ASSESSMENT of the EFFECTIVENESS of A FUNCTIONAL SPLINT for OSTEOARTHRITIS of the TRAPEZIOMETACARPAL JOINT of the DOMINANT HAND: A RANDOMIZED CONTROLLED STUDY

Objective: To assess the effectiveness of a functional splint for trapeziometacarpal osteoarthritis.Methods: Forty patients with a diagnosis of painful trapeziometacarpal osteoarthritis of the dominant hand were randomized into 2 groups. the study group received the splint at baseline and used it during activities of daily living for 180 days and the control group used the splint only during the evaluations for the first 90 days and during activities of daily living for the following 90 days. Pain, strength, hand function and dexterity (with and without splint) were measured by a blinded assessor at baseline, 45, 90 and 180 days.Results: the groups were homogenous at baseline for all outcomes evaluated. Pain without the splint was significantly different between groups over time; the study group experienced a decrease in pain beginning with the first evaluation (45 days), whereas the control group achieved a lower pain score only at the end of the study, after having used the splint for 90 days. No significant differences between groups were found for the other parameters.Conclusion: Splint use during activities of daily living for patients with trapeziometacarpal osteoarthritis reduces pain, but does not alter function, grip strength, pinch strength or dexterity.Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Universidade Federal de São Paulo, Div Rheumatol, Rheumatol Rehabil Sect, Disciplina Reumatol, BR-04023900 São Paulo, BrazilUniversidade Federal de São Paulo, Div Rheumatol, Rheumatol Rehabil Sect, Disciplina Reumatol, BR-04023900 São Paulo, BrazilWeb of Scienc

MODELAGEM MATEMÁTICA: UMA OPORTUNIDADE PARA O EXERCÍCIO DA REFLEXIVIDADE DO PROFESSOR DE MATEMÁTICA

The present article shows a discussion around the data achieved in a survey implemented in a group of Mathematics teachers of elementary and secondary school. The aim of this investigation was to point out the Mathematical Modelling potentialities addressed to the exercise of the teacher reflexivity. To the explanations of this research, we based on the orientations of the curriculum directives as to an education that promotes the formation of professionals capable of making decisions and the formation of analytical citizens. Thus, we understood that the Mathematical Modelling, by its peculiar characteristics, promotes the development of pedagogical practices that support a greater interaction between student and teacher, allowing a reflective practice to the teacher. This study was developed in three steps which contemplated: the observation of the involved teachers' lessons in their regular schedule, the development of the teachers continuing formation course with emphasis on Mathematical Modelling, and the observation of these teachers when they were developing Modelling activities along with their students. The Data were analyzed according to a characterization of reflective teacher built by means of Dewey (1933, 1979), Schön (1992, 2000), Zeichner (1993) e Alarcão (2010) texts.From the results achieved we highlighted that the Mathematical Modelling activity actions raise situations that encourage teachers to reflect on their own practices.  Apresentamos neste artigo uma discussão acerca dos resultados obtidos por meio de uma pesquisa, realizada com um grupo de professores de Matemática do ensino fundamental e médio, cujo objetivo era apontar as potencialidades da Modelagem Matemática para o exercício da reflexividade do professor. Dentre as justificativas desta pesquisa, pautamo-nos nas orientações das diretrizes curriculares quanto a um ensino que favoreça a formação de profissionais capazes de tomar decisões e formar cidadãos críticos. Neste sentido, consideramos que a Modelagem Matemática, por suas características peculiares, promove o desenvolvimento de práticas pedagógicas que favorecem uma maior interação entre aluno e professor, possibilitando ao docente uma prática reflexiva. O estudo se desenvolveu em três fases, que contemplaram a observação das aulas dos professores envolvidos em seu horário regular, a realização de um curso de formação continuada de professores com ênfase em Modelagem Matemática, e a observação da aula, desses professores, ao desenvolverem com seus alunos atividades de Modelagem. Os dados foram analisados segundo uma caracterização de professor reflexivo construída a partir dos textos Dewey (1933, 1979), Schön (1992, 2000), Zeichner (1993) e Alarcão (2010). Dentre os resultados obtidos destacamos que as ações peculiares da atividade de Modelagem Matemática, suscitam situações que estimulam os professores à refletirem sobre sua prática. &nbsp

Germline ATM Mutations Detected by Somatic DNA Sequencing in Lethal Prostate Cancer

DNA damage response; PARP inhibition; Prostate cancerRespuesta al daño del ADN; Inhibición de PARP; Cáncer de próstataResposta al dany de l'ADN; Inhibició de PARP; Càncer de pròstataBackground Germline mutations in the ataxia telangiectasia mutated (ATM) gene occur in 0.5–1% of the overall population and are associated with tumour predisposition. The clinical and pathological features of ATM-mutated prostate cancer (PC) are poorly defined but have been associated with lethal PC. Objective To report on the clinical characteristics including family history and clinical outcomes of a cohort of patients with advanced metastatic castration-resistant PC (CRPC) who were found to have germline ATM mutations after mutation detection by initial tumour DNA sequencing. Design, setting, and participants We acquired germline ATM mutation data by saliva next-generation sequencing from patients with ATM mutations in PC biopsies sequenced between January 2014 and January 2022. Demographics, family history, and clinical data were collected retrospectively. Outcome measurements and statistical analysis Outcome endpoints were based on overall survival (OS) and time from diagnosis to CRPC. Data were analysed using R version 3.6.2 (R Foundation for Statistical Computing, Vienna, Austria). Results and limitations Overall, seven patients (n = 7/1217; 0.6%) had germline ATM mutations detected, with five of them having a family history of malignancies, including breast, prostate, pancreas, and gastric cancer; leukaemia; and lymphoma. Two patients had concomitant somatic mutations in tumour biopsies in genes other than ATM, while two patients were found to carry more than one ATM pathogenic mutation. Five tumours in germline ATM variant carriers had loss of ATM by immunohistochemistry. The median OS from diagnosis was 7.1 yr (range 2.9–14 yr) and the median OS from CRPC was 5.3 yr (range 2.2–7.3 yr). When comparing these data with PC patients sequenced by The Cancer Genome Atlas, we found that the spatial localisation of mutations was similar, with distribution of alterations occurring on similar positions in the ATM gene. Interestingly, these include a mutation within the FRAP-ATM-TRRAP (FAT) domain, suggesting that this represents a mutational hotspot for ATM. Conclusions Germline ATM mutations are rare in patients with lethal PC but occur at mutational hotspots; further research is warranted to better characterise the family histories of these men and PC clinical course