Using stem cells in skin regeneration: possibilities and reality

Tissue-engineered skin has a long history of clinical applications, yet current treatments are not capable of completely regenerating normal, uninjured skin. Nonetheless, the field has experienced a tremendous development in the past 10 years, encountering the summit of tissue engineering (TE) and the arising of stem cell research. Since then, unique features of these cells such as self-renewal capacity, multi-lineage differentiation potential, and wound healing properties have been highlighted. However, a realistic perspective of their outcome in skin regenerative medicine applications is still absent. This review intends to discuss the directions that adult and embryonic stem cells (ESCs) can take, strengthening the skin regeneration field. Distinctively, a critical overview of stem cellsâ differentiation potential onto skin main lineages, along with a highlight of their participation in wound healing mechanisms, is herein provided. We aim to compile and review significant work to allow a better understanding of the best skin TE approaches, enabling the embodiment of the materialization of a new era in skin regeneration to come, with a conscious overview of the current limitations

DNA copy number profiles of gastric cancer precursor lesions

<p>Abstract</p> <p>Background</p> <p>Chromosomal instability (CIN) is the most prevalent type of genomic instability in gastric tumours, but its role in malignant transformation of the gastric mucosa is still obscure. In the present study, we set out to study whether two morphologically distinct categories of gastric cancer precursor lesions, i.e. intestinal-type and pyloric gland adenomas, would carry different patterns of DNA copy number changes, possibly reflecting distinct genetic pathways of gastric carcinogenesis in these two adenoma types.</p> <p>Results</p> <p>Using a 5K BAC array CGH platform, we showed that the most common aberrations shared by the 11 intestinal-type and 10 pyloric gland adenomas were gains of chromosomes 9 (29%), 11q (29%) and 20 (33%), and losses of chromosomes 13q (48%), 6(48%), 5(43%) and 10 (33%). The most frequent aberrations in intestinal-type gastric adenoma were gains on 11q, 9q and 8, and losses on chromosomes 5q, 6, 10 and 13, whereas in pyloric gland gastric adenomas these were gains on chromosome 20 and losses on 5q and 6. However, no significant differences were observed between the two adenoma types.</p> <p>Conclusion</p> <p>The results suggest that gains on chromosomes 8, 9q, 11q and 20, and losses on chromosomes 5q, 6, 10 and 13, likely represent early events in gastric carcinogenesis. The phenotypical entities, intestinal-type and pyloric gland adenomas, however, do not differ significantly (P = 0.8) at the level of DNA copy number changes.</p

Cultura e clima organizacional para segurança do paciente em Unidades de Terapia Intensiva

RESUMO Objetivo Avaliar a percepção dos profissionais de saúde sobre o clima e a cultura de segurança do paciente em Unidades de Terapia Intensiva (UTI) e a relação entre os instrumentos Hospital Survey on Patient Safety Culture (HSOPSC) e o Safety Attitudes Questionnaire (SAQ). Método Estudo transversal realizado em hospital de ensino no interior do estado de São Paulo, Brasil, em março/abril de 2014. Aplicaram-se o HSOPSC, o SAQ e um instrumento para levantamento das informações sociodemográficas e profissionais aos funcionários das UTI adulto, pediátrica e neonatal. A análise utilizou a estatística descritiva. Resultados As escalas apresentaram boa confiabilidade. Maiores fragilidades para a segurança do paciente foram observadas nos domínios “condições de trabalho” e “percepções da gerência” do SAQ e “resposta não punitiva aos erros” do HSOPSC. As fortalezas no SAQ foram o “clima de trabalho em equipe” e a “satisfação no trabalho” e para o HSOPSC “expectativas e ações de promoção de segurança supervisores/gerentes” e “aprendizado organizacional e melhoria mútua”. Na UTI Neonatal houve maior satisfação no trabalho do que nas demais UTI. A UTI Adulto apresentou menores pontuações para a maioria dos domínios do SAQ e HSOPSC. A correlação entre as escalas foi de força moderada (r=0,66). Conclusão Há diferenças de percepções quanto à segurança do paciente entre as UTI, o que corrobora com a existência de microculturas locais. O estudo não demonstra que o SAQ e o HSOPSC sejam equivalentes

Segurança do paciente em Unidades de Terapia Intensiva: desenvolvimento de um projeto de pesquisa

RESUMO Objetivo Relatar a experiência sobre os diferentes processos envolvidos no desenvolvimento de um Projeto de Pesquisa em Segurança do Paciente em Unidades de Terapia Intensiva. Método Estudo com delineamento misto: coorte histórica para a coleta dos dados dos pacientes e eventos adversos/incidentes e transversal para a coleta dos dados da equipe de enfermagem. A coleta de dados ocorreu durante 90 dias, em 2012, no Instituto Central do Hospital das Clínicas da Universidade de São Paulo e o Hospital Universitário da Universidade de São Paulo. Processos desenvolvidos A pesquisa envolveu diversas etapas para sua efetivação: implantação doNursing Activities Score (NAS) no Instituto Central do Hospital das Clínicas da Universidade de São Paulo, desenvolvimento de sistema de banco de dados, digitalização de prontuários, treinamento de monitores, extração e carga de dados dos pacientes e coleta de dados durante a passagem de plantão, prontuários. Considerações finais Treinamentos, comprometimento dos pesquisadores e parceria com profissionais da tecnologia da informação foram fundamentais para a qualidade dos resultados obtidos e da produção científica alcançada. Espera-se que esse relato de experiência possa orientar e encorajar os pesquisadores a realizar pesquisas complexas que contribuam para a construção do conhecimento na enfermagem e saúde

