RESUMO: Objetivou-se avaliar o perfil sociodemográfico e clínico dos cuidadores e sua relação com a sobrecarga proveniente do cuidado ao idoso com demência. Estudo descritivo transversal, amostra não probabilística com 94 cuidadores de idosos com demência, realizado num Centro de Atenção à Saúde do Idoso no estado do Rio de Janeiro. A coleta de dados ocorreu de fevereiro a junho de 2016, por meio de questionário sociodemográfico e escala de Zarit. Quarenta e seis (50%) cuidadores apresentaram sobrecarga moderada, 35 (38%) pouca sobrecarga e 11 (12%) sobrecarga moderada/severa; 71 (77%) cuidadores usavam de 1 a 5 medicamentos e 20 (22%) 6 a 11 medicamentos. Observou-se as tendências: indivíduos com rendas mais baixas evidenciaram maiores níveis de sobrecarga; cuidadores com menor tempo de experiência possuíam sobrecarga moderada; quanto maior a sobrecarga, menor a média da idade. Verificou-se que a sobrecarga do cuidado coloca o cuidador em condições de vulnerabilidade biológica e psicológica. DESCRITORES: Demência; Cuidadores; Enfermagem familiar; Idosos; Vulnerabilidade. RELAÇÃO DO PERFIL EPIDEMIOLÓGICO DOS CUIDADORES DE IDOSOSCOM DEMÊNCIA E A SOBRECARGA DO CUIDADO* Fue objetivo del estudio evaluar el perfil sociodemográfico y clínico de los cuidadores y su relación con la sobrecarga del cuidado al anciano con demencia. Estudio descriptivo transversal, con muestra probabilística con 94 cuidadores de ancianos con demencia, realizado en un Centro de Atención a la Salud del Anciano en estado de Rio de Janeiro. Los datos fueron obtenidos de febrero a junio de 2016, por medio de cuestionario sociodemográfico y escala de Zarit. Cuarenta y seis (50%) cuidadores presentaron sobrecarga moderada, 35 (38%) poca sobrecarga y 11 (12%) sobrecarga moderada/severa; 71 (77%) cuidadores usaban de 1 a 5 medicamentos e 20 (22%) 6 a 11 medicamentos. Se observaron las siguientes tendencias: individuos con rentas más bajas evidenciaron mayores niveles de sobrecarga; cuidadores con menos tiempo de experiencia tenían sobrecarga moderada; cuanto mayor la sobrecarga, menor la media de edad. Se verificó que la sobrecarga del cuidado pone el cuidador en condiciones de vulnerabilidad biológica y psicológica.

Filamin-A (FLNA) plays a crucial role in somatostatin receptor (sst) subtype-2 signaling in somatotropinomas. Our objective was to investigate the in vivo association between FLNA and sst2 expression, sst5 expression, dopamine receptor subtype-2 (D2) expression, somatostatin receptor ligand (SRL) responsiveness and tumor invasiveness in somatotropinomas. Quantitative real-time PCR was used to evaluate the absolute mRNA copy numbers of FLNA/sst2/sst5/D2 in 96 somatotropinomas. FLNA, sst2 and sst5 protein expression levels were also evaluated using immunohistochemistry. The Knosp-Steiner criteria were used to evaluate tumor invasiveness. Median FLNA, sst2, sst5 and D2 copy numbers were 4,244, 731, 156 and 3,989, respectively. Thirty-one of the 35 available tumors (89%) were immune positive for FLNA in the cytoplasm and membrane but not in the nucleus. FLNA and sst5 expression were positively correlated at the mRNA and protein levels (p < 0.001 and p = 0.033, respectively). FLNA was positively correlated with sst2 mRNA in patients who were responsive to SRL (p = 0.014, R = 0.659). No association was found between FLNA and tumor invasiveness. Our findings show that in somatotropinomas FLNA expression positively correlated with in vivo sst5 and D2 expression. Notably, FLNA was only correlated with sst2 in patients who were controlled with SRL. FLNA was not associated with tumor invasiveness.

Objective: To analyze the association between sociodemographic profile, health profile and the quality of life of caregivers of elderly people diagnosed with dementia. Method: A cross-sectional study was carried out in a geriatric outpatient unit with 35 elderly caregivers diagnosed with dementia. A socio-demographic and health characterization form was used as well as the WHOQOL-bref scale. To verify the association of the variables, the Spearman or Pearson correlation tests were applied, according to the normality of the data. Results: A moderate association between caregiver age and quality of life was found, as well as between total time of care and quality of life, which reveals that the care provided to the elderly with dementia has repercussions on the quality of life. The domains of the WHOQOL-bref with the highest means were Social and Physical Relations, and those with lower mean values were Psychological and Environmental. Conclusion: The identification of conditions that influence the quality of life of caregivers of elderly people with dementia allows actions to promote, protect and recover the health and well-being of those who provide care to be established, so that this care is both for themselves and for the elderly.

