Jacqueline Andréia Bernardes Leão Cordeiro

Association of the TP53 codon 72 polymorphism and breast cancer risk: a meta-analysis

This study was conducted in order to investigate the implications of the R72P polymorphism in the TP53 gene in breast cancer risk. The enlightenment of this matter might provide a piece of information about the potential implications of this polymorphism in patient risk. A meta-analysis was conducted considering a large sample size from studies with conflicting results on the R72P polymorphism in breast cancer patients. Relevant studies were selected from PubMed and SciELO databases for data extraction and statistical analysis. Database was built according to the continent and considering the genotype frequencies, sample size and genotyping methodology. The dominant models (RR vs RP + PP and RR + RP vs. PP), homozygous (RR vs. PP), heterozygous (RR vs. RP and RP vs. PP) and the allele (R vs. P) were used. Genotype frequencies were summarized and evaluated by χ2 test of heterogeneity in 2×2 contingency tables with 95% CIs. Odds Ratios (OR) were calculated with a fixed-effect model (Mantel-Haenszel) or a random-effect model (DerSimonian-Laird) if the studies were considered homogeneous (P > 0.05) or heterogeneous (P < 0.05), respectively, using BioEstat® 5.0 software. Supported by a large sample size composed by 25,629 cases and 26,633 controls from 41 studies, we found significant association between the R72P polymorphism in the TP53 gene and the breast cancer risk. The overall data shows an increased risk due to the P allele dominant model, but not in Asia where the risk was associated with the R allele and R dominant model.

Eficácia de estratégias educativas para ações preventivas da pneumonia associada à ventilação mecânica

El objetivo fue determinar la eficacia de la estrategia educativa para mejorar el desempeno del equipo de enfermeria en la realizacion de procedimientos de prevencion de neumonia asociada a la ventilacion mecanica. Se llevo a cabo un ensayo clinico controlado no aleatorio en 2011, en una Unidad de Cuidados Intensivos en Goiânia, Goias, con el equipo de enfermeria asignado en el grupo de intervencion (n = 24) y de comparacion (n = 11). Treinta dias despues del workshop (intervencion), los grupos fueron observados sistematicamente por medio de una lista de verificacion de la instalacion del ventilador, posicionamiento de la cabeza, cambio de la posicion, el uso del equipo de proteccion personal, la higiene bronquial y la verificacion por via oral de la presion del manguito y la instalacion de la alimentacion enteral. Cada procedimiento se utilizo como unidad de analisis y de resultados. La intervencion fue efectiva para la limpieza de la lengua (51%), la instalacion del ventilador (43%) y la correcta secuencia de succion tubo-nariz-boca, en la higiene bronquial (13%). Estudios en diferentes escenarios podrian confirmar la eficacia de la estrategia educativa (workshop), asi como identificar otras estrategias educativas para prevenir la neumonia asociada a la ventilacion mecanica.Resumen El objetivo fue determinar la eficacia de la estrategia educativa para mejorar el desempeño del equipo de enfermería en la realización de procedimientos de prevención de neumonía asociada a la ventilación mecánica. Se llevó a cabo un ensayo clínico controlado no aleatorio en 2011, en una Unidad de Cuidados Intensivos en Goiânia, Goiás, con el equipo de enfermería asignado en el grupo de intervención (n = 24) y de comparación (n = 11). Treinta días después del workshop (intervención), los grupos fueron observados sistemáticamente por médio de una lista de verificación de la instalación del ventilador, posicionamiento de la cabeza, cambio de la posición, el uso del equipo de protección personal, la higiene bronquial y la verificación por vía oral de la presión del manguito y la instalación de la alimentación enteral. Cada procedimiento se utilizó como unidad de análisis y de resultados. La intervención fue efectiva para la limpieza de la lengua (51%), la instalación del ventilador (43%) y la correcta secuencia de succión tubo-narizboca, en la higiene bronquial (13%). Estudios en diferentes escenarios podrían confirmar la eficacia de la estrategia educativa (workshop), así como identificar otras estrategias educativas para prevenir la neumonía asociada a la ventilación mecánica. Palabras clave: Neumonía Asociada al Ventilador. Educación continua. Enfermería. 1Mestre em Enfermagem. Enfermeira da Unidade de Terapia Intensiva do Hospital das Clínicas da Universidade Federal de Goiás. Goiânia-GO. Brasil. email: mestradofernanda@gmail.com; 2Doutora em Enfermagem. Professor Associado da Faculdade de Enfermagem da Universidade Federal de Goiás. Goiânia-GO. Brasil. e-mail: virginia@fen.ufg.br; 3Doutora em Epidemiologia. Professor Associado da Faculdade de Enfermagem da Universidade Federal de Goiás. Goiânia-GO. Brasil. e-mail: ruth@fen.ufg.br ; 4Mestre em Enfermagem. Enfermeiro da Unidade de Terapia Intensiva do Hospital das Clínicas da Universidade Federal de Goiás. Goiânia-GO. Brasil. E-mail: caixeta2@uol.com.br ; 5Doutora em Ciências da Saúde. Professor Associado da Faculdade de Enfermagem da Universidade Federal de Goiás. Goiânia-GO. Brasil. e-mail: lizete@fen.ufg.br ; 6Doutoranda em Enfermagem. Professor Assistente da Faculdade de Enfermagem da Universidade Federal de Goiás. Goiânia-GO. Brasil. e-mail: jackbl@uol.com.br PESQUISA RESEARCH INVESTIGACIÓN The objective of the study was to determine the efficacy of educational strategy to improve the performance of nursing staff in performing preventive procedures of ventilator-associated pneumonia. This randomized controlled clinical trial was conducted during 2011 in an intensive care unit in Goiânia, Brazil, with the nursing staff allocated in the intervention group (n=24) and comparison group (n=11). Thir ty days after workshops (intervention), the groups was systematically observed using a checklist including ventilator setting-up, angle for bed head elevation, patient decubitus position changing, use of personal protective equipment, bronchial and oral hygiene, verification of the cuff pressure and installation of enteral feeding. Each procedure was used as a unit of analysis and outcome. The intervention was effective for cleaning the tongue (51%), for the ventilator setting-up (43%) and for the correct order tubenose-mouth during bronchial hygiene (13%). Studies in different scenarios should confirm the efficacy of studied strategy (workshop), as well as identify additional educational strategies to prevent ventilator-associated pneumonia.

