aparência física anterior e as atividades interrompidas ou dificultadas pela doença. Ao longo de todo esse processo, elas se defrontam com o paradoxo vida e morte e conseguem manter uma visão positiva de futuro, almejando a retomada do projeto de vida e amplitude de possibilidades com a retomada da saúde...

For some decades childhood cancer has been considered a fatal disease. However, with improvements in therapeutic procedures and early detection methods, the number of children who survive is increasing, with the care becoming directed toward living with cancer as well as toward the needs of these survivors. This study aimed to comprehend, through phenomenological analysis, the feelings that children, who are finishing their cancer treatment, attributed to their future. Six interviews were conducted with children aged eight to thirteen years and from the convergences and divergences in their reports the categories of analysis emerged. The content analysis of the reports revealed that when the treatment is finished and the child has no disease symptoms the old references used at the time of treatment still remain for some time. The children spoke about their past and made assumptions regarding what might happen. They expressed the desire to regain their prior physical appearance, and resume the activities that were interrupted or impeded by the disease. Throughout this process they were faced with the life and death paradox, yet managed to maintain a positive outlook for the future, aiming to resume the life project and enjoy a range of possibilities with the return to health...

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OBJECTIVE: To determine the effect of twice-daily proton pump inhibitor (PPI) treatment on the relationship between laryngopharyngeal pH environment and symptoms in patients with laryngopharyngeal reflux (LPR). STUDY DESIGN AND SETTING: Retrospective analysis of records from consecutive patients seen at a single clinical site between 2009 and 2012. SUBJECTS AND METHODS: Forty-three records of patients diagnosed with LPR who underwent pre- and posttreatment pH studies were included. Prior to treatment, all had a Reflux Symptom Index (RSI) > 13 and an abnormal pH study. Patients were treated for ≥ 4 weeks with twice-daily PPIs. Following treatment, patients completed a second RSI and pH study. RESULTS: Most patients (67.4%) had symptom normalization; however, most patients (60.5%) did not have pH normalization. For all patients whose symptoms did not normalize, pH scores also did not normalize; 32.6% of patients showed no subjective or objective treatment response. For individuals whose symptoms normalized but whose pH scores did not normalize, there was a significant decrease in upright pH score. For the entire group, pretreatment symptom and upright pH scores were strongly positively correlated. Improvements in symptom and upright pH scores following treatment were moderately positively correlated. CONCLUSION: Laryngopharyngeal pH failed to normalize for most individuals after PPI treatment; only pH improvement was necessary for symptom normalization. Many patients had no treatment response. Laryngopharyngeal reflux patients may make up a heterogeneous group, and PPI responsivity may help explain conflicting results from previous studies. Posttreatment pH monitoring is recommended in studies investigating the efficacy of PPI therapy for LPR.

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Estudo qualitativo-descritivo sobre a questão da morte e o morrer em suas nuances bioéticas, bem como o modo como os profissionais de saúde estão enfrentando e discutindo tais aspectos, a superação diante das dificuldades e a construção de uma nova relação médico/paciente.

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Esta pesquisa buscou revelar a experiência vivida por alunos da primeira turma do Currículo Integrado no Cursode Enfermagem da Universidade Estadual de Londrina. Trata-se de uma pesquisa qualitativa, orientada pelafenomenologia existencial-hermenêutica de Heidegger em que foram entrevistados dez alunos da primeira turma.Os resultados mostraram que os alunos sentiram-se inseguros, com medo e colocavam-se como cobaias.Enfrentaram os jogos competitivos no confronto das verdades e na busca de reconhecimento externo. Lutarampor maior número de livros na biblioteca, pelos campos de estágio e tentaram encontrar a sua identidade diantede um novo jeito de estar na sala de aula. Revelaram suas opiniões, lidando com o temor de falar e seravaliados, utilizando novos instrumentos e ganhando confiança em si próprios por meio da ocupação de novosespaços existenciais. O sentido de ser aprendiz mostrou-se uma construção constante, que se inicia nomomento da opção do vestibular e não se fecha mais.

