Cardiopulmonary resuscitation for lay people: Evaluation of videos from the perspective of digital health literacy

OBJECTIVE

to analyze the quality indicators and technical content of the videos for lay people posted on the YouTube platform, on cardiopulmonary resuscitation in adults and their audiovisual production regarding the principles of digital health literacy.

METHOD

a descriptive and exploratory study, which selected videos recorded between December 2015 and April 2021. They were analyzed by indicators of the production of audiovisual material, considering the American Heart Association guidelines and the principles of digital health literacy. Descriptive and inferential statistics were performed.

RESULTS

of the 121 videos analyzed, 26 did not comply with any indicator on cardiopulmonary resuscitation, four reached 81% compliance, eight videos reached 79%, nine reached 69% and 74 videos, from 6% to 63%. According to the principles of digital health literacy, one video met 85% of the indicators, 81 met from 50% to 80% and 39, from 10% to 49%. A positive correlation was identified between literacy and cardiopulmonary resuscitation.

CONCLUSION

no video presented 100% compliance with the American Heart Association guidelines. The absence of mechanisms for supervision and control over health-related contents allows for the posting of mistaken videos, which have been used as a learning method by people and can thus miss their greatest goal: save lives.

Reanimación cardiopulmonar para legos: evaluación de videos desde la perspectiva de la alfabetización digital en salud

Resumen Objetivo: analizar los indicadores de calidad y contenido técnico de los videos publicados en la plataforma YouTube, para legos, sobre reanimación cardiopulmonar en adultos y su producción audiovisual según los principios de la alfabetización digital en salud. Método: estudio descriptivo, exploratorio, que seleccionó videos grabados entre diciembre de 2015 y abril de 2021. Fueron analizados en función de los indicadores de producción de material audiovisual, considerando las directrices de la American Heart Association y los principios de la alfabetización digital en salud. Se realizó estadística descriptiva e inferencial. Resultados: de los 121 videos analizados, 26 no cumplieron con ninguno de los indicadores de reanimación cardiopulmonar; cuatro lograron un 81% de conformidad; ocho videos, 79%; nueve videos, 69% y 74 videos de seis a 63%. De acuerdo con los principios de la alfabetización digital en salud, un video cumplió con el 85% de los indicadores; 81 videos cumplieron del 50 al 80% y 39 videos del 10 al 49%. Se identificó una correlación positiva entre la alfabetización y la reanimación cardiopulmonar. Conclusión: ningún video cumplió el 100% de las directrices de la American Heart Association. La falta de mecanismos de supervisión y control sobre los contenidos relacionados con la salud permite la publicación de videos erróneos, que han sido utilizados como experiencia de aprendizaje por las personas y es probable que no cumplan con el principal objetivo, que es salvar vidas.

Cardiopulmonary resuscitation for lay people: Evaluation of videos from the perspective of digital health literacy

Objective:

to analyze the quality indicators and technical content of the videos for lay people posted on the YouTube platform, on cardiopulmonary resuscitation in adults and their audiovisual production regarding the principles of digital health literacy.

Method:

a descriptive and exploratory study, which selected videos recorded between December 2015 and April 2021. They were analyzed by indicators of the production of audiovisual material, considering the American Heart Association guidelines and the principles of digital health literacy. Descriptive and inferential statistics were performed.

Results:

of the 121 videos analyzed, 26 did not comply with any indicator on cardiopulmonary resuscitation, four reached 81% compliance, eight videos reached 79%, nine reached 69% and 74 videos, from 6% to 63%. According to the principles of digital health literacy, one video met 85% of the indicators, 81 met from 50% to 80% and 39, from 10% to 49%. A positive correlation was identified between literacy and cardiopulmonary resuscitation.

Conclusion:

no video presented 100% compliance with the American Heart Association guidelines. The absence of mechanisms for supervision and control over health-related contents allows for the posting of mistaken videos, which have been used as a learning method by people and can thus miss their greatest goal: save lives.

