Resumo Objetivo: Investigar a qualidade de vida relacionada à saúde e correlações com fatores psicossociais (ansiedade, depressão e autoestima) em homens prostatectomizados. Métodos: Estudo descritivo correlacional realizado com 85 homens submetidos a prostatectomia radical há no mínimo três meses e no máximo cinco anos. Foram utilizados o European Organization for Research and Treatment of Cancer- QLQ C30 e European Organization for Research and Treatment of Cancer “Prostate Cancer” 25 items - EORTC QLQ-PR25; Escala de Autoestima de Rosenberg e Hospital Anxiety and Depression Scale. Resultados: Os participantes mostraram comprometimento da qualidade de vida no que se refere a prejuízos da função sexual e presença de sintomas urinários. Houve correlação entre os aspectos psicossociais e algumas escalas de avaliação da qualidade de vida, principalmente as escalas funcionais e de sintomas. Conclusão: Evidenciou-se que a prostatectomia radical causa prejuízo na qualidade de vida dos homens, demandando assistência dos profissionais de saúde para minimizar os efeitos das complicações mais comuns. Recomenda-se a implementação de intervenções educativas e apoio multiprofissional pautados em melhor compreensão das implicações físicas e psicossociais para ajudar a melhorar a qualidade de vida dos homens após a prostatectomia radical.

BackgroundMatrix metalloproteinases (MMPs) are key players in tumor progression, helping tumor cells to modify their microenvironment, which allows cell migration to secondary sites. The role of integrins, adhesion receptors that connect cells to the extracellular matrix, in MMP expression and activity has been previously suggested. However, the mechanisms by which integrins control MMP expression are not completely understood. Particularly, the role of α2β1 integrin, one of the major collagen I receptors, in MMP activity and expression has not been studied. Alternagin-C (ALT-C), a glutamate-cysteine-aspartate-disintegrin from Bothrops alternatus venom, has high affinity for an α2β1 integrin. Herein, we used ALT-C as a α2β1 integrin ligand to study the effect of ALT-C on MMP-9 and MMP-2 expression as well as on tumor cells, fibroblats and endothelial cell migration.MethodsALT-C was purified by two steps of gel filtration followed by anion exchange chromatography. The α2β1 integrin binding properties of ALT-C, its dissociation constant (Kd) relative to this integrin and to collagen I (Col I) were determined by surface plasmon resonance. The effects of ALT-C (10, 40, 100 and 1000 nM) in migration assays were studied using three human cell lines: human fibroblasts, breast tumor cell line MDA-MB-231, and microvascular endothelial cells HMEC-1, considering cells found in the tumor microenvironment. ALT-C effects on MMP-9 and MMP-2 expression and activity were analyzed by quantitative PCR and gelatin zymography, respectively. Focal adhesion kinase activation was determined by western blotting.ResultsOur data demonstrate that ALT-C, after binding to α2β1 integrin, acts by two distinct mechanisms against tumor progression, depending on the cell type: in tumor cells, ALT-C decreases MMP-9 and MMP-2 contents and activity, but increases focal adhesion kinase phosphorylation and transmigration; and in endothelial cells, ALT-C inhibits MMP-2, which is necessary for tumor angiogenesis. ALT-C also upregulates c-Myc mRNA level, which is related to tumor suppression.ConclusionThese results demonstrate that α2β1 integrin controls MMP expression and reveal this integrin as a target for the development of antiangiogenic and antimetastatic therapies.Electronic supplementary materialThe online version of this article (10.1186/s40409-018-0150-2) contains supplementary material, which is available to authorized users.