Letramento funcional em saúde e conhecimento de doentes renais em tratamento pré-dialítico

Objetivo: analisar o letramento funcional em saude (LFS) e o conhecimento sobre doenca renal cronica de 60 pacientes em tratamento pre-dialitico. Metodo: estudo transversal. O LFS foi mensurado pelo instrumento B-TOFHLA; e o conhecimento, por questionario. Foram realizados testes de correlacao de Pearson e Qui-quadrado e modelos de regressoes lineares. Resultados: todos entrevistados apresentaram LFS inadequado, e a maioria apresentou conhecimento insuficiente em relacao a doenca e ao tratamento. Menor escolaridade foi fator preditivo para piores escores de LFS. Conhecimento insuficiente foi relacionado a idade e ao comprometimento cognitivo. Conclusao: embora nao tenha sido encontrada associacao entre as variaveis preditivas, a limitada capacidade de obter e usar informacoes relacionadas a saude e o conhecimento insuficiente em relacao a propria doenca e tratamento podem contribuir para piores desfechos de DRC. Sao necessarias estrategias de intervencoes adequadas ao limitado LFS e maior conhecimento e habilidade dos profissionais para lidar com o assunto.Objective: to analyze the functional health literacy (FHL), i.e., understanding and knowledge about chronic renal disease of 60 patients in pre-dialytic treatment. Method: this is a cross-sectional study. FHL was measured by B-TOFHLA; and the knowledge, by questionnaire. Pearson correlation and Chi-square tests were carried out as well as linear regression models. Results: all respondents presented inadequate FHL, and most showed insufficient knowledge about the disease and treatment. Low schooling was a predictive factor for worst FHL scores. Insufficient knowledge was related to age and compromised cognition. Conclusion: although association between predictive variables has not been found, limited capability to obtain and use health-related information and insufficient knowledge about their own condition and treatment can contribute to worse outcomes for CKD. Appropriate intervention strategies are necessary to deal with limited FHL and also greater knowledge and ability of professionals to deal with the matter.

