A proteína do gene P53 e do receptor do fator de crescimento epidérmico na genese e prognóstico do glioblastoma

AnexosOrientador:Luiz Fernando Bleggi TorresTese(doutorado)- Universidade Federal do Paraná. Setor de Ciencias da Saúde. Programa de Pós-graduaçao em Clínica CirúrgicaInclui bibliografiaResumo: O glioblastoma (GBM), apesar de ser o tumor primário mais freqüente do sistema nervoso central do adulto, é o que apresenta pior prognóstico. Os avanços tecnológicos ocorridos nas últimas décadas, em termos de diagnóstico e tratamento não impediram que a sobrevida média continue a girar em torno de um ano. Avanços nos conhecimentos da biologia molecular têm demonstrado diversas vias de sinalização intra-celulares envolvidas nos mecanismos mitogênicos. Com base nêsses princípios, investigou-se num grupo de 45 pacientes portadores de GBM, a importância do oncogene EGFR e do gene supressor p53, através de técnicas de imunohistoquímica, como possíveis fatores de relevância na gênese e prognóstico do GBM, com aferição simultânea do índice proliferativo (Ki-67). Todos os pacientes, com média de idade de 54.24 ± 13.9 anos, sendo 28 homens e 17 mulheres, tinham sido anteriormente submetidos a tratamento cirúrgico, complementado com radiação e eventualmente quimioterapia. Aqueles com história clínica igual ou menor que três meses integraram o grupo I ou primário (35) e os com história mais longa formaram o grupo II ou secundário (10). Foi demonstrado, com significância estatística, que o grupo I é integrado por pacientes com média de idade superior aos do grupo II, com predomínio de porcentagem de EGFR positivo em relação ao p53 e com tempo de sobrevida menor. Da mesma forma, os integrantes do grupo II são mais jovens, têm maior sobrevida e exibem predomínio de p53. Foi identificado um sub-grupo de pacientes do grupo I em que EGFR tem valor prognóstico e demonstrado o valor prognóstico de p53 no grupo II e na população geral, com significância estatística. Finalmente, a análise deu suporte à provável participação do EGFR na gênese do GBM do grupo I e do p53 como fator relevante na gênese do grupo II, configurando assim, dois grupos diferentes em termos de perfil genético, comportamento clínico e prognóstico. Não foi conferido valor prognóstico à determinação de Ki-67. A inclusão da determinação de EGFR e p53 nos processos rotineiros de diagnóstico bem como a possível utilização de ambos como futuros alvos terapêuticos é sugerida. Palavras-chave: Glioblastoma, prognóstico, EGFR, p53, Ki-67.Abstract: Glioblastoma (GBM) represents the most frequent, and yet, the tumor with the worst prognosis in human adult brain. In spite of recent technological advances, patients's median survival doesn't reach beyond one year. Mitogenic pathways are becoming increasingly well known due to advances in molecular biology. The present study, based on those principles, investigated 45 patients harboring GBMs, focusing on the imunohistochemical determination of EGFR (oncogene) and p53 (suppressor gene) and their possible role in tumor genesis and prognosis, as well as participation of Ki- 67 as labeling index. All patients, 28 males and 17 females, averaging 54.24 ±13.9 years, had been previously submitted to surgical treatment, radiotherapy and eventually chemotherapy. Group I was formed by patients (35) with a clinical history of three months or less and group II harbored patients (10) with longer histories. It was shown that patients in group I, are in average, older than those in group II, have a much higher percentage of positive EGFR and exhibit a poorer survival (all data with statistical significance). On the other hand, group II patients are younger, live longer and have a much higher percentage of positive p53 (all data with statistical significance). A subgroup of patients in group I was identified in which EGFR poses as prognostic factor. Determination of p53 was of prognostic importance in group II as well as in the general population studied. Participation of the EGFR was inferred in the genesis of GBM in group I as well as that of p53 in group II. According to the results, two groups with different genetic, clinical, and prognostic profiles have been characterized. It was not possible to attribute prognostic value to the determination of Ki-67. Identification of EGFR and p53 as part of routine work-up in the diagnosis of GBM as well as their possible role as therapeutic targets in novel treatment strategies are suggested. Key words: Glioblastoma, prognosis, EGFR, p53, Ki-67

