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O câncer, frequentemente relacionado ao envelhecimento, impulsiona pacientes a buscarem tratamento hospitalar ou métodos alternativos, como plantas medicinais. Este estudo visou avaliar os perfis sociodemográfico e clínico e o consumo de plantas para fins medicinais entre pacientes idosos em tratamento oncológico no Hospital Araújo Jorge (HAJ). Dados de 55 pacientes foram analisados, abrangendo informações sociodemográficas, tipos de câncer, tratamento, a utilização de plantas medicinais, o objetivo de uso, as fontes de informações sobre plantas e se notaram alguma reação adversa após o consumo. A faixa etária mais encontrada foi 61 a 70 anos (67,27%), a maioria dos pacientes eram homens (63,64%), com ensino fundamental incompleto (32,73%), casados (56,36%) e que moram no interior de Goiás (43,64%). Quanto ao tratamento, a maioria realizava quimioterapia (40,00%) e o câncer gástrico foi mais relatado (14,54%). Sobre o uso de plantas medicinais, a maioria relatou simpatizar com o consumo (58,18%), e acredita em sua segurança devido à origem natural (59,37%). Informações sobre o uso de plantas medicinais eram obtidas com amigos, vizinhos e familiares (21,81%). Ao relatar sobre o consumo de plantas medicinais durante a quimioterapia, a maioria não percebeu nenhum efeito (40,63%). Foram citadas 17 plantas, que eram utilizadas no tratamento anticâncer (29,00%) e preparadas como infusões (18,75%) pelo uso das folhas frescas (60,00%), principalmente para uso interno (46,87%). Diante disso, a atenção farmacêutica se mostra vital para guiar pacientes nas práticas seguras e eficazes de consumo. Isso inclui direcionar sobre doses adequadas, efeitos colaterais e interações, garantindo bem-estar e prevenindo riscos à saúde.
Cancer, which is often related to ageing, drives patients to seek hospital treatment or alternative methods such as medicinal plants. This study aimed to evaluate the sociodemographic and clinical profile and the consumption of plants for medicinal purposes among elderly patients undergoing cancer treatment at the Araújo Jorge Hospital (AJH). Data from 55 patients was analyzed, covering sociodemographic information, types of cancer, treatment, the use of medicinal plants, the purpose of use, the source of information about plants and whether they noticed any adverse reactions after consumption. The most common age group was 61 to 70 years (67.27%), the majority of patients were men (63.64%), had incomplete primary education (32.73%), were married (56.36%) and lived in the interior of Goiás (43.63%). With regard to treatment, the majority were undergoing chemotherapy (40,00%) and gastric cancer was the most frequently reported (14.54%). With regard to the use of medicinal plants, the majority were sympathetic to their consumption (58.18%) and believed them to be safe due to their natural origin (59.37%). Information on the use of medicinal plants was obtained from friends, neighbors and family members (21.81%). When reporting on the consumption of medicinal plants during chemotherapy, the majority did not notice any effect (40.63%). Seventeen plants were mentioned, which were used for anticancer treatment (29,00%) and prepared as infusions (18.75%) with fresh leaves (60,00%), mainly for internal use (46.87%). In view of this, pharmaceutical care is vital to guide patients in safe and effective consumption practices. This includes guidance on appropriate doses, side effects and interactions, ensuring well-being and preventing health risks.
Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou maisRESUMO
RESUMEN Las arbovirosis son enfermedades virales transmitidas por artrópodos (arthropod-borne virus). Dengue, zica y chikungunya se destacan entre los arbovirus emergentes y reemergentes en los últimos años en todo el mundo. La similitud de los síntomas de estas infecciones hace que el diagnóstico clínico sea ineficaz, dificultando las medidas profilácticas y preventivas para nuevos brotes. El diagnóstico molecular mediante la técnica de reacción en cadena de la polimerasa (PCR) en tiempo real es una de las formas de diagnosticar esas enfermedades. En este estudio se recopiló y evaluó la literatura sobre el diagnóstico de arbovirosis. Nuestro objetivo era responder a una pregunta orientadora: ¿la metodología de PCR en tiempo real es eficaz para diagnosticar arbovirosis? Se buscaron artículos científicos de acceso abierto en las bases de datos Pubmed (50 artículos) y Scielo (107 artículos), entre 2014 y 2019. La selección se realizó utilizando los criterios de inclusión y exclusión, quedando solo 20 artículos. Entre estos, el 85% fueron estudios transversales, el 10% fueron revisiones sistemáticas y el 5% fueron estudios de casos. El período de publicaciones fue del 50% en 2017; 35% en 2016; y 5% en 2014, 2015 y 2019, cada. En cuanto a los virus tratados en los artículos, el 25% de los estudios investigaron sobre el dengue; el 25% el chikungunya y el 20% el virus del Zica. La efectividad del diagnóstico molecular se publicó en el 21% de los artículos (sensibilidad y especificidad); el 53% destacó el límite de detección; 70%, ausencia de reacciones cruzadas; y el 80%, la diferenciación entre virus.
