Increased expression of protease-activated receptor 1 (PAR-1) in human leukemias

Protease-activated receptor 1 (PAR-1) is a G-protein-coupled receptor that is overexpressed in solid tumors, being associated with several pro-tumoral responses including primary growth, invasion, metastasis and angiogenesis. Expression of PAR-1 in human leukemic cell lines is reported but the status of its expression in human leukemic patients is currently unknown. In this study we evaluated the expression pattern of PAR-1 in patients with the four main types of leukemia - chronic lymphocytic leukemia subtype B (B-CLL), acute lymphoblastic leukemia subtype B (B-ALL), acute myeloid leukemia (AML) and chronic myeloid leukemia (CML). Flow cytometry analyses show that lymphocytes from B-CLL patients express this receptor at similar levels to healthy individuals. On the other hand, it was observed a significant increase in PAR-1 expression in B-ALL lymphocytes as compared to B-CLL and healthy donors. Flow cytometric and real-time PCR demonstrated a significant increase in PAR-1 expression in granulocytes from CML patients in blast phase (CML-BP) but not in chronic phase (CML-CP) as compared to healthy donors. Finally, a significant increase in PAR-1 expression has been also observed in blasts from AML (subtypes M4 and M5) patients, as compared to monocytes or granulocytes from healthy donors. We conclude that PAR-1 might play an important biological role in aggressive leukemias and might offer additional strategies for the development of new therapies.     

Randomized clinical efficacy of superficial peeling with 85% lactic acid versus 70% glycolic acid

BACKGROUND:

Peeling is a procedure which aims to accelerate the process of skin exfoliation.

OBJECTIVES

Development of formulations containing lactic acid at 85% or glycolic acid at 70% and the evaluation of these formulations on clinical efficacy in reduction of fine wrinkles.

METHODS

Preliminary stability tests were carried out and an in vivo study was performed with three groups with 9 representatives each. One was the control group, which used only sunscreen; another one used lactic acid+sunscreen, and the last group used acid glycolic+sunscreen. Clinical efficacy was assessed with a CCD color microscope, through the digitization of images before and after treatment. The applications were carried out by a dermatologist, once a mont h every 30 days, during 3 months. The area with wrinkles was calculated by planimetry point counting, in accordance with Mandarin-de-Lacerda.

RESULTS

The formulations were stable in the visual and Ph evaluation. There was no improvement in the control group; for lactic acid, there was significant improvement after the second peeling application on the outer lateral area of the right eye and after the third application on the outer lateral area of the left eye. For the glycolic acid group, there was significant improvement in the outer lateral area of the left eye after the first application, and of the right eye region, after three applications. The formulations used must be kept under refrigeration and should be manipulated every 30 days.

CONCLUSIONS

Both peelings were effective in reducing fine wrinkles of the outer lateral eye area after three applications (p≤0.05%). It was observed that peeling efficacy in the external-lateral region of one eye might be different compared with that in skin of the external-lateral region of the other eye, relative to the speed of skin improvement.     

Physical Activity Is Associated with Malignant and Benign Breast Diseases in Low-Income Brazilian Women

We compared the relationships among percentage of body fat (%BF) and physical activity with breast cancer (BC) and benign breast diseases (BBD) in low-income Brazilian women. A case-control study including 106 incident BC cases, 178 incident BBD cases, and 181 control women recruited from a public hospital-based screening center was conducted. Logistic regression models showed that sedentary women have a higher odds of developing BC in the age adjusted model [odds ratio (OR) = 2.39, 95% confidence interval (CI) 1.43–3.99]. After adjusting for hormonal-related risk factors and family history of breast cancer (OR = 2.94, 95%CI 1.50–5.79) and also for the %BF (OR = 2.71, 95%CI 1.36–5.37) the odds remained high. Independent of the adjustments made, %BF did not affect the odds for developing BC. When the same models were tested for women with BBD, we found a significant association with sedentary lifestyle in all models tested, with an OR = 3.03 (95%CI 1.69–5.42) in the fully adjusted model. In the same way, in the fully adjusted model %BF was significantly associated to risk for BBD (OR = 0.54, 95%CI 0.30–0.98). Similar to results found in other populations, our data suggest that physical activity is an important, independent protective factor for the risk of developing BC and BBD in low-income women from an admixed population.     

