O enfermeiro e a amamentação pós câncer de mama: O desbravar das intervenções / The nurse and breastfeeding after breast cancer: Unveiling interventions

Introdução: Dados da Organização Mundial da Saúde (OMS, 2018), afirmam que atualmente o Câncer de mama é o tipo de neoplasia maligna responsável pelo maior número de mortes de mulheres em todo planeta, chegando a 23% de casos de câncer no mundo. A sobrevida de mulheres diagnosticadas com câncer de mama em países desenvolvidos é de 85% e em desenvolvimento esse número diminue para 60%. Algumas mulheres estão ainda em fase reprodutiva e quando engravidam, expressam sua intensa vontade de amamentar mesmo após o tratamento com cirurgia, ou seja, mastectomia unilateral. A presente pesquisa visa fornecer subsídios para nortear o enfermeiro quanto a prescrição das intervenções do aleitamento materno da mulher pós câncer de mama, sendo resolutivo quanto as suas dúvidas, anseios, dificuldades e realização da técnica correta para uma amamentação efetiva. Objetivo: Destacar a atuação do enfermeiro frente ao aleitamento materno a mulheres que foram acometidas por câncer de mama, identificando suas dificuldades frente ao aleitamento e propor um protocolo de orientação para auxiliar no relacionamento desse binômio. Método: Foi utilizada revisão integrativa da literatura, por meio de artigos científicos nacionais e internacionais publicados nas bases de dados realizada por meio de buscas na Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS), Scientific Eletronic Labrary On-line (SCIELO) , livros e cartilhas/manuais do Ministério da Saúde, entre o período de 2010 a 2018. Foram utilizados artigos originais, em português e inglês, disponível na íntegra online, publicados nos últimos dez anos. A estratégia de busca foi realizada a partir dos cruzamentos dos Descritores em Ciências em Saúde (DECS): Aleitamento Materno, Câncer Mamário, Enfermeiro. Resultado: Foram selecionados 13 (treze) artigos, 3 (três) livros e 6 (seis) cartilhas/manuais do Ministério da Saúde para compor a revisão. Conclusão: Esta pesquisa infere que o enfermeiro está presente no período do puerpério orientando, supervisionando, estimulando e apoiando a mulher que passou pelo tratamento do câncer em sua nova tarefa: amamentar seu filho. Assim, após o levantamento dos dados necessários, elaborou-se um protocolo específico de orientação sobre amamentação para mulheres pós tratamento de câncer de mama

Kerr-AdS and its Near-horizon Geometry: Perturbations and the Kerr/CFT Correspondence

We investigate linear perturbations of spin-s fields in the Kerr-AdS black hole and in its near-horizon geometry (NHEK-AdS), using the Teukolsky master equation and the Hertz potential. In the NHEK-AdS geometry we solve the associated angular equation numerically and the radial equation exactly. Having these explicit solutions at hand, we search for linear mode instabilities. We do not find any (non-)axisymmetric instabilities with outgoing boundary conditions. This is in agreement with a recent conjecture relating the linearized stability properties of the full geometry with those of its near-horizon geometry. Moreover, we find that the asymptotic behaviour of the metric perturbations in NHEK-AdS violates the fall-off conditions imposed in the formulation of the Kerr/CFT correspondence (the only exception being the axisymmetric sector of perturbations).Comment: 26 pages. 4 figures. v2: references added. matches published versio

The phenotypic spectrum associated with OTX2 mutations in humans

OBJECTIVE: The transcription factor OTX2 is implicated in ocular, craniofacial, and pituitary development. DESIGN: We aimed to establish the contribution of OTX2 mutations in congenital hypopituitarism patients with/without eye abnormalities, study functional consequences, and establish OTX2 in the human brain, with a view to investigating the mechanism of action. METHODS: We screened patients from the UK (n=103), international centers (n=24), and Brazil (n=282); 145 were within the septo-optic dysplasia spectrum, and 264 had no eye phenotype. Transactivation ability of OTX2 variants was analysed in murine hypothalamic GT1-7 neurons. In situ hybridization was performed on human embryonic brain sections. Genetically engineered mice were generated with a series of C-terminal OTX2 variants. RESULTS: Two chromosomal deletions and six haploinsufficient mutations were identified in individuals with eye abnormalities; an affected relative of one patient harboured the same mutation without an ocular phenotype. OTX2 truncations led to significant transactivation reduction. A missense variant was identified in another patient without eye abnormalities, however studies revealed it was most likely not causative. In the mouse, truncations proximal to aa219 caused anophthalmia, while distal truncations and the missense variant were tolerated. During human embryogenesis, OTX2 was expressed in the posterior pituitary, retina, ear, thalamus, choroid plexus, and partially in the hypothalamus, but not in the anterior pituitary. CONCLUSIONS: OTX2 mutations are rarely associated with hypopituitarism in isolation without eye abnormalities, and may be variably penetrant, even within the same pedigree. Our data suggest that the endocrine phenotypes in patients with OTX2 mutations are of hypothalamic origin

