Necessitats dels familiars de pacients amb càncer

El càncer produeix un impacte a la família en totes les seves esferes, la família ha de modificar les seves rutines familiars i adoptar nous rols. En el moment del diagnòstic del càncer, a cada família hi ha una persona que assumeix el rol de cuidador principal. Aquest cuidador és el que s’ocupa del malalt a casa i fa d’enllaç entre la família i l’equip sanitari. En front del càncer, la família i el cuidador tenen un conjunt de dubtes, d’inquietuds, de preocupacions que s’acaben traduint en necessitats. L’equip sanitari i Infermeria especialment ha d’atendre aquestes necessitats i ajudar a satisfer-les. Objectiu: L’objectiu principal d’aquest treball es descriure quines són les necessitats que presenten la família i el cuidador dels pacients oncològics. Metodologia: Es va dur a terme una revisió de la literatura entre setembre del 2013 i maig del 2014. Es va utilitzar la base de dades Pubmed, a més de pàgines web i llibres. Es van obtenir un total de 75 fonts, 56 en angles, 18 en espanyol i 1 en català. Resultats: La bibliografia agrupa les necessitats de les famílies i els cuidadors en 7 grans categories: físiques, psicològiques i emocionals, socials, de informació i formació, econòmiques, de transport i espirituals. Pel que fa a necessitats més especifiques, algunes de les més freqüents són tenir informació sobre el pronòstic del malalt, assegurar-se de que l’equip sanitari està donant la millor atenció possible al malalt. Sembla haver-hi una relació entre el grau de no satisfacció de les necessitats i el grau d’ansietat i depressió en la família i el cuidador. Els autors consultats no coincideixen en afirmar si la majoria del les necessitats es veuen satisfetes o no. Conclusions: La família i el cuidador d’un pacient amb càncer també han de rebre atenció per part dels professionals. En moltes ocasions la família treu importància a les seves necessitats per tal de que l’equip sanitari es centri només en el malalt. Infermeria té un paper fonamental en detectar les necessitats dels familiars i cuidadors i en ajudar a satisfer-les, de manera que la família estigui en les millors condicions possibles per cuidar del malalt. Paraules clau: Càncer, família, cuidador, necessitats familiars, rol d’Infermeria

Linfonodos axilares em pacientes com câncer de mama: avaliação ultrassonográfica

O estadiamento axilar nas pacientes portadoras de câncer de mama inicial é fator essencial no planejamento terapêutico. Atualmente este é realizado durante o tratamento cirúrgico, mas há uma tendência em buscar técnicas pré-operatórias e de menor morbidade para avaliação dos linfonodos axilares. A ultrassonografia é um exame amplamente usado para esta finalidade e muitas vezes associado a punção aspirativa por agulha fina ou por agulha grossa. Entretanto, os critérios ultrassonográficos de suspeição para linfonodos axilares não apresentam valores preditivos significativos, gerando resultados discrepantes em estudos sobre sensibilidade e especificidade do método. O objetivo deste trabalho é realizar uma revisão na literatura médica sobre a ultrassonografia no estadiamento axilar e as principais alterações morfológicas do linfonodo metastático.

«Me quedaré con lo positivo»: Análisis de blogs de mujeres con cáncer de mama

En este artículo se analizan siete blogs escritos por mujeres con cáncer de mama. En primer lugar, se indaga sobre su forma de concebir el cuerpo en relación, por un lado, al impacto del cáncer en los órganos y procesos corporales ligados a la feminidad y, por el otro, a su carácter mortal. En segundo lugar, se analiza su atribución de agencia en relación a la enfermedad y su curación. Se observa que la responsabilidad en la curación se atribuye principalmente a los médicos, pero aparece con fuerza la idea que la mujer se puede sanar mediante cambios en su estilo de vida y a través del pensamiento positivo. Este establece un marco en el que las afectadas de cáncer encuentran dificultades para reconocer y expresar aspectos considerados negativos del proceso como la rabia, la desesperación o el miedo a la muerte, al mismo tiempo que marca una distinción entre pacientes con trayectorias de éxito en su curación y los que no lo consiguen, que son culpabilizados.

Randomized, crossover, double-blind, placebo-controlled trial to assess the lipid lowering effect of co-formulated TDF/FTC