This research aimed to unfold the reality experienced by the first class of the Nursing Integrated Curriculum at theUniversidade Estadual de Londrina. This is a qualitative research guided by Heidegger’s hermeneutic phenomenology approach carried out with 10 students. Results showed that the students felt insecure and afraid,comparing themselves to guinea pigs. They endured competitive games by confronting truths and looking forexternal recognition. They fought for a larger number of books in the library, for internship fields and tried to findtheir identities facing a new way of being in the classroom. They revealed their opinions dealing with the fear ofbeing exposed and criticized by using new tools and achieving more self-confidence while occupying newexistential spaces. The meaning of being an apprentice revealed itself as a constant construction that begins inthe moment they choose which course to take at the Vestibular test and does not ever cease.

Esta investigación buscó revelar la experiencia vivida por alumnos del primer grupo del Currículum Integrado enel Curso de Enfermería de la Universidad Estatal de Londrina. Se trata de una investigación cualitativa, orientadapor la fenomenología existencial-hermenéutica de Heidegger, en que fueron entrevistados diez alumnos delprimer grupo. Los resultados mostraron que los alumnos se sintieron inseguros, con miedo y se colocaban comoconejillos de Indias. Enfrentaron los juegos competitivos en el confronto de las verdades y en la busca dereconocimiento externo. Lucharon por mayor número de libros en la biblioteca, por los campos de prácticas eintentaron encontrar su identidad delante de una nueva manera de estar en la sala de clase. Revelaron susopiniones, lidiando con el temor de hablar y ser evaluado, utilizando nuevos instrumentos y ganando confianzaen sí mismos a través de la ocupación de nuevos espacios existenciales. El sentido de ser aprendiz se mostrócomo una construcción constante, que se inicia en el momento de la opción de la selectividad y no se cierra más.

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Esta pesquisa buscou compreender o significado da cirurgia para a criança. Trata-se de uma pesquisaqualitativa, de abordagem fenomenológica, na modalidade da estrutura do fenômeno situado. Foramentrevistadas 14 crianças de três hospitais da cidade de Londrina-Pr. Os resultados da análise dos discursos dascrianças construíram categorias empíricas que foram agrupadas em três momentos: período pré, trans e pósoperatório.O primeiro momento reúne as lembranças dos sintomas da doença, da comunicação da necessidadeda cirurgia e do medo. O segundo descreve as recordações do ambiente físico e humano do centro cirúrgico. Oterceiro momento agrupa as experiências de dor e de intercorrências pós-operatórias, as restrições enecessidades não atendidas e a superação de dificuldades. Assim, viver uma cirurgia significa, para a criança,um rompimento do seu mundo cotidiano, mobilizando vários sentimentos que abrangem desde a percepçãocorporal dos efeitos do estar doente até sentimentos profundos como medo, tristeza, ansiedade e solidão.Constitui-se também na superação de dificuldades para retornar a sua vida cotidiana.

The aim of this research was to understand the meaning of surgery to a child. It is a phenomenological qualitative research withthe structured phenomenon-based approach. Fourteen children were interviewed in three hospitals in Londrina-PR. Results ofdiscourse analyses built empirical categories that were grouped into three moments: period pre-operative, intra-operative andpost-operative. The first moment gathers memories of the symptoms of the illness, of the announcement of a need for surgeryand the fear. The second describes the memories of the physical and human environment of Operation Room. The third linksthe experiences of pain and post-operatory complications, the restrictions, the non-fulfilled needs and overcoming thedifficulties. Therefore, to a child, undergo a surgery means a discontinuity of daily routine, bringing forth feelings that range frombody perception of being sick to deep feelings such as fear, sadness, anxiety and loneliness. It also means overcoming thedifficulties to return to daily life.

Esta investigación buscó comprender el significado de la cirugía para el niño. Se trata de una investigacióncualitativa, de abordaje fenomenológico, en la modalidad de la estructura del fenómeno situado. Fueronentrevistados 14 niños de tres hospitales de la ciudad de Londrina- PR. Los resultados del análisis de losdiscursos de los niños construyeron categorías empíricas que fueron agrupadas en tres momentos: período pre,trans y postoperatorio. El primer momento reúne los recuerdos de los síntomas de la enfermedad, de lacomunicación, de la necesidad de la cirugía y del miedo. El segundo describe las memorias del ambiente físico yhumano del centro quirúrgico. El tercer momento agrupa las experiencias de dolor y de intercurrenciaspostoperatorias, las restricciones y necesidades no atendidas y la superación de dificultades. Así, vivir unacirugía significa para el niño una ruptura de su mundo diario, movilizando varios sentimientos que abarcan desdela percepción corporal de los efectos del estar enfermo hasta sentimientos profundos como miedo, tristeza,ansiedad y soledad. Se constituye también en la superación de dificultades para volver a su vida cotidiana.

