Estratégias de autocuidado das pessoas com doença oncológica submetidas a quimioterapia/radioterapia e a sua relação com o conforto

This article constitutes a systematic review of the literature on self-care strategies that facilitate the promotion of self-care and comfort designed for the person with cancer undergoing chemotherapy / radiation therapy.Aims to determine the best available evidence on the strategies used by the person with cancer undergoing qimioterapia to promote self-care and comfort and which factors facilitators developed by nurses.In the conduct of this systematic literature review methodology was used PI (C) OD.Results: Identified 10 studies included in this systematic review of the literature. From the data analysis it was found that people undergoing chemotherapy and radiotherapy adopt self-care strategies to cope with the situation they are in and the side effects caused by treatments. The rest, relaxation techniques and listening to music are strategies to cope with fatigue, stress and anxiety. A good network of family support, good disease management, and all aspects were given appointments as promoters of self-care to physical and psychological level. The use of alternative medicines to fight the side effects was found also as a significant factor. Early intervention, monitoring and follow up interventions are identified by patients as promoting well-being and safety. Regarding the relationship between self-care and comfort are no results, which may mean the need for development in this area.Este artículo es una revisión sistemática de la literatura sobre estrategias de autocuidado que faciliten la promoción del autocuidado y confort diseñado para la persona con cáncer sometidos a quimioterapia / radioterapia. Su objetivo es determinar la mejor evidencia disponible sobre las estrategias utilizadas por las personas con cáncer sometidas a qimioterapia para promover el autocuidado y el  bienestar y cuáles son los factores facilitadores desarrollados por las enfermeras. En el desarrollo de esta revisión sistemática de la literatura se utilizó la metodología de PI (C) OD.Resultados: Se identificaron 10 estudios incluidos en esta revisión sistemática de la literatura. A partir del análisis de datos se encontró que las personas que reciben quimioterapia y radioterapia adoptan estrategias de autocuidado para hacer frente a la situación en que se encuentran y los efectos secundarios causados por los tratamientos. El reposo, técnicas de relajación y escuchar música son las estrategias para luchar con la fatiga, el estrés y la ansiedad. Una buena red de apoyo familiar, la buena gestión de la enfermedad y todas las consultas marcadas eran aspectos indicados como promotores de autocuidado a nivel físico y psicológico. El uso de medicinas alternativas para combatir los efectos secundarios fue también un factor encontrado como promotor de autocuidado. La intervención temprana, la vigilancia y el seguimiento de las intervenciones son identificados por los pacientes como promotoras del bienestar y la seguridad. En cuanto a la relación entre el cuidado personal y el confort no e encontraron resultados, lo que significa la necesidad de desarrollo en esta área.Este artigo constitui-se uma revisão sistemática da literatura sobre as estratégias que facilitam o autocuidado na promoção do autocuidado e conforto desenvolvidas pela pessoa com doença oncológica submetida a quimioterapia/radioterapia.Tem como objectivo determinar a melhor evidência disponível sobre as estratégias utilizadas pela pessoa com doença oncológica submetida a qimioterapia para promoção do autocuidado e conforto e quais os factores facilitadores desenvolvidos pelos enfermeiros. Na condução da presente revisão sistemática da literatura foi utilizada a metodologia PI(C)OD.Resultados: Identificados 10 estudos incluídos na presente revisão sistemática da literatura. A partir da análise dos dados constatou-se que as pessoas submetidas a quimioterapia e radioterapia adoptam estratégias de autocuidado para fazer face à situação em que se encontram e aos efeitos secundários decorrentes dos tratamentos. O repouso, técnicas de relaxamento e ouvir música são estratégias para fazer face à fadiga, stress e ansiedade. Uma boa rede de suporte familiar, boa gestão da doença, tendo todas as consultas marcadas foram aspectos indicados como promotores de autocuidado a nível físico e psicológico. A utilização de medicinas alternativas para combate aos efeitos secundários foi também um factor encontrado como promotor de autocuidado. A intervenção precoce, acompanhamento e follow up são intervenções identificadas pelos doentes como promotoras de bem-estar e segurança. No que respeita a relação entre autocuidado e conforto não foram encontrados resultados, o que pode significar necessidade de desenvolvimento nesta área

