Objetivo: investigar percepções de idosos sobre grupos de convivência. Método: estudo exploratório, com abordagem qualitativa, realizado em seis grupos de convivência da cidade de Cajazeiras-PB, Brasil, no período de setembro a outubro de 2010, utilizando a técnica de discurso do sujeito coletivo. Resultados: dos 60 participantes deste estudo, 48 (80%) eram mulheres, 21 (35%) tinham entre 65 e 69 anos, 30 (50%) eram viúvos, 46 (77%) aposentados, 32 (53%) não concluíram o ensino fundamental, 40 (67%) moravam acompanhados de familiares, 25 (42%) tinham entre seis e dez anos de participação nos grupos, 33 (55%) participavam espontaneamente e 30 (50%) apontaram a dança como a melhor atividade desenvolvida no grupo. Diante dos questionamentos, foram obtidas as ideias centrais e os discursos coletivos representados por três temas: razões/motivos para idosos buscarem grupos de convivência; importância dos encontros com o grupo para os idosos; mudanças ocorridas na vida após o ingresso no grupo. Dos temas, foram extraídas as ideias centrais: solidão, lazer, convivência, liberdade, mudou tudo, vontade de viver. Conclusão: Os grupos proporcionam ganhos para os idosos, sinalizando entre estes o direito de envelhecer com dignidade e melhorando a qualidade de vida.

Cell-free circulating DNA in plasma and serum may serve as a biomarker for malignant tumor detection and follow up in patients with a variety of solid tumors including prostate cancer. In healthy patients, DNA is normally released from an apoptotic source which generates small fragments of cell-free DNA, whereas cancer patients have cell-free circulating DNA that originated from necrosis, autophagy, or mitotic catastrophe. Cell-free circulating DNA levels were measured by a quantitative real-time PCR method with a set of primers targeted to amplify the consensus ALU apoptotic versus necrotic origin. Prostate cancer patients before and 3 months after diagnosis showed cell-free circulating DNA released at apoptotic and non-apoptotic cell death. Interestingly, all patients after 6 months demonstrated DNA released at non-apoptotic cell. The principal source of cell-free circulating DNA is of apoptotic and non-apoptotic cell death. However, during treatment, this feature could change. Therefore, the study of cell-free circulating DNA would be important to follow the evolution of the disease during the treatment.

The etiology of temporomandibular disorders (TMD), which are considered as a heterogeneous group of psychophysiological disturbances, remains a controversial issue in clinical dentistry. This study aimed to evaluate whether the salivary alpha-amylase (sAA), cortisol levels, and anxiety symptoms differ between children with and without TMD. Initially, 316 young subjects were screened in public schools (nonreferred sample); 76 subjects aged 7-14 years were selected and comprised the TMD and control groups with 38 subjects each matched by sex, age, and the presence/absence of sleep bruxism. Four saliva samples were collected: upon waking, 30 min and 1 h after awakening (fasting), and at night (at 8 PM) on 2 alternate days to examine the diurnal profiles of cortisol and sAA. Anxiety symptoms were screened using the Multidimensional Anxiety Scale for Children (MASC-Brazilian version). Shapiro-Wilk test, Student's t-test/Mann-Whitney U test, and correlation tests were used for data analysis. No significant differences were observed in the salivary cortisol area under the curve (AUC G mean ± SD = 90.22 ± 63.36 × 94.21 ± 63.13 µg/dL/min) and sAA AUC G (mean ± SD = 2544.52 ± 2142.00 × 2054.03 ± 1046.89 U/mL/min) between the TMD and control groups, respectively (p > 0.05); however, the clinical groups differed in social anxiety domain (t = 3.759; CI = 2.609, 8.496), separation/panic (t = 2.243; CI = 0.309, 5.217), physical symptoms (U = 433.500), and MASC total score (t = −3.527; CI = −23.062, −6.412), with a power of the test >80% and large effect size (d = 0.80), with no significant correlation between the MASC total score, cortisol, and sAA levels. Although children with TMD scored higher in anxiety symptoms, no difference was observed in the salivary stress biomarkers between children with and without TMD.

