RESUMO
Se realizó una investigación documental sobre la educación de posgrado en Enfermería con el propósito de reflexionar sobre algunas premisas a considerar en el desarrollo de este proceso pedagógico como aspectos indispensables para elevar su calidad y pertinencia, a la vez que contribuye a su dirección científica. Consideramos a la educación de posgrado como un proceso continuo que se inicia una vez graduado de cualquier carrera universitaria y permite a este egresado alcanzar otros niveles de conocimiento y desempeño en correspondencia con los avances científico-técnicos, así como responder de manera eficaz a las demandas y exigencias profesionales y sociales. El trabajo tiene como eje central los requerimientos generales que la sociedad socialista plantea a la educación de posgrado, que en el caso de Enfermería, debe orientarse como un sistema de enseñanza cuyos propósitos deben considerar esencialmente los avances científico-técnicos en este y otros campos imprescindibles para el ejercicio profesional y su relación con la necesidad de producción social. Entre las ideas que se presentan como premisas se destacan: el completamiento, actualización, especialización o reorientación cíclica de los conocimientos de los egresados de la educación superior, en correspondencia con el desarrollo científico técnico; la formación y desarrollo de cuadros científicos del más alto nivel; profundizar en la concepción científica del mundo; lograr una alta efectividad en la aplicación, en la actividad laboral y en la vida social de los conocimientos, habilidades y hábitos adquiridos; así como la concepción integral que debe caracterizar a este proceso(AU)
Documentary research was conducted on graduate education in nursing in order to reflect on some assumptions to be considered in the development of the educational process as essential aspects to improve their quality and relevance, while contributing to its scientific management. We see graduate education as an ongoing process that begins upon graduation from any university and allows the graduate to reach other levels of knowledge and performance in correspondence with the scientific-technical progress and respond effectively to the demands and requirements professional and social. The work has at its core the general requirements of socialist society poses to postgraduate education, in the case of Nursing should be directed as a school system whose purpose should be considered essentially the scientific and technical advances in this and other fields necessary to professional practice and its relation to the need of social production. Among the ideas presented as premises are: the completion, updating, expertise or knowledge cyclic reorientation of graduates from higher education, in correspondence with the scientific and technical development, the formation and development of scientific cadres of the highest level ; deepen the scientific world, to achieve high efficiency in the application, in working and social life of knowledge, skills and habits acquired as well as an integrated concept that should characterize this process(AU)
Assuntos
Humanos , Educação de Pós-Graduação em Enfermagem/tendências , Educação de Pós-Graduação em Enfermagem/métodosRESUMO
PURPOSE: We show the result of a randomized phase II clinical trial with an epidermal growth factor (EGF)-based cancer vaccine in advanced non-small-cell lung cancer (NSCLC) patients, evaluating immunogenicity, safety, and effect on survival. PATIENTS AND METHODS: Eighty patients with stage IIIB/IV NSCLC after finishing first-line chemotherapy were randomly assigned to receive best supportive care or EGF vaccinations. RESULTS: Vaccination was safe. Adverse events were observed in less than 25% of cases and were grade 1 or 2 according to National Cancer Institute Common Toxicity Criteria. Good anti-EGF antibody response (GAR) was obtained in 51.3% of vaccinated patients and in none of the control group. Serum EGF concentration showed a major decrease in 64.3% of vaccinated patients. GAR patients survived significantly more than those with poor antibody response (PAR). Also, patients whose serum EGF dropped below 168 pg/mL survived significantly more than the rest. There was a trend to an increased survival for vaccinated patients compared with controls. The survival advantage for vaccinated patients compared with controls was statistically significant in the subgroup of patients with age younger than 60 years. CONCLUSION: Vaccination with EGF was safe and provoked an increase in anti-EGF antibody titers and a decrease in serum EGF. There was a direct correlation between antibody response and survival. There was a direct correlation between decrease in serum EGF and survival. In patients younger than 60 years, vaccination was associated with increased survival.