AIDS in adults 50 years of age and over: characteristics, trends and spatial distribution of the risk

OBJECTIVE: to analyze the sociodemographic characteristics, epidemic trend and spatial distribution of the risk of AIDS in adults 50 years of age and over.METHOD: population-based, ecological study, that used secondary data from the Notifiable Disease Information System (Sinan/AIDS) of Paraíba state from the period January 2000 to December 2010.RESULTS: during the study period, 307 cases of AIDS were reported among people 50 years of age or over. There was a predominance of males (205/66, 8%), mixed race, and low education levels. The municipalities with populations above 100 thousand inhabitants reported 58.5% of the cases. There was a progressive increase in cases among women; an increasing trend in the incidence (positive linear correlation); and an advance in the geographical spread of the disease, with expansion to the coastal region and to the interior of the state, reaching municipalities with populations below 30 thousand inhabitants. In some locations the risk of disease was 100 times greater than the relative risk for the state.CONCLUSION: aging, with the feminization and interiorization of the epidemic in adults 50 years of age and over, confirms the need for the induction of affirmative policies targeted toward this age group

Patient safety in organizational culture as perceived by leaderships of hospital institutions with different types of administration

Abstract OBJECTIVE To identify the perceptions of leaderships toward patient safety culture dimensions in the routine of hospitals with different administrative profiles: government, social and private organizations, and make correlations among participating institutions regarding dimensions of patient safety culture used. METHOD A quantitative cross-sectional study that used the Self Assessment Questionnaire 30 translated into Portuguese. The data were processed by analysis of variance (ANOVA) in addition to descriptive statistics, with statistical significance set at p-value ≤ 0.05. RESULTS According to the participants' perceptions, the significant dimensions of patient safety culture were 'patient safety climate' and 'organizational learning', with 81% explanatory power. Mean scores showed that among private organizations, higher values were attributed to statements; however, the correlation between dimensions was stronger among government hospitals. CONCLUSION Different hospital organizations present distinct values for each dimension of patient safety culture and their investigation enables professionals to identify which dimensions need to be introduced or improved to increase patient safety

TRAIL-receptor preferences in pancreatic cancer cells revisited: Both TRAIL-R1 and TRAIL-R2 have a licence to kill

Background TRAIL is a potent and specific inducer of apoptosis in tumour cells and therefore is a possible new cancer treatment. It triggers apoptosis by binding to its cognate, death-inducing receptors, TRAIL-R1 and TRAIL-R2. In order to increase its activity, receptor-specific ligands and agonistic antibodies have been developed and some cancer types, including pancreatic cancer, have been reported to respond preferentially to TRAIL-R1 triggering. The aim of the present study was to examine an array of TRAIL-receptor specific variants on a number of pancreatic cancer cells and test the generality of the concept of TRAIL-R1 preference in these cells. Methods TRAIL-R1 and TRAIL-R2 specific sTRAIL variants were designed and tested on a number of pancreatic cancer cells for their TRAIL-receptor preference. These sTRAIL variants were produced in HEK293 cells and were secreted into the medium. After having measured and normalised the different sTRAIL variant concentrations, they were applied to pancreatic and control cancer cells. Twenty-four hours later apoptosis was measured by DNA hypodiploidy assays. Furthermore, the specificities of the sTRAIL variants were validated in HCT116 cells that were silenced either for TRAIL-R1 or TRAIL-R2. Results Our results show that some pancreatic cancer cells use TRAIL-R1 to induce cell death, whereas other pancreatic carcinoma cells such as AsPC-1 and BxPC-3 cells trigger apoptosis via TRAIL-R2. This observation extended to cells that were naturally TRAIL-resistant and had to be sensitised by silencing of XIAP (Panc1 cells). The measurement of TRAIL-receptor expression by FACS revealed no correlation between receptor preferences and the relative levels of TRAIL-R1 and TRAIL-R2 on the cellular surface. Conclusions These results demonstrate that TRAIL-receptor preferences in pancreatic cancer cells are variable and that predictions according to cancer type are difficult and that determining factors to inform the optimal TRAIL-based treatments still have to be identified

Molecular Plasticity of E-Cadherin and Sialyl Lewis X Expression, in Two Comparative Models of Mammary Tumorigenesis

The process of metastasis involves a series of steps and interactions between the tumor embolus and the microenvironment. Key alterations in adhesion molecules are known to dictate progression from the invasive to malignant phenotype followed by colonization at a distant site. The invasive phenotype results from the loss of expression of the E-cadherin adhesion molecule, whereas the malignant phenotype is associated with an increased expression of the carbohydrate ligand-binding epitopes, (e.g. Sialyl Lewis (x/a)) that bind endothelial E-selectin of the lymphatics and vasculature.Our study analyzed the expression of two adhesion molecules, E-cadherin and Sialyl Lewis x (sLe(x)), in both a canine mammary carcinoma and human inflammatory breast cancer (IBC) model, using double labelled immunofluorescence staining.Our results demonstrate that canine mammary carcinoma and human IBC exhibit an inversely correlated cellular expression of E-cadherin and sLe(x) within the same tumor embolus.Our results in these two comparative models (canine and human) suggest the existence of a biologically coordinated mechanism of E-cadherin and sLe(x) expression (i.e. molecular plasticity) essential for tumor establishment and metastatic progression