A Research Report submitted to the Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, in fulfilment of the requirement for the degree of Master of Science in Medicine in the branch of Plastic and Reconstructive Surgery / Introduction: Chronic wounds are commonly associated with biofilms and exaggerated inflammation resulting in non-healing: “Bioflammacides” are a recently described group of compounds used in the treatment of chronic and recalcitrant wounds.“Bioflammacides” target biofilms and inflammation aiding a change in the wound environment enabling cutaneous wound healing. Aim: This study aims to evaluate the effects of two targeted “active” topical dressings: a bioflammacide gel (Flavonix®), and a nanocrystalline silver sheet (Acticoat®), on the wound healing events in an in vivo rat chronic wound model. 
Methods: A chronic wound model was created in 128 Sprague-Dawley rats, modifying previously described methods by combining burn and excisional wounds. Wounds were inoculated with a bacteria broth (Pseudomonas
aeruginosa 
and
 Staphylococcus 
aureus) on POD 7; Flavonix®, Acticoat® 
and a negative control. An additional non-inoculated control group (no bacterial or other broth) was included. Eight animals were assigned to each group at each time point.The study was conducted over 21 days and the categorical variables assessed were epithelial gap, cellular proliferation at the wound edge at days 10,14 and 21 semi-quantitative culture for bacterial load at Days 10 and 21: Both Acticoat® and Flavonix®
showed improved wound healing compared to the control group. Epithelial gap distances were significantly different between the Acticoat® group and the negative control group at Day 21 (p
=
0.0350) (8mm
vs.
12.8mm).
Cellular profileration profiles were most modulated in the Flavonix®
treated group at Day 21 in iii comparison to the negative control group (p=0.013) (1.45
vs.
8.65). Bacterial load based on semi-quantitative culture showed significant differences in Pseudomonas aeruginosa counts at POS 21 with all treatment groups except Acticoat® but failed to show a significant change with the Staphylococcus aureus counts in any groups Conclusion: Flavonix® and Acticoat®
both demonstrated similar effects on wound healing events in our chronic wound model with significant differences being noted between the treated groups and negative controls n epithelial gap reduction and cellular proliferation profiles. Bacterial burden in the form of a mixed species biofilm was not convincingly altered by any of the treatment groups, but this did not alter the wound in its ability to close suggesting that inflammatory balance plays an important role as a common pathway in cutaneous healing

A research report submitted to the Faculty of Humanities University of the Witwatersrand, Johannesburg, in partial fulfilment of the requirements for the degree of Master of Arts (Drama Therapy), 2017 / The main intention of this paper is to share my experiences and discoveries explored through a theatre-making qualitative research process. In this manner, I created and directed my own autobiographical play as a means of revisiting and working through specific traumatic events in my past. The aim is to share how this helped heal the wounds of the past. In this paper, I have included my personal encounters, my observations and my reflections how Therapeutic Theatre and theatre-making methodologies were used in creating, in rehearsing and in the performance of the play to facilitate the healing of my traumatic past. The play, entitled Home Is Where Pap En Vleis Is, deals with a specific event believed to be the source of the trauma I have been dealing with. I used the play as a vehicle to journey into a dark forest to face my demons. As in Psychodrama, or in Robert Landy’s Role Method, the actor who played me took an auxiliary role while I, as the director, took the role of the helper. Together, we journeyed into the dark forest of my psyche to meet the ghosts needing to be laid to rest. Apart from seeking healing, as a training Drama Therapist, I also wanted to learn about the transformative potential of Therapeutic Theatre. As in the mythological Gilgamesh’s quest (Booker 2004:72) or as in the hero’s journey (Campbell 1968: 227), I wanted to come back with the boon. I needed to collect the “valuable prize”, by contributing to the development of Therapeutic Theatre in the South African context. Sharing the play with the audience was also a way of journeying with the larger community. / XL2018