The Invisible Scar: The Mother of Babies with Labiopalatin Fissure

O diagnóstico de uma malformação como a fissura labiopalatina demanda cuidados com o bebê, mas também convoca atenção para a mãe que idealizava um filho esteticamente e funcionalmente perfeito. Diante dessa demanda, a presente pesquisa objetivou compreender o processo de tornar-se mãe de um bebê com fissura labiopalatina e a reelaboração do sentimento materno do “bebê-sonhado” para o “bebê-nascido”. Foi realizada uma pesquisa qualitativa, do tipo exploratória, que contou com a participação de dez mães de bebês com fissura, que responderam um roteiro de entrevista semiestruturado, cujos dados foram compreendidos por meio de análise lexical no Interface de R pour les Analyses Multimensionnelles de Textes et de Questionnaires (IRaMuTeQ). Os resultados mostram a reação das mães ao diagnóstico, o processo de aceitação do novo filho, a expectativa pela cirurgia e correção da malformação, as preocupações e dificuldades de adaptação às limitações do bebê e ao processo de tratamento. Conclui-se a importância de oferecer o diagnóstico precoce da malformação às mães desde a gestação e auxiliá-las na sua aceitação e no desenvolvimento de uma boa relação da díade mãe-bebê.The diagnosis of a malformation such as cleft lip and palate demands care for the baby, but it also calls attention to the mother who idealized an aesthetically and functionally perfect child. In view of this demand, the present research aimed to understand the process of becoming the mother of a baby with cleft lip and palate and the re-elaboration of the maternal feeling of the "baby-dreamed" for the "baby-born". A qualitative exploratory research was carried out, with the participation of ten mothers of cleft babies, who answered a semi-structured interview script, whose data were understood through lexical analysis in the Interface de R pour les Analyses Multimensionnelles de Textes et de Questionnaires (IRaMuTeQ). The results show the mothers' reaction to the diagnosis, the process of acceptance of the new child, the expectation for surgery and correction of the malformation, the concerns and difficulties of adapting to the baby's limitations and the treatment process. We conclude the importance of offering mothers an early diagnosis of malformation since pregnancy and assisting them in their acceptance and in developing a good mother-baby relationship

Metástases cerebrais de câncer de colo de útero: relato de três casos

Cervical uterine cancer (CUC) spreads locally (pelvis and paraortic lymphnodes) or distantly (lungs, liver and bones). Metastasis to central nervous system (CNS) are rare. There are about 80 cases reported in the literature. Outcome is poor and survival varies from 3 to 6 months. Three cases of CNS metastasis from CUC are reported, one infratentorial and two supratentorials in location. In one patient, the initial manifestation was due to the cerebral lesion, a feature re p o rted for the first time. All cases were treated by surg e ry, radiotherapy and/or chemotherapy. Clinical findings and treatment options of these rare lesions are reviewed._________________________________________________________________________________________ RESUMO: Tumores do cólo uterino se disseminam por contigüidade ou via hematogênica (pulmão, fígado e ossos). Metástases para sistema nervoso central são incomuns. Apenas cerca de 80 casos são citados na literatura. Manifestações clínicas são devidas à hipertensão intracraniana e a déficits focais. A sobrevida varia de 3 a 6 meses. Três casos são relatados sendo um infratentorial e dois supratentoriais. No primeiro , o diagnóstico da metástase antecedeu o da lesão uterina. No segundo, houve 5 anos sem recidiva após a cirurgia, fato este inédito. O tratamento foi cirurgia, radioterapia e/ou quimioterapia. A discussão enfatiza manejo multidisciplinar destas raras lesões