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ABSTRACT Purpose: to identify, in the literature, the factors associated with the development of vestibular dysfunctions in individuals with type 2 diabetes mellitus (DM2). Methods: an integrative review of the literature, whose survey was conducted in the databases ISI, SciELO, LILACS and PubMed, using the following descriptors: "type 2 diabetes mellitus", "vertigo", "dizziness", and "vestibular diseases". Articles published in the last 10 years that answered the research question ("What factors are associated with the development of vestibular disorders in individuals with DM2?") were included in the study. Results: the search returned 426 articles, 10 of which met the eligibility criteria. Most of the participants of the selected studies who had vestibular dysfunctions were women over 40 years old and had more than one comorbidity related to DM2, the main one being the systemic arterial hypertension (SAH). According to the literature, the physiology of the inner ear allows small glucose alterations to influence its normal functioning, which makes diabetic individuals more susceptible to developing vestibular dysfunctions. Conclusion: according to this study, DM2 can trigger or contribute to the manifestation of vestibular dysfunction, whose main associated factors are advanced age, female gender, and various comorbidities, as dyslipidemia, SAH and metabolic syndrome.
RESUMO Objetivo: identificar na literatura os fatores que estão associados ao desenvolvimento de disfunções vestibulares em indivíduos com diabetes mellitus tipo 2 (DM2). Métodos: trata-se de uma revisão integrativa da literatura, cuja busca foi realizada nas bases de dados ISI, Scielo, LILACS e PubMed, sendo utilizados os descritores: "type 2 diabetes mellitus", "vertigo", "dizziness" e "vestibular diseases". Foram incluídos artigos publicados nos últimos dez anos e que respondessem a seguinte questão: quais fatores estão associados ao desenvolvimento de disfunções vestibulares em indivíduos com DM2? Resultados: a busca resultou em 426 artigos, sendo que 10 atenderam aos critérios de elegibilidade. A maioria dos participantes dos estudos selecionados que apresentaram disfunções vestibulares eram do sexo feminino, idade superior a 40 anos e possuíam mais de uma comorbidade associada a DM2, sendo a principal, a hipertensão arterial sistêmica (HAS). De acordo com a literatura, a fisiologia da orelha interna permite que pequenas alterações de glicose influenciem seu funcionamento normal, o que torna os indivíduos diabéticos mais suscetíveis a desenvolverem disfunções vestibulares. Conclusão: o presente estudo constatou que a DM2 pode desencadear ou contribuir para a manifestação da disfunção vestibular, tendo como principais fatores associados a idade avançada, o sexo feminino e comorbidades diversas, tais como dislipidemia, HAS e síndrome metabólica.
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This study assessed the prevalence and clinical implications of the TP53 p.R337H mutation in Brazilian breast cancer patients through a systematic literature review. The literature review was performed in the PubMed, Scientific Electronic Library Online (SciELO), and Medical Literature Analysis and Retrieval System Online (MEDLINE) databases from 1997 to 2018. We used the keyword "R337H" in the search since it resulted in the largest number of published articles on the subject. Initially, we found 75 articles, and, after reviewing the titles and abstracts, we selected 18 studies investigating the prevalence of the TP53 p.R337H mutation in breast cancer patients and its clinical implications. The reading of the full texts led to the inclusion of seven studies. The studies were carried out in the states of São Paulo, Rio Grande do Sul, Rio de Janeiro, and Bahia. The TP53 p.R337H mutation was detected in 87 (4.8%) of the 1.789 women with breast cancer investigated. The prevalence of the TP53 p.R337H mutation in the selected studies ranged from 0.5 to 8.6%. These findings highlight the recommendation for screening the R337H variant in breast cancer patients in Brazil and suggest the need for new research addressing the clinical and prognostic aspects of breast cancer patients with TP53 p.R337H mutation-positive.
