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Renata dos Santos - Top 30 Publications

A diagnostic model for impending death in cancer patients: Preliminary report.

Several highly specific bedside physical signs associated with impending death within 3 days for patients with advanced cancer were recently identified. A diagnostic model for impending death based on these physical signs was developed and assessed.

Acute symptomatic complications among patients with advanced cancer admitted to acute palliative care units: A prospective observational study.

Limited information is available on the symptomatic complications that occur in the last days of life.

Bedside clinical signs associated with impending death in patients with advanced cancer: preliminary findings of a prospective, longitudinal cohort study.

Five highly specific physical signs associated with death within 3 days among cancer patients were recently reported that may aid in the diagnosis of impending death. In this study, the frequency and onset of another 52 bedside physical signs and their diagnostic performance for impending death were examined.

Frequency and factors associated with unexpected death in an acute palliative care unit: expect the unexpected.

Few studies have examined the frequency of unexpected death and its associated factors in a palliative care setting.

Symptom Expression in the Last Seven Days of Life Among Cancer Patients Admitted to Acute Palliative Care Units.

The symptom burden in the last week of life of patients with advanced cancer has not been well characterized.

Clinical signs of impending death in cancer patients.

The physical signs of impending death have not been well characterized in cancer patients. A better understanding of these signs may improve the ability of clinicians to diagnose impending death. We examined the frequency and onset of 10 bedside physical signs and their diagnostic performance for impending death.

Longitudinal temporal and probabilistic prediction of survival in a cohort of patients with advanced cancer.

Survival prognostication is important during the end of life. The accuracy of clinician prediction of survival (CPS) over time has not been well characterized.

Variations in vital signs in the last days of life in patients with advanced cancer.

Few studies have examined variation in vital signs in the last days of life.

Early correction of malocclusion using planas direct tracks.

The correction of functional posterior crossbite through Planas Direct Tracks has many characteristics that can become advantages. The aim of this study was to present a clinical case showing how to use this procedure for early correction with resources available through public health services. The patient, a 4-year-old girl, arrived to receive treatment due to a functional unilateral crossbite. When the mandible was moved to the centric position, it was observed that the teeth had occlusal trauma. An occlusal adjustment was performed. The adjustment was not sufficient to promote functional equilibrium; thus, Planas Direct Tracks were made, resulting in functional equilibrium and correction of the malocclusion. As shown in the case report, the Planas Direct Tracks were effective for the correction of the posterior crossbite. If malocclusion is considered a public health problem, implementation of low-cost and easy-to-execute techniques is needed.

Prevalence of malocclusion and related oral habits in 5- to 6-year-old children.

To verify the prevalence of malocclusion and the influence of harmful oral habits on deciduous dentition in 5- and 6-year-old children enrolled in Brazilian public elementary schools during 2010.

Impact of an educational and preventive program on practice of breastfeeding.

Treatment in vitro of retinal cells with IL-4 increases the survival of retinal ganglion cells: the involvement of BDNF.

Interleukin 4 (IL-4) is a pleiotropic cytokine involved in many functions during the development as well as in adult life. Previous work from our group demonstrated, in vitro, that this interleukin is able to prevent rat retinal ganglion cells death after axotomy. The aim of the present study was to investigate the signaling pathways involved in this trophic effect, particularly the cAMP pathway and also to demonstrate the expression of IL-4 in retinas at different stages of post natal development. Our results show that the trophic effect of IL-4 on rat retinal ganglion cells is dependent on the activation of Janus Kinase 3, Protein Kinase A, c-Jun N-terminal Kinase and Tropomyosin related Kinase receptors, on the increase in intracellular calcium levels, on polypeptide release and on the endogenous Brain Derived Neurotrophic Factor (BDNF). We also observed that treatment with IL-4 enhances c-AMP response element binding and Mitogen Activated Protein Kinase phosphorylation and increases the expression of BDNF. Concerning the IL-4 expression our data show an increase in IL-4 levels during post natal development. Taken together our results demonstrate that the trophic effect of IL-4 on retinal ganglion cells of newborn rats is mediated by cAMP pathway and BDNF release.