Características Sócio-comportamentais, o Conhecimento Sobre o Exame Citopatológico e os Resultados Citológicos de Usuárias do Serviço Único de Saúde

Objetivos: Analisar, por meio de estudo de coorte transversal, a associação entre as características sociodemográficas-comportamentais, o conhecimento sobre o exame citopatológico e o resultado citológico das mulheres atendidas no Centro de Saúde da Família (CSF) da Vila Mutirão, em Goiânia, Goiás. Métodos: As pacientes incluídas no estudo atendidas responderam um questionário sobre o conhecimento a respeito do exame citopatológico, características sociodemográficas e comportamentais. Os dados coletados foram inseridos em um banco de dados no Microsoft® Excel 2010 e utilizado o Software R i386 versão 3.6.3. Para validação das associações foi utilizado o teste do Qui-quadrado (x²), com nível de significância de 5% (p<0,05). Resultados: Das 64 participantes, 96,8% possuem escolaridade até o ensino fundamental. Dessas, 65,5% afirmam ser pardas, a maioria com renda familiar menor que dois salários mínimos, indicando 53,1%. Cerca de 78,0% possuem vida sexualmente ativa, sendo 54,7% iniciado após os 16 anos, 49,2% apresentavam mais de dois parceiros sexuais. Sobre o conhecimento do citopatológico, 93,8% tem o conhecimento, entretanto 89,9% não o realizam na periodicidade adequada. A microbiota lactobacilar foi a mais frequente com 60,93%. Mulheres que faziam uso de cigarros há mais de 10 anos tiveram maior frequência de microbiota não lactobacilar no exame citopatológico com significante associação (p=0,0065). Conclusões: O estudo reforça a importância da necessidade de criação estratégica de medidas educativas e de saúde pública, além de programas de educação sexual e sobre a importância da realização do exame citopatológico e sua periodicidade.

Helicobacter pylori virulence dupA gene: risk factor or protective factor?

Helicobacter pylori is the etiological agent of chronic gastritis, peptic ulcer, and gastric cancer. The duodenal ulcer-promoting gene dupA, which is located in the plasticity region of the H. pylori genome, is homologous to the virB gene which encodes a type IV secretion protein in Agrobacterium tumefaciens. Studies have shown associations between H. pylori dupA-positive strains and gastroduodenal diseases. However, whether dupA acts as a risk factor or protective factor in these diseases remains unclear. Therefore, in this study, we aimed to verify the presence of the dupA gene in infectious H. pylori strains in the Brazilian mid-west and to investigate its association with the clinical outcomes of patients with dyspepsia. Additionally, the phylogenetic origin of the strains was determined. Gastric biopsies from 117 patients with dyspepsia were analyzed using histological and molecular techniques. The hpx gene (16S rRNA) was used to screen for H. pylori infection, and positive samples were then subjected to dupA gene detection and sequencing. The estimated prevalence of H. pylori infection was 64.1%, with the dupA gene being detected in a high proportion of infectious strains (70.7%). Furthermore, a risk analysis revealed that for women, a dupA-positive H. pylori infection increased the chance of developing gastritis by twofold. The partial dupA sequences from isolated infectious strains in this work are similar to those of strains isolated in westerns countries. This study provides useful insights for understanding the role of the H. pylori dupA gene in disease development.

Effectiveness of multipoint cardiac resynchronizing therapy in heart failure: a systematic review and meta-analysis of randomized controlled trials

BACKGROUND

Cardiac resynchronization therapy is an important validated technique for patients with dyssynchrony and heart failure. However, the response rate to conventional resynchronization is approximately 50%; therefore, new techniques and schedules have emerged. This study aimed to evaluate the different clinical and echocardiographic variables of conventional versus multipoint cardiac resynchronization therapy.

RESEARCH DESIGN AND METHOD

A systematic review was conducted of randomized clinical trials in the PubMed, Cochrane, and Embase databases on cardiac resynchronization intervention with multipoint stimulation clinical and echocardiographic outcomes evaluated before and 3 months after the intervention.

RESULTS

Three studies (N = 139) were ultimately selected, and 100% of patients had a New York Heart Association functional class of II-IV, QRS > 120 ms, and a left ventricular ejection fraction < 35%. Significantly greater improvement was observed in the functional class of patients who underwent multipoint versus conventional therapy. The final systolic volume and ejection fraction improved in the multipoint group, but the difference was not statistically significant.

CONCLUSIONS

The literature lacks sufficient randomized controlled studies to enable conclusions regarding cardiac resynchronization therapy responses using different strategies. Moreover, the improvement in functional class in the multipoint pacing group involved few patients and had slight statistical relevance.