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Papillary thyroid carcinoma (PTC) is the most common type of thyroid cancer and can present as lymph node metastasis in 30 to 65% of cases when initially diagnosed. High frequency recurrence, distant metastasis and treatment resistance can be found in cases of PTC so early diagnosis and treatment are critical for improved prognosis and better survival rates. The characterization of new biomarkers has proved useful for the diagnosis and follow-up of these patients. HLA-G is a non-classical HLA class I molecule whose expression in cancer cells has been associated with tumor evasion of immune response. Therefore, the aim of this study was to investigate the HLA-G expression and its clinical significance in PTC. Paraffin-embedded thyroid biopsies of 70 PTC patients (40 of whom had presented with metastasis) were evaluated. HLA-G-staining was observed in tumor cells in PTC, and the HLA-G expression was significantly associated with an increased occurrence of lymph node metastasis (p=0.0006) and capsular invasion (p=0.02). This preliminary data shows the HLA-G expression in thyroid carcinoma specimens for the first time and suggests that this expression could impair efficient anti-tumor immunity in PTC. This would indicate that HLA-G could have an independent prognostic value in PTC, principally for tumor recurrence.
Assuntos
Carcinoma/genética , Antígenos HLA-G/genética , Linfonodos/patologia , Recidiva Local de Neoplasia/genética , Glândula Tireoide/patologia , Neoplasias da Glândula Tireoide/genética , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Biomarcadores/metabolismo , Carcinoma/diagnóstico , Carcinoma/imunologia , Carcinoma/patologia , Carcinoma Papilar , Feminino , Expressão Gênica , Antígenos HLA-G/imunologia , Humanos , Imuno-Histoquímica , Linfonodos/imunologia , Metástase Linfática , Masculino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/diagnóstico , Recidiva Local de Neoplasia/imunologia , Recidiva Local de Neoplasia/patologia , Prognóstico , Câncer Papilífero da Tireoide , Glândula Tireoide/imunologia , Neoplasias da Glândula Tireoide/diagnóstico , Neoplasias da Glândula Tireoide/imunologia , Neoplasias da Glândula Tireoide/patologiaRESUMO
Introdução: o câncer de mama triplo-negativo inclui os tumores que não expressam receptores de estrógenos, receptores de progesterona e HER2. O subtipo triplo-negativo apresenta características mais agressivas, como aparecimento em idade mais precoce, estágio avançado ao diagnóstico, alta graduação histológica e nuclear, alto índice mitótico, maior frequência de metástases regionais e à distância, além de menor sobrevida. Objetivo: comparar os aspectos clínicos e patológicos de 345 pacientes com carcinomas mamários tratadas em um hospital de referência na região Centro-oeste do Brasil, a fim de avaliar o impacto do fenótipo triplo-negativo no prognóstico das pacientes. Metodologia: as pacientes foram selecionadas no Laboratório de Anatomia Patológica da instituição e os dados clínicos e patológicos coletados a partir dos respectivos prontuários. A análise estatística empregou análise univariada e análise de sobrevida pelo método de Kaplan-Meier e Log-rank. Resultados: os fatores prognósticos clássicos foram comprovados para o grupo, incluindo comprometimento de linfonodos regionais (p<0,001), metástase à distância (p<0,001) e tamanho do tumor (p<0,001). Quando os tumores, distribuídos em dois grupos (TN e NTN), foram comparados, diferenças estatisticamente significativas foram observadas com relação ao grau nuclear (p<0,0001) e à sobrevida em cinco anos (p<0,0001), que variou de 70,3% para as pacientes NTN a 47,1% para as pacientes TN. Conclusão: nossos resultados confirmaram o perfil mais agressivo dos tumores TN que, independentemente dos fatores prognósticos clássicos dos carcinomas de mama, cursam com maior agressividade e maior taxa de mortalidade, requerendo assim maior atenção assistencial.
