Caracterização de uma nova exonuclease identificada em uma biblioteca metagenômica

A abordagem metagenômica tem permitido o acesso ao material genético de microrganismos não cultivados e tem sido usada para identificação de novos genes. Apesar da importância dos mecanismos de reparo de DNA para a manutenção da integridade genômica nosso conhecimento sobre mecanismos de reparo de DNA é baseado em organismos modelo como E. coli e pouco é conhecido sobre os organismos de vida livre e não cultivados. Neste trabalho, a abordagem metagenômica foi aplicada para descobrir novos genes envolvidos com a manutenção da integridade genômica. Um clone positivo foi identificado por replicar a biblioteca metagenômica em meio seletivo contendo H2O2. O clone metagenômico foi capaz de complementar parcialmente a deficiência em reparo de DNA de cepas simples e duplo-mutantes de E.coli (recA e xthA nfo, respectivamente) submetidas ao estresse gerado por H2O2 e MMS.A análise de sequência mostrou uma ORF codificando para uma proteína hipotética membro da superfamília Exo_Endo_Phos (PF03372) e, a filogenia indicou que a mesma não está inclusa em nenhuma das subfamílias EEP. Assim, uma nova nuclease foi identificada e experimentalmente caracterizada in vivo e in vitro. Ensaios específicos utilizando a nuclease purificada e oligonucleotideos fluorescentemente marcados revelaram sua atividade 3´-5´exonuclease, em substratos simples e dupla-fita, dependente de Magnésio e sensível a EDTA. Uma vez que este é o primeiro relato e caracterização de uma enzima obtida a partir de abordagem metagenômica mostrando uma atividade exonuclease, foi nomeada EXOMEG1

Estudo teórico de intermediários tetraédricos acidez / basicidade e estereosseletividade enzimáticos

The present work aimed first, the theoretical study of tetrahedral intermediate stability formed from carbonyl addition reactions using the second (MP2) and third (MP3) order Møller–Plesset perturbation theory. Linear correlations between electronic energy difference of reactions with Wiberg Indexes and C-O bond lengths were obtained, and was observed that the stability of adducts formed depends directly of electronic density involved between these atoms. The knowing of electronic parameters of these structures has an important hole due to the large use on reactions that in his course forms this tetrahedral intermediate. Employing the ONIOM (B3LYP:AMBER) methodology, was evaluated the stereoselectivity of a enzymatic reaction between CAL B enzyme and a long chain ester. In this study, were obtained the electronic energies of ground state and intermediate state of transesterification rate-determing step from two possible proquirals faces Re and Si. The objective was study the enantioselectivity of CAL B and rationalizes it using quantum theory of atoms in molecules (QTAIM). A theoretical study employing inorganic compounds was performed using ab initio CBS-QB3 method aiming to find a link between thermodynamic and equilibrium involving acids and bases. The results observed showed an excellent relationship between difference in Gibbs free energy, ΔG of acid dissociation reaction and ΔG of hydrolysis reaction of the corresponding conjugate base. It was also observed, a relationship between ΔG of hydrolysis reaction of conjugate acids and their corresponding atomic radius showing that stability plays an important role in hydrolysis reactions. The importance of solvation in acid/base behavior when compared to theoretical and experimental ΔG´s also was evaluated.

Padronização de testes para avaliação do estado de mania e potencial anti-maníaco de um agonista do receptor NOP