Early Diagnosis of Invasive Aspergillosis in Neutropenic Patients. Comparison between Serum Galactomannan and Polymerase Chain Reaction

Background Invasive aspergillosis (IA) is a major cause of morbidity and mortality in profoundly neutropenic patients, so early diagnosis is mandatory. Aim Consecutive patients with hematological malignancies undergoing intensive chemotherapy were screened for IA with two different methods which were compared. Methods From October 2000 to August 2003 we tested 1311 serum samples from 172 consecutive patients with a polymerase chain reaction assay and between April 2005 and April 2008 we tested 806 serum samples from 169 consecutive patients with a Galactomannan (GM) test. Bronchoalveolar (BAL) samples were obtained whenever the patient's condition allowed and tested with either method. Results: The serum PCR assay had a sensitivity of 75.0% and a specificity of 91.9% and the serum GM assay had a sensitivity of 87.5% and a specificity of 93.1%, ( P > 0.05). The presence of two or more consecutive positive serum samples was predictive of IA for both assays. BAL GM/PCR was positive in some patients without serum positivity and in patients with 2 or more positive serum GM/PCR. Conclusions: No significant differences between the 2 serum tests were found. The GM assay has the advantage of being standardized among several laboratories and is incorporated in the criteria established by the European Organization for Research and Treatment of Cancer/Invasive Fungal Infections Cooperative Group and the National Institute of Allergy and Infectious Diseases Mycosis Study Group (EORTC/MSG), however is much more expensive. BAL GM and PCR sampling aids in IA diagnosis but needs further validation studies to differentiate between colonization and true infection in cases where serum GM or PCR are negative

Extracellular vesicles shed by trypanosoma brucei brucei manipulate host mononuclear cells

Funding Information: Funding: This study was supported by FCT—Foundation for Science and Technology, I.P., through research grant PTDC/CVT-CVT/28908/2017 and by national funds within the scope of Centro de Investigação Interdisciplinar em Sanidade Animal (CIISA, UIDB/00276/2020) and Global Health and Tropical Medicine (GHTM, UID/04413/2020). Funding Information: This study was supported by FCT?Foundation for Science and Technology, I.P., through research grant PTDC/CVT-CVT/28908/2017 and by national funds within the scope of Centro de Investiga??o Interdisciplinar em Sanidade Animal (CIISA, UIDB/00276/2020) and Global Health and Tropical Medicine (GHTM, UID/04413/2020). Publisher Copyright: © 2021 by the authors. Licensee MDPI, Basel, Switzerland.African trypanosomiasis or sleeping sickness is a zoonotic disease caused by Trypanosoma brucei, a protozoan parasite transmitted by Glossina spp. (tsetse fly). Parasite introduction into mammal hosts triggers a succession of events, involving both innate and adaptive immunity. Macrophages (MΦ) have a key role in innate defence since they are antigen-presenting cells and have a micro-bicidal function essential for trypanosome clearance. Adaptive immune defence is carried out by lymphocytes, especially by T cells that promote an integrated immune response. Like mammal cells, T. b. brucei parasites release extracellular vesicles (TbEVs), which carry macromolecules that can be transferred to host cells, transmitting biological information able to manipulate cell immune response. However, the exact role of TbEVs in host immune response remains poorly understood. Thus, the current study examined the effect elicited by TbEVs on MΦ and T lymphocytes. A combined approach of microscopy, nanoparticle tracking analysis, multiparametric flow cytometry, colourimetric assays and detailed statistical analyses were used to evaluate the influence of TbEVs in mouse mononuclear cells. It was shown that TbEVs can establish direct communication with cells of innate and adaptative immunity. TbEVs induce the differentiation of both M1-and M2-MΦ and elicit the expansion of MHCI+, MHCII+ and MHCI+ MHCII+ MΦ subpopulations. In T lymphocytes, TbEVs drive the overexpression of cell-surface CD3 and the nuclear factor FoxP3, which lead to the differentiation of regulatory CD4+ and CD8+ T cells. Moreover, this study indicates that T. b. brucei and TbEVs seem to display opposite but complementary effects in the host, establishing a balance between parasite growth and controlled immune response, at least during the early phase of infection.publishersversionpublishe