Genetic progress with reciprocal recurrent selection for interpopulation hybrids of maize

O objetivo deste trabalho foi avaliar o progresso genético na obtenção de híbridos interpopulacionais com a seleção recorrente recíproca. Na safra 2005/2006, foram avaliados os híbridos interpopulacionais de milho (Zea mays) originados de três ciclos de seleção (0, 1 e 2) iniciados em 2003, os híbridos simples parentais e o híbrido duplo de F1, em blocos ao acaso com cinco repetições, em dois locais. Na safra seguinte, somente os híbridos interpopulacionais dos ciclos 0 e 2 foram avaliados nas mesmas condições, com 40 repetições por local. O híbrido interpopulacional apresentou desempenho equivalente ao do melhor híbrido parental simples em poucos ciclos seletivos. As estimativas do progresso genético por ciclo foram de 7,9% (ou 0,7 Mg ha-1) para produtividade de espigas despalhadas e de 3,5% para prolificidade. É possível inferir que a seleção recorrente recíproca é eficiente em elevar a produção de híbridos interpopulacionais obtidos a partir de populações F2 de híbridos simples de milho.The objective of this work was to evaluate the genetic progress obtained in interpopulation hybrids with the reciprocal recurrent selection. During the 2005/2006 planting season, maize (Zea mays) interpopulation crosses from three selection cycles (0, 1 and 2) initiated in 2003, single-cross parental hybrids and the double-cross F1 hybrid were evaluated in randomized blocks with five replicates, at two locations. In the next planting season, only interpopulational hybrids from cycles 0 and 2 were evaluated under the same conditions, with 40 replicates per location. The interpopulation hybrid had a yield performance equivalent to that of the best single-cross parent in few selection cycles. The estimates of genetic progress per cycle were of 7.9% (or 0.7 Mg ha-1) for unhusked ear yield and of 3.5% for prolificacy. It is possible to infer that the reciprocal recurrent selection effectively improves the yield of interpopulational hybrids obtained from F2 generations of single-cross maize hybrids

Cytogenetic characterization of Ameivula ocellifera (Spix, 1825) (Squamata, Teiidae) from the brazilian northeast

Ameivula is as a new genus of Teiidae family that emerged after extensive revision of species that comprised the former complex of species called Cnemidophorus group. Its species has a wide distribution from the northeast of Brazil to northern Argentina. Cytogenetic studies in the Teiidae family have shown that karyotypical data are important tools in phylogenetic and systematic studies within this group allowing to determine the position of species in the family. Thus, this study aimed to describe the karyotype of Ameivula ocellifera (Spix, 1825) from Picos, Piauí state in the Brazilian Northeast. Specimens were collected from August 2014 to October 2015 using interception traps and pitfalls, mounted randomly along the Caatinga area. The animals were collected and transported to Federal Institute of Piauí, campus Picos, where was carried out all laboratory procedures. Individuals analyzed showed a diploid number of 2n = 50 for both sexes, with karyotype composed by 30 macrochromosomes and 20 microchromosomes of telocentric and subtelocentric types. There were no heteromorphic sex chromosomes in the studied specimens. C-band technique evidenced the heterochromatic blocks in pericentromeric and telomeric regions of chromosomes. The nucleolar organizing regions appeared as a simple unit located at the terminal portion of the long arm of chromosomal pair number 5. The chromosomal characteristics of A. ocellifera analyzed do not show divergences regarding individuals from other regions. However, the nucleolar organizing regions seems to be a good chromosomal marker that permits to distinguish the species already studied

Cytogenetic study in the Brazilian semiarid lizard Tropidurus hispidus (Squamata, Tropiduridae)