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BACKGROUND: In January 2005, the Cord Blood Bank (CBB) at the Mexican Institute of Social Security initiated activities. Herein, we describe the experience generated during this period (January 1, 2005-December 31, 2009). STUDY DESIGN AND METHODS: Good manufacturing practices and standard operating procedures were used to address donor selection, as well as umbilical cord blood (UCB) collection, processing, and cryopreservation. Based mainly on HLA and nucleated cell content, specific UCB units were thawed, processed, and released for transplantation. RESULTS: A total of 589 UCB units were stored, representing 54% of the total number of units collected. Forty-eight units (8.14% of the stored units) were released for transplantation of 36 patients. Twenty-six patients (72% of cases) corresponded to patients with acute leukemia, five (14%) to patients with marrow failure, and the rest (five; 14%) to patients with hemoglobinopathies and other syndromes. The median number of nucleated cells infused per patient was 6.71 × 10(7) /kg and the median number of CD34+ cells was 4.8 × 10(5) /kg. Current engraftment data indicate that engraftment occurred in 56%, and no engraftment in 44%, of cases. Engraftment was more frequent (59%) in patients that received more than 3 × 10(7) total nucleated cells (TNCs)/kg body weight, than in those receiving fewer than 3 × 10(7) TNCs/kg (40%). Myeloid engraftment was observed 7 to 54 days posttransplant (median, 23 days), whereas platelet engraftment was detected on Days 12 to 87 posttransplant (median, 38 days). To date, the disease-free survival rate was 41% and the overall survival was 47%, with survival periods of 126 to 1654 days. CONCLUSION: Although the experience presented herein is still limited and the period of analysis is still short, the results obtained during these 5 years are encouraging.

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O avanço científico e tecnológico tem permitido o desenvolvimento de programasde diagnóstico e intervenção precoces. No entanto, muito se tem que avançar no que serefere à implantação e ao desenvolvimento dos serviços de suporte emocional aos pais decrianças com deficiência auditiva. Assim, este artigo tem o propósito de apresentar estudossobre o impacto que causa nos pais o nascimento de um filho com essa deficiência,enfatizando a vivência do diagnóstico transmitido diretamente à mãe ou a ambos osgenitores, o que vem afetar todo o grupo familiar. O intuito é contribuir com os profissionaisque atuam junto a essas famílias, no sentido de poderem intervir-lhes mais eficazmente,compreendendo melhor esses pais, assim como contribuir para uma reflexão sobre anecessidade de mudanças na política de saúde auditiva(AU)

The scientific and technological advancement has allowed the development ofearly diagnosis programs and interventions. However, it is necessary to go further in orderto establish and develop the emotional support service to the parents of children withhearing loss, who do not have any kind of support yet. Thus, the aim of this article is todescribe some studies about the subject concerning the impact of parents on hearingimpairment diagnosis, emphasizing diagnosis coping and family relationships affected.The goal is to contribute with the professionals who attend those families, in order to beable to intervene more effectively and to understanding those parents better, as well as tocontribute for a reflection about the necessity of changes on the politics of hearing health(AU)

RESUMEN

This study examined how health professionals signify the religiosity and faith of patients under cancer treatment and how they themselves experience such phenomena. This is a qualitative-descriptive study, using the phenomenological framework as set out by Stein and Ales Bello, as a way of understanding the human being in its totality - physical, mental and spiritual. Most professionals report they are spiritualists, two are Catholics, one physician is a Buddhist and another is a Spiritist. They believe that religion is inherent to all human beings. Professionals convicted of their religion (less than half) believe in divine protection and recognize religiosity as a support and comfort for patients and their families in coping with illness. They expect patients to live their faith with prudence, never losing sight of reality.