Response of the Diatom Phaeodactylum tricornutum to Photooxidative Stress Resulting from High Light Exposure

The response of microalgae to photooxidative stress resulting from high light exposure is a well-studied phenomenon. However, direct analyses of photosystem II (PSII) D1 protein (the main target of photoinhibition) in diatoms are scarce. In this study, the response of the diatom model species Phaeodactylum tricornutum to short-term exposure to high light was examined and the levels of D1 protein determined immunochemically. Low light (LL) acclimated cells (40 µmol photons m−2 s−1) subjected to high light (HL, 1,250 µmol photons m−2 s−1) showed rapid induction of non-photochemical quenching (NPQ) and ca. 20-fold increase in diatoxanthin (DT) concentration. This resulted from the conversion of diadinoxanthin (DD) to DT through the activation of the DD-cycle. D1 protein levels under LL decreased about 30% after 1 h of the addition of lincomycin (LINC), a chloroplast protein synthesis inhibitor, showing significant D1 degradation and repair under low irradiance. Exposure to HL lead to a 3.2-fold increase in D1 degradation rate, whereas average D1 repair rate was 1.3-x higher under HL than LL, leading to decreased levels of D1 protein under HL. There were significant effects of both HL and LINC on P. tricornutum maximum quantum yield of PSII (Fv/Fm), showing a reduction of active PSII reaction centres. Partial recovery of Fv/Fm in the dark demonstrates the photosynthetic resilience of this diatom to changes in the light regime. P. tricornutum showed high allocation of total protein to D1 and an active D1-repair cycle to limit photoinhibition

Observation of associated near-side and away-side long-range correlations in √sNN=5.02 TeV proton-lead collisions with the ATLAS detector

Two-particle correlations in relative azimuthal angle (Δϕ) and pseudorapidity (Δη) are measured in √sNN=5.02  TeV p+Pb collisions using the ATLAS detector at the LHC. The measurements are performed using approximately 1  μb-1 of data as a function of transverse momentum (pT) and the transverse energy (ΣETPb) summed over 3.1<η<4.9 in the direction of the Pb beam. The correlation function, constructed from charged particles, exhibits a long-range (2<|Δη|<5) “near-side” (Δϕ∼0) correlation that grows rapidly with increasing ΣETPb. A long-range “away-side” (Δϕ∼π) correlation, obtained by subtracting the expected contributions from recoiling dijets and other sources estimated using events with small ΣETPb, is found to match the near-side correlation in magnitude, shape (in Δη and Δϕ) and ΣETPb dependence. The resultant Δϕ correlation is approximately symmetric about π/2, and is consistent with a dominant cos⁡2Δϕ modulation for all ΣETPb ranges and particle pT

Microvertebrates preserved in mammal burrows from the Holocene of the Argentine Pampas: a taphonomic and paleoecological approach

Microvertebrates are a major component of many assemblages recovered from the Quaternary of the Argentine Pampas. The main goal of this paper is to analyse the taphonomic history of a Holocene microfossil bonebed, recovered from the infilling of a burrow. Evidences suggest the plains vizcacha Lagostomus maximus as the putative producer of the burrow. The assemblage includes individuals belonging to different taxa of mammals (marsupials and rodents) and reptiles (snakes). Taphonomic features suggest that the accumulation inside the burrow was related to flooding processes in the plain. The burrow was a natural trap that favoured the accumulation and preservation of remains corresponding to individuals from different sources. According to the taphonomic evidence, some individuals (Lagostomus maximus, Lestodelphys halli and Serpentes indet.) died inside the burrow, whereas others (Microcavia australis, Reithrodon auritus and Ctenomys sp.) died outside the burrow, and after a time of being exposed on the surface their remains were transported by surface run-offs into the burrow. The record of Lestodelphys halli and Serpentes indet. in the burrow produced by Lagostomus maximus could be related to a circumstantial use. Mammal burrows are a significant taphonomic mode for the late Cenozoic of the Argentine Pampas