A research report submitted Welma de Beer, student number 1296294, to Drama for Life, Wits School of Arts in partial fulfilment of the requirement of a Master of Arts in drama therapy degree by course work and research report. / This study gave expression to my initiatory journey into the last life-cycle of my life, as archetypally represented by the Crone (Prétat, 1994:7–11). It is a personal journey that engages with a specific research question: In what ways can Drama Therapy facilitate the contemplation and initiation of the “Crone” as life stage through self-revelatory performance? Two essential questions frame this study: How can Drama Therapy help us to create a process that contains the inherent destruction that forms part of transformation? If so, what would be the elements and methods that can help facilitate such a process? These questions will be investigated through a creative project, using the method of Performance as Research and the form of self-revelatory performance. The self-revelatory performance engaged with autobiographical moments from my own life and focussed on the theme of transformation. This research report seeks to extrapolate and evaluate the process for the purposes of defining the role and function of drama therapy as self-revelatory performance. The work of Rene Emunah (2009) on the self-revelatory play as a tool for Drama Therapy serves as foundation for this research. Other writings which influenced the study were the work of Victor Turner (Schechner,1993) on liminality, Richard Schechner (1976) on ritual and performance, anthropology of performance and environmental space, Kabi Thulo (2009) on shamanism, Willmar Sauter (2000) on the Theatrical Event and Jacob Moreno’s idea of the Encounter (Kristofferson, 2014). Key concepts that will be investigated are: Jung’s concept of transformation and how it expresses itself through rites of passage, initiation and ritual, myth and storytelling, the crone archetype and self-revelatory theatre. The study’s research findings were derived from the processes of devising, performance and post-performance “insights” which form a part of this creative project. Essentially, this study suggests possible processes that can be used effectively in drama therapy to create a “rite of passage”, “honouring” a new life stage that can “reprogram” or transform us. The study posits that transformation is contained and facilitated when we are able to self-reflect on our history, thoughts, beliefs and cultural coding. Self-revelatory playmaking can be a valuable tool in drama therapy which holds the potential to assist cathartic self-reflection in a safe space (Emunah, 1994:225). This study provides a qualitative description of the phenomena of self-revelatory v playmaking and performance and grapples with how it creates a “rite of passage” to facilitate the transitioning into the last phase of life. / GR2017

Purpose: To introduce the simplified therapeutic intervention scoring system (TISS-28), the original therapeutic intervention scoring system (TISS-76) and simplified acute physiological score (SAPS) version II in critically ill adult patients, in order to describe the validity and reliability of TISS-28 as a suitable measure of quantifying nursing workload in the adult intensive care units (ICU) of a public sector hospital in Johannesburg. Objectives: To describe the profile of patient admissions to the intensive care units, to investigate the impact of the patients’ profile on the requirements for nursing workload and to validate the use of TISS-28 as a measure of quantifying nursing workload in this setting. Design: A non-experimental, comparative descriptive, correlational and prospective two-staged design was utilized to meet the study objectives. Stage I involved face and content validation of TISS-28 by a panel of ICU nurse experts (n=6). Stage II involved assessment of concurrent and construct validity as well as inter-rater reliability of TISS-28 using participants (n=105) drawn from trauma, cardiothoracic and multidisciplinary ICUs. Data necessary for the calculation of TISS-28, TISS-76 and SAPS II were recorded for each patient in the ICU at 24 and 48 hours after admission and in the wards after discharge within 24-48 hours. Descriptive and inferential statistics were used to analyze data. Results: Content Validity Index (CVI) of 0.93 was found for TISS-28. A significant positive correlation was found between TISS-28 and TISS-76 scores (r = 0.7857, p = 0.0001) as well as TISS-28 and SAPS II scores (r = 0.2098, p = 0.0317). A significant difference was found between TISS-28 scores among patients in the ICU and patients in the ward (t = 25.59, p = 0.0001; t = 21.48, p = 0.0001) respectively. A significant correlation was found between the data collected from a sample of patients by the researcher and the expert assistant researcher with an intra-class correlation coefficient of 0.99 and a p-value of 0.0001. Conclusions: The findings support validity and reliability of TISS-28 hence its feasibility for use in South African ICUs. Recommendations for nursing education, practice, management and research are proposed.

