Health-related quality of life of primary caregivers of persons with paraplegia

Study Design: A cross-sectional descriptive study was performed with structured questionnaires and interviews conducted with 60 primary caregivers of persons with paraplegia (T1 to S2) owing to traumatic spinal cord injury (SCI).Objectives: the purpose of this study was the assessment of the health-related quality of life (HRQoL) of primary caregivers of persons with paraplegia owing to traumatic SCI.Setting: Sa oSa Paulo, SP, Brazil.Methods: the HRQoL was assessed by the Short Form-36 (SF-36) health survey questionnaire and caregiver burden was evaluated by the Caregiver Burden Scale (CBS).Results: Among 60 caregivers evaluated, 49 (81.7%) were female, with mean age of 35.8 (SD = 12.91) years, 16 (26.6%) being wives and 14 (23.4%) sisters of pe rsons with paraplegia. It was found that the caregivers spend an average of 11.3 h/ day caring for individuals with paraplegia. Twenty-three caregivers (38.3%) had a chronic disease and 32 (53.3%) were sole caregivers taking upon themselves the full responsibility of caring for the persons with paraplegia. the subjects reported lower scores on bodily pain and vitality than the other dimensions of the SF-36. the mean global CBS score was 1.71 (SD = 0.50) and mean scores for each dimension ranged from 1.39 (SD = 0.64) for emotional involvement to 2.44 (SD = 0.79) for environment dimension.Conclusion: the primary caregivers of spinal cord-injured persons reported low scores on all of the SF-36 and CBS dimensions, bodily pain and vitality being the SF-36 dimensions that received the lowest scores.Universidade Federal de São Paulo, Discipline Plast Surg, Div Plast Surg, BR-04023062 São Paulo, BrazilUniversidade Federal de São Paulo, Dept Nursing, BR-04023062 São Paulo, BrazilUniversidade Federal de São Paulo, Discipline Plast Surg, Div Plast Surg, BR-04023062 São Paulo, BrazilUniversidade Federal de São Paulo, Dept Nursing, BR-04023062 São Paulo, BrazilWeb of Scienc

Antibody–drug conjugates: smart chemotherapy delivery across tumor histologies

Antibody-drug conjugates; Enfortumab vedotin; Smart chemotherapyConjugats anticossos-medicament; Enfortumab vedotin; Quimioteràpia intel·ligentConjugados anticuerpos-fármaco; Enfortumab vedotin; Quimioterapia inteligenteAs distinct cancer biomarkers have been discovered in recent years, a need to reclassify tumors by more than their histology has been proposed, and therapies are now tailored to treat cancers based on specific molecular aberrations and immunologic markers. In fact, multiple histology-agnostic therapies are currently adopted in clinical practice for treating patients regardless of their tumor site of origin. In parallel with this new model for drug development, in the past few years, several novel antibody–drug conjugates (ADCs) have been approved to treat solid tumors, benefiting from engineering improvements in the conjugation process and the introduction of novel linkers and payloads. With the recognition that numerous surface targets are expressed across various cancer histologies, alongside the remarkable activity of modern ADCs, this drug class has been increasingly evaluated as suitable for a histology-agnostic expansion of indication. For illustration, the anti-HER2 ADC trastuzumab deruxtecan has demonstrated compelling activity in HER2-overexpressing breast, gastric, colorectal, and lung cancer. Examples of additional novel and potentially histology-agnostic ADC targets include trophoblast cell-surface antigen 2 (Trop-2) and nectin-4, among others. In the current review article, the authors summarize the current approvals of ADCs by the US Food and Drug Administration focusing on solid tumors and discuss the challenges and opportunities posed by the multihistological expansion of ADCs.Paulo Tarantino reports personal fees from AstraZeneca outside the submitted work. Roberto Carmagnani Pestana reports consulting fees from Bayer and honoraria from Pfizer, Merck, Bayer, and Servier outside the submitted work. Shanu Modi reports grants and nonfinancial support from Daiichi-Sankyo, Genentech, Novartis, Synta Pharmaceuticals, Seattle Genetics, Macrogenics, Carrick Pharmaceuticals, and Eli Lilly outside the submitted work. Aditya Bardia reports institutional grants from Genentech, Novartis, Pfizer, Merck, Sanofi, Radius Health, Immunomedics Inc, Mersana, Innocrin, and Biotheranostics Inc; consulting fees from Biotheranostics Inc, Pfizer, Novartis, Genentech, Merck, Radius Health, Immunomedics Inc, Spectrum Pharma, Taiho, Sanofi, Daiichi Pharma, AstraZeneca, Puma, Phillips, and Eli Lilly; and meeting support from Biotheranostics Inc, Pfizer, Novartis, Genentech, Merck, Radius Health, Immunomedics Inc, Spectrum Pharma, Taiho, Sanofi, and Phillips outside the submitted work. Sara M. Tolaney reports consulting fees from Novartis, Eli Lilly, Pfizer, Merck, AstraZeneca, Eisai, Puma, Genentech, Immunomedics Inc, Nektar, Tesaro, Daiichi-Sankyo, Athenex, Bristol Myers Squibb, and Nanostring outside the submitted work. Javier Cortes reports grants from Roche, Ariad Pharmaceuticals, AstraZeneca, Baxalta GMBH-Servier Affaires, Bayer Healthcare, Eisai, F Hoffman-LaRoche, Guardant Health, MSD, Pfizer, Piqur Therapeutics, Puma C, and Queen Mary University of London; intellectual property for MedSIR; consulting fees from Roche, Celgene, Cellestia, AstraZeneca, Biothera Pharmaceuticals, Seattle Genetics, Daiichi Sankyo, Erytech, Athenex, Polyphor, Lilly, Merck Sharp & Dohme, GlaxoSmithKline, Leuko, Bioasis, and Clovis Oncology; and honoraria from Roche, Novartis, Celgene, Eisai, Pfizer, Samsung Bioepis, Lilly, Merck Sharp & Dohme, and Daiichi-Sankyo outside the submitted work. Jean-Charles Soria was formerly employed at AstraZeneca and is now employed by Amgen; owns stock in AstraZeneca, Gritstone Bio, and Relay Therapeutics; and serves on the Board of Directors for Hookipa Pharmaceuticals outside the submitted work. Giuseppe Curigliano reports a grant from Merck; consulting fees from Roche, Pfizer, Novartis, Seattle Genetics, Lilly, Ellipses Pharma, Foundation Medicine, Samsung, Daichii-Sankyo, and Exactsciences; honoraria from Pfizer, Novartis, Seattle Genetics, and Daichii-Sankyo; and meeting support from Foche and Pfizer outside the submitted work. Chiara Corti made no disclosures

