Mastectomia preventiva: ainda uma estratégia controversa?

The follow up and care of BRCA1/2 women, and the decisions concerning risk reduction strategies, challenge the classical patient-doctor relationship. Non-directive counseling with open discussion about different alternatives for breast cancer risk reduction is usually recommended. Scientific evidence in this field is complex, due to the lack of randomized data and heterogeneous selection criteria for different studies. The physicians in charge of this follow up must be aware of the latest scientific data, to allow for an informed discussion with their patients. Decisions must be tailored taking into account individual factors. Surgical prevention (prophylactic mastectomy and/or oophorectomy) reduces the risk of invasive breast cancer in BRCA and BRCA2 patients, with prophylactic mastectomy (PM) being the most effective procedure for cancer prevention, in these women. Although effective in this setting, prophylactic surgery is still criticized because it could be non-therapeutic and only decided on the family history or clinical decision. With generalization of commercial BRCA1 and BRCA2 screening, a more accurate selection of candidates for PM is possible. Acceptance of this procedure by women at risk and health practitioners is variable. We suggest that risk management of these high-risk women must be done by multidisciplinary teams. Keywords: breast cancer, BRCA1, BRCA2, prophylactic mastectomy. O seguimento de portadoras de mutações nos genes BRCA1/2 e a tomada de decisões sobre as suas estratégias de gestão de risco, desafiam a relação médico-doente clássicamente estabelecida. Neste contexto, há quem advogue o aconselhamento não directivo, com discussão das várias alternativas de redução de risco de cancro, nomeadamente do cancro da mama. A evidência cientifica nesta area é complexa de analizar pois há falta de estudos randomizados e os critérios de selecção são complexos. Os médicos responsáveis pelo seguimento destas doentes devem estar actualizados de forma a possibilitar uma discussão informada e orientá-las na decisão que melhor se adequa aos seus factores individuais. A prevenção cirurgica (mastectomia preventiva e/ou ooforectomia preventiva) reduz de forma significativa o risco de cancro da mama invasivo em mulheres portadoras de mutações nos genes BRCA1 and BRCA2. A mastectomia preventiva é, neste contexto, a estratégia mais eficaz na redução da incidência de cancro da mama. Apesar da sua eficácia, é um procedimento controverso, principalmente porque é considerado não terapêutico e a decisão da sua realização poder ser tomada apenas baseada em critérios clínicos. Com a generalização do rastreio BRCA1 e BRCA2 é possivel fazer uma selecção mais correcta das candidatas para mastectomia preventiva. A aceitação desta técnica cirurgica pelas mulheres em risco e pelos profissionais de saude é variável. A integração da gestão do risco hereditário de cancro da mama em unidades multidisciplinares é sugerida. Palavras chave: cancro da mama, BRCA1, BRCA2, mastectomia profilactica.

As Dificuldades no Ensino-Aprendizagem das Ciências da Terra

O trabalho ora apresentado sobre o tema, Dificuldades no Ensino/Aprendizagem das Ciências da Terra, vem na sequência de uma investigação para apresentação de um trabalho científico do final da Curso em Geologia, constituindo um requisito parcial para obtenção do grau de licenciatura. A motivação para a realização deste trabalho, foi o despertar do gosto pelos conteúdos de Geologia que vim adquirindo ao longo da formação, mas também, como optei pela área de ensino, queria constactar no terreno, como se ensina esta ciência, o interesse dos alunos, as dificuldades tanto do professor como do aluno no processo Ensino/ Aprendizagem da mesma. Tem como objectivo principal conhecer as principais dificuldades no processo Ensino/ Aprendizagem desta ciência de modo a contribuir com algumas sugestões de superação, caso sejam necessárias. No entanto, há que evidenciar também o papel da Geologia e o seu contributo na compreensão da história da Terra, no desenvolvimento, etc. Com efeito, julgamos, que com este trabalho podemos não só, aumentar o nosso conhecimento sobre o tema, mas também contribuir com sugestões que podem ser úteis tanto para as futuras formações como para melhorar o Ensino/Aprendizagem no terreno

The contribution of up-cycled food waste to a balanced diet of low-income households

This paper focuses on the contribution of an upcycling food organization to a balanced diet, which rescues and redistributes fresh or freshly cooked food to low-income households. To determine the nutritional balance of food hampers provided by our case study organization, according to the Portuguese food guidelines, we have weighed all items of food hampers in three weighing rounds over a period of four months. The results suggest that upcycled foods can contribute to a more balanced diet in terms of “Potato, Cereal and Cereal Products”, “Vegetables”, “Meat, Fish, Seafood and Eggs” and “Fruits”, both according to the Portuguese Food Wheel and compared to that of the general Portuguese population. The novelty of this study is the evaluation of the contribution to the balanced diet of the population in a vulnerable situation, of perishable foods such as freshly cooked, in traditional restaurants, cafes, bakeries, and hotels, or is naturally fresh (fruit and vegetables food aid services) up-cycled by a food aid organization.This work was supported by Portuguese national funds through FCT—Foundation for Science and Technology, under project UIDP/00713/2020.info:eu-repo/semantics/publishedVersio

The transition from two-dimensional to three-dimensional foam structures

Small cells in an experimental sample of two-dimensional foam, such as that which is contained between two glass plates, may undergo a transition to a three-dimensional form, becoming detached from one boundary. We present the first detailed observations of this phenomenon, together with computer simulations. The transition is attributed to an instability of the Rayleigh-Plateau type. A theoretical analysis is given which shows that an individual cell is susceptible to this instability only if it has less than six sides

Simulation of defects in bubble clusters

Topological defects in foam, either isolated (disclinations and dislocations) or in pairs, affect the energy and stress, and play an important role in foam deformation. Surface Evolver simulations were performed on large finite clusters of bubbles. These allow us to evaluate the effect of the topology of the defects, and the distance between defects, on the energy and pressure of foam clusters of different sizes. The energy of such defects follows trends similar to known analytical results for a continuous medium

Microbes and cancer: friends or faux?