Acústicas bioquímicas semi-automatizadas por processamento de imagem Dipstick com base em arduino

Apesar da ampla disponibilidade de dispositivos para leitura de tiras reativas para análise de urina, falhas potenciais persistem na rotina baseada na interpretação humana. O objetivo deste estudo foi desenvolver e avaliar o desempenho de um dispositivo baseado em Arduino para a leitura semi-automática de parâmetros de fitas reativas. O parâmetro glicose de um modelo de tira reativa comercial foi analisado pelo sistema, que prevê a concentração do analito submetendo a cor observada na tira a um modelo de regressão, ajustado a um banco de dados de padrões de cores. O sistema foi avaliado através da leitura de 80 tiras com 16 amostras de concentrações aleatórias de glicose. O menor coeficiente de variação após cinco leituras replicadas foi de 4,5% e o mais alto foi de 16,6% (MSE = 68,7 mg / dL; r = 0,979). O dispositivo apresentou resultados satisfatórios mais baixos custos. Para torná-lo útil na rotina laboratorial, seriam necessárias novas experiências com outros parâmetros e outras classes de tiras reativas para análise de urina.

Evaluation of breastfeeding self-effectiveness and its associated factors in puerperal women assisted at a public health system in Brazil

Abstract Objectives: evaluate breastfeeding self-efficacy and its associated factors in puerperal women assisted at a public health system in Brazil. Methods: it is a cross-sectional analytical study, with convenience sampling and two instruments: sociodemographic, personal and clinical, and Breastfeeding Self-Efficacy Scale (BSES-SF), applied to puerperal women in a puerperal outpatient clinic at two public maternity hospitals in Goiânia/GO, from September to November 2019. Inclusion criteria: mothers in puerperal period, age above 18 years, children born at term and on exclusive breastfeeding. Exclusion criteria: report depression and premature wean. Results: 128puerperal women were interviewed. The average age was 26.7 (± 5.9) years old. The levels of self-efficacy were high (95.3%) and no puerperal had a low level. The variables with statistical significance were: experience in breastfeeding (p= 0.0312), not having received information on breastfeeding during pregnancy (p=0.0292), did not receive other milk at the maternity (p=0.0380), did not feel pain while breastfeeding (p=0.0242), being able to breastfeed on demand (p=0.0124), presence of breast engorgement (p=0.0207), presenting protruding nipples (p=0.0427). Conclusions: clinical and personal aspects were identified as risk factors for early weaning. This can provide information for the training ofprofessionals and structuring the interventions in health services, with a view in preventing these risks.

An In Silico Analysis Identified FZD9 as a Potential Prognostic Biomarker in Triple-Negative Breast Cancer Patients

Objective

Breast cancer (BC) is the main cause of cancer-related deaths in women across the world. It can be classified into different subtypes, including triple-negative (TN), which is characterized by the absence of hormone receptors for estrogen and progesterone and the lack of the human epidermal growth factor receptor 2. These tumors have high heterogeneity, acquire therapeutic resistance, and have no established target-driven treatment yet. The identification of differentially expressed genes in TN breast tumors and the in silico validation of their prognostic role in these tumors.

Materials and Methods

We employed a microarray dataset and, by using the GEO2R tool, we identified a list of differentially expressed genes. The in silico validation was conducted using several online platforms including the KM Plotter, cBioPortal, bc-GenExMiner, Prognoscan, and Roc Plotter.

Results

We observed that FZD9 was among the top differentially expressed genes in a cohort of patients with different TNBC subtypes. The FZD9 expression was significantly different in TN breast tumors than in non-TN (nTN) breast tumors (p<0.0001), and the basal TN subtype showed the highest levels (p<0.0001). In addition, the FZD9 levels were significantly inversely and positively proportional (p<0.0001) to estrogen receptor, progesterone receptor, and human epidermal growth factor receptor-2 clinical parameters. The high levels of FZD9 were associated with worse overall survival (p=0.007), relapse-free survival (p=5.8e-05), and worse survival in patients who received chemotherapy (p=3.2e-05; 0.007).

Conclusion

Our cumulative results demonstrated that FZD9 plays an important role in TNBC and may be a potential prognostic biomarker. Nevertheless, further in vitro and in vivo assays are necessary to confirm our findings and to strengthen the evidences about the mechanisms by which FZD9 functions in these tumors.