Introduction: Triple-negative breast cancers are tumors that don't express estrogen receptors, progesterone receptors and HER2. The triple-negative phenotype exhibits more aggressive characteristics, including early onset, high stage on diagnosis, elevated nuclear grade, high mytotic index, agressive patterns of regional and distant metastasis, besides poor prognosis. Objective: To compare the clinical and pathological aspects of a group with 345 breast cancer patients treated in a referral hospital in the center of Brazil, in order to compare the impact of triple-negative phenotype on the patient prognosis. Methods: Patients were selected in the Pathology Laboratory of the institution. Clinical and pathological data were collected from the respective clinical files. Statistical methods comprised univariate analysis and survival curves were generated by using Kaplan-Meier and Log-rank tests. Results: Classic prognostic factors were confirmed for the whole group, including regional lymph nodes metastasis (p<0.001), distant metastasis (p<0.001) and tumor size (p<0.001). By comparing the two groups of breast tumors (TN and NTN), significant statistical differences were observed concerning nuclear grade (p<0.0001) and five year survival (p<0.0001), which varied from 70.3% for NTN patients to 47.1% for TN patients. Conclusion: Our results reinforce the aggressive profile of triple-negative breast cancer that, despite of the classic prognostic factors described for breast cancer, evolves with higher aggressiveness and elevated mortality rates, requiring special attention
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Humanos , Feminino , Análise de Sobrevida , Carcinoma/patologia , Fenótipo , Neoplasias da Mama/patologia , PrognósticoRESUMO
BACKGROUND: There are few studies relating the practice of water exercises and blood pressure responses. AIM: The objective of this study was to evaluate the subacute blood pressure behaviour in elderly hypertensive women after a water exercise session. METHODS: This was a controlled clinical trial, carried out with 16 hypertensive elderly women with the following characteristics (mean ± SD): age 66 ± 2.94 years, body weight 68.43 ± 12.08 kg, height 158 ± 5.34 cm and body mass index 27.32 ± 4.30 kg/m(2). The study occurred on 2 days, 48 hours apart, with an experimental protocol and a control protocol. The experimental protocol underwent a moderately intense and predominantly aerobic 40-minute session with water exercises for the upper and lower limbs. The control protocol did not enter the pool and did not exercise, but all other procedures were similar to those of the experimental protocol. The blood pressure measurements were performed at times before and every 10 minutes for 30 minutes after the protocols. Student's t-test was used to determine if the averages of the two samples were significantly different. RESULTS: Blood pressure increased significantly but not greatly after the water exercise session, but this did not happen with the control protocol. Systolic blood pressure in the experimental protocol decreased significantly only 30 minutes after the exercise session, which did not occur in the control protocol. Diastolic blood pressure, on the other hand, decreased significantly at minutes 10, 20 and 30. This also did not occur with the control protocol, but an intergroup analysis showed that diastolic blood pressure was similar for the two protocols. CONCLUSIONS: The results of this study show that a prescription of water exercises can be carried out in relative safety with this group of patients, and that systolic blood pressure tended to decrease, as shown by the measurement at minute 30.
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Pressão Sanguínea , Terapia por Exercício/métodos , Hipertensão/terapia , Imersão , Água , Fatores Etários , Idoso , Brasil , Estudos Cross-Over , Diástole , Terapia por Exercício/efeitos adversos , Feminino , Humanos , Hipertensão/diagnóstico , Hipertensão/fisiopatologia , Pessoa de Meia-Idade , Fatores Sexuais , Sístole , Fatores de Tempo , Resultado do TratamentoRESUMO
The TK6 lymphoblastoid cell line is known to be mismatch repair (MMR) and p53 proficient. Deficiency in MMR results in a mutator phenotype characterized by microsatellite instability (MSI) and increased hprt mutant frequency (MF). Increased hprt MF is also a biomarker of effect for exposure to ionizing radiation. In order to test if a mutator phenotype could be induced by low doses of gamma ionizing radiation, an hprt cloning assay and a MSI investigation were performed after radiation exposure. The spontaneous MF was 1.6 x 10-6. The groups exposed to 0.2, 0.5 and 1.0 Gy had hprt MFs of 2.3, 3.3 and 2.2 x 10-6, respectively. The spontaneous MSI frequency per allele in non-selected cells was 5.4 x 10-3, as evidenced at the loci D11S35, nm23-H1, D8S135 and p53. MSI frequencies in the groups exposed to 0.2, 0.5 and 1.0 Gy were found to be < 4.7, < 7.7 and < 12 x 10-3, respectively. The frequencies of hprt mutants and MSI found in this study suggest that low doses of ionizing radiation increase hprt mutant frequency without triggering the mutator phenotype pathway.
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Hipoxantina Fosforribosiltransferase , Radiação Ionizante , Timidina Quinase , Repetições de Microssatélites , Mutação , FenótipoRESUMO
The multisteps of tumorigenesis involve the classic chromosomal instability and the mutator phenotype pathways featured by a predisposition to acquire mutations in tumor suppressor genes and oncogenes. Expansion and contraction of microsatellite sequences due to a deficient mismatch repair system are a marker of the mutator phenotype. Controversial results regarding the extent of microsatellite instability (MSI) have been reported in the development and progression of myeloid malignancies. Here, we investigated MSI and loss of heterozygosity (LOH) frequencies at the microsatellite loci BAT-26, D7S486, D8S135, ANK1, IFNA, TP53 and bcr of 19 Brazilian patients with acute (AML) and chronic myeloid leukemia (CML). One AML patient and one CML patient were categorized as having a high degree of microsatellite instability (MSI-H), corresponding to 10.5 percent (2/19) of all patients. LOH at loci BAT-26 and TP53 was present in 30 percent of the patients with AML alone. Despite the small sample size, our results suggest that the mutator phenotype, as verified by MSI frequency, could play a role in the leukemogenesis of a small subset of patients with myeloid leukemia.