Detection of anti-infliximab antibodies is impacted by antibody titer, infliximab level and IgG4 antibodies: a systematic comparison of three different assays

Background: There is scant information on the accuracy of different assays used to measure anti-infliximab antibodies (ADAs), especially in the presence of detectable infliximab (IFX). We thus aimed to evaluate and compare three different assays for the detection of IFX and ADAs and to clarify the impact of the presence of circulating IFX on the accuracy of the ADA assays.Methods: Blood samples from 79 ulcerative colitis (UC) patients treated with infliximab were assessed for IFX levels and ADAs using three different assays: an in-house assay and two commercial kits, Immundiagnostik and Theradiag. Sera samples with ADAs and undetectable levels of IFX were spiked with exogenous IFX and analyzed for ADAs.Results: The three assays showed 81-96% agreement for the measured IFX level. However, the in-house assay and Immundiagnostik assays detected ADAs in 34 out of 79 samples, whereas Theradiag only detected ADAs in 24 samples. Samples negative for ADAs with Theradiag, but ADA-positive in both the in-house and Immundiagnostik assays, were positive for IFX or IgG4 ADAs. In spiking experiments, a low concentration of exogenous IFX (5 mu g/ml) hampered ADA detection with Theradiag in sera samples with ADA levels of between 3 and 10 mu g/ml. In the Immundiagnostik assay detection interference was only observed at concentrations of exogenous IFX higher than 30 mu g/ml. However, in samples with high levels of ADAs (> 25 mu g/ml) interference was only observed at IFX concentrations higher than 100 mu g/ml in all three assays. Binary (IFX/ADA) stratification of the results showed that IFX+/ADA and IFX-/ADAs + were less influenced by the assay results than the double-positive (IFX+/ADAs+) and double-negative (IFX-/ADAs-) combination.Conclusions: All three methodologies are equally suitable for measuring IFX levels. However, erroneous therapeutic decisions may occur when patients show double-negative (IFX-/ADAs) or double-positive (IFX+/ADAs+) status, since agreement between assays is significantly lower in these circumstances

Contribution for new genetic markers of rheumatoid arthritis activity and severity : sequencing of the tumor necrosis factor-alpha gene promoter

© 2007 Fonseca et al.; licensee BioMed Central Ltd. This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly citedThe objective of this study was to assess whether clinical measures of rheumatoid arthritis activity and severity were influenced by tumor necrosis factor-alpha (TNF-alpha) promoter genotype/haplotype markers. Each patient's disease activity was assessed by the disease activity score using 28 joint counts (DAS28) and functional capacity by the Health Assessment Questionnaire (HAQ) score. Systemic manifestations, radiological damage evaluated by the Sharp/van der Heijde (SvdH) score, disease-modifying anti-rheumatic drug use, joint surgeries, and work disability were also assessed. The promoter region of the TNF-alpha gene, between nucleotides -1,318 and +49, was sequenced using an automated platform. Five hundred fifty-four patients were evaluated and genotyped for 10 single-nucleotide polymorphism (SNP) markers, but 5 of these markers were excluded due to failure to fall within Hardy-Weinberg equilibrium or to monomorphism. Patients with more than 10 years of disease duration (DD) presented significant associations between the -857 SNP and systemic manifestations, as well as joint surgeries. Associations were also found between the -308 SNP and work disability in patients with more than 2 years of DD and radiological damage in patients with less than 10 years of DD. A borderline effect was found between the -238 SNP and HAQ score and radiological damage in patients with 2 to 10 years of DD. An association was also found between haplotypes and the SvdH score for those with more than 10 years of DD. An association was found between some TNF-alpha promoter SNPs and systemic manifestations, radiological progression, HAQ score, work disability, and joint surgeries, particularly in some classes of DD and between haplotypes and radiological progression for those with more than 10 years of DD.This work was supported by grant POCTI/SAU-ESP/59111/2004 from Fundação Ciência e Tecnologia.info:eu-repo/semantics/publishedVersio