Desarrollo y aplicación de la Terapia Asistida por Animales en el hospital universitario

This report refers to the experience of the Board of Nursing of Hospital São Paulo, Universidade de São Paulo, in the development and implantation of Animal-Assisted Therapy, as one of its projects humanization of hospital: Projeto Amicão. Aiming to offer patients a positive experience that differs from the routine of the hospital environment, some units of the Hospiral São Paulo received the visit of an animal for sessions of Animal-Assiste Therapy. The results achieved among patients and its companions and health professionals were positive, in addition to arouse the attention and the interest of other health institutions and the media. It is thus evidenced the importance of reporting the experience of Projeto Amicão in the hospital.Este informe se refiere a la experiencia de la Junta de Enfermería, Hospital de São Paulo (HSP), Universidad Federal de São Paulo en el desarrollo y el despliegue de la Terapia Asistida por Animales (TAA), como uno de sus proyectos de humanización del hospital: Proyecto Amicão. Con la finalidad de ofrecer los pacientes una experiencia positiva que difiere de la rutina del entorno hospitalario, algunas unidades de lo HSP recibió la visita de un animal para los períodos de sesiones de TAA. Los logros entre los pacientes, sus acompañantes y profesionales de la salud fueron positivos, y despertó la atención y el interés de otras instituciones de salud y de los medios de comunicación. Es así de relieve la importancia de comunicar la experiencia del Proyecto Amicão en el hospital.O presente relato refere-se à experiência da Diretoria de Enfermagem do Hospital São Paulo da Universidade Federal de São Paulo (UNIFESP) no desenvolvimento e implantação da Terapia Assistida por Animais, como um de seus projetos de humanização hospitalar: Projeto Amicão. Objetivando proporcionar aos pacientes uma experiência positiva que difere da rotina do ambiente hospitalar, algumas unidades do Hospital São Paulo receberam a visita de um animal para sessões de Terapia Assistida por Animais. Os resultados alcançados entre pacientes, acompanhantes e profissionais da saúde foram positivos, além de despertar a atenção e o interesse de outras instituições de saúde e da mídia. Ficou, assim, evidenciada a importância de se relatar a experiência do Projeto Amicão no ambiente hospitalar.Universidade Federal de São Paulo (UNIFESP) Hospital São Paulo Departamento de EnfermagemCentro Universitário São CamiloUNIFESP, Hospital São Paulo Depto. de EnfermagemSciEL

Success in publication by graduate students in psychiatry in Brazil: an empirical evaluation of the relative influence of English proficiency and advisor expertise

Abstract\ud \ud Background\ud This study evaluates the success of graduate students in psychiatry in an emerging country, in terms of the quantity and quality of their publication productivity (given by the number of papers and impact factors of the journals in which they publish). We investigated to what extent student proficiency in English and the scientific capabilities of academic advisors predict that success.\ud \ud \ud Methods\ud Our sample comprised 43 master’s and doctoral students in psychiatry (n = 28 and n = 15, respectively) at the University of São Paulo School of Medicine, in São Paulo, Brazil. We collected information about their knowledge of English and the ways in which they wrote their articles to be submitted to periodicals published in English. Multiple regression analyses were carried out in order to investigate the influence English proficiency, h-index of supervisors and use of language editing assistance had on the number and impact of student publications.\ud \ud \ud Results\ud Although 60% of students scored ≥80 (out of 100) on English tests given at admission to the graduate program, 93.09% of the sample used some form of external editing assistance to produce their papers in English. The variables “number of publications” and “impact factor of journals” were significantly related to each other (r = 0.550, p < 0.001). Multiple regression analysis revealed that the impact factor of periodicals where students published their articles as first authors correlated significantly not only with student proficiency in English at admission (p = 0.035), but also with the degree of language editing assistance (p = 0.050) and the h-index of the academic advisor (p = 0.050).\ud \ud \ud Conclusions\ud Albeit relevant, knowledge of English was not the key factor for the publication success of the graduate students evaluated. Other variables (h-index of the advisor and third-party language editing assistance) appear to be also important predictors of success in publication.Article with resources from PROEX/CAPE