Major mutations in the NS3 gene region of hepatitis C virus related to the resistance to direct acting antiviral drugs: a systematic review

Hepatitis C virus (HCV) remains a global public health problem with high prevalence rates and chronicity of infection. Present work aimed to describe the main mutations in the NS3 region of the HCV genome related to the resistance of patients to the currently available direct-acting antivirals (DAAs). To guide the study description, the preferred items in the PRISMA protocol for systematic review were used. The data collected were HCV genotypes and subtypes and mutations in HCV NS3, general and stratified by continent. The 10 papers selected for this systematic review reported studies in seven countries, on three continents, and generated data of 2937 patients. The most frequent HCV subtype was 1a. Prevalence of genotypes suggested that there were few demographic regions reached by the studies, since there were regional variations in the type of genotypes reported in the available bibliographies. Of the total study population, 35.3% (n = 1037) had mutations in the NS3 gene region of HCV, suggesting a high rate of resistance to DAAs and a low sustained virologic response among those who used some therapeutic option. Ten major mutations were identified: Q80K, V170I, S122G, V36L, T54S, D168Q, A156S, Q80G, S122R, and V55A. The Q80K mutation was the highlight of the study, appearing not only with greater representativity (61.6%) but also as the only one described in the three continents analyzed. This systematic review reinforces the need to carry out more studies of detection of these mutations to fill in all information gaps that might help in optimization of treatment.

Doenças associadas à deficiência do sistema complemento

Introdução: O sistema complemento é composto por diversas proteínas plasmáticas e é um importante mecanismo de defesa da imunidade inata e adquirida, que exerce funções homeostáticas e fisiológicas, como a remoção de células apoptóticas e complexos imunes. A deficiência neste mecanismo pode ser hereditária ou adquirida, e leva ao aumento da susceptibilidade a doenças infecciosas e não infecciosas, raras e fatais. Objetivo: Descrever as principais causas e consequências da deficiência do sistema complemento e relacioná-las com múltiplas patologias. Material e Métodos: Trata-se de uma revisão bibliográfica narrativa, tendo como base de dados, artigos publicados no Scientific Electronic Library Online (SciELO), National Library of Medicine (PubMed), Medical Literature Analysis and retrieval System Online (MEDLINE), nos últimos 5 anos. Resultados: A associação do complemento e doenças foram observadas em situações de deficiência do sistema complemento, anormalidades na regulação e nas inflamações. Mutações genéticas ou aumento do consumo do complemento levam à ativação imprópria ou excessiva do complemento, podendo conduzir a consequências lesivas e ao desenvolvimento de diversas doenças, como, lúpus eritematoso sistêmico, síndrome urêmica hemolítica atípica, glomerulopatia C3, hemoglobinúria paroxística noturna, glomerulonefrite pósinfecciosas, artrite reumatoide, dentre outras. Conclusão: É evidente a participação do sistema complemento na patogênese e patogenia de diversas doenças. O investimento em pesquisas, que visem ampliar o entendimento do papel do mecanismo do sistema complemento, pode contribuir para o desenvolvimento de intervenções terapêuticas paliativas e ou de cura de diversas doenças, com a consequente melhoria da qualidade de vida dos indivíduos acometidos.

Percepção dos familiares sobre a atuação da equipe de cuidados paliativos durante internação hospitalar

O presente estudo objetivou compreender as repercussões dos cuidados paliativos na perspectiva de familiares de pacientes durante o período de internação hospitalar. Trata-se de um estudo transversal descritivo com abordagem qualitativa e exploratória. O procedimento metodológico utilizado nesse estudo compreendeu na realização de entrevistas semiestruturadas com familiares de pacientes em cuidados paliativos internados em um hospital de referência em reabilitação e readaptação da cidade de Goiânia/GO. Os critérios de inclusão foram: Familiares de pacientes em período de internação com condições para dar entrevista e com idade superior a 18 anos. Já como critérios de exclusão, não foram pesquisados familiares que referiram diagnóstico de algum transtorno psiquiátrico e menores de 18 anos. A análise das entrevistas se baseou na perspectiva da Teoria Fundamentada nos Dados. Após a transcrição e posterior análise das entrevistas, as categorias explicativas que surgiram dos discursos das entrevistadas foram: 1) Causa da internação e noção de cuidados paliativos; 2) Abordagem da equipe e adesão dos familiares; 3) Fragilidades e potencialidades da equipe; 4) Dificuldades e expectativas. Os resultados obtidos permitem concluir que a percepção dos familiares em relação à equipe de cuidados paliativos é da existência de lacunas e dificuldades por parte da equipe em assistir de forma adequada e emancipatória os pacientes e familiares, não comtemplando os objetivos  do tratamento proposto. Foi possível compreender os anseios dos usuários e as fragilidades da equipe. Tal fato pode contribuir para o planejamento de estratégias futuras, visando melhorias na assistência da equipe de cuidados paliativos.