Efficacy of health education strategies for preventive interventions of ventilator-associated pneumonia

El objetivo fue determinar la eficacia de la estrategia educativa para mejorar el desempeno del equipo de enfermeria en la realizacion de procedimientos de prevencion de neumonia asociada a la ventilacion mecanica. Se llevo a cabo un ensayo clinico controlado no aleatorio en 2011, en una Unidad de Cuidados Intensivos en Goiânia, Goias, con el equipo de enfermeria asignado en el grupo de intervencion (n = 24) y de comparacion (n = 11). Treinta dias despues del workshop (intervencion), los grupos fueron observados sistematicamente por medio de una lista de verificacion de la instalacion del ventilador, posicionamiento de la cabeza, cambio de la posicion, el uso del equipo de proteccion personal, la higiene bronquial y la verificacion por via oral de la presion del manguito y la instalacion de la alimentacion enteral. Cada procedimiento se utilizo como unidad de analisis y de resultados. La intervencion fue efectiva para la limpieza de la lengua (51%), la instalacion del ventilador (43%) y la correcta secuencia de succion tubo-nariz-boca, en la higiene bronquial (13%). Estudios en diferentes escenarios podrian confirmar la eficacia de la estrategia educativa (workshop), asi como identificar otras estrategias educativas para prevenir la neumonia asociada a la ventilacion mecanica.Resumen El objetivo fue determinar la eficacia de la estrategia educativa para mejorar el desempeño del equipo de enfermería en la realización de procedimientos de prevención de neumonía asociada a la ventilación mecánica. Se llevó a cabo un ensayo clínico controlado no aleatorio en 2011, en una Unidad de Cuidados Intensivos en Goiânia, Goiás, con el equipo de enfermería asignado en el grupo de intervención (n = 24) y de comparación (n = 11). Treinta días después del workshop (intervención), los grupos fueron observados sistemáticamente por médio de una lista de verificación de la instalación del ventilador, posicionamiento de la cabeza, cambio de la posición, el uso del equipo de protección personal, la higiene bronquial y la verificación por vía oral de la presión del manguito y la instalación de la alimentación enteral. Cada procedimiento se utilizó como unidad de análisis y de resultados. La intervención fue efectiva para la limpieza de la lengua (51%), la instalación del ventilador (43%) y la correcta secuencia de succión tubo-narizboca, en la higiene bronquial (13%). Estudios en diferentes escenarios podrían confirmar la eficacia de la estrategia educativa (workshop), así como identificar otras estrategias educativas para prevenir la neumonía asociada a la ventilación mecánica. Palabras clave: Neumonía Asociada al Ventilador. Educación continua. Enfermería. 1Mestre em Enfermagem. Enfermeira da Unidade de Terapia Intensiva do Hospital das Clínicas da Universidade Federal de Goiás. Goiânia-GO. Brasil. email: mestradofernanda@gmail.com; 2Doutora em Enfermagem. Professor Associado da Faculdade de Enfermagem da Universidade Federal de Goiás. Goiânia-GO. Brasil. e-mail: virginia@fen.ufg.br; 3Doutora em Epidemiologia. Professor Associado da Faculdade de Enfermagem da Universidade Federal de Goiás. Goiânia-GO. Brasil. e-mail: ruth@fen.ufg.br ; 4Mestre em Enfermagem. Enfermeiro da Unidade de Terapia Intensiva do Hospital das Clínicas da Universidade Federal de Goiás. Goiânia-GO. Brasil. E-mail: caixeta2@uol.com.br ; 5Doutora em Ciências da Saúde. Professor Associado da Faculdade de Enfermagem da Universidade Federal de Goiás. Goiânia-GO. Brasil. e-mail: lizete@fen.ufg.br ; 6Doutoranda em Enfermagem. Professor Assistente da Faculdade de Enfermagem da Universidade Federal de Goiás. Goiânia-GO. Brasil. e-mail: jackbl@uol.com.br PESQUISA RESEARCH INVESTIGACIÓN The objective of the study was to determine the efficacy of educational strategy to improve the performance of nursing staff in performing preventive procedures of ventilator-associated pneumonia. This randomized controlled clinical trial was conducted during 2011 in an intensive care unit in Goiânia, Brazil, with the nursing staff allocated in the intervention group (n=24) and comparison group (n=11). Thir ty days after workshops (intervention), the groups was systematically observed using a checklist including ventilator setting-up, angle for bed head elevation, patient decubitus position changing, use of personal protective equipment, bronchial and oral hygiene, verification of the cuff pressure and installation of enteral feeding. Each procedure was used as a unit of analysis and outcome. The intervention was effective for cleaning the tongue (51%), for the ventilator setting-up (43%) and for the correct order tubenose-mouth during bronchial hygiene (13%). Studies in different scenarios should confirm the efficacy of studied strategy (workshop), as well as identify additional educational strategies to prevent ventilator-associated pneumonia.

