Quality of life in Amazonian women during cervical cancer treatment: the moderating role of spirituality

This study aimed to examine the contribution of psychological variables to quality of life (QoL) of Amazonian women and to analyze the moderating role of spirituality in the relationship between psychological morbidity and Qol and between illness perception and QoL. This cross-sectional study included 119 women undergoing treatment for cervical cancer (CC). The Pearson correlation test was used to evaluate the relationship between sociodemographic, clinical, and psychological variables. To test how psychological morbidity, illness perception, and spirituality contribute to QoL, a path analysis was performed and to test the moreating role of spirituality, a moderation analysis was conducted. The results revealed that the presence of symptoms, high psychological morbidity, negative body image, and threatening illness perception were predictors of lower QoL. Spirituality moderated the relationship between psychological morbidity and QoL, and between illness perception and QoL. The moderating role of spirituality emphasizes its role as a coping strategy and should be included in cancer treatment. Interventions should target psychological morbidity, threatening illness perception, and address women’s concerns with body image and sexual concerns. CC treatment should include interprofessional healthcare teams addressing the biological and psychosocial factors of Amazonian women. As a result of this study a mobile application to monitor women’s health, adapted to cultural and social characteristics, was created.This study was conducted at the Psychology Research Centre (PSI/01662), School of Psychology, University of Minho, supported by the Foundation for Science and Technology (FCT) through the Portuguese State Budget (Ref: UIDB/PSI/01662/2020)

Childhood Adrenocortical Tumours: a Review

Childhood adrenocortical tumour (ACT) is not a common disease, but in southern Brazil the prevalence is 15 times higher than in other parts of the world. One hundred and thirty-seven patients have been identified and followed by our group over the past four decades. Affected children are predominantly girls, with a female-to-male ratio of 3.5:1 in patients below 4 years of age. Virilization alone (51.6%) or mixed with Cushing's syndrome (42.0%) was the predominant clinical picture observed in these patients. Tumours are unilateral, affecting both glands equally. TP53 R337H germline mutations underlie most childhood ACTs in southern Brazil. Epidemiological data from our casuistic studies revealed that this mutation has ~10% penetrance for ACT. Surgery is the definitive treatment, and a complete resection should always be attempted. Although adjuvant chemotherapy has shown some encouraging results, its influence on overall outcome is small. The survival rate is directly correlated to tumour size; patients with small, completely excised tumours have survival rates close to 90%, whereas in those patients with inoperable tumours and/or metastatic disease it is less than 10%. In the group of patients with large, excisable tumours, half of them have an intermediate outcome. Recent molecular biology techniques and genomic approaches may help us to better understand the pathogenesis of ACT, the risk of developing a tumour when TP53 R337H is present, and to predict its outcome. An ongoing pilot study consisting of close monitoring of healthy carriers of the TP53 R337H mutation - siblings and first-degree relatives of known affected cases - aims at the early detection of ACTs and an improvement of the cure rate

Morte súbita e angina vasoespástica

Variant angina is defined by chest pain occurring at rest associated with transitory ST segment elevation on ECG, and is caused by a spasm of a coronary artery. Frequently, variant angina is associated with atherosclerotic coronary obstruction and patients with normal coronary arteries are rare. Patients with variant angina and normal coronary arteries have good prognosis, and the development of ventricular arrhythmias or sudden death is rare. The authors present two cases of sudden cardiac death in patients with variant angina and normal coronary arteries

Anthocyanins content and chemical composition of the essential oil of three blackberry cultivars from southern Brazil

In this work, fruits of three cultivars, Caingangue, Cherokee and Guarani, originated from collections from Embrapa, Pelotas, Rio Grande do Sul, were analyzed concerning the anthocyanin content and the essential oils composition. The anthocyanin content were determined by spectrophotometry, resulting in 0.606 ± 0.018 g/ 100 g, 0.728 ± 0.020 g/100 g and 0.854 ± 0.065 g/ 100 g expressed as cyanidin-3- glucoside, for the three cultivars, respectively. The essential oils were obtained by hydrodistillation in a Clevenger apparatus and the chemical characterization was performed by GC-FID and GCMS. The oil composition of Caingangue cultivar presented predominance of monoterpenes, especially piperitone (50.5%) and camphor (15.5%). The oil fractions of Cherokee and Guarani cvs. were characterized by sesquiterpenes. Cherokee fruits presented high amount of β-caryophyllene (29.6%) followed by the hexadecanoic acid (11.7%), whereas in Guarani fruits spathulenol (22.4%), globulol (16.9%), epi-globulol (11.3%), δ-cadinene (10.0%) and α-cadinene (10.0%) were the main constituents.Colegio de Farmacéuticos de la Provincia de Buenos Aire