Les anticorps monoclonaux (Acm) ont révolutionné la prise en charge de nombreuses maladies inflammatoires chroniques. L’administration par voie systémique des Acm ne semble pas optimale pour le traitement des maladies respiratoires. Ce travail a eu pour objectif d’étudier le comportement des anticorps après leur administration par voie pulmonaire. Le cetuximab, un anticorps anti-EGFR, a été étudié dans un modèle murin de tumeur pulmonaire bioluminescente et chez le macaque. Le G6-31, un anticorps anti-VEGF, a été étudié dans un modèle murin transgénique de tumeur pulmonaire spontanée. Les résultats montrent que les anticorps administrés par voie pulmonaire sont efficaces, persistent durablement dans le poumon et passent peu dans le compartiment sanguin. L’administration par voie pulmonaire d’Acm pourrait donc augmenter l’index thérapeutique de ces médicaments. Ces résultats ouvrent la voie pour l’administration par voie pulmonaire d’Acm dans les pathologies respiratoires en général. / Monoclonal antibodies (mAbs) modified profoundly the treatment of many chronic inflammatory diseases. Systemic administration of mAbs does not seem to be optimal for the treatment of respiratory diseases. This work aims at studying the fate of mAbs after pulmonary delivery. The lung delivery of Cetuximab, an anti-EGFR antibody, was assessed in an orthotopic mouse model of lung tumor and in macaques. G6-31, an anti-VEGF antibody, was studied in a transgenic murine model of spontaneous lung tumors. The results showed that mAbs, after pulmonary delivery, were pharmacologically effective, persisted durably into the lung and passed slowly into the bloodstream. Pulmonary delivery of mAbs might increase the therapeutic index of these drugs. Altogether, these results open the way for the pulmonary administration of mAbs in respiratory disorders

A olanzapina é um fármaco antipsicótico atípico utilizado no tratamento da esquizofrenia. Como efeitos adversos relacionados ao seu uso encontram-se obesidade, hiperlipidemia, diabetes mellitus tipo 2 e hipertensão, podendo acarretar no desenvolvimento de síndrome metabólica. O presente trabalho tem por objetivo realizar a monitorização terapêutica em pacientes na terapia com olanzapina, estabelecendo uma possível correlação entre a dose-concentração plasmática e a potenciação do risco a reações adversas, constituindo suporte clínico na eficácia do tratamento. A análise dos parâmetros antropométricos (peso, índice de massa corpóreo, circunferência do braço, circunferência do abdome, circunferência do quadril, prega cutânea triciptal, prega cutânea biciptal, prega cutânea subescapular, prega cutânea suprailíaca, resistência, porcentagem de massa gorda e taxa metabólica basal), parâmetros hemodinâmicos (pressão arterial sistólica, pressão arterial diastólica e freqüência cardíaca) e parâmetros bioquímicos (aspartato aminotranferase, alanina aminotransferase, gama glutamiltransferase, creatinina, ácido úrico, amilase, insulina, bilirrubinas, glicemia, cálcio, sódio e potássio), perfil lipídico (colesterol total, LDLcolesterol, HDL-colesterol e triglicérides), concentração de homocisteína e proteína C reativa, são relevantes na medida em que representam marcadores importantes de alterações relacionadas a desordens metabólicas ou de risco aterosclerótico. Como a obesidade e as coronariopatias podem induzir tais alterações, é importante avaliar qual o risco que o aumento de peso induzido pela olanzapina traz para o paciente esquizofrênico. A análise estatística foi realizada utilizando-se um modelo linear de efeito misto, apropriado para análise de medidas realizadas ao longo de um período pré-estabelecido. O nível de significância foi fixado em p<0,05. / The olanzapine is an atypical antipsychotic drug used to treat schizophrenia. How adverse effects related to its use, are obesity, hyperlipidemia, diabetes mellitus type II and hypertension, may result in the development of metabolic syndrome. This study aims to carry out monitoring therapy in