Homing of bone marrow stromal cells (MSCs) to bone and bone marrow after transplantation, important for the correction of conditions such as metabolic storage disorders, can occur but with poor efficiency. Substantial improvements in engraftment will be required in order to derive a clinical benefit from MSC transplantation. Chemokines are the most important factors controlling cellular migration. Stromal-derived factor-1 (SDF-1) has been shown to be critical in promoting the migration of cells to the bone marrow, via its specific receptor CXCR4. The aim of our study was to investigate CXCR4 expression on MSCs and its role in mediating migration to bone marrow. We show that CXCR4, although present at the surface of a small subset of MSCs, is important for mediating specific migration of these cells to bone marrow. 4 Clinically, MSCs may be used to enhance HSC engraftment after transplantation, to correct inherited disorders of bone and cartilage, or as vehicles for gene therapy. 5,6 Crucial to the success of any of these strategies is efficient engraftment to bone and bone marrow. So far results have shown that although MSCs can engraft to those tissues, levels are at the limit of detection and clinically useful only in certain disorders such as osteogenesis imperfecta. 7 Higher levels will be required to achieve a therapeutic benefit in the majority of applications.The chemokine stromal-derived factor-1 (SDF-1) and its ligand CXCR4 play an important role in homing as shown by studies on engraftment of hematopoietic stem/progenitor cells 8 and on colonization of bone and bone marrow by metastatic breast and prostate cancer cells. 9 We have examined the expression of CXCR4 by MSCs and the migration of these cells to bone marrow stroma. Here we show for the first time that CXCR4 is important for MSC migration to bone marrow. However cell surface receptor levels are low, with large amounts found intracellularly. Study design Isolation of MSC cultures and CD34 ؉ cellsBone marrow aspirates were obtained, under local ethical approval, from the posterior iliac crest of donors aged 0 to 18 years after parental consent.MSCs were isolated by plastic adherence as previously described 10 and cultured in Dulbecco modified Eagle medium (DMEM; Invitrogen, Paisley, United Kingdom) ϩ 10% fetal calf serum (FCS; Stem Cell Technologies, Vancouver, BC). CD34 ϩ cells were isolated using the Minimacs system according to the manufacturer's instruction (Miltenyi Biotech, Bisley, United Kingdom) Reverse-transcription-polymerase chain reaction (RT-PCR)Total RNA from MSCs or peripheral blood mononuclear cells (PBMCs), the latter activated with 10 g/mL phytohemagglutinin (PHA; Abbott Murex, Dartford, United Kingdom), was extracted using RNAzol (AMS Biotechnology, Abington, United Kingdom) according to the manufacturer's instructions, then reverse transcribed using a First Strand cDNA Synthesis kit (Amersham Pharmacia Biotech, Little Chalfont, United Kingdom). cDNA was analyzed by PCR for CXCR4 using 2 sets of primers: 668-bp amplicon forwa...

Bariatric surgery is an effective intervention in the treatment of obesity, but lifestyle and diet should be monitored after this procedure to ensure success. The Bariatric Food Pyramid was created basing on long-term nutritional care that proposes a standard of healthy living and eating habits considering gastric capacity and specific nutritional needs. The purpose of the current study is to evaluate the life habits and diet quality of patients who have undergone bariatric surgery (who have been recovering for at least 6 months) based on the specific food pyramid. Retrospective data analysis was performed using medical records of patients who had been followed for at least 6 months after bariatric surgery. The following data were collected from patient records: age, gender, education level (years), BMI (preoperative and postoperative), percentage of excess weight loss (EWL) relative to the time of surgery, frequency of physical activity, use of nutritional supplements, usual dietary intake history, and fluid intake. Results were analyzed using descriptive statistics. We evaluated 172 patient records. In this study, there was a low prevalence of physical activity, use of vitamin-mineral supplements, and water intake. There also was low consumption of protein, fruit, vegetables, and vegetable oils. In addition, intake of carbohydrates, sugars, and fats were higher than the recommendations established by the pyramid. The results indicate that patients who have undergone bariatric surgery have an inadequate diet according to food evaluation with the specific pyramid. In the long term, this may lead to weight gain and vitamin and mineral deficiencies.

RESUMO Considerando os benefícios biopsicossociais decorrentes da interação humanos/natureza, questionou-se como a hipótese da biofilia tem sido inserida nos cuidados paliativos. Objetivou-se mapear, através de revisão integrativa, a concepção histórica e científica da temática, atestando a contemplação dos princípios dos cuidados paliativos. De 1.928 textos científicos, 71 abarcaram o tema, sendo possível identificar, ao menos, um dos nove princípios, com destaque para a integração com aspectos psicológicos e espirituais. A biofilia foi aplicada, sobretudo, ao aspecto emocional, e a zooterapia, ao relacional. Contudo, diante das limitações impostas ao atendimento de aspectos de biossegurança e dependência do voluntariado, propõe-se a inserção da horticultura terapêutica em hospices e visita do animal de estimação.