In-depth genome characterization of a Brazilian common bean core collection using DArTseq high-density SNP genotyping

Background: Common bean is a legume of social and nutritional importance as a food crop, cultivated worldwide especially in developing countries, accounting for an important source of income for small farmers. The availability of the complete sequences of the two common bean genomes has dramatically accelerated and has enabled new experimental strategies to be applied for genetic research. DArTseq has been widely used as a method of SNP genotyping allowing comprehensive genome coverage with genetic applications in common bean breeding programs. Results: Using this technology, 6286 SNPs (1 SNP/86.5 Kbp) were genotyped in genic (43.3%) and non-genic regions (56. 7%). Genetic subdivision associated to the common bean gene pools (K = 2) and related to grain types (K = 3 and K = 5) were reported. A total of 83% and 91% of all SNPs were polymorphic within the Andean and Mesoamerican gene pools, respectively, and 26% were able to differentiate the gene pools. Genetic diversity analysis revealed an average HE of 0.442 for the whole collection, 0.102 for Andean and 0.168 for Mesoamerican gene pools (FST = 0.747 between gene pools), 0. 440 for the group of cultivars and lines, and 0.448 for the group of landrace accessions (FST = 0.002 between cultivar/line and landrace groups). The SNP effects were predicted with predominance of impact on non-coding regions (77.8%). SNPs under selection were identified within gene pools comparing landrace and cultivar/line germplasm groups (Andean: 18; Mesoamerican: 69) and between the gene pools (59 SNPs), predominantly on chromosomes 1 and 9. The LD extension estimate corrected for population structure and relatedness (r2 SV) was~88 kbp, while for the Andean gene pool was~395 kbp, and for the Mesoamerican was ~ 130 kbp. Conclusions: For common bean, DArTseq provides an efficient and cost-effective strategy of generating SNPs for large-scale genome-wide studies. The DArTseq resulted in an operational panel of 560 polymorphic SNPs in linkage equilibrium, providing high genome coverage. This SNP set could be used in genotyping platforms with many applications, such as population genetics, phylogeny relation between common bean varieties and support to molecular breeding approaches

Integrality and longitudinality of primary care for women's health: an analysis of three amazonian municipalities

O estado do Amazonas abrange municípios ribeirinhos que, devido a suas peculiaridades, são um desafio para organização da Atenção Primária à Saúde (APS). Este estudo objetivou avaliar os atributos essenciais de integralidade e longitudinalidade da APS da mulher em idade reprodutiva em três municípios amazônicos, pois doenças preveníveis pela APS apresentam alta incidência nessa população. Esta é uma pesquisa transversal, de caráter exploratório e abordagem quantitativa, que utilizou o instrumento Avaliação da Atenção Primária (PCATool) Versão Adulto para entrevistar 857 mulheres. Os resultados foram insatisfatórios na avaliação dos dois atributos, longitudinalidade e integralidade, com diferenças significativas entre os municípios. Na avaliação da APS sobre questões de relevância epidemiológica para saúde da mulher amazônica os resultados demonstraram que os serviços de assistência pré-natal e a realização de exame preventivo para o câncer de colo de útero estavam disponíveis para cerca de 90% das mulheres. O aconselhamento para testagem de HIV foi relatado por mais de 60% das mulheres entrevistadas. Assim, este estudo identificou limites e desafios da Atenção Primária a Saúde da mulher nesses municípios, reforçando a importância de processos avaliativos como instrumentos de melhor gerenciamento das políticas públicas em saúde.The State of Amazonas has riparian municipalities that, due to their peculiarities, are a challenge for the organization of Primary Health Care (PHC). This study aimed to evaluate the integral attributes and longitudinality of PHC to Women's Health in reproductive age in three municipalities of the state, because diseases preventable by PHC are present at high incidence in this population. This is a cross-sectional, exploratory and quantitative study that used the Primary Care Assessment Tool (PCATool) instrument -Adult version -to interview 857 women. The results were unsatisfactory in the evaluation of the two attributes, longitudinality and Integrality, with significant differences between the municipalities. In the PHC evaluation on issues of epidemiological relevance for the health of Amazonian women, the results showed that prenatal care and preventive examination for cervical cancer were available for about 90% of the women. Counseling for HIV testing was reported by more than 60% of the women interviewed. Therefore, this study identified the limits and challenges of Primary Health Care for Women in these municipalities, reinforcing the importance of evaluation processes as tools for better management of public health policies.Pró-reitoria de Extensão da Universidade Federal do Amazonas (UFAM, Edital nº 04/2011 – MEC/SESu) e da Fundação de Amparo à Pesquisa do Amazonas (FAPEAM), pelo Programa de Apoio à Iniciação Científica do Amazonas da Universidade Federal do Amazonas (PAIC/UFAM, Edital PAIC/2013