Abstract INTRODUCTION: Previous studies have described improvements on lipid parameters when switching from other antiretroviral drugs to tenofovir (TDF) and impairments in lipid profile when discontinuing TDF. [1-3] It is unknown, however, if TDF has an intrinsic lipid-lowering effect or such findings are due to the addition or removal of other offending agents or other reasons. MATERIALS AND METHODS: RESULTS: 46 subjects with a median age of 43 (40-48) years were enrolled in the study: 70% were male, 56% received DRV/r and 44% LPV/r. One subject withdrew the study voluntarily at week 4 and another one interrupted due to diarrhoea at week 24. Treatment with TDF/FTC decreased total, LDL and HDL-cholesterol from 235.9 to 204.9 (p<0.001), 154.7 to 127.6 (p<0.001) and 50.3 to 44.5 mg/dL (p<0.001), respectively. In comparison, total, LDL and HDL-cholesterol levels remained stable during placebo exposure. Week 12 total cholesterol (p<0.001), LDL-cholesterol (p<0.001) and HDL-cholesterol (p=0.011) levels were significantly lower in TDF/FTC versus placebo. Treatment with TDF/FTC reduced the fraction of subjects with abnormal fasting total-cholesterol (≥200 mg/dL) from 86.7% to 56.8% (p=0.001) and LDL-cholesterol (≥130 mg/dL) from 87.8% to 43.9% (p<0.001), which was not observed with placebo. There were no virological failures, and CD4 and triglyceride levels remained stable regardless of exposure. CONCLUSION: Coformulated TDF/FTC has an intrinsic lipid-lowering effect, likely attributable to TDF.

SMRT-mediated co-shuttling enables export of class IIa HDACs independent of their CaM kinase phosphorylation sites

The Class IIa histone deacetylases (HDAC)4 and HDAC5 play a role in neuronal survival and behavioral adaptation in the CNS. Phosphorylation at 2/3 N-terminal sites promote their nuclear export. We investigated whether non-canonical signaling routes to Class IIa HDAC export exist because of their association with the co-repressor Silencing Mediator Of Retinoic And Thyroid Hormone Receptors (SMRT). We found that, while HDAC5 and HDAC4 mutants lacking their N-terminal phosphorylation sites (HDAC4(MUT), HDAC5(MUT)) are constitutively nuclear, co-expression with SMRT renders them exportable by signals that trigger SMRT export, such as synaptic activity, HDAC inhibition, and Brain Derived Neurotrophic Factor (BDNF) signaling. We found that SMRT's repression domain 3 (RD3) is critical for co-shuttling of HDAC5(MUT), consistent with the role for this domain in Class IIa HDAC association. In the context of BDNF signaling, we found that HDAC5(WT), which was more cytoplasmic than HDAC5(MUT), accumulated in the nucleus after BDNF treatment. However, co-expression of SMRT blocked BDNF-induced HDAC5(WT) import in a RD3-dependent manner. In effect, SMRT-mediated HDAC5(WT) export was opposing the BDNF-induced HDAC5 nuclear accumulation observed in SMRT's absence. Thus, SMRT's presence may render Class IIa HDACs exportable by a wider range of signals than those which simply

Reações de Etanol com CO/H2 na Presença do Sistema Catalítico Ru(acac)3/I-

The hydrocarbonylation reaction of ethanol with a CO/H2 mixture assisted by Ru(acac)3/iodide was investigated. Bronsted and Lewis acids and iodides salt were used as homogeneous promoters. The etherification reaction was the main reaction under typical acidic conditions of the catalytic system. When a hydrocarbon solvent (toluene) was added to the initial reaction, the alcohol conversion and the carbonylation products were increased. The catalytic activity of the Bronsted acids (conv. EtOH = 71-92%) was higher than that of the Lewis acids promoters (conv. EtOH = 65-85%). The salt present the lower catalytic activity among the promoters used. The long time reaction carried out with ethanol showed an increase of the product selectivity of the homologation and carbonylation reactions while the etherification reaction selectivity decreased. The recycled ether led to 60-65% ethanol conversion to C5 and C6 products. The main catalytic species are H+[Ru(CO)3I3]-, [HRu3(CO)11]- and [HRu(CO)4]-. The first one is active in the carbonylation and homologation reactions of alcohols while the two others take part only in the homologation reaction.

Compostos de platina em quimioterapia do câncer

The vast majority of clinically used antitumor drugs are either synthetic or natural product based organic compounds. In this review we describe different aspects, such as structure-activity relationships, mechanism of action, clinical uses and possible future prospects, of the platinum antitumor complexes, a distinct class of antitumor agents.

Desenvolvimento e caracterização de recobrimentos de Ni-Co e de seus óxidos mistos para a produção de oxigênio por eletrólise alcalina da água

This paper describes the development and characterisation of Ni-Co coatings to be used as anodes in water electrolysis. Chemical oxidation of the surface was performed through thermal treatment at 400ºC for 10 h. The resulting surfaces were analysed by X-ray diffraction, EDX, SEM, cyclic voltammetry and constant current electrolysis. The electrochemical oxidation occurring on bare surfaces during electrolysis promotes the formation of thick oxide layers resulting in loss of activity. In oxidised surfaces the chemical Ni-Co oxide grown during the thermal treatment prevents further oxidation thus retaining their activity towards oxygen evolution. An optimum condition for the growth of mixed oxide with high activity was found for the bath containing 50 g L-1 CoSO4.

