A dor e a incapacidade funcional decorrente do comprometimento da coluna vertebral por metástases impactam de forma significativa na qualidade de vida de qualquer paciente. Como forma de amenizar os sintomas, dois grandes grupos de tratamento são possíveis na atualidade: cirurgia e/ou radioterapia. O objetivo principal deste estudo foi avaliar o impacto da cirurgia de descompressão medular na Qualidade de Vida Relacionada à Saúde de pacientes acometidos por metástase em algum nível da coluna vertebral. Trata-se de um estudo quantitativo, descritivo, correlacional e de corte longitudinal do tipo prospectivo que englobará quatro avaliações: antes da cirurgia (T0), dois (T1), quatro (T2) e seis (T3) meses após o procedimento cirúrgico. As entrevistas individuais foram realizadas pela pesquisadora no serviço de internação no momento anterior à cirurgia e no ambulatório nos três momentos subsequentes acima descritos. Os instrumentos utilizados para coleta de dados foram: questionário estruturado para caracterização sociodemográfica e clínica da amostra; Escala de Dor de Faces Revisada (FPS-R); questionário de avalição da Qualidade de Vida Relacionada à Saúde (EORTC QLQ-C30). Realizou-se comparação dos resultados do pré-operatório (T0) com os momentos T1, T2 e T3. A amostra foi constituída por 22 pacientes, com idade média de 56 anos, sem diferenças quanto à prevalência relacionada ao sexo, todos com baixa escolaridade e com renda mensal média de aproximadamente um salário mínimo. Os tumores primários mais prevalentes por ordem de frequência foram: mama, próstata, pulmão e colorretal. A abordagem cirúrgica mais utilizada foi a vertebral posterior (63,6%), sendo o segmento lombar (36,4%) o mais acometido. No período pré-operatório (T0), os participantes apresentaram baixo escore para Estado de Saúde Global/Qualidade de Vida e para quase todos os domínios da Escala Funcional e Escala de Sintomas. Nos três momentos distintos (T1, T2 e T3) comparados em relação ao pré-operatório (T0), houve melhora estatisticamente significativa no desempenho de papel, na presença de dor, insônia e constipação intestinal dos pacientes. Não houve diferença significativa nas atividades de vida diária em nenhum dos três períodos analisados após a cirurgia, sempre levando-se em consideração a fase pré-operatória (T0) como padrão / Pain and functional disability resulting from the impairment of spinal metastasis impact significantly on Quality of Life of any patient. To reduce the symptoms, two groups of treatment are possible nowadays: surgery and/or radiotherapy. The aim of this study was to evaluate the impact of spinal decompressive surgery on Health-Related Quality of Life (HRQoL) of patients affected by metastasis at some level of the spine. It is a prospective, quantitative, descriptive correlational and longitudinal study that comprises four ratings: before surgery (T0), two (T1), four (T2) and six (T3) months after surgical procedure. The researcher held individual interviews at the hospital service prior to surgery and at the ambulatory within three moments described above. The following data collection instruments were used: structured questionnaire for sociodemographic and clinical sample characteristics; Faces Pain Scale Revised (FPS-R); questionnaire of Health-Related Quality of Life (EORTC QLQ-C30). It was performed comparison the preoperative (T0) results with times T1, T2 and T3. The sample consisted of 22 patients with a mean age of 56 years without differences in prevalence related to sex, all with low education and with average monthly income of approximately one basic wage. The most prevalent primary tumors were in order of frequency: breast, prostate, lung and colorectal. The most used surgical approach was the posterior vertebral (63,6%) in which the lumbar segment (36,4%) was the most affected. In the preoperative period (T0), participants presented low score for State of Global Health/Quality of Life and for most areas of Functional Scale and Symptoms Scale. In three different times (T1, T2 and T3) compared regarding the preoperative period (T0), there was a statistically significant improvement in the performance status, presence of pain, insomnia and constipation of patients. There was no significant difference in daily activities in any of the three periods analyzed after surgery, always taking into account the preoperative phase (T0) as standard

A dor e a incapacidade funcional decorrente do comprometimento da coluna vertebral por metástases impactam de forma significativa na qualidade de vida de qualquer paciente. Como forma de amenizar os sintomas, dois grandes grupos de tratamento são possíveis na atualidade: cirurgia e/ou radioterapia. O objetivo principal deste estudo foi avaliar o impacto da cirurgia de descompressão medular na Qualidade de Vida Relacionada à Saúde de pacientes acometidos por metástase em algum nível da coluna vertebral. Trata-se de um estudo quantitativo, descritivo, correlacional e de corte longitudinal do tipo prospectivo que englobará quatro avaliações: antes da cirurgia (T0), dois (T1), quatro (T2) e seis (T3) meses após o procedimento cirúrgico. As entrevistas individuais foram realizadas pela pesquisadora no serviço de internação no momento anterior à cirurgia e no ambulatório nos três momentos subsequentes acima descritos. Os instrumentos utilizados para coleta de dados foram: questionário estruturado