patients in treatment with olanzapine, establishing a possible correlation between the dose-plasma concentration and potentiation of the risk to adverse reactions, providing clinical support in the effectiveness of treatment. Analysis of anthropometric parameters (weight, body mass index, arm circumference, circumference of the abdomen, the hip circumference, triceps skinfold thickness, biciptal skin fold, subscapular skin fold, skin fold suprailíaca, strength, percentage of fat mass and metabolic rate basal), hemodynamic parameters (systolic blood pressure, diastolic blood pressure and heart rate) and biochemical parameters (aspartate aminotranferase, alanine aminotransferase, gamma glutamyl transferase, creatinine, uric acid, amylase, insulin, total bilirubin, glucose, calcium, sodium and potassium ), lipid profile (total cholesterol, LDL-cholesterol, HDL-cholesterol and triglycerides), concentration of homocysteine and C-reactive protein, are relevant in so far represent important markers of changes related to metabolic disorders and atherosclerotic risk. As obesity and coronary diseases can induce such changes, which is important to evaluate the risk that the weight gain induced by olanzapine brings to the schizophrenic patient. Statistical analysis was performed using a mixed effect linear model, suitable for analysis of measurements taken over a pre-established. The significance level was set at p <0.05.

Essa pesquisa interroga a respeito do exercício da prática clínica quando seus fundamentos, conceitos e teorias próprios não estão referidos aos espaços tradicionais de tratamento, como é o caso da prática do Acompanhamento Terapêutico. Trata-se de um levantamento bibliográfico das articulações teórico-práticas realizadas pelos pesquisadores brasileiros que escreveram sobre o tema do AT e posteriormente um recorte específico dos trabalhos que se situam no campo da psicanálise, tendo a finalidade de reunir a produção teórica desta prática e analisá-la. A pesquisa se propõe a oferecer um panorama do campo mostrando como e em que momento histórico o AT surgiu, quais as elaborações teóricas embasaram seu fazer e como a psicanálise contribui para este trabalho. Como conseqüência a disponibilização do conjunto de material produzido neste campo pode contribuir na elaboração de uma posição ou um lugar teórico sobre o AT. O AT surgiu no campo da saúde mental no momento histórico conhecido como Reforma Psiquiátrica, visto que se caracteriza pela aproximação à loucura e por seus novos modos de tratamento. Por ter surgido neste espaço as teorizações no campo se enquadram, em sua maioria, nos enfoques da reabilitação psicossocial e da psicanálise. De acordo com o material bibliográfico pesquisado é possível afirmar que O AT seria definido por uma prática e não por uma abordagem teórica, já que a rigor, não há uma teorização acerca do AT, pois seus autores importaram conceitos de diferentes correntes com bases epistemológicas distintas. O AT pode ser sustentado teoricamente a partir dos preceitos que orientam a clínica psicanalítica com as psicoses, compreendido como uma oferta clínica que sustenta saídas e promove a circulação. É, assim, portanto que o AT propicia em ato uma aproximação e experimentação de laços sociais, ou seja, possibilidades de encontro com efeitos de real. Conclui-se que o AT não é uma prática psicanalítica, no entanto, ao ser desempenhado por um psicanalista, alguns lugares lhe são possíveis, podendo se prestar a ser suporte das identificações imaginárias, ser secretário do alienado até contribuir para a construção do sinthome, que se referem às posições que o AT pode se colocar na transferência / This research delves into the clinical practice when its foundations, concepts and theories do not refer to the traditional spaces of treatment, as is the case with the practice of Therapeutic Acompaniment . It deals with a bibliographical research of the theoreticalpractical articulation by Brazilian researchers who write about Therapeutic Acompaniment