Pink shrimp (P. brasiliensis and P. paulensis) residue: influence of extraction method on carotenoid concentration.

The main residue from the shrimp processing is formed by head and carapace and represents from 40 to 50% (w/w) of the integral shrimp. The recovery of the carotenoid fraction from this residue stands for an alternative to increase its aggregated value. Therefore, the objective of this study was to use the pink shrimp waste as raw material to obtain carotenoid enriched extracts, evaluating different pre-treatments and extraction methods. The shrimp waste was supplied by a local public market (Florianópolis, SC, Brazil). The investigation of the different pre-treatments applied to the raw material shows that cooking associated with milling and drying produced the extract richest in carotenoid fraction. The extraction methods considered in this work were Soxhlet, maceration and ultrasound by means of different organic solvents and also a vegetable oil as solvent. The extracts were evaluated in terms of yield, carotenoid profile, total carotenoid content (TCC), UV-Visible scanning spectrophotometry and mid-Fourier transform infrared spectroscopy (FTIR). The results indicate that shrimp waste can provide carotenoid enriched extracts, particularly astaxanthin, in concentrations up to 252 μg(astaxanthin)g(extract)(-1). The most adequate solvents were acetone and hexane: isopropanol (50:50, v/v) used in the maceration procedure. The UV-Vis results revealed the presence of carotenoids and flavonoids in the extracts while the FTIR spectroscopy indicated the existence of fatty acids, proteins, and phenolics.

Inhibition of C6 rat glioma proliferation by Ru2Cl(Ibp)4 depends on changes in p21, p27, Bax/Bcl2 ratio and mitochondrial membrane potential.

The ruthenium compound [Ru(2)Cl(Ibp)(4)] (or RuIbp) has been reported to cause significantly greater inhibition of C6 glioma cell proliferation than the parent HIbp. The present study determined the effects of 0-72h exposure to RuIbp upon C6 cell cycle distribution, mitochondrial membrane potential, reactive species generation and mRNA and protein expression of E2F1, cyclin D1, c-myc, pRb, p21, p27, p53, Ku70, Ku80, Bax, Bcl2, cyclooxygenase 1 and 2 (COX1 and COX2). The most significant changes in mRNA and protein expression were seen for the cyclin-dependent kinase inhibitors p21 and p27 which were both increased (p<0.05). The marked decrease in mitochondrial membrane potential (p<0.01) and modest increase in apoptosis was accompanied by a decrease in anti-apoptotic Bcl2 expression and an increase in pro-apoptotic Bax expression (p<0.05). Interestingly, COX1 expression was increased in response to a significant loss of prostaglandin E(2) production (p<0.001), most likely due to the intracellular action of Ibp. Future studies will investigate the efficacy of this novel ruthenium-ibuprofen complex in human glioma cell lines in vitro and both rat and human glioma cells growing under orthotopic conditions in vivo.

Effects of somatosensory stimulation on motor function after subacute stroke.

Previous works showed potentially beneficial effects of a single session of peripheral nerve sensory stimulation (PSS) on motor function of a paretic hand in patients with subacute and chronic stroke.

Effects of somatosensory stimulation on motor function in chronic cortico-subcortical strokes.

Somatosensory stimulation enhances aspects of motor function in patients with chronic, predominantly subcortical infarcts. We investigated the effects of somatosensory stimulation on motor function in stroke patients with predominantly cortical involvement in the middle cerebral artery territory in a double-blind, pseudorandomized crossover trial. Motor performance was evaluated with the Jebsen-Taylor test before, after 2-hour somatosensory stimulation, and after subsequent motor training (n=11). In one experimental session, patients were submitted to median nerve stimulation (MNS) and in the other session, to control stimulation (CS). The order of the sessions was counterbalanced across patients. Improvement in performance in the Jebsen-Taylor test after somatosensory stimulation and after motor training was significantly greater in the MNS session than in the CS session. Additionally, patients who received MNS in the second session maintained the beneficial effects of training 30 days later. A single MNS session improves hand motor function in patients with chronic cortico-subcortical strokes and appears to favor consolidation of training effects. Somatosensory stimulation may be an adjuvant tool for stroke rehabilitation in patients with cortical lesions.