Determinação de traços de Co e Co2 "em linha" por cromatografia em fase gasosa

The present work describes a rapid and sensitive method for the determination of carbon monoxide and carbon dioxide at low concentration levels, on line, in ethylene and hydrogen lines. These gases were separated in a column filled with Porapak Q, converted to methane and quantified by a flame ionization detector. Some modifications were made in the injection system and in the lines of the carrier gas. The detection limits of 2,6 ppbV and 4,85 ppbV for CO and CO2, respectively, were reached after modifications.

A Co-Processor Approach for Efficient Java Execution in Embedded Systems

This thesis deals with a hardware accelerated Java virtual machine, named REALJava. The REALJava virtual machine is targeted for resource constrained embedded systems. The goal is to attain increased computational performance with reduced power consumption. While these objectives are often seen as trade-offs, in this context both of them can be attained simultaneously by using dedicated hardware. The target level of the computational performance of the REALJava virtual machine is initially set to be as fast as the currently available full custom ASIC Java processors. As a secondary goal all of the components of the virtual machine are designed so that the resulting system can be scaled to support multiple co-processor cores. The virtual machine is designed using the hardware/software co-design paradigm. The partitioning between the two domains is flexible, allowing customizations to the resulting system, for instance the floating point support can be omitted from the hardware in order to decrease the size of the co-processor core. The communication between the hardware and the software domains is encapsulated into modules. This allows the REALJava virtual machine to be easily integrated into any system, simply by redesigning the communication modules. Besides the virtual machine and the related co-processor architecture, several performance enhancing techniques are presented. These include techniques related to instruction folding, stack handling, method invocation, constant loading and control in time domain. The REALJava virtual machine is prototyped using three different FPGA platforms. The original pipeline structure is modified to suit the FPGA environment. The performance of the resulting Java virtual machine is evaluated against existing Java solutions in the embedded systems field. The results show that the goals are attained, both in terms of computational performance and power consumption. Especially the computational performance is evaluated thoroughly, and the results show that the REALJava is more than twice as fast as the fastest full custom ASIC Java processor. In addition to standard Java virtual machine benchmarks, several new Java applications are designed to both verify the results and broaden the spectrum of the tests.

Reações de Cp'(CO)2MnPPH2H com CH3COCl e CH3S(O)2Cl em THF/trietilamina: evidências da primeira estabilização por complexação de um fósforo-homólogo das sulfonamidas

Cp'Mn(CO)3 (Cp'=h5-C5H4-CH 3) reacts with P(C6H5)2H in THF to give Cp'(CO)2MnPPh2H (Ph = Phenyl) (1), by substitution of one CO ligand. The reaction of 1 with CH3COCl and CH3S(O)2Cl in the presence of triethylamine occurs under electrophilic substitution on the diphenylphosphan ligand to yield the acetyl- and sulfonylphosphane complexes of manganese(I) Cp'(CO)2MnPPh2COCH3 (2) and Cp'(CO)2MnPPh2S(O)2 CH3 (3). The complex stabilisation of these molecules, wich are hitherto unknown in the free state, is only accomplished by blocking the free electron pair on phosphorus by coordination. The new complexes 1, 2 and 3 were analysed by IR, ¹H-NMR and 31P-MNR spectroscopy and their similar structures are discusssed.

Investigação espectroscópica dos carbonilos heterobimetálicos cis-[Fe(CO)4(HgX)2], X = Cl, Br,I

The series of compounds cis-[Fe(CO)4(HgX)2], X=Cl,Br,I shows an octahedral geometry around the iron atom with the two HgX groups cis to each other. In this paper the assignment for the carbonyl stretching modes and the calculation of their force constants were performed on the basis of the Cotton-Krainhanzel model. Taking into account all the data from the IR, 199Hg NMR and UV-vis spectra it is possible to verify the influence of X on the electronic densities at the metallic centers.

Caracterização de catalisadores Cu/CeO2/Al2O3 por redução a temperatura programada e atividade para oxidação de CO

The kinetic parameters for the CO oxidation reaction using copper/alumina-modified ceria as catalysts were determined. The catalysts with different concentrations of the metals were prepared using impregnation methods. In addition, the reduction-oxidation behaviour of the catalysts were investigated by temperature-programmed reduction. The activity results show that the mechanism for CO oxidation is bifunctional : oxygen is activated on the anionic vacancies of ceria surface, while carbon monoxide is adsorbed preferentially on the higher oxidation copper site. Therefore, the reaction occurs on the interfacial active centers. Temperatures-programmed Reduction patterns show a higher disperdion when cerium oxide is present.

A síntese do aduto binuclear [Fe(CNBu t)(CO)4(HgSO4 )]

The binuclear [Fe(CNBu t)(CO)4(HgSO4 )] adduct was obtained in the reaction of HgSO4 with [Fe(CNBu t)(CO)4] in methanol. This adduct, without a similar in the homoleptic pentacarbonyliron, was characterized by analytical and spectroscopic data. Further Mössbauer and molar conductivity studies have confirmed it's adduct nature.