Carcinoma invasor, carcinoma in situ e hiperplasia epitelial ductal atípica: correlação dos achados histopatológicos entre mamotomia e cirurgia

OBJECTIVE: To compare the histopathological findings of carcinoma and atypical hyperplasia obtained with breast biopsy and the respective surgical procedures.MATERIAL AND METHODS: 527 breast biopsies were carried out at our services within an 18-month period. Out of these biopsies, 118 were diagnosed as carcinoma in situ or invasive carcinoma and atypical hyperplasia. Diagnosis was obtained with digital stereotactic breast biopsy. Patients presented asymptomatic, had subclinical lesions on mammographic screening, averaged 55 years of age, and were, in their majority, postmenopausal women.RESULTS: Out of the 118 patients who fulfilled our study criteria, we were able to establish a comparison with the histopathological findings of surgical biopsy in 73 cases (61,9%). There was a loss of follow up in 45 cases (38,1 %). The histopathological findings were compatible with those of breast biopsy in 60 cases (82%), both in relationto the type and histopathological grade of the lesion.CONCLUSIONS: Breast biopsy represents an important alternative to surgical biopsy for the diagnosis of nonpalpable breast lesions. It is a rapid, easy to operate methodthat provides optimal results. In addition, its results presented a good rate of agreement with the histopathological findings of surgical biopsy. The quality of the collected material was considered satisfactory for the purpose of diagnosis. OBJETIVO: Comparar os resultados histopatológicos de carcinoma e hiperplasia atípica obtidos através da mamotomia com os das respectivas biópsias cirúrgicas.MATERIAIS E MÉTODOS: Foram realizadas nesta instituição 527 mamotomias em 18 meses. Destas, 118 tiveram diagnóstico de carcinoma in situ ou invasor e hiperplasia atípica, através da mamotomia guiada por estereotaxia digital. As pacientes eram assintomáticas, apresentando lesão subclínica ao rastreio mamográfico. A idade média destas pacientes era de 55 anos e a maioria encontrava-se na pós-menopausa.RESULTADOS: Das 118 pacientes que preencheram os critérios para este estudo, foi possível realizar a comparação com os resultados histopatológicos da biópsia cirúrgica em 73 casos (61,9%). Em 45 casos houve perda de follow up (38,1%). O laudo histopatológico pós-cirúrgico foi compatível com o da mamotomia em 60 casos (82%), tanto em relação ao tipo quanto ao grau histopatológico da lesão.CONCLUSÃO: A mamotomia tem representado uma importante alternativa à biópsia cirúrgica para o diagnóstico das lesões impalpáveis da mama. Trata-se de um método rápido, de fácil realização, com ótimos resultados, além de apresentar boa taxa de concordância com os resultados histopatológicos obtidos através da biópsia cirúrgica. A qualidade do material obtido tem sido considerada satisfatória para o diagnóstico

Participation, knowledge production, and evaluative research: participation by different actors in a mental health study

This article reflects on the interrelations between participation, knowledge production, and public policy evaluation in light of issues from our own experience with evaluative research on a municipal network of Psychosocial Care Centers (CAPS) in Brazil. The article discusses the coordination of the complex process and the potentials and limits of partnerships for conducting qualitative evaluative studies in mental health with participation by different social actors. The authors conclude that qualitative evaluative research aligned with the perspective of including different points of view representing various segments is the best approach for understanding the numerous spin-offs from the implementation of services linked to the Brazilian psychiatric reform movement, given the inherent specificities of the mental health field.No presente texto apresentamos considerações sobre pesquisa avaliativa qualitativa e participativa com base em investigação desta natureza realizada junto a uma rede municipal de Centros de Atenção Psicossocial (CAPS) ligados ao Sistema Único de Saúde (SUS). A coordenação do complexo processo, bem como as potencialidades e limites do estabelecimento de parcerias para a realização de trabalhos de investigação avaliativa qualitativa em saúde mental, com a inclusão de diferentes atores sociais, são aqui discutidas. Concluímos que a pesquisa avaliativa qualitativa aliada à perspectiva de inclusão de distintos pontos de vista dos vários segmentos envolvidos é a que melhor se adequa à compreensão dos muitos desdobramentos oriundos da implementação de serviços ligados ao movimento de reforma psiquiátrica brasileira, dado as especificidades inerentes ao campo da saúde mental.Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Universidade Federal de São Paulo (UNIFESP)Universidade Estadual de Campinas FCMUNIFESPSciEL

