A subprodução de exames diagnósticos de Câncer de mama na região de saúde Pirineus com proposta intervencionista : The underproduction of breast Cancer diagnostic exams in the region of Pireneus with an interventionist proposal

O câncer de mama é o mais prevalente em mulheres em todo o mundo e é um dos tipos de neoplasia mais temidos pelo sexo feminino, haja vista sua alta frequência e efeitos psicológicos gerados. O rastreamento do câncer de mama consiste em identifica-lo em seus estágios iniciais, em populações assintomáticas e, com isso, possibilitar a mudança em seu prognóstico. O presente estudo objetiva realizar a análise situacional da produção de exames diagnósticos de câncer de mama da Região de Saúde de Pireneus em Goiás, identificando fatores causais para a escassez de exames realizados. A insuficiência de  informação à população feminina, além da carência de um fluxo de assistência bem definido e de sistemas de informação não alimentados, configuram o cenário atual da região. Logo, informação em saúde para a população, capacitação dos profissionais de saúde e das secretarias de saúde acerca de protocolos tornam-se pontos essenciais para a mudança e melhoria do cenário de saúde feminino.&nbsp

Proteasome inhibition and ROS generation by 4-nerolidylcatechol induces melanoma cell death

Induction of apoptotic cell death in response to chemotherapy and other external stimuli has proved extremely difficult in melanoma, leading to tumor progression, metastasis formation and resistance to therapy. A promising approach for cancer chemotherapy is the inhibition of proteasomal activity, as the half-life of the majority of cellular proteins is under proteasomal control and inhibitors have been shown to induce cell death programs in a wide variety of tumor cell types. 4-Nerolidylcatechol (4-NC) is a potent antioxidant whose cytotoxic potential has already been demonstrated in melanoma tumor cell lines. Furthermore, 4-NC was able to induce the accumulation of ubiquitinated proteins, including classic targets of this process such as Mcl-1. As shown for other proteasomal inhibitors in melanoma, the cytotoxic action of 4-NC is time-dependent upon the pro-apoptotic protein Noxa, which is able to bind and neutralize Mcl-1. We demonstrate the role of 4-NC as a potent inducer of ROS and p53. The use of an artificial skin model containing melanoma also provided evidence that 4-NC prevented melanoma proliferation in a 3D model that more closely resembles normal human skin.FAPESP [2006/50479-7, 2006/60930-8, 2008/58817-4, 2009/54816-6 2010/50157-5]FAPESPCNPqCNPqINCT_if (CNPq)INCT-if CNPqCAPESCAPESPRP-USPPRPUS

Neurostimulation Combined With Cognitive Intervention in Alzheimer’s Disease (NeuroAD): Study Protocol of Double-Blind, Randomized, Factorial Clinical Trial

Despite advances in the treatment of Alzheimer’s disease (AD), there is currently no prospect of a cure, and evidence shows that multifactorial interventions can benefit patients. A promising therapeutic alternative is the use of transcranial direct current stimulation (tDCS) simultaneously with cognitive intervention. The combination of these non-pharmacological techniques is apparently a safe and accessible approach. This study protocol aims to compare the efficacy of tDCS and cognitive intervention in a double-blind, randomized and factorial clinical trial. One hundred participants diagnosed with mild-stage AD will be randomized to receive both tDCS and cognitive intervention, tDCS, cognitive intervention, or placebo. The treatment will last 8 weeks, with a 12-month follow-up. The primary outcome will be the improvement of global cognitive functions, evaluated by the AD Assessment Scale, cognitive subscale (ADAS-Cog). The secondary outcomes will include measures of functional, affective, and behavioral components, as well as a neurophysiological marker (Brain-derived neurotrophic factor, BDNF). This study will enable us to assess, both in the short and long term, whether tDCS is more effective than the placebo and to examine the effects of combined therapy (tDCS and cognitive intervention) and isolated treatments (tDCS vs. cognitive intervention) on patients with AD.Clinical Trial Registration: www.ClinicalTrials.gov, identifier NCT02772185—May 5, 2016

Riociguat treatment in patients with chronic thromboembolic pulmonary hypertension: Final safety data from the EXPERT registry

Objective: The soluble guanylate cyclase stimulator riociguat is approved for the treatment of adult patients with pulmonary arterial hypertension (PAH) and inoperable or persistent/recurrent chronic thromboembolic pulmonary hypertension (CTEPH) following Phase