Avaliação do impacto familiar em pais de crianças diagnosticadas com microcefalia pelo Zika Vírus

Objetiva-se avaliar o impacto familiar em pais de crianças diagnosticadas com microcefalia pelo Zika vírus. Trata-se deum estudo transversal analítico com abordagem quantitativa, utilizando-se de um questionário sociodemográfico e aescala de impacto familiar (EIF). Foram pesquisados 76 pais com filhos em tratamento de reabilitação e readaptaçãoem um centro de referência de Goiânia/GO. Foram realizadas análises descritivas utilizando-se frequência relativa eabsoluta, média e desvio padrão. O teste utilizado para avaliar a existência ou não de diferença estatisticamente significativa (p≤0,05) foi a análise de variância (ANOVA) Scheffé. O pré-natal foi o período predominante do recebimentodo diagnóstico de microcefalia. Foi evidenciado uma dificuldade por parte dos pais em encontrar pessoas de confiançapara cuidar do filho, bem como, falta de compreensão de outras pessoas pelo fardo que é cuidar do filho deficiente.Os participantes que apresentaram maior tendência em empreender atividades com amigos, festas e bares, também semostraram mais propensos a atividades físicas e de lazer. Após o choque inicial do recebimento do diagnóstico, os paispassam reorganizar e adaptar aos desafios, alterando a rotina familiar. É fundamental o envolvimento dos profissionaisde saúde, fornecendo suporte e orientação a essas famílias.Palavra-chave: Infecção pelo Zika vírus; Microcefalia; Saúde da Família. ABSTRACTAimed to evaluate the family impact in parents of children diagnosed with microcephaly by the Zika virus. This is a crosssectional analytical study with a quantitative approach, using a sociodemographic questionnaire and the Family Impact Scale(FIA). A total of 76 parents with children in rehabilitation and rehabilitation treatment were surveyed at a reference centerin Goiânia / GO. Descriptive analyzes were performed using relative and absolute frequency, mean and standard deviation.The test used to evaluate the existence or not of a statistically significant difference (p≤0.05) was the analysis of variance(ANOVA) Scheffé. Prenatal care was the predominant period for the diagnosis of microcephaly. It was evidenced a difficultyfor the parents to find reliable people to take care of the child, as well as lack of understanding of others for the burdenof caring for the disabled child. Participants who showed a greater tendency to engage in activities with friends, parties andbars were also more prone to physical and leisure activities. After the initial shock of receiving the diagnosis, the parentsreorganize and adapt to the challenges, changing the family routine. The involvement of health professionals is essential,providing support and guidance to these families.Keywords: Zika Virus infection; Microcephaly; Family health.

Association between polymorphisms in the genes encoding toll-like receptors and dectin-1 and susceptibility to invasive aspergillosis: a systematic review

Invasive aspergillosis is a common fungal infection in immunocompromised individuals. Some studies have shown that toll-like receptor and dectin-1 genetic polymorphisms may alter signaling pathways, thus increasing an individual's susceptibility to invasive aspergillosis. We investigated the pertinent literature to determine whether polymorphisms in the genes encoding toll-like receptors and dectin-1 increase the susceptibility to invasive aspergillosis. This study systematically reviewed the literature using the databases PubMed/PMC, Scopus, and Web of Science using the keywords invasive aspergillosis, polymorphism, Toll-like, and Dectin-1. From the initial search, 415 studies were found and according to our inclusion and exclusion criteria, eight studies were selected. Several studies described single-nucleotide polymorphisms (SNPs) that are associated with a greater susceptibility to invasive aspergillosis. These SNPs were found in the genes that encode toll-like receptors 1, 3, 4, and 5 and the gene that encodes dectin-1; upon activation, both cellular receptors initiate a signaling cascade that can result in the production of cytokines and chemokines. Thus, our literature review uncovered a significant association between polymorphisms in the genes that encode toll-like receptors and dectin-1 and invasive aspergillosis. More studies should be performed to better understand the relationship between toll-like receptor and dectin-1 genetic polymorphisms and invasive aspergillosis susceptibility.