Bipolar disorder is characterized by mood impairment, alternating between mania/hypomania and depression, and its exact pathophysiology is already unknown. The treatment of bipolar disorder is based on prevention of the manic and depressive episodes using mood stabilizers. Nociceptin/orfanin FQ (N/OFQ) is an endogenous heptadecapeptide which binds as an agonist to NOP receptor, which is a G-coupled inhibitory receptor. N/OFQ and its receptor modulate a lot of functions in the organism, including emotional processes. It is known that the plasmatic concentration of N/OFQ is altered in patients in both phases depressive and manic of bipolar disorder and it is assumed that this system has a role on the etiology of this disorder. Concerning mania, the animal models used in research tend to focus in an unique aspect of the manic behavior, as hyperactivity or agressivity. In the 60’s, the hole board test was proposed, and it consists of an apparatus with holes where a behavior known as head-dippings is measured. High levels of head-dippings are suggestive of neophilia, while low levels can be characteristic of an anxious-like behavior. As the increase of exploratory and goal-directed behavior are characteristics of manic behavior, this test could help in mania research. Thus, this work was organized in 3 steps and aims to: (1) investigate the induction of a manic-like state promoted by ouabain, a Na+/K+-ATPase inhibitor, in the mouse open field test; (2) set up the hole board as a test to measure manic-like behaviors; and (3) investigate the N/OFQ effects in prevention of this kind of behavior on hole board. Male Swiss mice were used in this study, and they take part of only one of the described steps. Depending on the step performed, mice received one or more of the following treatments: (1) ouabain 10-6 , 10-5 , 10-4 , 10-3 or 10-2 M, intracerebroventricular (icv); (2) sodium valproate 300 mg/kg, intraperitoneal (ip); (3) sodium valproate 400 mg/kg, ip; (4) diazepam 1 mg/kg, ip; (5) methylphenidate 10 mg/kg, ip; and (6) N/OFQ 0,1 or 1 nmol, icv. The results suggest that hole board can be used to evaluate a manic state, through analysis of different animal behaviors. However, it was not possible to standard the model of Na+ /K+ -ATPase dysfunction through ouabain administration in mice. Moreover, the data suggest that N/OFQ, at the doses tested, has not affected the methylphenidate-induced mania-like behavior. Taken together, the results point to a new approach of manic research, through the hole board using. However, more studies are necessary in order to verify the role of N/OFQ system on bipolar disorder.

Coordenação dos sistemas antioxidantes da catalase e da ascorbato peroxidase durante o envelhecimento acelerado de sementes de cártamo e girassol

World consumption of vegetable oils has increased in recent years because of its application in food, chemical, pharmaceutical and, more recently, energy industry. However, oilseeds, which these oils are extracted, have low viability, affecting the cultivation and productivity of these species. The aim of this study was to analyze the effect of aging on the coordination of catalase (CAT) and ascorbate peroxidase (APX) antioxidant systems in safflower and sunflower. . Therefore, seeds were subjected to accelerated aging for 3, 6 and 9 days and grown in moistened paper towel for 72 hours. Additionally, before accelerated aging, sunflower seeds were pretreated by osmopriming with 10 mM ascorbate (ASC) or 3 amino 1,2,4 triazol (3-AT), a specific inhibitor of CAT activitie. The method of artificial aging used was efficient in both species, because it caused a decrease in germination, seedling development and growth, especially in safflower. The aging caused inhibition of CAT activity for both species and to compensate for such inhibition , sunflower increased mRNA expression of this enzyme , while safflower mobilized over the activity of APX. Analysis of the expression of malate synthase and sugar content demonstrated that sunflower seeds consumes lipid reserves in quiescent state, while the safflower is more dependent on carbohydrate. Pretreatment with 3-AT inhibited CAT activity and stimulated the APX, though with ASC acted reverse on these systems. None of the treatments recovered the physiological decline aging. It is concluded that aging change the oilseeds antioxidant metabolism, despite interspecies variations in response to this process, the depletion of the CAT antioxidant system was common. Because of this we propose that the measurement of CAT activity can be used to identify aging seed lots.

Efeito da Olmesartana na resposta inflamatória em modelo de mucosite intestinal em ratos