Resumo O objetivo deste estudo é identificar fatores que influenciam a tomada de decisões de profissionais de saúde diante de pacientes em cuidados de fim de vida internados em unidades de terapia intensiva. Trata-se de pesquisa quantitativa realizada em dois hospitais paranaenses, entre março e maio de 2018, com amostra de 45 integrantes de equipe multiprofissional. Constatou-se preocupação dos entrevistados em respeitar a autonomia, proteger a dignidade e preservar a qualidade de vida de pacientes e familiares por meio da decisão compartilhada. Porém, a tendência de obstinação terapêutica para cumprir o dever profissional mostrou necessidade de mais discussões e formação em cuidados paliativos para minimizar conflitos éticos. Aprovação CEP-PUCPR 2.397.069/2017

Background: The practice of palliative care is involved with ethical conflicts related to the life-death process and relief of suffering. The inability to act in the face of such dilemmas, due to internal or external barriers, can cause moral distress in the healthcare professionals. Objective: The purpose of this integrative review is to analyze which circumstances cause moral distress in healthcare professionals who work in palliative care. Methods: An integrative review of the literature was made in the SCIELO and PubMed databases, based on the descriptors “palliative care” and “moral distress.” Articles published between 2015-2020, in Portuguese, Spanish and English were included, following the PRISMA criteria. Results: From a selection of 97 documents, 56 were completed reviewed and 23 studies were included in the review. Most articles refer to the nursing area, followed by multidisciplinary studies. The circumstances related to moral distress were identified involving: personal aspects; patients and caregivers; team; environment and organization. Communication problems, lack of resources and witnessing professionals giving false hope to patient and family members were the events related to moral distress most mentioned by the articles in the review. Recommendations for reducing and preventing moral distress include empowerment and educational programs in bioethics and palliative care. Conclusions: Moral distress is an evident phenomenon in palliative care, involving different situations that can impact on quality-of-care provided as well as the well-being of the healthcare professionals.

The MSC differentiation protocol used in the present study induced expression of some endocrine markers. Insulin was not produced by these cells, probably because of incomplete induction of differentiation.

Objetivo: analisar as estratégias propostas no meio científico para a promoção do envelhecimento ativo no cenário brasileiro, e identificar as possíveis lacunas que o impedem de se tornar uma realidade. Método: revisão integrativa realizada nas bases de dados Scientific Eletronic Library (Scielo), Literatura Latino-Americana e do Caribe em Ciências da Saúde (Lilacs), e Pubmed, em Setembro 2020, com os descritores; envelhecimento saudável, bom envelhecimento, envelhecer bem, envelhecer saudável, envelhecimento bem-sucedido e envelhecimento sadio, nos idiomas Português, Espanhol e Inglês, publicadas entre 2016 e 2020, que abordassem pelo menos uma das dimensões dos fatores determinados pela Organização Mundial da Saúde para o desenvolvimento do envelhecimento ativo. Resultados: Dezessete estudos foram integrados à pesquisa pois abordavam as dimensões definidas pela OMS para o desenvolvimento do envelhecimento ativo, sendo uma única dimensão abordada na maior parte deles: a dimensão social é amplamente abordada em 11, a cultural e de lazer em 1; os outros 4 abordam duas dimensões conjuntamente, e nenhum aborda a dimensão econômica. Conclusão: A literatura científica tem demonstrado formas de promover o envelhecimento ativo, porém, muitas importantes dimensões ainda são pouco exploradas.

Vivemos em uma sociedade que se recusa a envelhecer. As exigências estéticas impostas pela sociedade, de aparência sempre jovial, negando ou escondendo os sinais que o passar do tempo impõe atingem diretamente as pessoas idosas, de forma estigmatizante, e tornam suas possibilidades diminuídas pelo sentimento de não pertencimento. Objetivo: O objetivo deste artigo é explorar as estratégias declaradas na luta contra o envelhecimento. Busca-se analisar os aspectos que apoiam as estratégias e discutir o fenômeno do combate ao envelhecimento na perspectiva bioética. Metodologia: Trata-se de uma pesquisa qualitativa que utilizou como material de análise o conteúdo de domínio público disponível na internet, em sua maioria visando o ideal estético. A pesquisa realizou coleta direta de dados com o pesquisador como o principal instrumento, e realizou análise de conteúdo de Bardin. Conclusão: Atualmente as estratégias declaradas na luta contra o envelhecimento, em sua maioria visam o ideal estético, como forma de permitir a pessoa idosa a permanência no meio social. São estratégias para disfarçar o envelhecimento ou tentar impedi-lo em uma busca incessante da juventude eterna.