Analysis of SOD2 protein as prognostic factor in stage IIIB cervical carcinoma

Orientador: Luiz Carlos ZeferinoDissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências MédicasResumo: O câncer do colo do útero é uma doença neoplásica maligna muito frequente, porém evitável. Foram estimados 528.000 casos novos da doença no mundo, no ano de 2012. No Brasil, a estimativa para 2018 é de 16.370 casos novos da doença. O desenvolvimento de ferramentas clínicas para apoio diagnóstico, terapêutico e seguimento das neoplasias malignas pode qualificar o cuidado em benefício da paciente. A proteína SOD2 faz parte da família de metaloenzimas atuantes no sistema celular antioxidante por catalisar a conversão do ânion de superóxido (O2-) em peróxido de hidrogênio (H2O2) em um processo conhecido como dismutase. A maioria dos estudos sobre a expressão de SOD2 e o câncer mostra que a superexpressão dessa enzima está associada com a presença de metástase e um mau prognóstico em muitas doenças malignas. Desta forma, este estudo teve como objetivo avaliar se a expressão da proteína SOD2 está associada com o prognóstico do carcinoma do colo do útero avançado. Metodologia: Trata-se de uma coorte cuja amostra foi constituída a partir das mulheres incluídas no ensaio clínico prospectivo Concomitant cisplatin plus radiotherapy and high-dose-rate brachytherapy versus radiotherapy alone for stage IIIB epidermoid cervical cancer: a randomized controlled trial, conduzido no Hospital da Mulher Prof. Dr. José Aristodemo Pinotti, Universidade Estadual de Campinas (UNICAMP), Brasil. No total, 147 mulheres foram incluídas, 72 mulheres no grupo que recebeu cisplatina concomitante a radioterapia (QT/RT) e 75 mulheres no grupo que recebeu apenas radioterapia (RT) e foram seguidas por sete anos. A amostra deste estudo foi constituída por 63 mulheres que ainda dispunham de blocos com material suficiente para reanálise com hematoxilina e eosina (HE) e os ensaios imuno-histoquímicos. A avaliação da expressão da SOD2 pela imuno-histoquímica baseou-se no percentual de células coradas e na intensidade da coloração, analisados separadamente e juntos utilizando um score. As analises do percentual de células coradas foram realizadas em três pontos de corte (50%, 75% e 90% de células coradas), e cada ponto de corte avaliado gerou um score específico, categorizado como alto e baixo. Dados de recidiva e óbito foram comparados com os da avaliação imuno-histoquímica. As curvas da sobrevida livre de doença e sobrevida global foram avaliadas por Kaplan-Meier e Log-rank. Fatores associados às sobrevidas foram analisados pela regressão de Cox. Resultados: A intensidade da coloração analisada separadamente e junto com o percentual de células coradas para qualquer ponto de corte estão associados com a recorrência. Casos com mais de 90% de células coradas e com alto score de 75% estão associados com óbito também. O alto score de 90% foi associado com a recidiva, recidiva sistêmica e o óbito. Sobrevida livre de doença e sobrevida global foram piores em mulheres cujo carcinoma teve mais de 90% de células coradas e naqueles com alto score de 75% e 90%. Conclusão: A forte intensidade de coloração e o alto percentual de células coradas para a proteína SOD2 estão relacionados com a recorrência e também com a sobrevida global de carcinoma do colo do útero estádio IIIBAbstract: Cervical cancer is a very common malignant neoplastic disease, however avoidable. Were estimated 528.000 new cases diagnosed each year worldwide. In Brazil, for 2018, it is estimated 16.370 new cases of the disease. The development of clinical tools for diagnosis, treatment and for follow-up support of malignant neoplasms may qualify the outcome, benefiting the patients. The protein SOD2 is part of the family of metalloenzymes acting in the antioxidant cell system by catalyzing the conversion of the superoxide (O2-) anion into hydrogen peroxide (H2O2) in a process known as dismutase. Most studies on SOD2 expression and cancer showed that the high expression of this protein is associated with the presence of metastasis and a poor prognosis in many malignancies. The aim of this study was to evaluate whether SOD2 protein expression is associated with the prognosis of cervical carcinoma stage IIIB. Methodology: This study selected patients from a cohort consisting of tumor samples from women included in the prospective clinical trial Concomitant cisplatin plus radiotherapy and high-dose-rate brachytherapy versus radiotherapy alone for stage IIIB epidermoid cervical cancer: a randomized controlled trial, conducted at the Women's Hospital Prof. Dr. José Aristodemo Pinotti, State University of Campinas (UNICAMP), Brazil. Of the 147 women included, 72 received cisplatin concomitantly with radiotherapy (CRT) and 75 women received radiotherapy alone (RT) and were followed-up to seven years. The sample of this study consisted of 63 women who had available blocks to reanalysis with hematoxylin and eosin (HE) and immunohistochemistry assay. The evaluation of SOD2 expression by immunohistochemistry assay was based on the percentage of stained cells and the staining intensity, analyzed separately and together by a score. The analyses of the percentage of stained cells was performed using three cut points (50%, 75% and 90% of stained cells), and each cut point generating a specific score, categorized as high and low. Relapse and death data were compared to immunohistochemistry evaluation. Disease-free survival and overall survival curves were performed using the Kaplan-Meier method and the log-rank test. Factors associated with the survivals were analyzed by Cox Proportional Hazards Regression. Results: The intensity of staining analyzed separately and together to percentage of cells stained for any cut-off point are associated with recurrence. Cases with more than 90% stained cells and with high 75% score was also associated with death. High 90% score was associated with recurrence, distant recurrence and death. Disease-free survival and overall survival were worse in women whose carcinoma had more than 90% stained cells and those with high 75% score and 90% score. Conclusion: Strong intensity and high percentage of stained cells for SOD2 protein it is related to relapse and overall survival of squamous cell carcinoma of the cervix IIIBMestradoOncologia Ginecológica e MamáriaMestra em Ciências da Saúde304299/2014-6CNPQCAPE