Context Artificial intelligence (AI), in particular machine learning (ML), may be used to deeply analyze biomarkers of response to first-generation somatostatin receptor ligands (fg-SRLs) in the treatment of acromegaly. Aim To develop a prediction model of therapeutic response of acromegaly to fg-SRL. Methods Patients with acromegaly not cured by primary surgical treatment and who had adjuvant therapy with fg-SRL for at least 6 months after surgery were included. Patients were considered controlled if they presented GH &lt; 1.0 ng/mL and normal age-adjusted IGF-I levels. Six AI models were evaluated: logistic regression, k-nearest neighbor classifier, support vector machine, gradient-boosted classifier, random forest and multilayer perceptron. The features included in the analysis were age at diagnosis, sex, GH and IGF-I levels at diagnosis and at pretreatment, somatostatin receptor subtype 2 and 5 (SST2 and SST5) protein expression and cytokeratin granulation pattern (GP). Results A total of 153 patients were analyzed. Controlled patients were older (p = 0.002), had lower GH at diagnosis (p = 0.01), had lower pretreatment GH and IGF-I (p &lt; 0.001), and more frequently harbored tumors that were densely granulated (p = 0.014) or highly expressed SST2 (p &lt; 0.001).The model that performed best was the support vector machine with the features SST2, SST5, GP, sex, age, and pretreatment GH and IGF-I levels. It had an accuracy of 86.3%, positive predictive value of 83.3% and negative predictive value of 87.5%. Conclusion We developed a ML-based prediction model with high accuracy that has the potential to improve medical management of acromegaly, optimize biochemical control, decrease long-term morbidities and mortality and reduce health services costs.

Objetivo: Refletir sobre o ensino remoto como possibilidade de novas experiências e desafios em tempos de pandemia da Covid-19. Método: Análise reflexiva sobre as novas experiências e desafios no ensino remoto durante a pandemia da covid-19. Resultado: O ensino remoto traz a oportunidade de integrar aulas de maneira síncrona (em tempo real) através webconferência e atividades assíncronas (não se efetiva em tempo real) que possibilitam o uso de ferramentas interativas de aprendizagem estimuladas pelo professor, mediador do conhecimento, em especial da Enfermagem. Conclusão: Recomenda-se que o professor promova a interatividade permitindo que o aluno, usufruindo dos recursos disponíveis no ambiente virtual de aprendizagem, possa compor elementos dos conteúdos discutidos com experiências positivas de aprendizagem.

Relato de experiência cujo objetivo é descrever a inserção da disciplina de Legislação, Ética e Exercício de Enfermagem online no curso de graduação em Enfermagem da Universidade Estácio de Sá no Estado do Rio de Janeiro. A construção da interatividade na educação à distância foi fundamental para o planejamento contínuo do ambiente virtual através do desenvolvimento de habilidades e competências dos alunos exeqüíveis com a estratégia de ensino do Projeto Político Pedagógico do Curso combinando com as necessidades atuais da profissão sobre a legislação na Enfermagem. O desenvolvimento de estratégias de ensino articuladas através das ferramentas disponíveis no ambiente virtual visa promover o desenvolvimento crítico-reflexivo do futuro enfermeiro.

Objective: to examine the publications in education on-line in nursing through references in major databases from 2005 to 2009. Methods: literature review study conducted in the databases from Virtual Health Library from 2009/19/02 to 2009/24/04. For analysis of the information was held to organize the content found on the year, type of publication and methodological approach, the core content/production of knowledge and recommendations of the authors. Results: in 20 selected references were reviewed and 12 in the database Scielo, 06 in the BDENF and 14 in the Lilacs. It is tonic in the discussions of the authors studied: the development of training courses for nurses and midwives as well as courses in graduate programs via education on-line. Furthermore, it is necessary that the educational institutions and implement health education on-line investments in technological capabilities and infrastructure for teachers and learners. Conclusion: we note an evolution of education on-line in nursing in Brazil in which the possibilities of teaching in virtual environment for learning is everlasting and take into account some constraints relevant to interactivity as the availability of training courses and disciplines in undergraduate courses. Descriptors: education; education on-line; nursing.

Abstractβ‐arrestins seem to have a role in endocytosis and desensitization of somatostatin receptor subtype 2 (sst2) and could be associated with the responsiveness to somatostatin receptor ligands (SRL) in patients with acromegaly. To investigate the in vivo correlation between β‐arrestins 1 and 2 with sst2, sst5 and dopamine receptor subtype 2 (D2) expressions, and the association of β‐arrestins with response to first‐generation SRL and invasiveness in somatotropinomas. β‐arrestins 1 and 2, sst2, sst5 and D2 mRNA expressions were evaluated by quantitative real‐time RT‐PCR on tumoral tissue of 96 patients. Moreover, sst2 and sst5 protein expressions were also evaluated in 40 somatotropinomas by immunohistochemistry. Response to SRL, defined as GH <1 μg/l and normal IGF‐I levels, was assessed in 40 patients. The Knosp‐Steiner criteria were used to define invasiveness. Median β‐arrestin 1, β‐arrestin 2, sst2, sst5 and D2 mRNA copy numbers were 478; 9375; 731; 156; and 3989, respectively. There was a positive correlation between β‐arrestins 1 and 2 (R = 0.444, P < 0.001). However, no correlation between β‐arrestins and sst2, sst5 (mRNA and protein levels) or D2 was found. No association was found between β‐arrestins expression and SRL responsiveness or tumour invasiveness. Although previous data suggest a putative correlation between β‐arrestins and sst2, our data clearly indicated that no association existed between β‐arrestins and sst2, sst5 or D2 expression, nor with response to SRL or tumour invasiveness. Therefore, further studies are required to clarify whether β‐arrestins have a role in the response to treatment with SRL in acromegaly.