Different classes of repetitive DNA sequences are found in eukaryotes, often composing substantial portions of the genome, associated with their important role in the structural and functional genome organization. In this work, we mapped repetitive DNA sequences (18S rDNA, microsatellites and telomeric motifs) in the karyotype of Tropidurus hispidus, a species of lizard from the Brazilian semiarid region. We found a diploid number of 2n = 36 (6 pairs of biarmed macrochromosomes and 12 pairs of microchromosomes). The 18S rDNA clusters were localized at the subterminal region of the long arm of pair 2. The telomeric probes produced signals at terminal, interstitial and centromeric positions of some chromosome pairs, which might indicate the occurrence of chromosomal rearrangements via chromosome fusions. Microsatellite sequences were found in at least two distinct patterns - clustered in the telomeric/pericentromeric regions or observed as scattered signals in the chromosomes. This study represents an initial step to explore the evolutionary dynamics of repetitive sequences in the Tropidurus genus and considering the scarcity of data concerning the chromosomal mapping of repetitive sequences in Tropiduridae species, it reinforces the importance of integrating other methodologies, including the isolation and physical mapping of different repetitive DNA sequences, contributing to understanding the patterns of karyotypic evolution in lizards.Asociación Herpetológica Argentin

Importância da Atuação da Equipe Multiprofissional na Humanização da Assistência na UTI

OBJECTIVE: To elucidate the role of the multidisciplinary health team in the humanization of care in Intensive Care Units. METHOD: The present study consists of a review of the integrative literature, using the PICO strategy, where "p" population: Multiprofessional health team, "I" interest: Evaluation of the performance of the multiprofessional team in relation to humanization in the Intensive Care Unit o "C" and "O" Context: Performance of the multiprofessional team in the humanization of the ICU. The filter used for the searches was with the descriptors; (Patient Care Team) AND (Humanization of care) AND (Intensive Care Unit). RESULTS: The final sample consisted of 6 studies that resulted in two topics for discussion: training and professional performance in care with a focus on the disease and feelings experienced in the ICU. CONCLUSION: It was possible to conclude that there is a need for further studies focused on the theme and that mention strategies for its implementation.  OBJETIVO: Elucidar a atuação da equipe multiprofissional de saúde na Humanização da assistência em Unidades de Terapia Intensiva. MÉTODO: O presente trabalho consiste em uma revisão de literatura integrativa, utilizada a estratégia PICO, sendo “p” população: Equipe multiprofissional de saúde,“I” interesse: Avaliação da atuação da equipe multiprofissional em relação a humanização em Unidade de Terapia Intensiva o “C” e “O” Contexto: Atuação da equipe multiprofissional na humanização da UTI. O filtro utilizado para as buscas foi com os descritores; (Equipe de assistência ao paciente) AND (Humanização da assistência) AND (Unidade de terapia intensiva). RESULTADOS: A amostra final foi constituída por 6 estudos que resultaram em dois tópicos para discussão: formação e atuação profissional no cuidado como foco na doença e sentimentos vivenciados na UTI.  CONCLUSÃO: Foi possível concluir que necessitam mais estudos voltados para temática e que mencionem estratégias para sua implementação

The main diseases in the culture of pineapple: a review

Pineapple is a crop of great importance, having vitamins, minerals and capable of preventing diseases. Therefore, several researchers are interested in studying this crop, in addition to its use for other purposes, such as the production of juice pulp, jellies, sweets and other products, with its in natura form being the most sought after among countries. However, the attack of pathogens reduces pineapple production to worrying levels, and when not controlled, it even eradicates the entire plantation. Based on this, this review aimed to show the recent discoveries about the pineapple culture, emphasizing, mainly, the main diseases of this production chain. After gathering the main information on the most frequent diseases in pineapple production fields, we observed that fusariosis is considered the main disease of pineapple, followed by black spot, eye rot and root rot, being in short knowledge of these by producers is important in order to avoid irreversible damage. It is understood that more research is needed, since in the literature there are few field studies on this crop, especially with regard to seeking alternative means of controlling these diseases, so that the dissemination of this knowledge provides better information on agronomic interests