Comprehension of the education handout and health literacy of pacemaker users

ABSTRACT Objective: To verify the comprehension of the education handout and the level of Functional Health Literacy of individuals with cardiac pacemaker (PM) and whether there is correlation between the comprehension and Functional Health Literacy (FHL). Method: Cross-sectional study with 63 individuals with PM who answered to comprehension tests of the handout, literacy assessment (SAHLPA-50) and cognition (MMSE). Measurements of dispersion, Pearson correlation and multiple linear regression were calculated. Results: Most women, study time ≤ 9 years, 66.21 (average age) presented no cognitive changes. An adequate literacy level was evidenced in 50.8% individuals with PM and satisfactory comprehension of the handout. No correlation was identified between FHL, handout comprehension, age, years of study and cognition. Conclusion: The handout comprehension assessed by individuals with appropriate FHL indicated that it can be a printed material suitable for use, aiming to improve care process and knowledge of individuals with PM.

GSTM1 and GSTT1 genes null polymorphisms in kidney cancer susceptibility: evidence based on a meta-analysis

INTRODUCTION

Renal cancer is a complex and multifactorial oncourologic disease.

OBJECTIVE

To conduct a meta-analysis in order to investigate the association of GSTM1 and GSTT1 genes null polymorphisms in renal cancer.

METHOD

Case-control studies in humans, published from 1999 to 2013, that investigated the association of GSTM1 and GSTT1 genes null polymorphisms in renal cancer were grouped in order to make of this meta-analysis.

RESULTS

Ten articles were selected on the subject proposed. No associations were found between polymorphisms of GSTM1-null (OR = 1.015, 95% CI = 0.897 to 1.147) and GSTT1-null (OR = 1.081, 95% CI = 0.791 to 1.479) and renal cancer.

CONCLUSIONS

Based on the results obtained, we conclude that the GSTM1 and GSTT1 null polymorphisms are not associated with the risk of developing renal cancer, since they have limited role, if there is any on effective contribution in the development of renal tumors.

GENOTYPE ASSOCIATION GSTM1 NULL AND GASTRIC CANCER: EVIDENCE-BASED META-ANALYSIS

BACKGROUND

Gastric cancer is the fourth most common cancer in men and the sixth among women, except for non-melanoma skin tumors, in Brazil. Epidemiological evidences reveal the multifactorial etiology of this cancer, highlighting risk factors such as: infection by the bacterium Helicobacter pylori, advanced age, smoking, chronic alcohol abuse, eating habits and genetic polymorphisms. Considering the context of genetic polymorphisms, there is the absence of the GSTM1 gene. The lack of GSTM1 function to detoxify xenobiotics and promote defense against oxidative stress leads to increased DNA damage, promoting gastric carcinogenesis. This process is multifactorial and the development of gastric cancer results from a complex interaction of these variables.

OBJECTIVE

The aim of this study was to investigate the association of GSTM1 null polymorphism in the pathogenesis of gastric cancer.

METHODS

A meta-analysis was conducted from 70 articles collected in SciELO and PubMed databases, between September 2015 and July 2016. In order to evaluate a possible association, we used the odds ratio (OR) and confidence interval of 95% (CI 95%). To assess the heterogeneity of the studies was used the chi-square test. Statistical analysis was performed using the BioEstat® 5.3.

RESULTS

This study included 70 studies of case-control, including 28,549 individuals, which were assessed for the null polymorphism of the GSTM1 gene, and of which 11,208 (39.26%) were cases and 17,341 (60.74%) were controls. The final analysis showed that the presence of the GSTM1 gene acts as a protective factor against the development of gastric cancer (OR=0.788; 95%CI 0.725-0.857; P<0.0001). Positive statistical association was found in Asia (OR=0.736; 95%CI 0.670-0.809; P<0.0001) and Eurasia (OR=0.671; 95%CI 0.456-0.988; P=0.05). However, statistically significant data was not obtained in Europe (OR=1.033; 95%CI 0.873-1.222; P=0.705) and America (OR=0.866; 95%CI 0.549-1.364; P=0.534). Therefore, the results can not be deduced around the world.

CONCLUSION

This meta-analysis concluded that the presence of the GSTM1 gene is a protector for the emergence of gastric cancer, especially in Asian countries, but this result was not found in Europe and America.