and subsequently with a specific section of the psychoanalysis work, with the goal of assembling the theoretical product of this practice and analyzing it. The research intends to offer a view of the field showing how and at what point in history Therapeutic Acompaniment came to be, what theoretical elaborations founded its application and how psychoanalysis contributes to this work. As a consequence, the availability of the set of materials produced in this filed may contribute to the elaboration of a position or a theoretical space regarding Therapeutic Acompaniment. Therapeutic Acompaniment emerged in the mental health field at a historic moment known as the Psychiatric Reform, given that it is characterized by its affinity to insanity and by its new treatment methods. Having arised in this space, most theorizations in the field conform to the focus on psychosocial rehabilitation and psychoanalysis. According to the bibliographical material researched, it is possible to state that Therapeutic Acompaniment would be defined by a practice and not by a theoretical approach, since, strictly, there is no theorization regarding Therapeutic Acompaniment, since its authors imported concepts from different trends, with different epistemological bases. Therapeutic Acompaniment can be theoretically support from the precepts that guide the psychoanalytic clinic of psychosis, understood as a clinical practice that sustains egress and promotes circulation. Therefore Therapeutic Acompaniment provides an approximation and experimentation of social links, that is, possibilities of encounters with effects of the real. In conclusion, although Therapeutic Acompaniment is not a psychoanalytical practice, when it is used by a psychoanalyst it may find its space; it may provide support for imaginary identifications, function as secretary of the insane, and contribute to the construction of the sinthome, spaces which refer to the positions Therapeutic Acompaniment may assume during transference

A pesquisa promove uma investigação teórica sobre a terapêutica da psicanálise lacaniana, que visa oferecer aos profissionais da área de saúde uma possibilidade de compreensão sobre a especificidade dessa terapêutica, em contraposição aos modelos psicoterapêuticos também empregados no campo da Atenção à Saúde Mental. Nesse sentido, abordaremos os temas terapêutica, ética da psicanálise e as diferenças entre o método psicanalítico e as psicoterapias, tomando como referencial de problematização a obra de Jacques Lacan e trabalhos de comentadores, seja sob a forma de livros ou de artigos científicos. O princípio metodológico utilizado foi a Pesquisa Bibliográfica, ao passo que para análise dos dados foi escolhida a Análise Qualitativa Bibliográfica. A partir da investigação, verificamos a existência de diferenças importantes entre as propostas terapêuticas da psicanálise e da psicoterapia, as quais devem ser consideradas na escolha de um tratamento. Observamos, ainda, que a psicanálise lacaniana apresenta uma concepção de terapêutica - que deve ser analisada a partir de seu próprio campo - e que não focaliza a adaptação ou a eliminação de sintomas, como ocorre na psicoterapia. De forma diferente, ela promove efeitos terapêuticos, mas os transcende na direção de mudanças na posição subjetiva do sujeito, na relação com a alteridade e na postura ética de responsabilidade perante ao seu desejo / The research promotes a theoretical investigation on the therapeutics of Lacanian psychoanalysis in order to offer health professionals an understanding of the specificity of this treatment as opposed to psychotherapy models also employed in the field of Mental Health. In this sense, we shall discuss on therapeutics, the psychoanalysis ethics and the differences between the psychoanalytic method and psychotherapies, taking as questioning reference the work of Jacques Lacan and his commentators, either in the form of books or scientific articles. The methodological principle used it was the