Silage production, chemical composition and fermentative capacity of wilted sweet potato vines

A varia??o na disponibilidade de forragem ao longo do ano, aliada ? necessidade de se utilizar alimentos de menor custo para ruminantes, t?m contribu?do para um aumento na procura por novas alternativas para alimenta??o animal. Objetivou-se avaliar a produtividade de massa seca (PMS) de ramas e o efeito do emurchecimento na composi??o bromatol?gica e capacidade fermentativa (CF) de ramas de batata-doce visando a produ??o de silagens. Foram avaliados os gen?tipos BD-08, BD-23, BD-25, BD-31TO, BD-38, BD-43 e Brazl?ndia Roxa, utilizando-se o arranjo fatorial 7 x 2 (gen?tipos x ramas emurchecidas ou n?o), em delineamento em blocos ao acaso, com 4 repeti??es. Foram determinados a produ??o de massa seca e os teores de mat?ria seca (MS), prote?na bruta (PB), fbra em detergente neutro (FDN), fbra em detergente ?cido (FDA), hemicelulose, celulose, lignina, cinzas, carboidratos sol?veis (CS), nitrog?nio insol?vel em detergente ?cido (NIDA), capacidade tamp?o (CT) e capacidade fermentativa (CF) das ramas in natura e emurchecidas. A PMS das ramas variou de 4,2 a 7,9 t ha-1, com destaque para BD-25, BD-08 e BD-23 com produtividades superiores a 7,0 t ha-1. O emurchecimento promoveu aumento nos teores de MS (15,7 para 25,7%), de PB (11,0 para 11,9%), FDA (29,2 para 41,7%), lignina (8,6 para 15,5%), celulose (19,3 para 24,3%), cinzas (8,9 para 10,0%) e NIDA (9,7 para 32,8%), e redu??o nos teores de CS (15,0 para 7.6%), tornando as ramas emurchecidas de pior qualidade. O emurchecimento n?o infuenciou a CF das ramas (m?dia de 37,2) e promoveu eleva??o nos teores de FDN de forma diferenciada para cada gen?tipo. Os teores mais elevados de MS nas ramas emurchecidas compensaram o mais baixo teor de CS, tornando a CF das ramas semelhante. As ramas de batata-doce de todos os gen?tipos apresentaram elevado potencial de ensilabilidade.Funda??o de Amparo ? Pesquisa do Estado de Minas Gerais (FAPEMIG)Empresa de Pesquisa Agropecu?ria de Minas Gerais (EPAMIG)Conselho Nacional de Desenvolvimento Cient?fico e Tecnol?gico (CNPq)Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior (CAPES)The variation in the availability of forage throughout the year and the need to use low-cost food for ruminants contributed to an increase in the search for new food alternatives. This study aimed to evaluate the yield of the dry mass of vines and the effect of wilting on the chemical composition and fermentative capacity of sweet potato vines for silage production. The evaluated genotypes were BD-08, BD-23, BD-25, BD-31TO, BD-38, BD-43 and Brazl?ndia Roxa, using a 7x2 factorial arrangement (genotype x wilted vines or not), in a randomized block design, with four replications. We determined the dry matter yield (PMS) and dry matter (MS), crude protein (PB), neutral detergent fiber (FDN), acid detergent fiber (FDA), cellulose, hemicellulose, lignin, ash, water soluble carbohydrates (CS), acid detergent insoluble nitrogen (NIDA), buffering capacity (CT) and fermentative capacity (CF) of fresh and wilted vines. The MS of vines ranged from 4.2 to 7.9 t ha-1, with emphasis on BD-25, BD-08 and BD-23 with yields higher than 7.0 t ha-1. Wilting promoted increase in MS (15.7 to 25.7%), PB (11.0 to 11.9%), FDA (29.2 to 41.7%), lignin (8.6 to 15.5%), cellulose (19.3 to 24.3%), ash (8.9 to 10.0%) and NIDA (9.7 to 32.8%), and reduced levels of CS (15.0 to 7.6%), making the wilted branches of poorer quality. Wilting did not affect the CF of the vines (average 37.2) and promoted an increase in FDN differently for each genotype. The highest levels of MS in wilted vines offset the lower level of CS, making similar the CF of vines.The sweet potato vines of all genotypes presented high potential for silage