RESUMO:Este estudo consiste em uma revisão integrativa da literatura com o objetivo de sumarizar as pesquisas produzidas sobre Qualidade de Vida (QV) em homens submetidos à prostatectomia em publicações nacionais e internacionais publicadas de janeiro de 2009 a fevereiro de 2014, nas bases de dados PubMed, SciELO, LILACS e CINAHL. Foram identificados 40 artigos que atendiam aos critérios de inclusão. A análise dos trabalhos permitiu identificar foco principal no caráter físico e sintomatológico em detrimento aos aspectos psicológicos referidos após a cirurgia. Observou-se lacunas no conhecimento produzido, com escassos estudos brasileiros, predomínio de estudos com baixo nível de evidência e reduzido número de estudos com delineamento experimental, raros estudos com enfoque nos aspectos emocionais e ausência de definição do construto utilizado e de dados psicométricos dos instrumentos e escalas utilizadas. Entretanto, foi possível elaborar uma síntese do conhecimento científico acerca da QV em homens prostatectomizados na perspectiva da literatura internacional e nacional, incluindo diversos aspectos que permeiam esta investigação. Palavras-Chave: Qualidade de vida, câncer de próstata, prostatectomia, neoplasias da próstata ______________________________________________________________________ QUALITY OF LIFE IN MEN UNDERGOING PROSTATECTOMY: INTEGRATIVE REVIEWABSTRACT: This study consists of an integrative review of the literature with the aim of summarizing the researches produced on Quality of Life (QoL) in men submitted to prostatectomy in published national and international publications from January 2009 to February 2014 in the PubMed, SciELO, LILACS and CINAHL. We identified 40 articles, which met the pre-established criteria. The analysis of the work allowed to identify main focus on the physical and symptomatological character in detriment to the psychological aspects referenced after the surgery. We observed gaps in the knowledge produced, such as, few Brazilian studies, studies of experimental designs or that demonstrate a greater level of evidence, lack studies with a focus on emotional aspects, absence of the definition of the construct used, lack of psychometric data of the instruments and Scales used and the prevalence of low evidence studies. However, it was possible to elaborate a summary of the scientific knowledge about QoL in  R. 227, s/n -Setor Leste Universitário, Goiânia -GO, 74605-080, Brasil.

Objetivo: validar competências de enfermeiros atuantes nos cuidados com portadores de marca-passo. Método: tratase de estudo de validação de conteúdo, realizado entre março e novembro de 2017, pela técnica Delphi, sob protocolo CAAE nº63940217.3.0000.5462. A apreciação das competências foi realizada por sete juízes enfermeiros, doutores e experts em cardiologia, que consideraram o índice para validação de conteúdo (IVC) superior a 70%. Resultados: foram validados 119 itens de cuidado do total de 133, distribuídos em nove competências, com média geral de cada competência (AVE) e de concordância dos juízes (UA) com IVC>0,7. Dos 14 itens não validados após segunda rodada de avaliação, foram validados com AVE geral de 0,9 e UA de 1. Observouse relevância da competência sobre os conhecimentos de enfermagem para promoção da assistência segura aos familiares e à ação educativa ao paciente. Conclusão: As competencias foram validadas quanto à relevância e confiabilidade pelos juízes.

Reciprocal interactions between tumor, stromal cells and the extracellular matrix (ECM) are considered crucial steps for tumor development and progression. Both tumor and stromal cells secrete metalloproteases (MMPs) that modify the tumor microenvironment by degrading the ECM and releasing growth factors that may induce tumor cell proliferation, migration and invasion. MMPs activation is stimulated by co-activation of integrins, major cell-surface adhesion receptors. Disintegrins are strong integrin inhibitors found in snake venoms and used as prototypes for angiogenesis inhibitors. Alternagin-C (Alt-C), a disintegrin-like, Cys-rich protein isolated from Bothrops alternatus snake venom, has strong affinity for α2β1 integrin. ALT-C inhibited adhesion to collagen I of a variety of tumor cell lines, and in low concentrations, it induces VEGF expression and angiogenesis in an in vivo matrigel model. However, its mechanism of action was not very clear and it seems to depend on the cell type. Here, we show that ALT-C inhibited MMP-9 activity and mRNA expression in human breast cancer (MDA-MB-231) and MMP-2 activity in human micro vascular endothelial cells (HMEC-1) conditioned media from monocultures. ALT-C also increased the expression of angiogenic genes such as VEGF-A in fibroblasts and tumor cells but not in HMEC-1. However, ALT-C upregulated c-MYC mRNA expression only in tumor cells. ALT-C (10, 40, 100 and 1000 nM) also inhibited transendothelial migration of MDA-MB-231 cells through a monolayer of HMEC-1. In conclusion, these results suggest that α2β1 integrin binding by ALT-C may induce distinct effects in different cell lines by modulating MMP activity and stimulating the expression of angiogenic factors that influence tumor progression. These results may be very useful for medical and biotechnological applications in the development of anti-angiogenic and anti-metastatic therapies. Support: FAPESP, CNPq, CAPES (Brazil) Citation Format: Lívia Mara Santosa, Tamires de Castro Vieira, Heloísa Sobreiro Selistre-de-Araújo. Alternagin-C, an α2β1 integrin-binding disintegrin-like protein, induces distinct cell responses in fibroblasts, tumor breast and endothelial cells in vitro. [abstract]. In: Abstracts: AACR Special Conference on Cellular Heterogeneity in the Tumor Microenvironment; 2014 Feb 26-Mar 1; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2015;75(1 Suppl):Abstract nr B64. doi:10.1158/1538-7445.CHTME14-B64