A multi-stage genome-wide association study of bladder cancer identifies multiple susceptibility loci.

We conducted a multi-stage, genome-wide association study of bladder cancer with a primary scan of 591,637 SNPs in 3,532 affected individuals (cases) and 5,120 controls of European descent from five studies followed by a replication strategy, which included 8,382 cases and 48,275 controls from 16 studies. In a combined analysis, we identified three new regions associated with bladder cancer on chromosomes 22q13.1, 19q12 and 2q37.1: rs1014971, (P = 8 × 10⁻¹²) maps to a non-genic region of chromosome 22q13.1, rs8102137 (P = 2 × 10⁻¹¹) on 19q12 maps to CCNE1 and rs11892031 (P = 1 × 10⁻⁷) maps to the UGT1A cluster on 2q37.1. We confirmed four previously identified genome-wide associations on chromosomes 3q28, 4p16.3, 8q24.21 and 8q24.3, validated previous candidate associations for the GSTM1 deletion (P = 4 × 10⁻¹¹) and a tag SNP for NAT2 acetylation status (P = 4 × 10⁻¹¹), and found interactions with smoking in both regions. Our findings on common variants associated with bladder cancer risk should provide new insights into the mechanisms of carcinogenesis

A multi-stage genome-wide association study of bladder cancer identifies multiple susceptibility loci.

We conducted a multi-stage, genome-wide association study of bladder cancer with a primary scan of 591,637 SNPs in 3,532 affected individuals (cases) and 5,120 controls of European descent from five studies followed by a replication strategy, which included 8,382 cases and 48,275 controls from 16 studies. In a combined analysis, we identified three new regions associated with bladder cancer on chromosomes 22q13.1, 19q12 and 2q37.1: rs1014971, (P = 8 × 10⁻¹²) maps to a non-genic region of chromosome 22q13.1, rs8102137 (P = 2 × 10⁻¹¹) on 19q12 maps to CCNE1 and rs11892031 (P = 1 × 10⁻⁷) maps to the UGT1A cluster on 2q37.1. We confirmed four previously identified genome-wide associations on chromosomes 3q28, 4p16.3, 8q24.21 and 8q24.3, validated previous candidate associations for the GSTM1 deletion (P = 4 × 10⁻¹¹) and a tag SNP for NAT2 acetylation status (P = 4 × 10⁻¹¹), and found interactions with smoking in both regions. Our findings on common variants associated with bladder cancer risk should provide new insights into the mechanisms of carcinogenesis

Extragastrointestinal Stromal Tumor - report of a rare case

Despite the name, gastrointestinal stromal tumor (GIST) is a mesenchymal gastrointestinal neoplasm that may occur outside the gastrointestinal tract. The correct characterization based on histological features and immunohistochemical expression of c-kit (CD117) has allowed targeted treatment for this kind of cancer and therefore improvements in the outcome. The authors present a rare clinical case of a GIST of the pelvic cavity with a long 10 years follow-up

Assessment of community pharmacists´ counselling skills on headache management by using the simulated patient approach: a pilot study

Background: Headache, or cephalalgia, is one of the 20 most disabling diseases in the world and affects a large portion of the world´s population. People generally use over-the-counter medications to treat headaches and other minor symptoms. A pharmacist should help patients choose the most effective, safe, and convenient pharmacotherapeutic option. Objective: To assess the counselling skills of community pharmacists for headache management by using the simulated patient approach. Methods: A cross-sectional study was conducted from March 2010 to July 2010. Data were obtained from a convenience sample consisting of one pharmacist from each of the 24 participating community pharmacies. In order to evaluate the pharmacists´ counselling skills, a simulated patient role played a standardized headache case requesting self-medication. The interactions of the simulated patient with the pharmacists were audiovisually recorded using a hidden micro camera, and these recordings were analysed using a validated questionnaire. Results: Of the 24 evaluated pharmacists, 19 (79.1%) were women. Information was spontaneously provided by 15 (62.5%) pharmacists. At least one question was asked by the pharmacist to assess the signs and symptoms. Most pharmacists (n=17, 70.8%) recommended sodium dipyrone, either alone or in combination with other drugs. The most discussed items in the simulation visits were contraindications (n=17, 70.8%), indications (n=10, 41.6%), and drug administration times (n=8, 33.3%). None of the pharmacists recommended any non-pharmacological therapeutic alternatives. The overall impressions of the pharmacists professional counselling skills ranged from poor to fair. Conclusion: This study showed that the pharmacists counselling skills and the guidance provided by the pharmacists to the simulated patient were insufficient for the satisfactory management of headache.Antecedentes: El dolor de cabeza o cefalea es una de las 20 enfermedades más incapacitantes en el mundo y afecta a una gran parte de la población mundial. La gente utiliza generalmente medicamentos OTC para tratar los dolores de cabeza y otros síntomas menores. Un farmacéutico debería ayudar a los pacientes a elegir la opción farmacoterapéutica más efectiva, segura y conveniente. Objetivo: Evaluar las habilidades de los farmacéuticos comunitarios para el manejo del dolor de cabeza utilizando un abordaje de paciente simulado. Métodos: Se realizó un estudio transversal entre marzo 2010 y julio 2010. Se obtuvieron datos de una muestra de conveniencia consistente en un farmacéutico de cada 24 farmacias comunitarias participantes. Para evaluar las habilidades de asesoramiento de los farmacéuticos, un paciente simulado recreó un caso estandarizado de dolor de cabeza solicitando auto-medicación. Las interacciones del paciente simulado con el farmacéutico fueron audiovisualmente grabadas utilizando una micro-cámara oculta, y estas grabaciones fueron analizadas utilizando un cuestionario validado. Resultados: De los 24 farmacéuticos evaluados, 19 (79,1%) eran mujeres. 15 farmacéuticos (62,5%) proporcionaron información espontáneamente. El farmacéutico pregunto al menos una pregunta para evaluar los síntomas. La mayoría de los farmacéuticos (n=17, 70,8%) recomendó dipirona sódica, sóla o en combinación con otros medicamentos. Los ítems más discutidos en las visitas simuladas fueron las contraindicaciones (n=17, 70,8%), la indicación (n=10, 41,6%), y la frecuencia de administración (n=8, 33,3%). Ninguno de los farmacéuticos recomendó alguna alternativa terapéutica no farmacológica. La impresión general de las habilidades de asesoramiento profesional delos farmacéuticos osciló entre pobre y moderada. Conclusión: Este estudio mostró que las habilidades de asesoramiento de los farmacéuticos y los consejos proporcionados al paciente simulado fueron insuficientes para el manejo satisfactorio del dolor de cabeza