Assuntos
Vacinas Anticâncer/uso terapêutico , Carcinoma Pulmonar de Células não Pequenas/tratamento farmacológico , Carcinoma Pulmonar de Células não Pequenas/imunologia , Fator de Crescimento Epidérmico/uso terapêutico , Neoplasias Pulmonares/tratamento farmacológico , Neoplasias Pulmonares/imunologia , Adenocarcinoma/tratamento farmacológico , Adenocarcinoma/imunologia , Adulto , Idoso , Vacinas Anticâncer/efeitos adversos , Carcinoma de Células Grandes/tratamento farmacológico , Carcinoma de Células Grandes/imunologia , Carcinoma Pulmonar de Células não Pequenas/patologia , Carcinoma de Células Escamosas/tratamento farmacológico , Carcinoma de Células Escamosas/imunologia , Fator de Crescimento Epidérmico/efeitos adversos , Fator de Crescimento Epidérmico/imunologia , Receptores ErbB/metabolismo , Feminino , Humanos , Imunoterapia Ativa/métodos , Neoplasias Pulmonares/patologia , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Análise de Sobrevida , Resultado do TratamentoRESUMO
The extreme polymorphism found at some of the human leukocyte antigen (HLA) system loci makes it an invaluable tool for population genetic analyses. In the present study the genetic polymorphism of the Cuban population was estimated at HLA-A, -B, and -Cw loci by DNA typing. HLA class I allele and haplotype diversity were determined in 390 unrelated Cuban individuals (188 whites and 202 mulattos) from all over the country. In whites 19, 27, and 14 allele families for the HLA-A, -B, and -Cw loci, respectively, were identified. In mulattos, for the same loci, 20, 18, and 14 allele families were identified. Allele and haplotypes frequencies, comparisons with other worldwide populations based on genetic distances, neighbor-joining dendrograms, and correspondence analyses were estimated. Most of the identified allele groups and haplotypes are also common to sub-Saharan African and Europeans populations. However, Amerindian and Asian alleles were also detected at lower frequencies. The results clearly reveal the high diversity and interethnic admixture of the studied population. Our results provide useful information for the further studies of the Cuban population evolution and disease association in terms of HLA class I genes.
Assuntos
Antígenos de Histocompatibilidade Classe I/genética , Polimorfismo Genético , Alelos , Cuba , Frequência do Gene , Haplótipos , Humanos , FilogeniaRESUMO
Justificación: Los errores de la medicación en la quimioterapia o la medicación adyuvante que se utilice en cualquier etapa del proceso de utilización del medicamento: prescripción, trascripción, preparación, dispensación o administración son una causa frecuente de eventos adversos de los fármacos antineoplásicos. Métodos: La fuente principal de información la constituyeron las reuniones de análisis de la implementación del programa de garantía de calidad en oncología médica en el marco del servicio y la revisión de la literatura médica publicada desde 1995 hasta enero del 2006 aparecida en MEDLINE. La estrategia de búsqueda se condujo bajo los términos medication errors and chemotherapy. Un número adicional de búsquedas se realizaron bajo los términos: safety patient; antineoplastic drugs; preventing medication errors y se combinaron entre sí. Resultados: Se expone la experiencia del trabajo del servicio de oncología del Hospital Clinicoquirúrgico. Hermanos Ameijeiras en la implementación de una estrategia de trabajo en la prevención de errores en las fases del proceso de utilización del medicamento en oncología desde el año 2000 hasta la fecha; se han introducido como aspectos novedosos: hoja de tratamiento de quimioterapia, indicaciones estandarizadas en hojas preimpresas, tablas de diluciones de fármacos, nuevos sistemas organizativos de enfermería y hojas de reporte de toxicidad por el paciente....
Assuntos
Humanos , Protocolos de Quimioterapia Combinada Antineoplásica , Erros de MedicaçãoRESUMO
BACKGROUND: The angiotensin converting enzyme (ACE) is a key protein of the renin angiotensin system, whose main function is the conversion of angiotensin I to II. ACE is involved in the physiological control of blood pressure and it is a candidate gene for essential hypertension in humans. We tested the relevance of the ACE insertion/deletion (I/D) polymorphism in our population. METHODS: We recruited 243 hypertensive and 407 normotensive subjects in the city of Havana, matched according to age, sex and ethnic group. The ACE (I/D) polymorphism was determined by the polymerase chain reaction (PCR) technique. The fit of genotype frequencies to Hardy-Weinberg proportions was evaluated in all groups analyzed. The possible association between the ACE I/D polymorphism and hypertension status was tested by chi2 and odds ratio tests. RESULTS: All groups but black female cases were in Hardy-Weinberg equilibrium. The frequencies of the D allele in hypertensive/normotensive subjects were 0.61/0.59 in white males, 0.58/0.58 in white females, 0.47/0.59 in black males and 0.58/0.54 in black females. The distribution of ACE genotypes differed significantly between cases and controls only in black women according to the additive model (chi2p=0.04) but the adjusted OR did not show significant association (OR 1.14 95% CI 0.62 to 2.10). CONCLUSION: The ACE I/D polymorphism was not associated with hypertension in our multiethnic sample. While the chi2 test for additive model in black women suggested a marginal significance, the adjusted OR did not show any significant association.