Functional health literacy and knowledge of renal patients on pre-dialytic treatment

OBJECTIVE:

to analyze the functional health literacy (FHL), i.e., understanding and knowledge about chronic renal disease of 60 patients in pre-dialytic treatment.

METHOD:

this is a cross-sectional study. FHL was measured by B-TOFHLA; and the knowledge, by questionnaire. Pearson correlation and Chi-square tests were carried out as well as linear regression models.

RESULTS:

all respondents presented inadequate FHL, and most showed insufficient knowledge about the disease and treatment. Low schooling was a predictive factor for worst FHL scores. Insufficient knowledge was related to age and compromised cognition.

CONCLUSION:

although association between predictive variables has not been found, limited capability to obtain and use health-related information and insufficient knowledge about their own condition and treatment can contribute to worse outcomes for CKD. Appropriate intervention strategies are necessary to deal with limited FHL and also greater knowledge and ability of professionals to deal with the matter.

BRAF overexpression is associated with BRAF V600E mutation in papillary thyroid carcinomas

A common mutation in the BRAF gene, comprising the T1799A nucleotide transversion, which leads to the V600E amino acid substitution in the BRAF protein, has been observed in about 50% of papillary thyroid carcinomas (PTCs). However, BRAF protein expression has been rarely examined in such tumors. Clinical studies have shown important associations between BRAF mutation and clinical parameters in PTC, such as progression, invasion, and recurrence. The aim of this study was to evaluate the association between BRAF protein overexpression and the BRAF V600E mutation in a group of PTC patients. The study group included 116 patients with PTC from Araújo Jorge Hospital, Goiânia, Goiás, Brazil. Immunohistochemistry was utilized to analyze BRAF protein expression. Presence of the BRAF V600E mutation was determined by polymerase chain reaction amplification and restriction fragment length polymorphism, and confirmed by direct sequencing. The chi-square test with Yates correction and the Fisher exact test were used for statistical analysis. BRAF overexpression was detected in 55 patients with PTC (47.4%) and the BRAF V600E mutation was observed in 74 patients (63.8%). In the studied group, significant associations were observed between the BRAF V600E mutation and BRAF protein overexpression (P = 0.0115), and also between BRAF overexpression and extra-thyroid extension of the tumor (P = 0.0111). This study demonstrated a significant association between BRAF overexpression and the BRAF V600E mutation in PTC, highlighting the importance of these molecular events in the process of PTC carcinogenesis.

Association of the TP53 codon 72 polymorphism and breast cancer risk: a meta-analysis

This study was conducted in order to investigate the implications of the R72P polymorphism in the TP53 gene in breast cancer risk. The enlightenment of this matter might provide a piece of information about the potential implications of this polymorphism in patient risk. A meta-analysis was conducted considering a large sample size from studies with conflicting results on the R72P polymorphism in breast cancer patients. Relevant studies were selected from PubMed and SciELO databases for data extraction and statistical analysis. Database was built according to the continent and considering the genotype frequencies, sample size and genotyping methodology. The dominant models (RR vs RP + PP and RR + RP vs. PP), homozygous (RR vs. PP), heterozygous (RR vs. RP and RP vs. PP) and the allele (R vs. P) were used. Genotype frequencies were summarized and evaluated by χ² test of heterogeneity in 2×2 contingency tables with 95% CIs. Odds Ratios (OR) were calculated with a fixed-effect model (Mantel-Haenszel) or a random-effect model (DerSimonian-Laird) if the studies were considered homogeneous (P > 0.05) or heterogeneous (P < 0.05), respectively, using BioEstat® 5.0 software. Supported by a large sample size composed by 25,629 cases and 26,633 controls from 41 studies, we found significant association between the R72P polymorphism in the TP53 gene and the breast cancer risk. The overall data shows an increased risk due to the P allele dominant model, but not in Asia where the risk was associated with the R allele and R dominant model.

Dificuldades enfrentadas pelos pais de crianças com doença do refluxo gastroesofágico

Objetivo Identificar as dificuldades enfrentadas pelos pais de crianças com doença do refluxo gastroesofágico.Métodos Pesquisa qualitativa realizada com 16 familiares de crianças com doença do refluxo gastroesofágico. Foi utilizada uma questão norteadora, as entrevistas foram gravadas e transcritas. Utilizou-se a técnica de análise de conteúdo.Resultados Emergiram oito categorias relacionadas às dificuldades enfrentadas pelos pais: vômitos frequentes, pneumonia, custo com tratamento, convívio social prejudicado, perda de peso, padrão de sono prejudicado, gerando dificuldade na adesão ao tratamento com orientações insuficientes.Conclusão As dificuldades enfrentadas pelos pais de crianças com refluxo gastroesofágico foram representadas por categorias que podem servir de indicadores para a qualidade do cuidado prestado.