Experimental investigation of the fire resistance of partially encased beams

This research presents the fire resistance of partially encased beams (PEB). Fire resistance was determined by means of twelve experimental tests, according to European standard EN1363-1, for different load levels and shear conditions between stirrups and web steel. Three tests were also performed at room temperature for load bearing resistance. The experimental setup was designed for this purpose, using a small fire resistance furnace and portal reaction frame. Details about the specimens tested, the instruments used and the characteristics of thematerials, are also presented. Load-deflection and load-strain results were determined at room temperature. Deflection and temperature measurements were determined under ISO834 fire exposure. Results reveal the dependence of fire resistance on load level. An increase in 37% on load level is responsible for a decrease in 28% on fire resistance. Tests developed for the highest load level present similar fire resistance, independently of the shear condition; however, tests with welded stirrups present higher critical time. The main experimental results are presented and discussed. Particular emphasis was given to changes in temperature for each material, and on the global thermo-mechanical behaviour of this composite steel and concrete element

Experiential education in the pharmacy undergraduate curricula in Brazil

Objective: Considering the curriculum reform process taking place in pharmacy undergraduate programs in Brazil and the importance of practical experience to students throughout their learning process in university, this study aims to provide an overview of pharmacy undergraduate programs in Brazil and their respective internships. Methods: An observational, descriptive, cross-sectional study. A documentary analysis of pharmacy undergraduate programs in the face-to-face modality was carried out, with data obtained from the Political Pedagogical Projects of the programs, the curricula, and course descriptions containing information on internships, all provided by the Brazilian Ministry of Education. The data collected concerned higher education institutions (HEIs), pharmacy programs and internships. Results: Pharmacy undergraduate programs in Brazil have a median duration of 10 semesters, requiring from students a median of 6 internships, from the 6th semester on, totalizing 826 hours. The programs lack uniformity among their internships, mainly regarding total hours and the semester in which internships start. The pharmacy internships cover, in greater number, the areas of outpatient and community pharmacy, clinical analysis, and pharmaceutical technology, respectively, being clinical analysis the area with more hours. Public and private HEIs have different internship proceedings in their curricula, hence no homogeneity among them in the different regions of Brazil. Conclusions: This study demonstrates the diversity of pharmacy programs in Brazil in the context of internships, reflecting on the training and the activity of pharmacists in recent decades. Further studies are needed to deepen the understanding of this theme

Communication skills in Brazilian pharmaceutical education: a documentary analysis

Objective: To characterize the inclusion of the teaching of communication skills in the curriculum of Pharmacy Schools of Federal Institutions of Higher Education. Methods: An exploratory study of documental analysis of curriculum of Pharmacy Schools was carried out. A convenience sample was selected from undergraduate pharmacy courses of Federal Institutions of Higher Education (IFES). The variables collected were related to the identification of the course, its nature (elective or mandatory), workload, semester, and program content. Results: Among the 49 undergraduate pharmacy courses of IFES, 35 (71.4%) had their curriculum available online. The teaching of communication in health was identified in 26 (74.3%) curriculum. In this study, three courses (7.2%) specifically aimed at teaching communication skills, while 39 (92.9%) had content related to this subject. Most courses (22; 52.4%) belonged to the field of Social, Behavioral, and Administrative Sciences. As for the course period, there was a concentration in the third (19%) and fourth (28.6%) years. The main content present in the curriculum was related to the principles and techniques of health communication (42.8%). Conclusions: Data obtained enabled the identification of gaps in the curricula of undergraduate courses in pharmacy concerning the inclusion of the teaching of communication skills. These results can be used to reflect the current models adopted in Brazil for the teaching of this skills, especially after the recent publication of the new curricular guidelines for undergraduate pharmacy courses