Estratégia Nacional para a Medicina Genómica - PT_MedGen: desafios e prioridades

Documento preparado pela Comissão nomeada pelo Despacho n.º 5135/2021, de 20 de maio do SEAS (Diário da República n.º 98/2021, Série II de 2021-05-20, pp 107-108): Fernando de Almeida, Instituto Nacional de Saúde Doutor Ricardo Jorge I.P. – Presidente da Comissão; Astrid Moura Vicente, Instituto Nacional de Saúde Doutor Ricardo Jorge I.P. – Coordenadora da Comissão e responsável pelo GT Doenças Complexas; Patrícia Calado, Agência de Investigação Clínica e Inovação Biomédica – Cocoordenadora da Comissão e responsável pelo GT Comunicação; Manuel Santos, Universidade de Aveiro, GenomePT – Responsável pelo GT Boas práticas de Sequenciação; Ana Sofia Carvalho, ICBAS - Instituto de ciências Biomédicas Abel Salazar, Universidade do Porto - Responsável pelo GT Questões Éticas, Legais e Sociais; Cíntia Águas, Membro do GT Questões Éticas, Legais e Sociais; Cátia Sousa Pinto, Serviços Partilhados do Ministério da Saúde E.P.E. – Responsável pelo GT Dados de Saúde; Mário Jorge Gaspar da Silva, Instituto Superior Técnico, Universidade de Lisboa; BioData.pt – Responsável pelo GT Interoperabilidade de Partilha de Dados; Ana Portugal Melo, BioData.pt - Membro do GT Interoperabilidade de Partilha de Dados; Mónica Duarte Correia de Oliveira, Instituto Superior Técnico, Universidade de Lisboa – Responsável pelo GT Economia da Saúde; Joana Feijó, Health Cluster Portugal – Responsável pelo GT Indústria e Setor Privado; Laura Vilarinho, Instituto Nacional de Saúde Doutor Ricardo Jorge I.P. – Responsável pelo GT Doenças Raras; Carla Oliveira, I3S - Instituto de Investigação e Inovação, Universidade do Porto – Responsável pelo GT Cancro.Com os contributos adicionais de: Ana Berta Sousa, Centro Hospitalar Universitário de Lisboa Norte; Ana Fortuna, Centro Hospitalar Universitário do Porto; Gabriela Sousa, Instituto Português de Oncologia de Coimbra; Guiomar Oliveira, Centro Hospitalar Universitário de Coimbra; João Paulo Oliveira, Centro Hospitalar Universitário de São João; Jorge Pinto Basto, Colégio da Especialidade de Genética Médica da Ordem dos Médicos; Jorge Saraiva, Centro Hospitalar Universitário de Coimbra; Margarida Venâncio, Centro Hospitalar Universitário de Coimbra; Patrícia Dias, Centro Hospitalar Universitário de Lisboa Norte; Sérgio Sousa, Centro Hospitalar Universitário de Coimbra.À Comissão compete a definição de roadmap para o planeamento e implementação da Estratégia Nacional para a Medicina Genómica, que apoiará a contribuição de Portugal na iniciativa 1+MG.O presente documento visa propor o conceito e as linhas de ação prioritárias da Estratégia Nacional para a Medicina Genómica (PT_MedGen). O documento baseia-se na auscultação de alguns dos principais stakeholders nacionais, representados na Comissão nomeada pelo Despacho n.o 5135/2021 coordenada pelo INSA, e ainda na consulta de outras entidades e peritos de relevância. A estratégia PT_MedGen tem a meta global de criar infraestruturas e processos que permitam a adoção de abordagens de medicina personalizada na prática clínica, a par com a contribuição para a iniciativa 1+MG. Esta estratégia promoverá ainda a investigação, a inovação, a competitividade e a internacionalização, permitindo a criação de conhecimento e valor significativos na área da saúde.info:eu-repo/semantics/publishedVersio