Inter-Rater Agreement of a Functional Dual-Task Test Developed for the Assessment of Sports Related Concussions

Please enjoy Volume 5, Issue 1 of the JSMAHS. In this issue you will find Professional and under graduate research abstracts, case reports, and critically appraised topics. This research was funded by an OATA Research Grant Thank you for viewing this 5th Annual OATA Special Edition

El conocimiento como factor de vulnerabilidad a la tuberculosis entre estudiantes y profesionales de enfermería

Este estudo intencionou identificar a vulnerabilidade à tuberculose (TB) relacionada à detenção de conhecimento sobre a doença, entre 76 alunos de graduação e profissionais de enfermagem. Trata-se de um estudo quantitativo-descritivo cujos dados foram coletados por meio de um questionário fechado acerca da transmissibilidade, formas de prevenção e medidas de biossegurança, diagnóstico e preconceitos sobre a doença. Os dados foram analisados por meio do software SAS versão 9.1.3, com nível de significância de 5% (p < 0.05). Foi evidenciada a vulnerabilidade à TB entre alunos e profissionais relacionada ao conhecimento atinente à transmissibilidade, formas de prevenção e medidas de biossegurança e diagnóstico. No tocante à transmissibilidade, observou-se maior vulnerabilidade entre os profissionais. Os resultados revelam necessidade de investimento em tal questão por parte de instituições médico-assistenciais, considerando o papel desempenhado pela enfermagem nas estratégias de prevenção e controle da doença.Este estudio buscó identificar la vulnerabilidad a la tuberculosis (TB) relacionada al conocimiento poseído sobre la enfermedad entre 76 alumnos y profesionales de enfermería. Estudio cuantitativo descriptivo, con datos recolectados mediante cuestionario cerrado acerca de la transmisión, formas de prevención y medidas de bioseguridad, diagnóstico y preconceptos sobre la enfermedad. Datos analizados con software SAS versión 9.1.3 con nivel de significatividad de 5% (pThe objective of this study was to identify vulnerability to tuberculosis (TB) related to knowledge about the disease among 76 nursing students and professionals. A quantitative descriptive study was conducted using a closed questionnaire for the collection of data regarding transmission, preventive and biosafety measures, diagnosis, and prejudice regarding the disease. The SAS software version 9.1.3 was used for data analysis, with the level of significance set at 5% (p < 0.05). Nursing students and professionals showed a vulnerability to TB related to knowledge about transmission, preventive and biosafety measures, and diagnosis of the disease. With respect to transmission, vulnerability was higher among nursing professionals. The results indicate the need for investment by healthcare institutions surrounding this topic in view of the important role of nursing in the establishment of strategies for prevention and control of the disease

Iron Deficiency and Iron Deficiency Anemia in Children

Iron deficiency anemia is considered the most common and widespread nutritional form of anemia in childhood. Red cells are hypochromic and microcytic with low mean corpuscular volume (MCV), low mean corpuscular hemoglobin (MCH) and low reticulocyte hemoglobin content (CHr). Red blood cell distribution width (RDW) is increased. Serum iron is reduced, transferrin is increased and serum ferritin is decreased. Prematurity, decreased dietary source, malabsorption and blood loss represent the most common causes of iron deficiency. Recommended oral dose of elemental iron is 2–6 mg/kg/day; when normal hemoglobin values are reached, treatment must be generally continued for 3 months in order to replenish iron stores. Rarely intravenous therapy is required. The pediatricians and other health care providers should strive to prevent and eliminate iron deficiency and iron-deficiency anemia