URBAN CENTER. Una casa di vetro per le politiche urbane.

Nella cultura di governo della città, il termine "Urban Center" (o "Casa della città") designa una serie di strutture il cui denominatore comune risiede nello svolgimento di attività di servizio per le comunità urbane ai fini di soddisfare la crescente domenda di democrazia partecipativa e deliberativa nei processi di trasformazione degli insediamenti. Traendo spunto dalla storicizzazione del fenomeno e dal confronto tra i consolidati modelli statunitensi e le recenti esperienze in Italia, il volume si interroga sulla maturazione delle missioni dell' "Urban Center" nel passaggio da asettico spazio di informazione a luogo provilegiato per la costruzione trasparente di politiche urbane condivise. Il percorso logico del volume si sviluppa seguendo un fil rouge articolato in quattro parti. Il primo blocco si apre con due tematiche che costituiscono dialetticamente la cornice di riferimento entro cui può essere correttamente collocata la questione degli UC: l’urbanistica partecipata e il marketing urbano. Nella seconda parte attraverso lo studio di casi si ricostruisce il quadro delle articolate declinazioni statunitensi di Urban Center, consolidatesi in diversi decenni di storia. Sono strutture fortemente caratterizzate e autonome per stile, missioni, obiettivi, priorità, modalità operative, ma allo stesso tempo accomunate da un equilibrato mix di passione civile e pragmatismo professionale. Il terzo gruppo di saggi è dedicato alla condizione attuale e di prospettiva degli UC in Italia, delineando criticamente una sorta di “mappa dinamica” delle diverse strutture attivate e in divenire, caratterizzate per soggetti ispiratori, missioni “stili” e protagonismo degli attori coinvolti. Il cerchio delle riflessioni si chiude nella quarta parte discutendo la questione dell’innovazione di metodo per la costruzione di un UC sia attraverso la dimensione teoretica che le potenzialità operative. Testi in italiano e inglese di B. Monardo (curatore), M.C. Bizzarri, E. Carmagnani, M. Carta, F. Ceci, P. Colarossi, L. De Bonis, A. Dina, A. De Rossi, D. Filippi, A. Giorgi, P. Laconte, F. Lovato, L. J. Osmond, R. Shiffman, O Tommasi, A. Uttaro; postfazione di M. Ricci

Molecular Profiling of Hepatocellular Carcinoma Using Circulating Cell-Free DNA.

PurposeMolecular profiling has been used to select patients for targeted therapy and determine prognosis. Noninvasive strategies are critical to hepatocellular carcinoma (HCC) given the challenge of obtaining liver tissue biopsies.Experimental designWe analyzed blood samples from 206 patients with HCC using comprehensive genomic testing (Guardant Health) of circulating tumor DNA (ctDNA).ResultsA total of 153/206 (74.3%) were men; median age, 62 years (range, 18-91 years). A total of 181/206 patients had ≥1 alteration. The total number of alterations was 680 (nonunique); median number of alterations/patient was three (range, 1-13); median mutant allele frequency (% cfDNA), 0.49% (range, 0.06%-55.03%). TP53 was the common altered gene [&gt;120 alterations (non-unique)] followed by EGFR, MET, ARID1A, MYC, NF1, BRAF, and ERBB2 [20-38 alterations (nonunique)/gene]. Of the patients with alterations, 56.9% (103/181) had ≥1 actionable alterations, most commonly in MYC, EGFR, ERBB2, BRAF, CCNE1, MET, PIK3CA, ARID1A, CDK6, and KRAS. In these genes, amplifications occurred more frequently than mutations. Hepatitis B (HBV)-positive patients were more likely to have ERBB2 alterations, 35.7% (5/14) versus 8.8% HBV-negative (P = 0.04).ConclusionsThis study represents the first large-scale analysis of blood-derived ctDNA in HCC in United States. The genomic distinction based on HCC risk factors and the high percentage of potentially actionable genomic alterations suggests potential clinical utility for this technology

A multi-element psychosocial intervention for early psychosis (GET UP PIANO TRIAL) conducted in a catchment area of 10 million inhabitants: study protocol for a pragmatic cluster randomized controlled trial

Multi-element interventions for first-episode psychosis (FEP) are promising, but have mostly been conducted in non-epidemiologically representative samples, thereby raising the risk of underestimating the complexities involved in treating FEP in 'real-world' services