Cancer Related Anemia: An Integrated Multitarget Approach and Lifestyle Interventions

Cancer is often accompanied by worsening of the patient's iron profile, and the resulting anemia could be a factor that negatively impacts antineoplastic treatment efficacy and patient survival. The first line of therapy is usually based on oral or intravenous iron supplementation; however, many patients remain anemic and do not respond. The key might lie in the pathogenesis of the anemia itself. Cancer-related anemia (CRA) is characterized by a decreased circulating serum iron concentration and transferrin saturation despite ample iron stores, pointing to a more complex problem related to iron homeostatic regulation and additional factors such as chronic inflammatory status. This review explores our current understanding of iron homeostasis in cancer, shedding light on the modulatory role of hepcidin in intestinal iron absorption, iron recycling, mobilization from liver deposits, and inducible regulators by infections and inflammation. The underlying relationship between CRA and systemic low-grade inflammation will be discussed, and an integrated multitarget approach based on nutrition and exercise to improve iron utilization by reducing low-grade inflammation, modulating the immune response, and supporting antioxidant mechanisms will also be proposed. Indeed, a Mediterranean-based diet, nutritional supplements and exercise are suggested as potential individualized strategies and as a complementary approach to conventional CRA therapy

Educação e conscientização ambiental em um Colégio Estadual de SJP/PR / Education and environmental awareness at a State School of SJP/PR

A educação ambiental é um tema relevante atualmente, porém não é tratado com tamanha importância pelas instituições de ensino. Diante disso, o objetivo do presente artigo é implantar uma horta vertical, como uma forma de incentivo e utilização do espaço de área verde, a fim de proporcionar um ambiente mais agradável e sustentável no qual alunos e instituição poderão aproveitá-lo. Para isso foram utilizados os seguintes métodos: pesquisa bibliográfica, pesquisa de campo, questionário, palestra e observação. Os resultados encontrados mostraram que a implantação da horta foi uma atividade inovadora que trouxe grandes conhecimentos e experiências aos educandos que participaram da mesma, ofertando a ideia de uma alimentação mais saudável e preservação do meio ambiente por parte dos envolvidos. A instituição absorveu a ideia e irá trabalhar o conteúdo referente a sustentabilidade de forma prática, desenvolvendo projetos sustentáveis. Assim contribuirá no desenvolvimento dos alunos, formando uma consciência de conservação do local onde vivemos.Conclui-se que os resultados atingidos foram satisfatórios tanto para a equipe, quanto para os alunos e a equipe pedagógica, proporcionando para a instituição um projeto sustentável na área verde de recreação dos alunos

The National Early Warning Score and its subcomponents recorded within ±24 hours of emergency medical admission are poor predictors of hospital-acquired acute kidney injury

YesBackground: Hospital-acquired Acute Kidney Injury (H-AKI) is a common cause of avoidable morbidity and mortality. Aim: To determine if the patients’ vital signs data as defined by a National Early Warning Score (NEWS), can predict H-AKI following emergency admission to hospital. Methods: Analyses of emergency admissions to York hospital over 24-months with NEWS data. We report the area under the curve (AUC) for logistic regression models that used the index NEWS (model A0), plus age and sex (A1), plus subcomponents of NEWS (A2) and two-way interactions (A3). Likewise for maximum NEWS (models B0,B1,B2,B3). Results: 4.05% (1361/33608) of emergency admissions had H-AKI. Models using the index NEWS had the lower AUCs (0.59 to 0.68) than models using the maximum NEWS AUCs (0.75 to 0.77). The maximum NEWS model (B3) was more sensitivity than the index NEWS model (A0) (67.60% vs 19.84%) but identified twice as many cases as being at risk of H-AKI (9581 vs 4099) at a NEWS of 5. Conclusions: The index NEWS is a poor predictor of H-AKI. The maximum NEWS is a better predictor but seems unfeasible because it is only knowable in retrospect and is associated with a substantial increase in workload albeit with improved sensitivity.The Health Foundatio