Cancer is one of the most aggressive and deadly diseases in the world, representing the second leading cause of death. It is a multifactorial disease, in which genetic alterations play a key role, but several environmental factors also contribute to its development and progression. Infections induced by certain viruses, bacteria, fungi and parasites constitute risk factors for cancer, being chronic infection associated to the development of certain types of cancer. On the other hand, susceptibility to infectious diseases is higher in cancer patients. The state of the host immune system plays a crucial role in the susceptibility to both infection and cancer. Importantly, immunosuppressive cancer treatments increase the risk of infection, by decreasing the host defenses. Furthermore, alterations in the host microbiota is also a key factor in the susceptibility to develop cancer. More recently, the identification of a tumor microbiota, in which bacteria establish a symbiotic relationship with cancer cells, opened a new area of research. There is evidence demonstrating that the interaction between bacteria and cancer cells can modulate the anticancer drug response and toxicity. The present review focuses on the interaction between microbes and cancer, specifically aiming to: (1) review the main infectious agents associated with development of cancer and the role of microbiota in cancer susceptibility; (2) highlight the higher vulnerability of cancer patients to acquire infectious diseases; (3) document the relationship between cancer cells and tissue microbiota; (4) describe the role of intratumoral bacteria in the response and toxicity to cancer therapy.This research was funded by National Funds through FCT—Fundação para a Ciência e a Tecnologia, I.P., within CINTESIS, R&D Unit, grant number UIDB/4255/2020

Obstructive sleep apnea associated with Diabetes mellitus Type 2: a proteomic study

Background: We previously showed that Obstructive sleep apnea (OSA), a common public health concern causing deleterious cardiometabolic dysfunction, induced proteomic alterations in red blood cells (RBC) such as changes in the redox-oligomeric state of peroxiredoxin 2 (PRDX2)1-2. Herein, we aimed to investigate whether OSA patients with Type 2 Diabetes Mellitus before and after positive airway pressure (PAP) treatment present similar changes in the RBC antioxidant protein PRDX2 to better understand the molecular basic mechanisms associated with OSA and OSA outcomes. Methods: RBC samples from control snorers (n=22 being 3 diabetics) and OSA patients before and after six month of PAP-treatment (n=29 being 8 diabetics) were analysed by non-reducing western blot using antibody against PRDX2 or PRDXSO2/3 to measure the total and overoxidized levels of monomeric/dimeric/multimeric forms of PRDX2. Results: We confirmed previously data by showing that in OSA RBC the overoxidation on the monomeric forms of PRDX2 was higher compared to controls. After PAP treatment, this overoxidation decreased followed by an increase of multimeric-overoxidized forms of PRDX2 described to be associated with chaperone protective function. In contrast, the level of PRDX2 monomers in RBC diabetic OSA, although higher abundant its overoxidation level was much lower than those observed in OSA without comorbidity and did not significant change after treatment. Moreover, the level of PAP-induced PRDX2-overoxidized-multimers was also lower in these diabetic OSA patients. The level of overoxidized monomeric/dimeric forms of PRDX2 correlated negatively with levels of insulin / triglycerides and HbA1C, respectively. After PAP, the level of (overoxidized) PRDX2SO2/3 multimers correlated positively with adrenaline levels. Conclusions: The redox/oligomeric state of RBC PRDX2 that is regulated by overoxidation of the active cysteines was differentially modulated in diabetic OSA patients compared to OSA without this comorbidity. PAP-induced overoxidized oligo forms of PRDX2 that is associated with chaperone protective function showed decreased in OSA patients with diabetes. The clinical impact of these findings needs further investigation and validation.Project partially supported by Harvard Medical School-Portugal Program (HMSP-ICJ/0022/2011), ToxOmics - Centre for Toxicogenomics and Human Health (FCT-UID/BIM/00009/2013).info:eu-repo/semantics/publishedVersio

Determinantes do consumo alimentar de doentes hospitalizados

[Resumo][Abstract

Proposta de reabilitação de um edifício centenário cujo proprietário é a Câmara Municipal de Alvaiázere

Este projecto tem como objecto de estudo o edifício “Casa Apalaçada” de Alvaiázere, que é um edifício do século XIX, que apesar do mesmo ter sofrido algumas alterações ao longo da sua vida, ainda conserva elementos estruturais de “tabique” de madeira e alvenaria de pedra. Através de um conjunto de estudos que incluiu a caracterização arquitectónica e construtiva, os levantamentos geométrico e fotográfico e de inspecção visual e registo das anomalias do edifício, foi possível efectuar um diagnóstico das anomalias estruturais e não estruturais, e assim conduzir à definição de uma estratégia de intervenção pouco intrusiva, que permita a reposição das condições originais do edifício, respeitando os princípios da reversibilidade e compatibilidade construtiva preconizados nas Cartas e Convenções Internacionais da protecção do património cultural.Instituto Politécnico de Toma