An insight into Gandharan Art: Materials and Techniques of Polychrome Decoration

Gandharan art developed in the Himalayan area in the early centuries CE. It has been investigated mostly from an iconographic point of view, missing, until very recently, a systematic technical investigation of materials and techniques. Recently our team began performing chemical analyses of the traces of the polychromy originally covering statues, reliefs and architectural decorations, to discover the ancient painting techniques and artistic technologies. This paper presents the results of the analytical investigation (optical microscopy, Raman spectroscopy and gas chromatography coupled with mass spectrometry) of pigments, ground layers and binders of a new group of samples taken from stucco architectural decorations (2nd–3rd/4th centuries CE). The samples were collected directly at an archaeological site in the Swat Valley, ensuring the exact knowledge of their stratigraphic provenance, as well as the absence of any restoration treatment applied prior sampling. The results are discussed in the wider context of Gandharan polychromy investigated so far by our team, as found in sculptures and architectural decorations preserved in museums (in Italy and France) and in archaeological excavations in Pakistan. The aim of this research is to shed light on the materials and techniques of this Buddhist ancient art from this region and on the influences exerted on it from Eastern and Western artistic traditions

Impact of agrochemicals on non-target species: Calathus fuscipes Goeze 1777 (Coleoptera: Carabidae) as model

Carabid beetles are important in the biological control of arable crop pests. Agricultural practices can produce over time a delayed toxic effect at the organismal and population levels and can compromise the survival on these species. In this research, we quantified the cumulative sublethal effect on body size, Malpighian tubules and immune responses in Calathus fuscipes adults living in the potato field and exposed to lambda-cyhalothrin and cymoxanil-based commercial formulates. Reductions of morphological parameters such as body, pronotum and elytron in both males and females from the potato field indicated that the pre-imaginal stages (larvae and pupae) suffer the sublethal effects of exposure to the larvicide control action of lambda-cyhalothrin. Ultrastructural alterations recorded in Malpighian tubules at the level of plasma membrane, mitochondria and nucleus indicated the reduction of the detoxification capability. The basal phenoloxidase and lysozyme-like enzyme activities have measured as markers of immune competence. Spectrophometric analyses showed that the chronic exposure in field causes an increase of basal phenoloxidase enzyme activity, while the lytic activity of haemolymph was not affected. As a result, the use of larvicides and fungicides have a harmful effect on beneficial species such C. fuscipes living in the soil of potato fields. These morphological and physiological results recorded at the organismal level can provide useful information of effects at the population and community levels to preserve the biodiversity of agroecosystem

Production and reproduction traits in Holstein and Gyr crossbred cows in the Central Plateau, Brazil

Com o objetivo de comparar o desempenho leiteiro e reprodutivo de vacas da raça Holandesa e mestiças Holandês × Gir na região do Planalto Central foram utilizados dados de 1.456 vacas de cinco composições raciais, originadas das raças Holandesa (H) e Gir (G): puras H; ¾H ¼G; ½H ½G; 3/8H 5/8G; e ¼H ¾G. Analisaram-se as características produção média diária de leite (PMD), número de dias em lactação (DL) e produção total da lactação corrigida para 305 dias (P305), idade ao primeiro parto (IPP), período de gestação (PG) e intervalo de partos (IEP). Os maiores valores de PMD e P305 foram obtidos para os animais ¾H ¼G e ½H ½G e os menores, para os animais com maior proporção da raça Gir (¼H ¾G). Os valores das características reprodutivas IPP e IEP, no entanto, foram menores para os animais ¾H ¼G.Esses resultados evidenciam a adaptação das vacas mestiças ao ambiente a que foram submetidas ou que os animais puros da raça Holandesa, em razão do estresse nutricional e/ou térmico, não expressaram todo o seu potencial genético para produção leiteira.Além disso, os dados comprovaram a importância da utilização de sistemas de cruzamento na manutenção da produção dos animais e na sua adaptação ao ambiente.Data from 1456 purebred and crossbred cows of five different crossbred groups involving the Holstein (H) and Gyr (G) breeds (H; ¾H ¼G; ½H ½G; 3/8H 5/8G e ¼H ¾G) were used to compare their milk production and reproductive traits in the Brazilian central plateau region. The performance traits studied were: average daily milk production (DMP); lactation length (LL); total production in 305 days (P305) and age at first calving (AFC), gestation length (GL) and calving interval (CI). Higher averages of DMP and P305 were observed for animals ¾H ¼G and ½H ½G and the smallest ones for crossbred animals with larger proportion of the Gyr breed (¼H ¾G). The lowest values of AFC and CI were observed for ¾H ¼G animals. These results indicate the importance of crossbreeding strategies to produce animals that are more adapted to the environmental conditions of the region. Holstein purebreds probably do not express their full genetic potential due to nutritional and/or heat stress

