Têm sido atribuídas à dependência de nicotina 20% das mortes nos EUA. Estudos têm mostrado que 30% a 50% das pessoas que começam a fumar escalam para um uso problemático. Nos últimos 20 anos, a educação e a persuasão não foram suficientes para promover uma mudança política, cultural e social relacionada ao comportamento de fumar. As intervenções para interromper o uso de tabaco ainda não estão integradas às rotinas dos serviços de saúde no mundo. A falta de estratégias de integração, de tempo disponível para acoplar ações assistenciais mais específicas e mesmo a percepção dos profissionais de saúde de que os tratamentos para a dependência de nicotina são pouco efetivos são algumas das barreiras apontadas. Assim, elaborar um consenso sobre a dependência de nicotina teve como objetivos: • levantar dados epidemiológicos relevantes relacionados ao uso do tabaco no mundo e no Brasil; • revisar as ações gerais e centrais da nicotina; • elaborar um protocolo de triagem mínimo para serviços de atenção primária à saúde; • recomendar diretrizes básicas de avaliação, diagnóstico e tratamento para todos os níveis de atenção à saúde em relação à dependência de nicotina; • fornecer sugestões para a abordagem de grupos especiais de pacientes: adolescentes, gestantes, idosos, pacientes em regime de internação, obesos e pacientes com comorbidades psiquiátricas, cardiovasculares e respiratórias.

Loss of spindle-pole integrity during mitosis leads to multipolarity independent of centrosome amplification 1-4 . Multipolar-spindle conformation favours incorrect kinetochore-microtubule attachments, compromising faithful chromosome segregation and daughter-cell viability 5,6 . Spindle-pole organization influences and is influenced by kinetochore activity 7,8 , but the molecular nature behind this critical force balance is unknown. CLASPs are microtubule-, kinetochore-and centrosome-associated proteins whose functional perturbation leads to three main spindle abnormalities: monopolarity, short spindles and multipolarity 9-13 . The first two reflect a role at the kinetochore-microtubule interface through interaction with specific kinetochore partners 10,11,14 , but how CLASPs prevent spindle multipolarity remains unclear. Here we found that human CLASPs ensure spindle-pole integrity after bipolarization in response to CENP-E-and Kid-mediated forces from misaligned chromosomes. This function is independent of end-on kinetochore-microtubule attachments and involves the recruitment of ninein to residual pericentriolar satellites. Distinctively, multipolarity arising through this mechanism often persists through anaphase. We propose that CLASPs and ninein confer spindle-pole resistance to traction forces exerted during chromosome congression, thereby preventing irreversible spindle multipolarity and aneuploidy.Multipolar spindles are a hallmark of tumour cells and may arise owing to supernumerary centrosomes resulting from centrosome overduplication or cytokinesis failure. However, multipolar mitosis is usually incompatible with cell viability and normally assumes a transient nature due to the coalescence of extra centrosomes into two functional spindle poles 5,6 . An alternative but less understood mechanism is related to multipolar-spindle formation independent of centrosome amplification, for example due to premature centriole disengagement or loss of spindle-pole integrity [1][2][3][4]15 . To investigate the mechanism by which CLASPs (cytoplasmic linker-associated proteins) prevent spindle multipolarity in human cells, we used HeLa cells stably expressing the centriole marker centrin-GFP and immunodetection of γ-tubulin to determine the number of centrioles in each individual pole on CLASP1/2 depletion by RNAi. As positive controls, we used cells treated with either 2 µM cytochalasin D, an inhibitor of actin polymerization and cytokinesis; astrin (also known as SPAG5, spermassociated antigen 5) short interfering RNA (siRNA), which leads to premature centriole disengagement 15 ; or TOGp (also known as CKAP5, cytoskeleton-associated protein 5) siRNA, which perturbs spindle-pole integrity 2,. All of these treatments caused a significant increase in the percentage of mitotic cells with multipolar spindles (Fig. 1a). Simultaneous depletion of CLASP1 and CLASP2 ( Supplementary Fig. S1b) resulted in 17.3 ± 4.1% of mitotic cells with multipolar spindles, whereas individual depletion of CLASP1 or CLASP2 caused, respecti...

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This article presents the concepts and basic premises that are necessary for a better understanding of the Brief Interventions (BIs), with a literature review of its effectiveness and a discussion about BIs in Brazil. The theoretical premises are discussed, as well the concepts represented by the acronym FRAMES: Feedback; Responsibility; Advice; Menu; Empathic and Self-efficacy. Results of systematic reviews and metanalysis about BIs effectiveness are discussed and a summary box with the main studies is presented. Finally, the recent developments about the introduction of BIs in Brazil are commented. The importance of health professionals training and the adoption of BIs within different settings are emphasized considering its demonstrated effectiveness and economic feasibility.

A b s t r a c tRecently, several studies have focused on comorbity psychiatric disorders with alcohol and other substance dependence. The Brazilian Association of Studies on Alcohol and Other Drugs proposed the Brazilian Guidelines project. This study review diagnostic and therapeutic criteria to the most prevalent psychiatric comorbidities. Randomized clinical trials, epidemiological, animal studies and other forms of research are reviewed. The main psychiatric comorbidities are studied based on guidelines adopted by other countries and the literature data resumed. Epidemiological aspects, diagnoses, integrated treatment and service organization, as well as specific psychotherapic and pharmacological treatment are discussed. The Brazilian Association of Studies on Alcohol and Other Drugs Guidelines reassures the importance of adequate diagnoses and treatment regarding alcoholic and drug dependent patients suffering of comorbid psychiatric disorders.

The two modalities presented similar outcomes and, as the group format could present a better cost-benefit ratio, it may be used without decreasing compliance with treatment or treatment effectiveness.

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RESULTS:The respective sensitivity and specificity of mammography were 20% and 89%; sonography, 30% and 81%; and magnetic resonance imaging, 64% and 77%. The differences between patients with breast implants for cosmetic and oncological reasons were discussed. CONCLUSIONS:Our experience suggests that magnetic resonance imaging seems to be the best imaging method on its own for the evaluation of rupturing among asymptomatic patients.