Assuntos
Hipertensão/genética , Peptidil Dipeptidase A/genética , Polimorfismo Genético , Adulto , População Negra , Cuba , Feminino , Genótipo , Humanos , Hipertensão/etnologia , Masculino , Pessoa de Meia-Idade , População BrancaRESUMO
Celiac disease (CD) susceptibility has been strongly associated with HLA-DQ2 and HLA-DQ8. The main objective of this study was to assess the distribution of HLA DQA1*0501 and DQB1*02 alleles (DQ2) for the first time in a group of Cuban celiac patients. We evaluated 22 patients, 54 first-degree relatives, and 60 controls for detection of antitissue transglutaminase (tTG)-specific antibodies in serum. We found that 100% of the probands and 19% of the first-degree relatives were positive for the antibodies in serum. We did not detect any specific response for the healthy control individuals. We observed a significant over-representation of DQ2 heterodimer, both in patients and relatives. In the group of patients, 86.3% were positive for DQA1*0501, 90.2% were positive for DQB1*02, and 86.3% were positive for both alleles. The frequencies in relatives and controls were as follows: 70%, 90%, and 70%; and 56.6%, 45%, and 20%, respectively. In conclusion, we found that the proportion of our celiac patients carrying DQ2 was similar to the proportion of CD patients reported in populations with different genetic backgrounds. These results underline the primary importance of HLA-DQ alleles in susceptibility to celiac disease.
Assuntos
Doença Celíaca/genética , Predisposição Genética para Doença , Antígenos HLA-DQ/genética , Adolescente , Adulto , Criança , Pré-Escolar , Cuba , Feminino , Cadeias alfa de HLA-DQ , Cadeias beta de HLA-DQ , Humanos , MasculinoRESUMO
Los pacientes con alteraciones de la hemostasia constituyen un grupo de riesgo en la atención estomatológica cuando tienen que ser sometidos a procederes que presuponen sangramiento. La hemostasia está determinada por una serie de eventos complejos que evitan que se pierda sangre del torrente circulatorio, y la falla de cualquiera de estos mecanismos provocará salida de sangre de los vasos sanguíneos, máxime si el proceder estomatológico que se va a aplicar conlleva sangramiento de tejidos. Por tal motivo se debe solicitar un estudio del caso antes de proceder, con el fin de diagnosticar qué tipo de trastorno presenta el paciente e indicar tratamiento específico en su caso. Es propósito de este trabajo incursionar en aquellos trastornos de la hemostasia que involucran a las plaquetas y alargan el tiempo de sangramiento, así como abordar las deficiencias de factores de la coagulación que afectan este importante mecanismo; por otro lado, dada su importancia, abarcaremos los efectos antiinflamatorios no esteroideos (AINES) y anticoagulantes en pacientes que necesitan un tratamiento quirúrgico estomatológico, de manera que se facilite la labor del profesional de la salud que a diario se enfrenta con problemas de esta índole y dotarlo de un conocimiento valioso en cada uno de los aspectos tratados(AU)
Patients with hemostatic disorders are a risk group in dental care when they should undergo dental procedures that presupposes bleeding. Hemostasis is determined by a series of complex events that prevent the loss of blood, so, if any of these mechanisms fails, blood will come out of the blood vessels, especially if the dental procedure to be applied involves tissue bleeding. Before performing the procedure, one should request a study of the case to diagnose what type of disorder the patient might present with and give the specific treatment. This paper is aimed at studying those hemostatic disorders that involve platelets and extend the bleeding time and dealing with the coagulation factors defects affecting this important mechanism. On the other hand, we will address the effects of non-steroidal anti-inflammatory and anticoagulant agents in patients requiring a dental surgical treatment in order to facilitate the work of a health professional who daily faces problems of this kind and provide him with valuable knowledge on each of the analyzed issues(AU)