Trabalho em turnos de profissionais de enfermagem e a pressão arterial, burnout e transtornos mentais comuns

Objetivo: Analisar a influência do trabalho em turnos na pressão arterial, na presença de burnout e transtornos mentais comuns em profissionais de enfermagem. Método: Estudo transversal. O burnout foi avaliado pelo Maslach Burnout Inventory, e os Transtornos Mentais Comuns, pelo Self Reporting Questionnaire. Realizaram-se a medida casual da pressão e a Monitorização Ambulatorial da Pressão Arterial. Resultados: Participaram 231 profissionais. A maioria (59,7%) trabalhava em turnos, e essa condição associou-se (p≤0,05) com: maior carga de trabalho semanal; fazer plantão noturno; menor tempo de formado e de trabalho na instituição; etilismo; atividade de lazer; e alteração na monitorização ambulatorial da pressão arterial do período do sono. Os profissionais com transtornos mentais comuns e que trabalhavam em turnos apresentaram menores níveis de pressão casual diastólica (p=0,039) e maior prevalência de hipertensão (p=0,045). A presença de exaustão emocional associou-se com pressão arterial de vigília normal e despersonalização com pressão arterial de sono alterada. Conclusão: O trabalho em turnos associou-se à maior prevalência de fatores negativos relacionados ao trabalho, hábitos e estilos de vida inadequados e alteração da pressão no período de sono.Objective: To analyze the influence of shift work on blood pressure, the presence of burnout and common mental disorders in nursing professionals. Method: A crosssectional study. Burnout was assessed by the Maslach Burnout Inventory, and Common Mental Disorders by the Self-Reporting Questionnaire. Casual blood pressure measurement and Ambulatory Blood Pressure Monitoring (ABPM) were performed. Results: 231 professionals participated. The majority (59.7%) worked in shifts, and this condition was associated (p≤0.05) with: higher weekly workload; doing the night shift; shorter training and work time at the institution; alcoholism; leisure activity; and alteration in ambulatory blood pressure monitoring of the sleep period. The professionals with common mental disorders and who worked in shifts had lower casual diastolic pressure levels (p = 0.039) and higher hypertension prevalence (p = 0.045). The presence of emotional exhaustion was associated with normal waking blood pressure and depersonalization with altered sleep blood pressure. Conclusion: Shift work was associated with a higher prevalence of work-related negative factors, inadequate habits and lifestyles, and change in sleep blood pressure.Objetivo: Analizar la influencia del trabajo en turnos en la presión arterial, presencia de burnout y trastornos mentales comunes en profesionales enfermeros. Método: Estudio transversal. El burnout fue evaluado por el Maslach Burnout Inventory y los Trastornos Mentales Comunes, por el Self Reporting Questionnaire. Se realizaron la medida casual de la presión y el Monitoreo Ambulatorio de la Presión Arterial. Resultados: Participaron 231 profesionales. La mayoría (59,7%) trabajaba en turnos, y dicha condición se asoció (p≤0,05) con: mayor carga de trabajo semanal; hacer turno nocturno; menor tiempo de licenciado y de trabajo en el centro; etilismo; actividad de ocio; y modificación en el monitoreo ambulatorio de la presión arterial del período del sueño. Los profesionales con trastornos mentales comunes y que trabajaban en turnos presentaron menores niveles de presión casual diastólica (p=0,039) y mayor prevalencia de hipertensión (p=0,045). La presencia de agotamiento emotivo se asoció con presión arterial de vigilia normal y despersonalización con presión arterial de sueño modificado. Conclusión: El trabajo en turnos se asoció con la mayor prevalencia de factores negativos relacionados con el trabajo, hábitos y estilo de vida inadecuados y modificación de la presión en el período de sueño

Static and dynamic single leg postural control performance during dual-task paradigms

ABSTRACTCombining dynamic postural control assessments and cognitive tasks may give clinicians a more accurate indication of postural control under sport-like conditions compared to single-task assessments. We examined postural control, cognitive and squatting performance of healthy individuals during static and dynamic postural control assessments in single- and dual-task paradigms. Thirty participants (female = 22, male = 8; age = 20.8 ± 1.6 years, height = 157.9 ± 13.0 cm, mass = 67.8 ± 20.6 kg) completed single-leg stance and single-leg squat assessments on a force plate individually (single-task) and concurrently (dual-task) with two cognitive assessments, a modified Stroop test and the Brooks Spatial Memory Test. Outcomes included centre of pressure speed, 95% confidence ellipse, squat depth and speed and cognitive test measures (percentage of correct answers and reaction time). Postural control performance varied between postural control assessments and testing paradigms. Participants did not squat..