Introduction Human milk cannot currently be considered a major source of COVID-19 infection. On the other hand, it can contain specific antibodies that could modulate a possible newborn infection by SARS-CoV-2. Main issue A 32-year-old pregnant woman, gestational age 37 and 3/7 weeks, was admitted with a flu-like syndrome caused by COVID-19. The female newborn was appropriate for gestational age, with a birth weight of 2,890 g, length 48 cm, and head circumference 34 cm. Management The mother–infant dyad remained in the rooming-in unit during hospitalization, exclusively breastfeeding and following World Health Organization recommendations for contact and airway precautions. On the 3rd day after delivery, two mother’s milk samples (3 and 5 mL) were collected by hand expression. The samples were centrifuged for 10 min twice consecutively to separate fat, which was removed, and the remaining material was transferred to another tube to determine anti-SARS-CoV-2 Immunoglobulin A and Immunoglobulin G (ELISA, Kit EUROIMMUN AG, Luebeck, Germany). Anti-SARS-CoV-2 Immunoglobulin A was detected in the two samples evaluated, whose values were 2.5 and 1.9, respectively. No anti-SARSCoV-2 immunoglobulin G was detected. The exclusively-breastfed infant remained well through 45 days of age. Conclusion The presence of SARS-CoV-2 Immunoglobulin A in the milk of mothers infected with COVID-19 may be related to protection against the transmission and severity of the disease in their infants.

Introdução: As unidades de terapia intensiva (UTIs) têm sido organizadas como setores estratégicos para o suporte especializado de assistência ao paciente grave. Objetivo: Verificar as ações do enfermeiro para a identificação precoce das alterações sistêmicas causadas pela sepse grave relacionadas às alterações hemodinâmicas, neurológicas, respiratórias, renais e nutricionais dos pacientes internados em UTIs adulto. Métodos: Estudo descritivo com 24 enfermeiros. Os dados foram coletados por meio de formulário composto de questões estruturadas. Resultados: Apenas 36% dos enfermeiros possuem especialização em UTI adulto; verificou-se que os profissionais identificam parcialmente os sinais e sintomas apresentados pelo paciente séptico. Conclusão: Os enfermeiros encontram dificuldade na identificação precoce das alterações sistêmicas causadas pela sepse grave relacionada às alterações hemodinâmicas, neurológicas, respiratórias, renais e nutricionais dos pacientes internados em UTI adulto, o que pode estar relacionado com a falta de treinamento e de protocolos estabelecidos pelas instituições.Palavras-chave: unidade de terapia intensiva; sepse; síndrome de resposta inflamatória sistêmica; enfermagem. ABSTRACT Introduction:Intensive care units (ICUs) have been organized as strategic sectors for specialized support assistance to critically ill patients. Objective: To assess the actions of the nurse for the early identification of systemic changes caused by severe sepsis, related to hemodynamic, neurological, respiratory, renal and nutrition changes of patients in adult ICUs. Methods: Descriptive studies with 24 nurses. Data were collected using a questionnaire composed of structured questions. Results: Only 36% of nurses have expertise in adult ICUs, professionals partially identify the signs and symptoms presented by the septic patient. Conclusion: Nurses find difficulty in the early identification of systemic changes caused by severe sepsis, related to hemodynamic, neurological, respiratory, renal and nutritional changes seen in patients in adult ICUs, which may be related to lack of training and of protocols established by the institutions.