para caracterização sociodemográfica e clínica da amostra; Escala de Dor de Faces Revisada (FPS-R); questionário de avalição da Qualidade de Vida Relacionada à Saúde (EORTC QLQ-C30). Realizou-se comparação dos resultados do pré-operatório (T0) com os momentos T1, T2 e T3. A amostra foi constituída por 22 pacientes, com idade média de 56 anos, sem diferenças quanto à prevalência relacionada ao sexo, todos com baixa escolaridade e com renda mensal média de aproximadamente um salário mínimo. Os tumores primários mais prevalentes por ordem de frequência foram: mama, próstata, pulmão e colorretal. A abordagem cirúrgica mais utilizada foi a vertebral posterior (63,6%), sendo o segmento lombar (36,4%) o mais acometido. No período pré-operatório (T0), os participantes apresentaram baixo escore para Estado de Saúde Global/Qualidade de Vida e para quase todos os domínios da Escala Funcional e Escala de Sintomas. Nos três momentos distintos (T1, T2 e T3) comparados em relação ao pré-operatório (T0), houve melhora estatisticamente significativa no desempenho de papel, na presença de dor, insônia e constipação intestinal dos pacientes. Não houve diferença significativa nas atividades de vida diária em nenhum dos três períodos analisados após a cirurgia, sempre levando-se em consideração a fase pré-operatória (T0) como padrão / Pain and functional disability resulting from the impairment of spinal metastasis impact significantly on Quality of Life of any patient. To reduce the symptoms, two groups of treatment are possible nowadays: surgery and/or radiotherapy. The aim of this study was to evaluate the impact of spinal decompressive surgery on Health-Related Quality of Life (HRQoL) of patients affected by metastasis at some level of the spine. It is a prospective, quantitative, descriptive correlational and longitudinal study that comprises four ratings: before surgery (T0), two (T1), four (T2) and six (T3) months after surgical procedure. The researcher held individual interviews at the hospital service prior to surgery and at the ambulatory within three moments described above. The following data collection instruments were used: structured questionnaire for sociodemographic and clinical sample characteristics; Faces Pain Scale Revised (FPS-R); questionnaire of Health-Related Quality of Life (EORTC QLQ-C30). It was performed comparison the preoperative (T0) results with times T1, T2 and T3. The sample consisted of 22 patients with a mean age of 56 years without differences in prevalence related to sex, all with low education and with average monthly income of approximately one basic wage. The most prevalent primary tumors were in order of frequency: breast, prostate, lung and colorectal. The most used surgical approach was the posterior vertebral (63,6%) in which the lumbar segment (36,4%) was the most affected. In the preoperative period (T0), participants presented low score for State of Global Health/Quality of Life and for most areas of Functional Scale and Symptoms Scale. In three different times (T1, T2 and T3) compared regarding the preoperative period (T0), there was a statistically significant improvement in the performance status, presence of pain, insomnia and constipation of patients. There was no significant difference in daily activities in any of the three periods analyzed after surgery, always taking into account the preoperative phase (T0) as standard

Background: The secretory epithelial cells of the prostate gland use sophisticated vehicles named prostasomes to relay important information to sperm cells in semen. This prostasome-forming and secretory ability of the epithelial cells is also preserved in poorly differentiated prostate cancer cells. Aim: The aim of this thesis was to examine different characteristics of prostasomes, especially those derived from malignant prostate cells, linked to their potential role in diagnosis and prognostication of prostate cancer. Results: Serum samples of prostate cancer patients contained autoantibodies against seminal prostasomes in a higher concentration than did control sera. These autoantibodies were most frequently directed against 25 prostasome-associated proteins, but no one was prostate specific. Clusterin was one of the most frequently occurring prostasomal proteins. Elevated titers were however seen in both patients´ and control sera. Clusterin turned out to be a major antigen of seminal prostasomes. No prostate specific or prostate cancer specific protein was discovered upon proteomic analysis of prostasomes deriving from malignant cells of vertebral metastases of prostate cancer patients. Human chromosomal DNA was identified in both seminal prostasomes and PC-3 cell prostasomes and strong evidence existed that the DNA was localized inside the prostasomes. Four out of 13 DNA clones of seminal prostasomes featured gene sequences (31%). The corresponding figures for PC-3 cell prostasomes were 4 out of 16 clones (25%). Conclusions: Prostasomes are immunogenic and give rise to serum autoantibodies. The most frequently occurring autoantibodies were directed against 25 prostasomal proteins but none of these was exclusively prostate specific. Thirty different proteins were identified in prostate cancer metastasis-derived prostasomes but none of these proteins was prostate cancer specific. Human chromosomal DNA was identified in prostasomes of both normal and malignant cell origin.