Democracia económica e responsabilidade social nas sociedades tecnológicas

Coordenação científica da obra: Maria Miguel Carvalho | Ana Flávia Messa | Irene Patrícia NoharaO presente livro reúne a maioria das intervenções proferidas no workshop dedicado à «Democracia Económica e Responsabilidade Social nas Sociedades Tecnológicas», que se realizou na Escola de Direito da Universidade do Minho – EDUM (Braga), em 16 de janeiro de 2018. Este workshop – que teve o apoio do Centro de Investigação Interdisciplinar em Direitos Humanos (DH-CII), do Centro de Estudos em Direito da União Europeia (CEDU) da EDUM e da Faculdade de Direito da Universidade Presbiteriana Mackenzie (S. Paulo) -, visou promover a reflexão e o debate de questões éticas, morais e jurídicas colocadas pelo desenvolvimento económico globalizado, no contexto das sociedades tecnológicas contemporâneas, fomentando a partilha de conhecimento e de experiências entre investigadores portugueses e brasileiros. As signatárias, coordenadoras desta publicação e coorganizadoras do workshop, agradecem a disponibilidade demonstrada pelos Colegas das Faculdades de Direito da Universidade Presbiteriana Mackenzie (S.Paulo), da Universidade de Londrina, da Universidade do Porto e da Escola de Direito da Universidade do Minho para participar nesta iniciativa e que fizeram com que a mesma tenha tido enorme sucesso.Centro de Investigação em Justiça e Governação (JUSGOV)info:eu-repo/semantics/publishedVersio

SARS-CoV-2 introductions and early dynamics of the epidemic in Portugal

Genomic surveillance of SARS-CoV-2 in Portugal was rapidly implemented by the National Institute of Health in the early stages of the COVID-19 epidemic, in collaboration with more than 50 laboratories distributed nationwide. Methods By applying recent phylodynamic models that allow integration of individual-based travel history, we reconstructed and characterized the spatio-temporal dynamics of SARSCoV-2 introductions and early dissemination in Portugal. Results We detected at least 277 independent SARS-CoV-2 introductions, mostly from European countries (namely the United Kingdom, Spain, France, Italy, and Switzerland), which were consistent with the countries with the highest connectivity with Portugal. Although most introductions were estimated to have occurred during early March 2020, it is likely that SARS-CoV-2 was silently circulating in Portugal throughout February, before the first cases were confirmed. Conclusions Here we conclude that the earlier implementation of measures could have minimized the number of introductions and subsequent virus expansion in Portugal. This study lays the foundation for genomic epidemiology of SARS-CoV-2 in Portugal, and highlights the need for systematic and geographically-representative genomic surveillance.We gratefully acknowledge to Sara Hill and Nuno Faria (University of Oxford) and Joshua Quick and Nick Loman (University of Birmingham) for kindly providing us with the initial sets of Artic Network primers for NGS; Rafael Mamede (MRamirez team, IMM, Lisbon) for developing and sharing a bioinformatics script for sequence curation (https://github.com/rfm-targa/BioinfUtils); Philippe Lemey (KU Leuven) for providing guidance on the implementation of the phylodynamic models; Joshua L. Cherry (National Center for Biotechnology Information, National Library of Medicine, National Institutes of Health) for providing guidance with the subsampling strategies; and all authors, originating and submitting laboratories who have contributed genome data on GISAID (https://www.gisaid.org/) on which part of this research is based. The opinions expressed in this article are those of the authors and do not reflect the view of the National Institutes of Health, the Department of Health and Human Services, or the United States government. This study is co-funded by Fundação para a Ciência e Tecnologia and Agência de Investigação Clínica e Inovação Biomédica (234_596874175) on behalf of the Research 4 COVID-19 call. Some infrastructural resources used in this study come from the GenomePT project (POCI-01-0145-FEDER-022184), supported by COMPETE 2020 - Operational Programme for Competitiveness and Internationalisation (POCI), Lisboa Portugal Regional Operational Programme (Lisboa2020), Algarve Portugal Regional Operational Programme (CRESC Algarve2020), under the PORTUGAL 2020 Partnership Agreement, through the European Regional Development Fund (ERDF), and by Fundação para a Ciência e a Tecnologia (FCT).info:eu-repo/semantics/publishedVersio

Strategies for self-care of persons with cancer undergoing chemotherapy / radiotherapy and its relationship with the comfort