Background: In human assisted reproduction, the ovarian response to exogenous recombinant Follicle-stimulating Hormone (FSH) therapy is variable and difficult to predict. The standard protocol of ovarian hyperstimulation can result in satisfactory response; however, an unsatisfactory response necessitates FSH dose adjustment or results in ovarian hyperstimulation syndrome (OHSS). Polymorphisms in AMH and AMHR2 genes appear to affect hormone biological activities, thus affecting follicle recruitment and development, leading to infertility. We aimed to evaluate AMH and AMHR2 polymorphisms in infertile women, and correlate those findings with AMH, FSH and estradiol serum level response to controlled ovarian hyperstimulation (COH), as well as assisted reproduction outcomes. Methods: A cross-sectional study comprising 186 infertile women that underwent one cycle of high complexity assisted reproductive treatment. Blood samples were collected and a TaqMan assay was used for AMH G146T/rs10407022 and AMHR2 A-482G/rs2002555, A10G/rs11170555, C1749G/rs2071558 and G4952A/rs3741664 genotyping, and FSH, estradiol and AMH levels were measured. The findings were correlated to human reproduction outcomes. Results: AMH rs10407022 and AMHR2 rs2002555 polymorphisms were not associated with hormonal measurements, whereas AMHR2 rs11170555 and rs3741664 were positively associated with AMH, estradiol and FSH levels. The genotype distribution of AMH and AMHR2 genes according to Controlled Ovarian Hyperstimulation did not show a positive association. However, an association with AFC, degree of oocyte maturation (allele G of AMHR2 rs2071558) the number of embryos produced (alleles T and G of AMH rs10407022 and AMHR2 rs2002555, respectively) and frozen embryo (allele G of AMHR2 rs11170555) were found to be statistically associated. Considering COH, serum AMH and AFC were a positive predictor to OHSS. Regarding serum AMH and assisted reproduction outcomes, a positive correlation with all variables studied was found. Comparing AFC and AMH as predictors of human reproduction outcomes, the AFC was less effective than serum AMH. Considering pregnancy rates, no marker was positively associated. Conclusion: AMHR2 polymorphisms were associated with estradiol, AMH and FSH measurements, as well as number and quality of embryos, while AMH polymorphisms was associated with number of embryos produced. Serum AMH was correlated with nearly all variables analyzed in assisted reproductive treatment, demonstrating that it represents a better biomarker of OHSS and human reproduction outcomes compared to AMH and AMHR2 polymorphisms.

BackgroundBreast cancer affects millions of women worldwide, particularly in Brazil, where public healthcare system is an important model in health organization and the cost of chronic disease has affected the economy in the first decade of the twenty-first century. The aim was to evaluate the role of health policy in the burden of breast cancer in Brazil between 2004 and 2014.MethodsSecondary analysis was performed in 2017 with Brazilian Health Ministry official data, extracted from the Department of Informatics of the National Health System. Age-standardized mortality and the age-standardized incidence of hospital admission by breast cancer were calculated per 100,000 people. Public healthcare costs were converted to US dollars. Regression analysis was performed to estimate the trend of breast cancer rates and healthcare costs, and principal component analysis was performed to estimate a cost factor. Stata® 11.0 was utilized.ResultsBetween 2004 to 2014, the age-standardized rates of breast cancer mortality and the incidence of hospital admission and public healthcare costs increased. There was a positive correlation between breast cancer and healthcare public costs, mainly influenced by governmental strategies.ConclusionsGovernmental strategies are effective against the burden of breast cancer in Brazil.

Acne in adult women is a hard-to-manage frequent disease with many relapse cases. It mostly interferes with quality of life and causes major social and metabolic losses for patients. This is a transversal retrospective study and the aim was to standardize the research on circulating androgenic hormone levels and to detect hyperandrogenic states early, showing the frequency and the pattern of the altered hormones, useful resources to correctly evaluate each patient. In this study 835 women above 15 years of age, with acne or aggravation cases, were analyzed. The aim was to verify the percentage of androgen examinations with levels above normal. The levels of the hormones dehydroepiandrosterone sulfate, dehydroepiandrosterone (DHEA), dehydrotestosterone, androstenedione and total testosterone were measured in all patients. The evaluation of the hormone profile showed that 54.56% of the patients had hyperandrogenism, and the levels of DHEA were most frequently elevated. Therefore, in the face of the importance of hyperandrogenism in the pathogenesis of acne, standardizing the research of the hormone profile is paramount for the treatment and control of relapses in case of a surge of acne breakouts during a woman's adult life.