CONHECIMENTO DOS ACADÊMICOS DE MEDICINA ACERCA DO HPV E DO CÂNCER DE COLO UTERINO

Human papillomavirus (HPV) is known to induce tissue lesions with oncogenic potential in epithelial tissues. Given the high global prevalence of HPV infection and associated neoplasia, we evaluated the knowledge of medical students about the characteristics of HPV and the effect of this virus infection in the general population’s health. The importance of assessing the knowledge of medical students about the HPV is based on the necessity of training medical doctors with experince on the subject in order to promote the prevention and control new HPV cancer related cases in the population. This is a descriptive study performed with medical students at the Pontifical Catholic University of Goias (Goiânia, Goias, Brazil), through the application of validated questionnaire that assessed the level of knowledge about HPV infection, HPV vaccine and cervical cancer, the primary tumor associated with the virus. The overall percentage of correct answers obtained from the students was 80%. By evaluating the average of responses along the development of each semester in the course. It was concluded that there was significant progression in the HPV knowledge.

Padrão de metástase no câncer de mama triplo negativo

Introduction: Triple negative breast cancers (TNBC) are clinically heterogeneous malignancies that do not present receptors of the estrogen, progesterone and HER2 (ERBB2 or NEU). TNBC are among the most aggressive and deadly breast cancer subtypes. Objective: The present study aimed to elucidate the metastatic pattern of TNBC and attempt to correlate it to age, histology, tumor grade, tumor size, and other clinicopathological variables. Methods: 140 clinical files of patients with breast cancer in Araújo Jorge Hospital in Goiânia (GO), during the period 1998-2010, were selected; among these, 75 cases (53.6%) with TNBC diagnosis were found. Results: The significant variables were tumor size (p=0.0497) and number of metastatic lymph nodes (p=0.002). During the period of five years of observation, metastatic disease occurred in over half of all patients (52.0%). The most common sites of recurrence were lung, bone, and brain. Conclusion: Our finds concluded that patients with TNBC feature a more aggressive type of tumor, requiring increased vigilance in the early years of follow-up. Trabalho realizado na Pontifícia Universidade Católica de Goiás (PUC-Goiás) – Goiânia (GO), Brasil. Departamento de Medicina da PUC-Goiás – Goiânia (GO), Brasil. Faculdade de Enfermagem da Universidade Federal de Goiás (UFG) – Goiânia (GO), Brasil. Programa de Pós-graduação em Ciências da Saúde da UFG – Goiânia (GO), Brasil. Laboratório de Oncogenética e Radiobiologia (DON), Laboratório de Transplante de Medula Óssea (TMO), Hospital Araújo Jorge (HAJ), Associação de Combate ao Câncer em Goiás (ACCG) – Goiânia (GO), Brasil. Programa de Pós-graduação em Ciências Ambientais e Saúde (MCAS) da PUC-Goiás – Goiânia (GO), Brasil. Endereço para correspondência: Antonio Márcio Teodoro Cordeiro Silva – Rua 227A, 72, apto. 301 – Setor Universitário – CEP: 74610-155 – Goiânia (GO), Brasil – E-mail: marciocmed@gmail.com Conflito de interesses: nada a declarar. Recebido em: 08/03/2016. Aceito em: 17/08/2016 DOI: 10.5327/Z201700010003RBM

Alfabetización funcional en salud y el conocimiento de los pacientes renales en prediálisis

Objetivo: analisar o letramento funcional em saude (LFS) e o conhecimento sobre doenca renal cronica de 60 pacientes em tratamento pre-dialitico. Metodo: estudo transversal. O LFS foi mensurado pelo instrumento B-TOFHLA; e o conhecimento, por questionario. Foram realizados testes de correlacao de Pearson e Qui-quadrado e modelos de regressoes lineares. Resultados: todos entrevistados apresentaram LFS inadequado, e a maioria apresentou conhecimento insuficiente em relacao a doenca e ao tratamento. Menor escolaridade foi fator preditivo para piores escores de LFS. Conhecimento insuficiente foi relacionado a idade e ao comprometimento cognitivo. Conclusao: embora nao tenha sido encontrada associacao entre as variaveis preditivas, a limitada capacidade de obter e usar informacoes relacionadas a saude e o conhecimento insuficiente em relacao a propria doenca e tratamento podem contribuir para piores desfechos de DRC. Sao necessarias estrategias de intervencoes adequadas ao limitado LFS e maior conhecimento e habilidade dos profissionais para lidar com o assunto.Objective: to analyze the functional health literacy (FHL), i.e., understanding and knowledge about chronic renal disease of 60 patients in pre-dialytic treatment. Method: this is a cross-sectional study. FHL was measured by B-TOFHLA; and the knowledge, by questionnaire. Pearson correlation and Chi-square tests were carried out as well as linear regression models. Results: all respondents presented inadequate FHL, and most showed insufficient knowledge about the disease and treatment. Low schooling was a predictive factor for worst FHL scores. Insufficient knowledge was related to age and compromised cognition. Conclusion: although association between predictive variables has not been found, limited capability to obtain and use health-related information and insufficient knowledge about their own condition and treatment can contribute to worse outcomes for CKD. Appropriate intervention strategies are necessary to deal with limited FHL and also greater knowledge and ability of professionals to deal with the matter.

