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ABSTRACT BACKGROUND: The relationship between spirituality and health has been the object of growing discussion. There is a lack of data on spiritual needs assessments in Brazil. OBJECTIVE: This study aimed to assess the spiritual needs of patients admitted to a public tertiary hospital and perform a comparative analysis between patients with and without indications for palliative care. DESIGN AND SETTING: A cross-sectional observational study included patients hospitalized between August and December 2020 in Hospital do Servidor Publico Municipal, Sao Paulo, Brazil. METHODS: The included patients answered a questionnaire consisting of sociodemographic data, the Duke religiosity scale, and the Spiritual Needs Assessment for Patients (SNAP) tool for a spiritual needs assessment. The World Health Organization Palliative Needs tool (NECPAL) was used to evaluate the indications for palliative care. The level of significance adopted was 5%. RESULTS: A total of 66 patients were included in this study. Most participants (97%) declared themselves as belonging to a religion. The group without indication for palliative care by the NECPAL showed greater spiritual (P = 0.043) and psychosocial needs (P = 0.004). No statistically significant difference was observed in the religious needs domain (P = 0.176). There were no statistically significant differences in the Duke scale scores between the two groups. CONCLUSION: Spiritual, psychosocial, and religious needs are prevalent among hospitalized patients, and multidisciplinary teams must consider these needs in their management approach. In addition, this study suggests that psychosocial and spiritual needs can be even higher in patients who do not receive palliative care.

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Breast cancer (BC) is a highly heterogeneous disease. The treatment of BC is complicated owing to intratumoral complexity. Tissue biopsy and immunohistochemistry are the current gold standard techniques to guide breast cancer therapy; however, these techniques do not assess tumoral molecular heterogeneity. Personalized medicine aims to overcome these biological and clinical complexities. Advances in techniques and computational analyses have enabled increasingly sensitive, specific, and accurate application of liquid biopsy. Such progress has ushered in a new era in precision medicine, where the objective is personalized treatment of breast cancer, early screening, accurate diagnosis and prognosis, relapse detection, longitudinal monitoring, and drug selection. Liquid biopsy can be defined as the sampling of components of tumor cells that are released from a tumor and/or metastatic deposits into the blood, urine, feces, saliva, and other biological substances. Such components include circulating tumor cells (CTCs), circulating tumor DNA (ctDNA) or circulating tumor RNA (ctRNA), platelets, and exosomes. This review aims to highlight the role of liquid biopsy in breast cancer and precision medicine.

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BACKGROUND: The relationship between spirituality and health has been the object of growing discussion. There is a lack of data on spiritual needs assessments in Brazil. OBJECTIVE: This study aimed to assess the spiritual needs of patients admitted to a public tertiary hospital and perform a comparative analysis between patients with and without indications for palliative care. DESIGN AND SETTING: A cross-sectional observational study included patients hospitalized between August and December 2020 in Hospital do Servidor Publico Municipal, Sao Paulo, Brazil. METHODS: The included patients answered a questionnaire consisting of sociodemographic data, the Duke religiosity scale, and the Spiritual Needs Assessment for Patients (SNAP) tool for a spiritual needs assessment. The World Health Organization Palliative Needs tool (NECPAL) was used to evaluate the indications for palliative care. The level of significance adopted was 5%. RESULTS: A total of 66 patients were included in this study. Most participants (97%) declared themselves as belonging to a religion. The group without indication for palliative care by the NECPAL showed greater spiritual (P = 0.043) and psychosocial needs (P = 0.004). No statistically significant difference was observed in the religious needs domain (P = 0.176). There were no statistically significant differences in the Duke scale scores between the two groups. CONCLUSION: Spiritual, psychosocial, and religious needs are prevalent among hospitalized patients, and multidisciplinary teams must consider these needs in their management approach. In addition, this study suggests that psychosocial and spiritual needs can be even higher in patients who do not receive palliative care.

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Neoadjuvant chemotherapy (NAC) is often used to treat locally advanced disease for tumor downstaging, thus improving the chances of breast-conserving surgery. From the NAC response, it is possible to obtain prognostic information as patients may reach a pathological complete response (pCR). Those who do might have significant advantages in terms of survival rates. Breast cancer (BC) is a heterogeneous disease that requires personalized treatment strategies. The development of targeted therapies depends on identifying biomarkers that can be used to assess treatment efficacy as well as the discovery of new and more accurate therapeutic agents. With the development of new "OMICS" technologies, i.e., genomics, transcriptomics, and proteomics, among others, the discovery of new biomarkers is increasingly being used in the context of clinical practice, bringing us closer to personalized management of BC treatment. The aim of this review is to compile the main biomarkers that predict pCR in BC after NAC.

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RESUMO: A COVID-19 é a doença infecciosa cujo agente etiológico é um betacoronavirus, o SARS-CoV-2. Sua emergência se deu em uma província chinesa em dezembro de 2019, tornando-se uma pandemia que desafia a saúde pública global. Habitualmente, apresenta-se como uma síndrome gripal, com possibilidade de evolução para síndrome respiratória aguda grave. Além disso, pode provocar alterações na coagulação e resposta inflamatória do indivíduo, levando a complicações tromboembólicas. Este artigo relata o caso de um paciente de 58 anos, diagnosticado com COVID-19, que seguia em isolamento domiciliar e, evoluiu com dispneia e hemoptise no quarto dia de doença. O diagnóstico do tromboembolismo pulmonar (TEP) foi confirmado através de tomografia contrastada de tórax. O paciente foi internado para tratamento clínico, necessitando de acompanhamento em Unidade de Terapia Intensiva (UTI) entre o terceiro e quinto dia de internação. Após alta da UTI, o paciente evoluiu sem demais intercorrências, recebendo alta no décimo dia de internação hospitalar. (AU)

ABSTRACT: The Coronavirus disease 2019 (COVID-19) whose etiologic agent is a betacoronavirus, SARS-CoV-2. Emerged in a chinese province in December of 2019, becoming a pandemic that challenges global public health. It usually presents as a flu-like syndrome, with the possibility of progressing to severe acute respiratory syndrome. In addition, it can lead to cytokine storm syndrome that results in hyperinflammation, exacerbates immune response and may generate changes in the individual's coagulation, causing thromboembolic complications. This article reports the case of a 58-year-old patient diagnosed with COVID-19, who was still in-home isolation and developed dyspnea and hemoptysis on the fourth day of illness. The diagnosis of pulmonary thromboembolism (PTE) was confirmed by contrast-enhanced pulmonary artery tomography. The patient was admitted for clinical treatment, requiring follow-up in the Intensive Care Unit (ICU) between the third and fifth day of hospitalization. After discharge from the ICU, the patient evolved without further complications, being discharged on the tenth day of hospitalization. (AU)

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