Analysis of the BRAF V600E mutation in primary cutaneous melanoma

BRAF V600E is the most common mutation in cutaneous melanomas, and has been described in 30-72% of such cases. This mutation results in the substitution of valine for glutamic acid at position 600 of the BRAF protein, which consequently becomes constitutively activated. The present study investigated the BRAF V600E mutation frequency and its clinical implications in a group of 77 primary cutaneous melanoma patients treated in a cancer reference center in Brazil. Mutation analysis was accomplished by polymerase chain reaction, restriction fragment length polymorphism, and automated DNA sequencing. The chi-squared and Fischer exact tests were used for comparative analyses. The BRAF V600E mutation was detected in 54/77 (70.1%) melanoma subjects. However, no statistically significant association was found between the presence of the mutation and clinical or prognostic parameters. Our results demonstrated that the BRAF V600E mutation is a common event in melanomas, representing an important molecular target for novel therapeutic approaches in such tumors.

Qualidade de vida e tratamento hemodialítico: avaliação do portador de insuficiência renal crônica

Os relatos de portadores de insuficiência renal crônica em hemodiálise sobre as alterações em seu cotidiano após o início do tratamento motivaram indagar quais aspectos têm alterado a qualidade de suas vidas (QV). Estudo descritivo exploratório objetivando avaliar a QV dos portadores de doença renal crônica em hemodiálise, por meio do instrumento Kidney Disease and Quality of Life Short Form (KDQOL-SF). Foram entrevistados 72 pacientes em Goiânia - Brasil, entre abril e maio de 2005. A maioria (52,8%) era do sexo masculino, idade média 51,1 ± 16,6 anos, católica, renda menor que 2 salários mínimos ou não trabalhava, tinha companheiro fixo e fazia hemodiálise há menos que 60 meses. Os maiores escores foram obtidos nas Dimensões “Estímulo por Parte da Equipe de Diálise” (88,37), “Qualidade da Interação Social” (80,83) e “Função Cognitiva” (80,74). As Dimensões “Função Física” (20,49) e “Papel Profissional” (22,22) obtiveram os menores escores. A percepção dos indivíduos nas Dimensões do KDQOL-SF foi influenciada pela religião, gênero, idade, tempo de tratamento, presença de companheiro fixo, escolaridade, se residia sozinho e pelo trabalho. Conclui-se que o indivíduo em hemodiálise sofre alterações na sua QV, as quais indicam que aspectos estão influenciando-a negativamente e que podem direcionar ações dos profissionais.

Genotipagem de Papiloma Vírus Humano em paciente com papilomatose laríngea recorrente

Os HPVs são vírus de DNA circular de fita dupla medindo cerca de 8000pb. Vários estudos têm demonstrado que o HPV é o agente causal de tumores benignos, como papilomas, verrugas comuns e condilomas. Com o avanço das técnicas de detecção molecular, o genoma do HPV tem sido freqüentemente identificado em células neoplásicas malignas de origem epitelial, passando-se a associar o HPV a alguns tumores epiteliais, principalmente ao carcinoma cervical. Recentemente, diversas pesquisas se concentraram na tentativa de associar a infecção por HPVs aos cânceres de cabeça e pescoço. O presente relato de caso consiste na avaliação de uma paciente com história de papilomatose recorrente na laringe. Uma criança com sete anos de idade, do sexo feminino, foi atendida há dois anos com queixas de desconforto na garganta e disfonia. Os vários procedimentos clínicos indicaram presença de papilomas na laringe e o histopatológico acusou presença de coilocitose, achado sugestivo da infecção por HPV. Assim, a paciente foi submetida à retirada cirúrgica dos papilomas. Das peças cirúrgicas foi obtido DNA total, usado na investigação molecular, por PCR, para detecção do genoma de HPV. Desta forma, foi confirmada a presença do HPV do tipo 11, corroborando os achados de outros autores que argumentam que a ocorrência latente do HPV11 tem participação na evolução dessa patologia em crianças.