Intestinal Mucositis is inflammation and/or ulceration of mucosa of the gastrointestinal tract caused by anticancer therapies. Histologically, villous atrophy, damage to enterocytes and infiltration of inflammatory cells. Methotrexate (MTX) is a compound that depletes dihydrofolate pools and is widely used in the treatment of leukemia and other malignancies. The aim of this study was to evaluate the effect of Olmesartan (OLM), an angiotensin II receptor antagonist, on an Intestinal Mucositis Model (IMM) induced by MTX in Wistar rats. IMM was induced via intraperitoneal (i.p.) administration of MTX (7 mg/kg) for three consecutive days. The animals were pretreated with oral OLM at 0.5, 1 or 5 mg/kg or with vehicle 30 min prior to exposure to MTX, for three days. Small intestinal (duodenum, jejunum and ileum) homogenates were assayed for levels of the IL-1β, IL-10 and TNF-α cytokines, malondialdehyde and myeloperoxidase activity. Additionally, immunohistochemical analyses of MMP-2, MMP-9, COX-2, RANK/RANKL and SOCS-1 and confocal microscopy analysis of SOCS-1 expression were performed. Treatment with MTX+OLM (5 mg/kg) resulted in a reduction of mucosal inflammatory infiltration, ulcerations, vasodilatation and hemorrhagic areas (p<0.05) as well as reduced concentrations of MPO (p<0.001) and the pro-inflammatory cytokines IL-1β and TNF-α (p<0.01), and increase antiinflammatory cytosine IL-10 (p,0.05). Additionally, the combined treatment reduced expression of MMP-2, MMP-9, COX-2, RANK and RANKL (p<0.05) and increased cytoplasmic expression of SOCS-1 (p<0.05). Our findings confirm the involvement of OLM in reducing the inflammatory response through increased immunosuppressive signaling in an IMM. We also suggest that the beneficial effect of Olmesartan treatment is specifically exerted during the damage through blocking inflammatory cytosines.

Spondias tuberosa Arr. (UMBU): estudo fitoquímico e avaliação do potencial anti-inflamatório

Spondias tuberosa Arruda (Anacardiaceae) is a fruitful tree popularly known as umbuzeiro, tapereba or umbu. It is a native and endemic species from Brazil, widespread in Brazilian Northeast. The species is important in folk medicine of the semi-arid Northeast, where it is mainly used to treat various inflammatory conditions, digestive problems as well as viral and bacterial infections. However, despite the common use in folk medicine, there are scarce pharmacological and phytochemicals studies that afford scientific evidence to its popular use. Therefore, this study aimed to characterize the chemical markers in S. tuberosa leaves extract, obtained by maceration ethanol:water (70:30, [v/v]), and evaluate its anti-inflammatory potential in vivo. The phytochemical profile in TLC analysis suggested the occurence of the flavonoids rutin and isoquercitrin. HPLC analysis enabled us to confirm the presence of flavonoids and also, were detected the phenolic acids, chlorogenic acid and caffeic acid. In addition was developed and validated a HPLC method to evaluate the content of the identified compounds in S. tuberosa leaves extract according to RDC 899/2003 of ANVISA and ICH Guidelines 2005. In order to evaluate the anti-inflammatory potential of S. tuberosa leaves extract, the peritonitis and paw edema models induced by carrageenan were used, administration i.p. in mice. The results highlighted the anti-inflammatory property in vivo at 125, 250 and 500 mg/kg since a decrease in leukocyte influx to the site of inflammation, diameter of the edema and the level of myeloperoxidase were observed when compared to the drug control dexamethasone (2 mg/kg, i.p. route). Taken together, the results pointed out S. tuberosa as a potential species for developing phytotherapic derivatives in according to its popular use. With regard to the characterization markers, chlorogenic acid, caffeic acid, rutin and isoquercitrin were identified and quantified in Spondias tuberosa leaves extract so they could be used in quality control analyses of the raw material and extracts of this species.

Caracterização citoarquitetônica e por imunoistoquímica para tirosina-hidroxilase da substância negra, área tegmentar ventral e zona retrorubral do Sagui (Callithrix jacchus)

