A importância da biópsia líquida no diagnóstico oncológico: The importance of liquid biopsy in cancer diagnosis

Introdução: A biópsia Líquida veio para auxiliar  na ampliação dos  estudos de vários cânceres, pois esta doença é uma das que mais causa mortes no mundo. Essa nova metodologia vem para detectar células e fragmentos de origem tumoral. Objetivo: É descrever a técnica de diagnóstico por biópsia líquida para os cânceres existentes e aprofundado na definição da importância da biópsia líquida na detecção de uma gama  de biomarcadores tumorais. Metodologia: Este é um estudo do tipo transversal qualitativo  através de uma revisão bibliográfica  sobre “Biópsia Líquida”. Existe uma vasta bibliografia com fontes seguras nas informações sobre esse assunto. Que amplia o conhecimento de profissionais da área da saúde e principalmente ajudar pacientes com câncer. Conclusão: Esse artigo mostra como a Biópsia Líquida é relevante nas pesquisas de diversos cânceres, a partir da coleta de sangue para a detecção de analitos como CTC’s, cfDNA, exossomos entre outros, pois esses biomarcadores esclarecem melhor os tumores do que na Biópsia Tradicional, que é um método menos específico e  bem mais desconfortável.Introdução: A biópsia Líquida veio para auxiliar  na ampliação dos  estudos de vários cânceres, pois esta doença é uma das que mais causa mortes no mundo. Essa nova metodologia vem para detectar células e fragmentos de origem tumoral. Objetivo: É descrever a técnica de diagnóstico por biópsia líquida para os cânceres existentes e aprofundado na definição da importância da biópsia líquida na detecção de uma gama  de biomarcadores tumorais. Metodologia: Este é um estudo do tipo transversal qualitativo  através de uma revisão bibliográfica  sobre “Biópsia Líquida”. Existe uma vasta bibliografia com fontes seguras nas informações sobre esse assunto. Que amplia o conhecimento de profissionais da área da saúde e principalmente ajudar pacientes com câncer. Conclusão: Esse artigo mostra como a Biópsia Líquida é relevante nas pesquisas de diversos cânceres, a partir da coleta de sangue para a detecção de analitos como CTC’s, cfDNA, exossomos entre outros, pois esses biomarcadores esclarecem melhor os tumores do que na Biópsia Tradicional, que é um método menos específico e  bem mais desconfortável

Flavonoids in phylloclades discriminate endemic Semele androgyna chemotypes from Madeira

Thirty-five randomly-collected Semele androgyna Kunth samples were screened by RP-HPLC for their phenolic composition. Fraction analysis allowed the detection of 17 different compounds. According to their retention times and UV spectra obtained by diode array analysis, these phenolics represent three classes: phenolic acids, flavones and flavonols. Co-chromatography with specific standards enabled identification of quercetin, rutin and quercitrin in Semele tissues for the first time. Polymorphism based on phenolic composition was evaluated using multivariate analysis and showed four distinct S. androgyna clusters. This polymorphism was not associated with morphological diversity or different in ambient light intensities. Biochemical differentiation is thus present in this species. The application of multivariate analysis techniques to RP-HPLC data has allowed the classification of samples into two groups, previously proposed on the basis of morphological and cytotaxonomical information. Therefore, the use of phenolics as chemotaxonomic markers in Semele is highly recommended because of its diagnostic value, even at a subspecies level. Discriminant canonical analysis and Mahalanobis distances confirmed these clusters as recognisable chemosystematic units. However, these units do not support the separation of S. pterygophora.The Portuguese Foundation for Science and Technology (FCT) funded this work through the Centre of Macaronesian Studies (CEM). The authors are grateful to the Madeiran Centre of Science and Technology (CITMA), the Berardo Foundation and European Social Funding for financial assistance given during execution of this work. The assistance rendered by Mr Rogério Correia during field collection is gratefully acknowledged.info:eu-repo/semantics/publishedVersio

Primary Care Providers’ Perceptions of the Acceptability, Appropriateness, and Feasibility of a Mammography Decision Aid for Women Aged 75 and Older

Background. Clinicians need to find decision aids (DAs) useful for their successful implementation. Therefore, we aimed to conduct an exploratory study to learn primary care clinicians? (PCPs) perspectives on a mammography DA for women ≥75 to inform its implementation. Methods. We sent a cross-sectional survey to 135 PCPs whose patients had participated in a randomized trial of the DA. These PCPs practiced at 1 of 11 practices in Massachusetts or North Carolina. PCPs were asked closed-ended and open-ended questions on shared decision making (SDM) around mammography with women ≥75 and on the DA?s acceptability, appropriateness, and feasibility. Results. Eighty PCPs participated (24 [30%] from North Carolina). Most (n = 69, 86%) thought that SDM about mammography with women ≥75 was extremely/very important and that they engaged women ≥75 in SDM around mammography frequently/always (n = 49, 61%). Regarding DA acceptability, 60% felt the DA was too long. Regarding appropriateness, 70 (89%) thought it was somewhat/very helpful and that it would help patients make more informed decisions; 55 (70%) would recommend it. Few (n = 6, 8%) felt they had other resources to support this decision. Regarding feasibility, 53 (n = 67%) thought it would be most feasible for patients to receive the DA before a visit from medical assistants rather than during or after a visit or from health educators. Most (n = 62, 78%) wanted some training to use the DA. Limitations. Sixty-nine percent of PCPs in this small study practiced in academic settings. Conclusions. Although PCPs were concerned about the DA?s length, most found it helpful and informative and felt it would be feasible for medical assistants to deliver the DA before a visit. Implications. Study findings may inform implementation of this and other DAs

Endocrine Therapy Nonadherence and Discontinuation in Black and White Women

Background: Differential use of endocrine therapy (ET) by race may contribute to breast cancer outcome disparities, but racial differences in ET behaviors are poorly understood. Methods: Women aged 20-74 years with a first primary, stage I-III, hormone receptor-positive (HR+) breast cancer were included. At 2 years postdiagnosis, we assessed nonadherence, defined as not taking ET every day or missing more than two pills in the past 14 days, discontinuation, and a composite measure of underuse, defined as either missing pills or discontinuing completely. Using logistic regression, we evaluated the relationship between race and nonadherence, discontinuation, and overall underuse in unadjusted, clinically adjusted, and socioeconomically adjusted models. Results: A total of 1280 women were included; 43.2% self-identified as black. Compared to white women, black women more often reported nonadherence (13.7% vs 5.2%) but not discontinuation (10.0% vs 10.7%). Black women also more often reported the following: hot flashes, night sweats, breast sensitivity, and joint pain; believing that their recurrence risk would not change if they stopped ET; forgetting to take ET; and cost-related barriers. In multivariable analysis, black race remained statistically significantly associated with nonadherence after adjusting for clinical characteristics (adjusted odds ratio = 2.72, 95% confidence interval = 1.75 to 4.24) and after adding socioeconomic to clinical characteristics (adjusted odds ratio = 2.44, 95% confidence interval = 1.50 to 3.97) but was not independently associated with discontinuation after adjustment. Low recurrence risk perception and lack of a shared decision making were strongly predictive of ET underuse across races. Conclusions: Our results highlight important racial differences in ET-Adherence behaviors, perceptions of benefits/harms, and shared decision making that may be targeted with culturally tailored interventions