bibliographical research and for data analysis, it was chosen the Bibliographical Qualitative Analysis. From the research, we observed that there are important differences between the therapeutic approaches of psychoanalysis and psychotherapy that should be considered when choosing a treatment. We noted that Lacanian psychoanalysis presents a therapeutic design - which should be analyzed from its own field - that does not focus on adaptation or elimination of symptoms, as in psychotherapy. Differently, it promotes therapeutic effects, but transcends them towards changes in the subjective position of the subject, in relation to otherness and ethical responsibility of its desire

A dor é um dos sintomas que mais comprometem a produtividade, o bem estar e a qualidade de vida das pessoas, sobretudo dos idosos. Com o crescimento da utilização de Terapias Complementares para o seu tratamento surge a necessidade da realização de pesquisas que forneçam evidências sobre sua indicação e efetividade. Considerando a ampla utilização do Toque Terapêutico (TT) no tratamento complementar da dor decorrente de diversas condições clínicas e as críticas metodológicas aos resultados encontrados pelos autores, esta pesquisa buscou responder ao seguinte questionamento: Quais os efeitos do Toque Terapêutico sobre a dor inflamatória? Para tanto foi realizado um experimento utilizando o modelo de edema de pata induzido por Adjuvante Completo de Freund (CFA) em camundongos machos. A ação anti-inflamatória do TT foi verificada por meio de variação na dor, edema e migração de neutrófilos, antes e após a intervenção, aplicada durante 15 minutos, uma vez ao dia, por quatro dias. Os resultados apontaram aumento significativo no limiar nociceptivo mecânico e aumento na área do edema nas patas dos animais tratados com TT, no segundo dia de aplicação (p ? 0,05). A redução observada na migração de neutrófilos não foi estatisticamente significativa. Concluímos que a redução na dor corrobora os dados obtidos em estudos com seres humanos, com controle do efeito placebo. O modelo de edema de pata induzido por CFA é adequado à investigação experimental dos efeitos do TT sobre a dor inflamatória. Sugerimos a realização de novos experimentos para a elucidação dos mecanismos fisiológicos de ação envolvidos nos achados, sobretudo em decorrência do aumento do edema no grupo tratado com TT. / Pain is one of the symptoms that most endanger productivity, welfare and life quality of people, especially the elderly. With the increasing use of Complementary Therapies for its treatment there is the need to conduct studies that provide evidence about its indication and effectiveness. Considering the wide use of Therapeutic Touch (TT) in the adjunctive treatment of pain as a result of various clinical conditions and the methodological criticisms of the authors\' results, this research seeks to answer the following question: What are the effects of the Therapeutic Touch on inflammatory pain? For such, it was conducted an experiment using the model of paw edema induced by Freund\'s Complete Adjuvant (FCA) in male mice. The anti-inflammatory action of TT was verified by means of variation in pain, edema and neutrophilic migration, before and after the intervention, it was applied for 15 minutes once a day for four days. The results showed a significant increase in mechanical nociceptive threshold and an increase in the edema area in the paws of animals treated with TT, in the second day of treatment (p < 0.05). The observed reduction of neutrophilic migration was not statistically significant. It was concluded that the reduction in pain corroborates the data obtained in human studies, with control of the placebo effect. The model of paw edema induced by FCA is suitable for experimental investigation of the effects of TT on inflammatory pain. It is suggested further experiments to elucidate the physiological mechanisms of action underlying the findings, mainly due to the increase of edema in the group treated with TT.

