GB smoking cessation training for health care providers in LA: midterm confidence in competencies and estimation of population impact

Background Between 2011 and 2016, Global Bridges (GB) in Latin America successfully trained health care providers (HCP) in declarative and procedural knowledge and confidence in competencies (Moore `s level 3A, B and 4). However, a study that explored patients´ reported HCP performance failed to show effect. Methods Cross-sectional study among all trainees between 2011 and 2016. The survey was electronically conducted (Survey Monkey) with 26 questions that explored demography, confidence in skills and practices in smoking cessation. A sample size of 400 individuals was required. Inclusion criteria were: attended at least one day session and a valid email. A mathematical model of impact estimation was developed (subrogate of level 5 of Moore). Abstinence rates for brief advice and intensive intervention of were appraised from Cochrane Review. Results Of 1915 trainees with valid e-mail, 402 surveys were obtained in 2 recruitment rounds. The response rate was different for the two periods 2011-2014 (17%) and 2014-2016 (56%). Countries (Argentina 28%, Uruguay 20% and Mexico 17%) and occupation (physicians 61% and psychologists 18%) were unevenly represented. Among the responses, female gender prevailed (64.7%). 79.4% stated GB training was extremely/very useful and more than 80% expressed to be very confident/ confident to provide SC support. Respondents declared to assist 2.1 smokers per day (CI 1.6-2.6), and to offer brief advice and intensive advice, with or without drugs, in 80% and 69% of cases respectively. The model estimated that 1,564 trainees would have achieved 12,012 quitters with brief advice and 38,788 quitters due to intensive intervention in the following year after training, in the worst case scenario (lower CI). Conclusions GB´s SC program in Latin America exhibited to maintain trainees´ confidence in competences in the medium term and to return at least 50,800 quitters in the following year of the educational intervention

p53 and p16 in oral epithelial dysplasia and oral squamous cell carcinoma: A study of 208 cases

Background: The use of p16 and p53 as biomarkers of malignant transformation of oral epithelial dysplasia (OED) and biological behavior of oral squamous cell carcinoma (OSCC) is controversial. Aim: To determine the immunoexpression of p16 and p53 in OED and OSCC and to establish their possible relation to histopathological grading of OED/OSCC. Materials and Methods: Ninety-six OEDs (40 mild, 36 moderate, and 20 severe dysplasia); and 112 OSCCs (64 well-differentiated, 38 moderately differentiated, and 10 poorly differentiated) coming from archives of four centers of oral pathology were included. Histological slides from all cases were processed with immunohistochemical technique using anti-p53 and anti-p16 antibodies. The intensity of the immunoreactivity were classified using the ImageLab®MCM systemas follows: 60–90 strong. Forstatistical purposesa χ2 test (P 0.05). Statistical association of p16-positive and p53-positive cells to basal stratum of OED (P = 0.0008; P = 0.0000, respectively) and p16-positive cells and p53-positive cells to perivascular zone of OSCC (P = 0.001; P = 0.0000, respectively) was found. Conclusions: p16 and p53 could be not specific enough to identify patients suffering OED with high risk to malignancy; however, the evaluation of the presence of p16 and p53 in the tumoral invasive front of OSCC could contribute to establish the tumor progression

Advances in nanoplasmonic biosensors for clinical applications

Biomarkers are unquestionable biological indicators for diagnosis and therapeutic interventions providing appropriate classification of a wide range of health disorders and risk factors. Nonetheless, the detection and quantification of biomarkers need to be tested with sufficient reliability by robust analytical methods in order to assure clinical performance in health care settings. Since the analytical performance is determined by the sensitivity and specificity of the method employed, techniques have been intensively refined in order to avoid the misinterpretation of results and undesirable bias. Although biomarkers can be detected with the existing analytical techniques, to reproducibly quantify them in decentralized settings or remote locations with the required accuracy is still a challenge. Currently, only a few point-of-care devices for biomarker evaluation are commercially available. Thus, more focused research efforts are needed to overcome these limitations in order to provide universal patient-centered care platforms. To this end, plasmonic biosensors can be conveniently used as portable diagnostic devices for attaining timely and cost-effective clinical outcomes. The development of enhanced performance based on nanoplasmonics technology opens the way for sensor miniaturization, multiplexing and point of care testing. This review covers recent advances and applications of plasmonic and nanoplasmonic biosensors intended for biomarker diagnosis in clinical practice, including cancer, cardiovascular and neurodegenerative diseases. The review specially focuses on: (i) recent progress in plasmonics development including the design of singular nanostructured surfaces, (ii) novel chemical functionalization strategies for the appropriate incorporation of bioreceptors and (iii) plasmonic applications as real operative devices in the clinical field. Future prospects in the use of nanoplasmonic sensor platforms for personalised quantification and management of biomarkers directly in body fluids will also be discussed