O estudo teve por objetivos compreender como profissionais de saúde significam religiosidade e fé dos pacientes em tratamento de câncer, e como experienciam esse fenômeno. Trata-se de pesquisa qualitativa-descritiva, sob o referencial de análise fenomenológica em Stein e Ales Bello, um modo de compreender o ser humano na sua totalidade - física, psíquica e espiritual. A maioria dos profissionais de saúde se diz espiritualista, dois são católicos, um médico se diz budista e uma médica espírita. Acreditam que a religião é inerente a todo ser humano. Os convictos de suas religiões creem na proteção divina e reconhecem a religiosidade como sustento e conforto para o paciente e seus familiares enfrentarem a situação de adoecimento. Eles esperam que esses enfermos vivam a sua fé com prudência e sempre aderindo à realidade.

Este estudio tuvo por objetivo comprender como los profesionales de la salud le dan significado a la religiosidad y a la fe de los pacientes en tratamiento de cáncer, y como ellos experimentan ese fenómeno. Se refiere a una investigación cualitativa-descriptiva, bajo el referencial del análisis fenomenológico de Stein y Ales Bello, un modo de comprender al ser humano en su totalidad - física, psíquica y espiritual. La mayoría de los profesionales de la salud se declaró Espiritualista, dos son Católicos, un médico se dice Budista y una médica Espírita. Creen que la religión es inherente a todo ser humano. Los convictos de sus religiones creen en la protección divina y reconocen la religiosidad como sustento y confort para el paciente y sus familiares, también para que puedan enfrentar la situación de enfermarse. Ellos esperan que esos enfermos vivan su fe con prudencia y siempre adhiriendo a la realidad.

Asunto(s)

RESUMEN

The purpose of this study is to learn the meaning of being-a-child with cancer submitted to ambulatory treatment and using the toy library as a possibility to enable their expression about their world. Participants were seven children of ages 3 to 9 years, who had been diagnosed with some kind of childhood cancer. With the objective of learning about the meaning of these experiences to children with cancer, an analysis of these data was performed based on Martin Heidegger's existential phenomenology. The child-with-cancer showed a movement that was permeated sometimes by authenticity, when the child assumed the disease and their being-toward-death and also by the lack of authenticity, when they were influenced by the decadence attitude of their relatives and health team members. Playing provided a rich contact with the existence of these severely ill children.

Asunto(s)

RESUMEN

A proposta deste estudo é desvelar o sentido de Ser-criança com câncer em tratamento ambulatorial, utilizando a brinquedo-teca como possibilidade de favorecer a expressão, pela criança, de seu mundo cotidiano. Participaram sete crianças entre três e nove anos, com diagnóstico de algum tipo de câncer infantil. A fim de desvelar o sentido das vivências das crianças com câncer, foi realizada uma análise à luz da fenomenologia existencial de Martin Heidegger. A criança-com-câncer configurou-se como um ir e vir permeado ora pela autenticidade, quando a criança assumia sua doença e seu ser-para-a-morte, ora pela inautenticidade, quando se deixava levar pelo modo de ser da decadência dos familiares e da equipe de saúde. O brincar pôde favorecer um rico acesso às vivências da criança gravemente doente.

The purpose of this study is to learn the meaning of being-a-child with cancer submitted to ambulatory treatment and using the toy library as a possibility to enable their expression about their world. Participants were seven children of ages 3 to 9 years, who had been diagnosed with some kind of childhood cancer. With the objective of learning about the meaning of these experiences to children with cancer, an analysis of these data was performed based on Martin Heidegger's existential phenomenology. The child-with-cancer showed a movement that was permeated sometimes by authenticity, when the child assumed the disease and their being-toward-death and also by the lack of authenticity, when they were influenced by the decadence attitude of their relatives and health team members. Playing provided a rich contact with the existence of these severely ill children.

La propuesta de este estudio es develar el sentido del Ser-niño con cáncer en tratamiento ambulatorio, utilizando la ludoteca como posibilidad de favorecer la expresión, por parte del niño, de su mundo cotidiano. Participaron siete niños de entre tres y nueve años con diagnóstico de algún tipo de cáncer infantil. A los efectos de develar el sentido de las experiencias de los niños con cáncer, se realizó un análisis a la luz de la fenomenología existencial de Martin Heidegger. El niño-con-cáncer exhibió un movimiento de ida y vuelta, permeado algunas veces por la autenticidad, cuando el niño asumía su enfermedad y su ser-para-la-muerte, y otras veces por la inauten-ticidad, cuando se dejaba llevar por el modo de ser de la decadencia de los familiares y del equipo de salud. El jugar puede favorecer un rico acceso a las experiencias del niño gravemente enfermo.

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