O câncer cervical representa a terceira causa de morte por câncer em mulheres e está associado a infecções persistentes pelo Vírus do Papiloma Humano (HPV) em mais de 99% dos casos. Evidências sólidas mostram que a expansão de Células Mielóides Supressoras (MDSC) e fatores solúveis como a interleucina IL-10 são importantes mediadores da evasão tumoral à resposta imunológica contra tumores, que limita a eficácia de imunoterapias. Dada a importância epidemiológica dos tumores induzidos por HPV e a necessidade eminente do desenvolvimento de imunoterapias ativas contra essas lesões, desenvolvemos durante os últimos 12 anos, uma estratégia vacinal terapêutica baseada em DNA. Esta vacina codifica a proteína E7 do HPV-16 fusionada à glicoproteína D (gD) do Vírus Herpes Simplex do tipo 1 (HSV-1), denominada pgDE7h. O presente trabalho propôs a investigação de estratégias que restringem a imunossupressão, baseadas em um plasmídeo que codifica o receptor solúvel da citocina IL-10 (pIL10R) e da quimioterapia com gencitabina, na potencialização da vacina pgDE7h para controlar o crescimento de tumores que expressam as proteínas E6 e E7 do HPV-16 em modelo murino (células TC-1). Foi possível observar um atraso no crescimento do tumoral a partir da combinação da vacina com o pIL-10R. Adicionalmente, a utilização da eletroporação como método de entrega dos plasmídeos aumentou a proteção terapêutica para 90% e 60% quando os animais foram imunizados 5 ou 14 dias após o desafio, respectivamente. A combinação dos plasmídeos foi ainda capaz de elevar o número de linfócitos T CD8+ E7-específicos ativados, encontrados sistemicamente e no sítio tumoral. No consócio da imunização com a pgDE7h à gencitabina, foi possível observar um efeito sinérgico dessa associação, que aumentou a proteção antitumoral de 20% para 100% de animais livres de tumor, concomitante ao controle da expansão de populações imunossupressoras no baço. Além disso, a quimioimunoterapia administrada até 14 dias após o desafio com as células tumorais mostrou-se protetora em modelo de recidivas, simuladas por meio de transplantes subsequentes de células tumorais. Na busca de um protocolo vacinal com maior viabilidade clínica, combinamos a coadministração dos plasmídeos pgDE7h e pIL- 10R com o tratamento com gencitabina. Esta combinação terapêutica mostrou-se mais eficiente, onde se observou um aumento robusto da ativação de linfócitos T CD8+ E7-espefíficos, com regressão completa de tumores pré-estabelecidos. Em suma, esses resultados evidenciam que a associação de abordagens terapêuticas pode superar barreiras imunológicas presentes no ambiente tumoral e aumentar as chances de sucesso clínico do tratamento proposto. / Cervical cancer represents the third cause of cancer death among women, which is associated with persistent Human Papilloma Virus (HPV) infection in more than 99% of cases. Solid evidences show that the expansion of Myeloid-derived Suppressor Cells (MDSC) and soluble factors, such as IL-10, are important mediators of immune evasion mechanisms expressed by tumor cells, that limits the efficacy of immunotherapeutic approaches. Given the epidemiological importance of HPVinduced tumors and the crucial importance of developing active immunotherapies against neoplasias, during the past 12 years, we have been developing a DNA-based therapeutic vaccine strategy encoding the HPV-16 E7 protein fused to the Herpes Simplex Virus type 1 (HSV-1) glycoprotein D (gD), named pgDE7h. This work aimed to investigate the potential role of immunossupression restriction using a plasmid encoding the soluble IL-10 receptor (pIL10R) and the chemotherapeutic drug gemcitabine to enhance in enhancing the pgDE7h vaccine potency in the control of tumors expressing HPV-16 E6 and E7 proteins in a murine model (TC-1 cells). It was possible to observe a tumor growth delay after combining the vaccine with pIL-10R. Additionally, the use of electroporation as a plasmid delivery method provided a therapeutic protection of 90% and 60% when the animals were immunized 5 or 14 days after challenge, respectively. The combination of plasmids was also capable to increase substantially the numbers of activatedE7-specific CD8+ T lymphocytes both systemically and at the tumor site. When pgDE7h immunization was combined to chemotherapy, we observed a synergistic effect, which increased the antitumor protection from 20% to 100% and promoted the control of immunosuppressive cell populations in the spleen. It was possible to maintain the high antitumour protective effects of the chemo-immunotherapy when the animals were immunized 14 days after tumor cell challenge and tumor relapses after subsequent challenges with tumor cells. To search a vaccine protocol with greater applicability in a clinical setting, we combined co-administration of pgDE7h and pIL-10R and gemcitabine treatment. Our data showed that the combined treatment induced a robust increase in the activation of CD8+ T lymphocytes and a complete regression of pre-established tumors. All together, these results show that the combination of therapeutic approaches can overcome immunological barriers present in the tumor environment and increase the chances of clinical success of the propose therapeutic treatment.