Predictors and a Framework for Fostering Community Advocacy as a Community Health Worker Core Function to Eliminate Health Disparities

Objectives. Using a mixed-method, participatory research approach, we investigated factors related to community health worker (CHW) community advocacy that affect social determinants of health.Methods. We used cross-sectional survey data for 371 CHWs to assess demographics, training, work environment, and leadership qualities on civic, political, and organizational advocacy. We present advocacy stories to further articulate CHW activities. The data reported are from the recently completed National Community Health Workers Advocacy Study.Results. CHWs are involved in advocacy that is community-focused, although advocacy differs by intrinsic leadership, experience, training, and work environment. We propose a framework to conceptualize, support, and evaluate CHW advocacy and the iterative processes they engage in. These processes create opportunities for community voice and action to affect social and structural conditions that are known to have wide-ranging health effects on communities.Conclusions. The framework presented may have utility for CHWs, their training programs, and their employers as well as funders and policymakers aiming to promote health equity.Community health workers (CHWs) are essential to effective and comprehensive health systems throughout the world.1,2 In the United States, CHWs have been recognized as integral to providing patient-centered care and reducing health inequalities among disenfranchised groups.3 The workforce impact of CHWs is far-reaching in the realms of the prevention and control of chronic and infectious disease,4–13 the reduction of health care costs,14–16 and improved outreach, communication, and adherence,17–20 as well as in connecting clients to existing services.21 The recognition of the CHW model has resulted in increased integration of CHWs into the health delivery system. Although beneficial in terms of health care delivery, the institutionalization of the role of CHWs within systems of care may result in the devaluation of another CHW core function, that of building community capacity to address the social determinants of health (SDH) through advocacy and organizing.22–24 Studies have documented the influence of CHWs on the quality of the health care delivery system25,26 and on community-engaged strategies to address public housing27 and decrease community violence.28Balcazar et al.21 underscore the importance of maintaining the full spectrum of CHW roles within a changing health care delivery system, which includes not only influencing how care is delivered but also addressing power relationships that underlie the SDH. The World Health Organization’s Commission for Social Determinants of Health recently revised their conceptualization of SDH to include structural determinants of health, which are defined as macroeconomic and social policies related to labor, housing, and land and public policies concerning health, education, and social protection.29 Such structural determinants have been recognized as powerful predictors of health status.30 In responding to specific disease areas, CHWs report the need for a broad range of skills to effectively address the complex issues that they confront working with individuals and communities.31,32We document the findings of a mixed quantitative–qualitative national survey investigating CHW involvement in community-level advocacy, defined as working for a cause or a change to improve the health of a community. We propose a framework to conceptualize, support, and measure the intrinsic, training, and work environment characteristics associated with CHW community advocacy. The framework also describes the iterative process in which CHWs, by creating opportunities for community voice and action, positively affect social and structural conditions that determine the health of a community.     

C-reactive protein and hormones but not IL-6 are associated to body mass index in first trimester of pregnancy

Objective  

To investigate if body mass index (BMI) is related to inflammatory markers and hormones in early pregnancy.     

Prevalence of Lyme meningitis in children with aseptic meningitis in a Lyme disease-endemic region

This study determined the prevalence of Lyme meningitis in children with undifferentiated aseptic meningitis from April to December in a Lyme disease-endemic region. Of the 60 children, 8 were seropositive (prevalence 13.3%; 95% confidence interval: 6.3-25.1%), with another probable case having high cerebrospinal fluid antibody titers. Clinicians in endemic regions should evaluate children with undifferentiated aseptic meningitis for Lyme meningitis in appropriate seasons.     

The help-seeking by women with urinary incontinence in Brazil

Introduction and hypothesis  

Lower tract urinary symptoms are underestimated by women as well as health professionals. The objective of this study was to evaluate the behavior of adult women with urinary incontinence and overactive bladder symptoms in seeking medical treatment.