Functional health literacy and knowledge of renal patients on pre-dialytic treatment

Objetivo: analisar o letramento funcional em saude (LFS) e o conhecimento sobre doenca renal cronica de 60 pacientes em tratamento pre-dialitico. Metodo: estudo transversal. O LFS foi mensurado pelo instrumento B-TOFHLA; e o conhecimento, por questionario. Foram realizados testes de correlacao de Pearson e Qui-quadrado e modelos de regressoes lineares. Resultados: todos entrevistados apresentaram LFS inadequado, e a maioria apresentou conhecimento insuficiente em relacao a doenca e ao tratamento. Menor escolaridade foi fator preditivo para piores escores de LFS. Conhecimento insuficiente foi relacionado a idade e ao comprometimento cognitivo. Conclusao: embora nao tenha sido encontrada associacao entre as variaveis preditivas, a limitada capacidade de obter e usar informacoes relacionadas a saude e o conhecimento insuficiente em relacao a propria doenca e tratamento podem contribuir para piores desfechos de DRC. Sao necessarias estrategias de intervencoes adequadas ao limitado LFS e maior conhecimento e habilidade dos profissionais para lidar com o assunto.Objective: to analyze the functional health literacy (FHL), i.e., understanding and knowledge about chronic renal disease of 60 patients in pre-dialytic treatment. Method: this is a cross-sectional study. FHL was measured by B-TOFHLA; and the knowledge, by questionnaire. Pearson correlation and Chi-square tests were carried out as well as linear regression models. Results: all respondents presented inadequate FHL, and most showed insufficient knowledge about the disease and treatment. Low schooling was a predictive factor for worst FHL scores. Insufficient knowledge was related to age and compromised cognition. Conclusion: although association between predictive variables has not been found, limited capability to obtain and use health-related information and insufficient knowledge about their own condition and treatment can contribute to worse outcomes for CKD. Appropriate intervention strategies are necessary to deal with limited FHL and also greater knowledge and ability of professionals to deal with the matter.

Comprehension of the education handout and health literacy of pacemaker users.

Objective To verify the comprehension of the education handout and the level of Functional Health Literacy of individuals with cardiac pacemaker (PM) and whether there is correlation between the comprehension and Functional Health Literacy (FHL). Method Cross-sectional study with 63 individuals with PM who answered to comprehension tests of the handout, literacy assessment (SAHLPA-50) and cognition (MMSE). Measurements of dispersion, Pearson correlation and multiple linear regression were calculated. Results Most women, study time ≤ 9 years, 66.21 (average age) presented no cognitive changes. An adequate literacy level was evidenced in 50.8% individuals with PM and satisfactory comprehension of the handout. No correlation was identified between FHL, handout comprehension, age, years of study and cognition. Conclusion The handout comprehension assessed by individuals with appropriate FHL indicated that it can be a printed material suitable for use, aiming to improve care process and knowledge of individuals with PM.

GSTM1 and GSTT1 genes null polymorphisms in kidney cancer susceptibility: evidence based on a meta-analysis

INTRODUCTION Renal cancer is a complex and multifactorial oncourologic disease. OBJECTIVE To conduct a meta-analysis in order to investigate the association of GSTM1 and GSTT1 genes null polymorphisms in renal cancer. METHOD Case-control studies in humans, published from 1999 to 2013, that investigated the association of GSTM1 and GSTT1 genes null polymorphisms in renal cancer were grouped in order to make of this meta-analysis. RESULTS Ten articles were selected on the subject proposed. No associations were found between polymorphisms of GSTM1-null (OR = 1.015, 95% CI = 0.897 to 1.147) and GSTT1-null (OR = 1.081, 95% CI = 0.791 to 1.479) and renal cancer. CONCLUSIONS Based on the results obtained, we conclude that the GSTM1 and GSTT1 null polymorphisms are not associated with the risk of developing renal cancer, since they have limited role, if there is any on effective contribution in the development of renal tumors.