Este artículo es una revisión sistemática de la literatura sobre estrategias de autocuidado que faciliten la promoción del autocuidado y confort diseñado para la persona con cáncer sometidos a quimioterapia / radioterapia. Su objetivo es determinar la mejor evidencia disponible sobre las estrategias utilizadas por las personas con cáncer sometidas a qimioterapia para promover el autocuidado y el bienestar y cuáles son los factores facilitadores desarrollados por las enfermeras. En el desarrollo de esta revisión sistemática de la literatura se utilizó la metodología de PI (C) OD. Resultados: Se identificaron 10 estudios incluidos en esta revisión sistemática de la literatura. A partir del análisis de datos se encontró que las personas que reciben quimioterapia y radioterapia adoptan estrategias de autocuidado para hacer frente a la situación en que se encuentran y los efectos secundarios causados por los tratamientos. El reposo, técnicas de relajación y escuchar música son las estrategias para luchar con la fatiga, el estrés y la ansiedad. Una buena red de apoyo familiar, la buena gestión de la enfermedad y todas las consultas marcadas eran aspectos indicados como promotores de autocuidado a nivel físico y psicológico. El uso de medicinas alternativas para combatir los efectos secundarios fue también un factor encontrado como promotor de autocuidado. La intervención temprana, la vigilancia y el seguimiento de las intervenciones son identificados por los pacientes como promotoras del bienestar y la seguridad. En cuanto a la relación entre el cuidado personal y el confort no e encontraron resultados, lo que significa la necesidad de desarrollo en esta área.RESUMO: Este artigo constitui-se uma revisão sistemática da literatura sobre as estratégias que facilitam o autocuidado na promoção do autocuidado e conforto desenvolvidas pela pessoa com doença oncológica submetida a quimioterapia/radioterapia. Tem como objectivo determinar a melhor evidência disponível sobre as estratégias utilizadas pela pessoa com doença oncológica submetida a qimioterapia para promoção do autocuidado e conforto e quais os factores facilitadores desenvolvidos pelos enfermeiros. Na condução da presente revisão sistemática da literatura foi utilizada a metodologia PI(C)OD. Resultados: Identificados 10 estudos incluídos na presente revisão sistemática da literatura. A partir da análise dos dados constatou-se que as pessoas submetidas a quimioterapia e radioterapia adoptam estratégias de autocuidado para fazer face à situação em que se encontram e aos efeitos secundários decorrentes dos tratamentos. O repouso, técnicas de relaxamento e ouvir música são estratégias para fazer face à fadiga, stress e ansiedade. Uma boa rede de suporte familiar, boa gestão da doença, tendo todas as consultas marcadas foram aspectos indicados como promotores de autocuidado a nível físico e psicológico. A utilização de medicinas alternativas para combate aos efeitos secundários foi também um factor encontrado como promotor de autocuidado. A intervenção precoce, acompanhamento e follow up são intervenções identificadas pelos doentes como promotoras de bem-estar e segurança. No que respeita a relação entre autocuidado e conforto não foram encontrados resultados, o que pode significar necessidade de desenvolvimento nesta área.ABSTRACT: This article constitutes a systematic review of the literature on self-care strategies that facilitate the promotion of self-care and comfort designed for the person with cancer undergoing chemotherapy / radiation therapy. Aims to determine the best available evidence on the strategies used by the person with cancer undergoing qimioterapia to promote self-care and comfort and which factors facilitators developed by nurses. In the conduct of this systematic literature review methodology was used PI (C) OD. Results: Identified 10 studies included in this systematic review of the literature. From the data analysis it was found that people undergoing chemotherapy and radiotherapy adopt self-care strategies to cope with the situation they are in and the side effects caused by treatments. The rest, relaxation techniques and listening to music are strategies to cope with fatigue, stress and anxiety. A good network of family support, good disease management, and all aspects were given appointments as promoters of self-care to physical and psychological level. The use of alternative medicines to fight the side effects was found also as a significant factor. Early intervention, monitoring and follow up interventions are identified by patients as promoting wellbeing and safety. Regarding the relationship between self-care and comfort are no results, which may mean the need for development in this area