No abstract

Through narrative bioethics, this article presents the results of a study of the narratives of six people directly involved in the routine of the palliative care unit at the Hospital de Apoio de Brasilia, with the aim of contributing to the study of the complex problems faced by palliative care in daily practice. Focusing on the relationship between spirituality and bioethics, interviews with professionals, patients and families were conducted, seeking answers to the question of the meaning of life and its relationship to suffering. It was concluded that narrative bioethics applied to palliative care can provide important input to clarify issues related to the understanding of the spiritual realm by providing analytical frameworks that take into account human beings which express, feel, say and make sense of what is said. Keywords: Bioethics. Palliative care. Spirituality. ResumoCuidados paliativos, espiritualidade e bioética narrativa em unidade de saúde especializada Por meio da bioética narrativa, este artigo apresenta os resultados de estudo de narrativas de seis pessoas diretamente envolvidas na rotina da Unidade de Cuidados Paliativos do Hospital de Apoio de Brasília. O objetivo foi contribuir para a investigação dos complexos problemas enfrentados pelos cuidados paliativos na prática profissional diária, com foco na relação entre espiritualidade e bioética. Foram realizadas entrevistas com profissionais, pacientes e familiares, buscando respostas à questão do sentido da vida e sua relação com o sofrimento. Conclui-se que a bioética narrativa aplicada aos cuidados paliativos pode oferecer importantes subsídios para elucidar as questões ligadas à compreensão da esfera espiritual, ao prover marcos analíticos voltados para o ser humano, que expressa, sente, diz e cria sentido no que é dito. Palavras-chave: Bioética. Cuidados paliativos. Espiritualidade. ResumenCuidados paliativos, espiritualidad y bioética narrativa en una unidad de salud especializada Por medio de la bioética narrativa, el presente artículo presenta los resultados del estudio de las narrativas de seis personas directamente involucradas en la rutina de la unidad de cuidados paliativos del Hospital de Apoyo de Brasilia, con el objetivo de contribuir al estudio de los complejos problemas enfrentados por los cuidados paliativos en la práctica profesional diaria. Enfocándose en la relación entre espiritualidad y bioética, se realizaron entrevistas con profesionales, pacientes y familiares, buscando respuestas a la cuestión del sentido de la vida y su relación con el sufrimiento. Se concluye que la bioética narrativa aplicada a los cuidados paliativos puede proporcionar importantes aportes para aclarar cuestiones relacionadas con la comprensión de la esfera espiritual, al proveer marcos analíticos que toman en cuenta al ser humano que expresa, siente, dice y crea sentido en lo que es dicho. Palabras-clave: Bioética. Cuidados paliativos. Espiritualidad.

Children with lower physical fitness levels as well as those with lower motor coordination quotient are more likely to be overweight and/or obese. No significant relationship was observed between birth weight and weight status in childhood. Strategies to reduce childhood obesity should consider biological, behavioral, and also environmental predictors.

No abstract

The aim of this study was to investigate the occurrence, type and severity of anemia at the time of diagnosis of oral cancer, and its potential association with the degree of tumor cell differentiation. This case-control study used 366 medical records of patients treated at two referral centers for oral cancer diagnosis, specifically: cases (n=70) with a histopathological diagnosis of oral squamous cell carcinoma (OSCC) of the oral cavity, and controls (n=296) with benign oral lesions. Sociodemographic, behavioral, and clinical variables of both groups, as well as complete blood count values, were analyzed by descriptive statistics and crude/adjusted logistic regression. Anemia was detected in 15.7% of the cases and 11.8% of the controls. The presence of anemia had an OR=1.64 (odds ratio) (95%CI 0.54-5.00) for OSCC, with no significantly statistical association. Normocytic anemia was the most prevalent form of anemia when oral cancer was diagnosed (91.4% of the controls and 72.7% of the cases), and moderate to severely low hemoglobin levels were associated with OSCC diagnosis (OR 6.49;, albeit data on hematological examinations were missing.

Calotropis procera (Aiton) Dryand (Apocynaceae) is a native species in tropical and subtropical Africa and Asia. However, due to its fast growing and drought-tolerant, it has become an invasive species when it was introduced into Central and South America, as well as the Caribbean Islands. Currently, C. procera displays a wide distribution in the world. Invasiveness is important, in particular, because many invasive species exert a high reproductive pressure on the invaded communities or are highly productive in their new distributed areas. It has been suggested that a very deep root system and a high capacity to reduce stomatal conductance during water shortage could allow this species to maintain the water status required for a normal function. However, the true mechanism behind the successful distribution of C. procera across wet and dry environments is still unknown. C. procera leaves were collected from 12 natural populations in Brazil, Colombia and Mexico, ranging from wet to dry environments during 2014-2015. Many traits of morphology and anatomy from these distinct morphotypes were evaluated. We found that C. procera leaves had a considerable capacity to adjust their morphological, anatomical and physiological traits to different environments. The magnitude of acclimation responses, i.e., plasticity, had been hypothesized to reflect the specialized adaptation of plant species to a particular environment. However, allometric models for leaf area (LA) estimation cannot be grouped as a single model. Leaves are narrower and thicker with low amounts of air spaces inside the leaf parenchyma in wet environments, while they are broader and thinner with a small number of palisade cell layers in dry environments. Based on these, we argue that broader and thinner leaves of C. procera dissipate incident energy at the expense of a higher rate of transpiration to survive in environments in which water is the most limiting factor and to compete in favorable wet environments.

Prostate cancer (PCa) is the most frequent tumor among Latin American (LATAM) men. The incidence of de novo metastatic PCa is higher in LATAM than other parts of the world, and demographic changes in the region have increased disease burden. However, region-specific information regarding prevalence, progression, and treatment effectiveness is not currently available for nonmetastatic, castration-resistant PCa (nmCRPC). Nonmetastatic, castration-resistant PCa is a heterogeneous disease with varying potential to develop metastasis with limited treatments available, until recently. New clinical trials with promising results have allowed second-generation antiandrogen drugs to be used as first-line treatments, rendering guidelines outdated. As a result, this panel of experts reviewed the current status and challenges and developed recommendations for nmCRPC diagnosis and management in LATAM. The Americas Health Foundation (AHF) conducted a literature review and identified LATAM scientists and clinicians who have published in the field of PCa since 2012. The AHF convened a panel of 7 chosen experts urologists and medical oncologists from the region. The AHF developed specific questions relating to nmCRPC, which were answered by the experts prior to the multiday meeting. Each narrative was discussed and edited by the panel, through numerous rounds of discussion until a consensus was reached in a final manuscript. The panel proposes specific and realistic recommendations for improving access to diagnosis and management of PCa in LATAM. No treatment has yet shown improvement in overall survival; however, when including metastasis-free survival as an end point, second-generation antiandrogen drugs have emerged as effective treatment options and are currently included as first-line treatment. Although nmCRPC is a specific disease that represents a small percentage of patients with PCa, effective diagnostic and treatment strategies can contribute toward increasing quality of life and survival rates of patients with PCa in LATAM.

No abstract