um cuidado especializado do enfermeiro obstetra

Observa-se, hoje em dia, que algumas práticas na maternidade tendem a ignorar as preferências das mulheres em trabalho de parto, uniformizando os cuidados com prejuízo para o bem-estar e a qualidade de vida das famílias. As práticas em Obstetrícia têm vindo a tornar-se cada vez mais repletas de intervenção, focando-se apenas nos resultados físicos (mortalidade e morbilidade) e descurando as vivências das parturientes e família, assim como as consequências psicossociais de um parto traumático. O presente Relatório de Estágio pretende refletir os cuidados em maternidade na perspetiva EEESMOG, que se visa holística, centrada no cliente e baseada na evidência. Da mesma forma, espelha as aprendizagens efetuadas em contexto do Estágio com Relatório inserido no 6º CMESMO da ESEL. Foram escolhidos como referenciais teóricos norteadores os modelos de Nola Pender – Modelo de Promoção da Saúde, e a Teoria de Empowerment em Saúde de Nelma Shearer. Foi também realizada uma Revisão Sistemática da Literatura que visou responder à seguinte questão de investigação: “Quais os cuidados do EEESMOG promotores do empowerment das mulheres direcionado para uma tomada de decisão informada relativa ao trabalho de parto?”. Adicionalmente, foi efetuado um registo da interação durante a prestação de cuidados no decorrer do estágio, sobre os quais foi efetuada uma reflexão e confrontação com os resultados da RSL. Concluiu-se que os cuidados que o EEESMOG presta que são promotores de uma tomada de decisão informada para o trabalho de parto se inserem dentro de três grandes temas, nomeadamente Competências da esfera relacional, Competências da esfera da prática clínica e Competências da esfera científica, com especial referência para os cuidados que se relacionam com o Estabelecimento de Relação Terapêutica, a Educação para a Saúde, o Cuidado da Mulher em trabalho de parto, a Promoção do exercício do Consentimento Informado e a Prática baseada na Evidência

FOXM1 Is an Oncogenic Mediator in Ewing Sarcoma

<div><p>Ewing Family Tumors (Ewing Sarcoma and peripheral Primitive Neuroectodermal Tumor) are common bone and soft tissue malignancies of childhood, adolescence and young adulthood. Chromosomal translocation in these tumors produces fusion oncogenes of the EWS/ETS class, with EWS/FLI1 being by far the most common. EWS/ETS chimera are the only well established driver mutations in these tumors and they function as aberrant transcription factors. Understanding the downstream genes whose expression is modified has been a central approach to the study of these tumors. FOXM1 is a proliferation associated transcription factor which has increasingly been found to play a role in the pathogenesis of a wide range of human cancers. Here we demonstrate that FOXM1 is expressed in Ewing primary tumors and cell lines. Reduction in FOXM1 expression in Ewing cell lines results in diminished potential for anchorage independent growth. FOXM1 expression is enhanced by EWS/FLI1, though, unlike other tumor systems, it is not driven by expression of the EWS/FLI1 target GLI1. Thiostrepton is a compound known to inhibit FOXM1 by direct binding. We show that Thiostrepton diminishes FOXM1 expression in Ewing cell lines and this reduction reduces cell viability through an apoptotic mechanism. FOXM1 is involved in Ewing tumor pathogenesis and may prove to be a useful therapeutic target in Ewing tumors.</p> </div

FOXM1 knockdown reduces anchorage independent growth in Ewing cell lines.

<p> A: Three Ewing cell lines were transduced with either of two FOXM1 lentiviral shRNA or a nontargeting Luciferase control and polyclonal lines were selected with Puromycin. Real time quantitative PCR for FOXM1 shows significant reduction in FOXM1 transcript. All differences significant to p<>\scale 60%\raster="rg1"<>0.05 by Student’s t-test. B: Cell lines transduced with FOXM1-HP1 confirm a significant reduction in FOXM1 protein. C: Three Ewing cell lines with FOXM1 shRNA are plated in soft agar and compared to non-targeting control. All three demonstrate reduction in colony formation with either FOXM1 shRNA.</p

Thiostrepton reduces FOXM1 expression in Ewing cell lines, producing diminished cell viability by an apoptotic mechanism.

<p> A: Ewing cell lines were treated for 16 hours with Thiostrepton at increasing concentrations. Real time quantitative PCR shows a reduction of FOXM1 transcript. B: Ewing cell lines treated with 5 mcM Thiostrepton for 36–72 hours show decreased FOXM1 protein on western blot. C: Treatment of Ewing cell lines with increasing quantities of Thiostrepton for 72 hours results in reduced numbers of viable cells compared to diluent controls. D: Ewing cell lines treated as in panel B show cleavage of PARP, an indicator of apoptosis.</p

FOXM1 expression in Ewing Sarcoma.

<p>A: Microarray data from Affymetrix Human Exon 1.0 ST (HuEx) Arrays reveal FOXM1 expression levels which are comparable to Neuroblastoma (NBL) and not statistically different (p = 0.12). B: Real time quantitative PCR for FOXM1 (all splice forms) confirms significant levels of transcript in primary Ewing Sarcoma tumor specimens and the Ewing cell line TC71, compared to CHLA57, a Schwannoma cell line, DU145, a Prostate Carcinoma cell line, cultured primary fibroblasts (Fibr.) and mature cerebellar tissue (Cereb.). C: Western blot for FOXM1 detects FOXM1 protein in 6/7 Ewing cell lines tested and in the Prostate cell line DU145.</p

Additional file 4: Figure S2. of A multicenter, randomized study of decitabine as epigenetic priming with induction chemotherapy in children with AML

Distribution of differentially methylated loci (DML) according to functional CpG contextual distribution in Arms A (decitabine + chemotherapy) and B (chemotherapy alone). Pie charts demonstrate the frequency by which hyper or hypomethylated loci are distributed according to their functional position. (TIFF 443 kb

Additional file 2: Figure S1. of A multicenter, randomized study of decitabine as epigenetic priming with induction chemotherapy in children with AML

Schema of sample analysis workflow. (TIFF 269 kb