Sex- and age-related differences in the management and outcomes of chronic heart failure: an analysis of patients from the ESC HFA EORP Heart Failure Long-Term Registry

Aims: This study aimed to assess age- and sex-related differences in management and 1-year risk for all-cause mortality and hospitalization in chronic heart failure (HF) patients. Methods and results: Of 16 354 patients included in the European Society of Cardiology Heart Failure Long-Term Registry, 9428 chronic HF patients were analysed [median age: 66 years; 28.5% women; mean left ventricular ejection fraction (LVEF) 37%]. Rates of use of guideline-directed medical therapy (GDMT) were high (angiotensin-converting enzyme inhibitors/angiotensin receptor blockers, beta-blockers and mineralocorticoid receptor antagonists: 85.7%, 88.7% and 58.8%, respectively). Crude GDMT utilization rates were lower in women than in men (all differences: P\ua0 64 0.001), and GDMT use became lower with ageing in both sexes, at baseline and at 1-year follow-up. Sex was not an independent predictor of GDMT prescription; however, age >75 years was a significant predictor of GDMT underutilization. Rates of all-cause mortality were lower in women than in men (7.1% vs. 8.7%; P\ua0=\ua00.015), as were rates of all-cause hospitalization (21.9% vs. 27.3%; P\ua075 years. Conclusions: There was a decline in GDMT use with advanced age in both sexes. Sex was not an independent predictor of GDMT or adverse outcomes. However, age >75 years independently predicted lower GDMT use and higher all-cause mortality in patients with LVEF 6445%

Occupational Burnout Syndrome in the nursing context: an integrative literature review

OBJECTIVE To characterize the scientific production on Burnout Syndrome in the Nursingcontext, systematizing the location where the studies were carried out, the related constructs, the employed methods and their main results. METHOD An integrative review of the literature with a bibliometric approach of articles published in Portuguese, Spanish and English between 2005 and 2016. RESULTS 106 articles wereincluded. Mostinvolvedprevalence, and were descriptive, quantitative studies performed in hospitals.The Southeastern and Southern regions of Brazil had the largest number of publications, and stress was the construct most related to burnout.Most of the studies used the Maslach Burnout Inventory to investigate the presence of the syndrome. CONCLUSION New case-control and cohort studies should be carried out.Qualitative-exploratory studies are necessary to better understand Burnout Syndrome among nursing professionals usingfocus groups or interviews, as well as comparative causal studies, with the purpose of exploring the syndrome’smanifestations.OBJETIVO Caracterizar a produção científica sobre a Síndrome do Esgotamento Profissionalno contexto da enfermagem, sistematizando os locais onde as pesquisas foram realizadas, os construtos relacionados, os métodos empregados e seus principais resultados. MÉTODO Revisão integrativa da literatura, com abordagem bibliométrica, em artigos na língua portuguesa, espanhola e inglesa publicados entre 2005 e 2016. RESULTADOS Foram selecionados 106 artigos.A maioria estudos de prevalência, descritivos, quantitativos e realizados em hospitais. Nas regiões Sudeste e Sul do Brasil encontram-se o maior número de publicações, sendo o estresse o construto mais relacionado com o esgotamento profissional. A maior parte dos estudos utilizou o Maslach Burnout Inventory como meio de averiguação da presença da síndrome. CONCLUSÃO Novos estudos de caso controle e coorte devem ser realizados. Pesquisas de cunho qualitativo-exploratório são necessárias para poder compreender melhor a Síndrome do Esgotamento Profissionalentre os profissionais de enfermagem com grupos focais ou entrevistas, como também pesquisas causais comparativas, com o intuito de explorar as manifestações da síndrome.OBJETIVO Caracterizar la producción científica acerca del Síndrome del Agotamiento Profesionalen el marco de la enfermería, sistematizando los sitios en donde las investigaciones fueron realizadas, los constructos relacionados, los métodos empleados y sus principales resultados. MÉTODO Revisión integrativa de la literatura, con abordaje bibliométrico, en artículos en lengua portuguesa, española e inglesa publicados entre 2005 y 2016. RESULTADOS Fueron seleccionados 106 artículos. La mayoría se compuso de estudios de prevalencia, descriptivos, cuantitativos y realizados en hospitales. En las regiones Sureste y Sur de Brasil se halla el mayor número de publicaciones, siendo el estrés el constructo más relacionado con el agotamiento profesional. La mayor parte de los estudios utilizó el Maslach Burnout Inventorycomo medio de la averiguación de la presencia del síndrome. CONCLUSIÓN Nuevos estudios de caso control y cohorte deben llevarse a cabo. Investigaciones de cuño cualitativo-exploratorio son necesarias para poder comprender mejor el Síndrome del Agotamiento Profesionalentre los profesionales de enfermería con grupos focales o entrevistas, como también investigaciones causales comparativas, a fin de explorar las manifestaciones del síndrome

The anticancer agent 3-bromopyruvate: a simple but powerful molecule taken from the lab to the bedside

At the beginning of the twenty-first century, 3-bromopyruvate (3BP), a simple alkylating chemical compound was presented to the scientific community as a potent anticancer agent, able to cause rapid toxicity to cancer cells without bystander effects on normal tissues. The altered metabolism of cancers, an essential hallmark for their progression, also became their Achilles heel by facilitating 3BP's selective entry and specific targeting. Treatment with 3BP has been administered in several cancer type models both in vitro and in vivo, either alone or in combination with other anticancer therapeutic approaches. These studies clearly demonstrate 3BP's broad action against multiple cancer types. Clinical trials using 3BP are needed to further support its anticancer efficacy against multiple cancer types thus making it available to more than 30 million patients living with cancer worldwide. This review discusses current knowledge about 3BP related to cancer and discusses also the possibility of its use in future clinical applications as it relates to safety and treatment issues.This work was supported by the strategic programme UID/BIA/04050/2013 (POCI-01-0145-FEDER-007569)funded by national funds through the FCT I.P. and by the ERDF through the COMPETE2020 - Programa Operacional Competitividade e Internacionalização (POCI). João Azevedo-Silva received a fellowship from the Portuguese government from the FCT through FSE (Fundo Social Europeu) and POPH (Programa Operacional Potencial Humano) [grant number SFRH/BD/76038/2011]. Co-author Peter L.Pedersen was supported by NIH grant NCICAl0951 for many years for cancer research that led to a number of the findings described in this review.info:eu-repo/semantics/publishedVersio