It is known that the catecholamine group is constituted by dopamine, noradrenaline and adrenaline, in which the synthesis is regulated by an enzyme named tyrosine hydroxylase. Thus, 3-hydroxytyramine/dopamine (DA) is a precursor of the noradrenaline and adrenaline synthesis and acts as a neurotransmitter in the central nervous system. The three main nuclei, named the retrorubral field (A8 group), the substantia nigra pars compacta (A9 group) and the ventral tegmental area (A10 group), are arranged in the die-mesencephalic portion and are involved in three complexes circuitries - the mesostriatal, mesolimbic and mesocortical pathways. These pathways are related to behavioral manifestations, motricity, learning, reward and pathologies such as Parkinson’s Disease and Schizophrenia. Thus, the aim of this study was to perform de morphological analysis of the A8, A9 and A10 nuclei of the common marmoset (Callithrix jacchus). The marmoset is a neotropical primate, whose morphological and functional characteristics supports the suitability of use of this animal in biomedical research. Coronal sections of the marmoset brain were submitted to cytoarchitectonic characterization and TH-immunohistochemistry. Based on the morphology of the neurons, it was possible to subdivide the A10 group in seven regions: interfascicular nucleus, raphe rostral linear nucleus and raphe caudal linear nucleus, in the middle line; paranigral and parainterfascicular nucleus, in the middle zone; rostral portion of the ventral tegmental area nucleus and parabrachial pigmented nucleus, located in the dorsolateral portion of the mesencephalic tegmentum. A9 group was divided into four regions: substantia nigra compacta dorsal and ventral tiers; substantia nigra compacta lateral and medial clusters. No subdivisions were founded into A8 group. These results revealed that A8, A9 and A10 are phylogenetically conserved between species, but it’s necessary to expand the studies about this compartmentalization, investigating its occurrence in other primate species or investigating its functional relevance.

Citoarquitetura e imunoistoquímica para tirosinahidroxilase dos núcleos dopaminérgicos mesencefálicos do morcego (Artibeus planirostris)

The 3-Hidroxytyramine/dopamine (DA) is a monoamine of catecholamine family and isthe precursor substance synthesis of noradrenaline and adrenaline, having the enzymeTyrosine Hydroxylase (TH) as this regulatory process. In addition, the DA has theability to act as a neurotransmitter in the Central Nervous System - SNC, being themain neurotransmitter of brain nuclei, namely of A8 to A16. The nuclei of the midbrainthat express DA are the Retrorubral Field (RRF, A8), the Substantia Nigra parsCompacta (SNc, A9) and the Ventral Tegmental Area (VTA, A10). Such nuclei areinvolved in complex three circuitry that are the mesostriatal, mesolimbic andmesocotical and are directly related with several behavioral manifestations as motricitycontrol, reward signaling in behavioral learning, motivation and pathologicalconditions, such as Parkinson's Disease and schizophrenia. Interestingly, many of themorphological bases of these neural disturbance remain unknown. Considering therelevance of mesencephalic dopaminergic nuclei, the aim of this research is tocharacterize morphologically the dopaminergic nuclei (clusters A8, A9 and A10) of themidbrain of the bat (Artibeus planirostris). The Artibeus planirostris is a common bat inRio Grande do Norte. Ten animals were used in this research. The animals wereanesthetized, perfused, and the brain was removed from the skull. After dehydration insucrose, the brain was underwent microtomy. Saggital and coronal sections wereobtained and collected in six separate series. The series were Nissl-stained to identifythe cytoarchitectonic boundaries and the other series were subjected toimmunohistochemistry for TH. After cytoarchitectonic analysis and TH+ cellsidentification was possible to establish the anatomical boundaries of the nuclei, as wellas the subdivisions of three of the midbrain dopaminergic nuclei. The SNc is the mostrostral nucleus observed in the midbrain and is identified throughout the rostrocaudalextension of the midbrain. The VTA neurons were seen immediately caudal to the SNcappearance. The RRF neurons were observed just in the caudal levels of the midbrain.The SNc in Artibeus planirostris shows a particular feature, the tail of the SNc. The tailhave been described just in two other studied species. The present work shows aparticular variation in the organizational morphology of the SNc in the artibeus andcontribute to understand the phylogenetic routes by which the dopaminergic system hasevolved.

Avaliação do efeito anti-inflamatório dos fármacos: atorvastatin, carvedilol, olmesartan e telmisartan, em modelo experimental da doença periodontal induzida em ratos

A periodontite é uma doença crônica inflamatória mediada por marcadores inflamatórios, tais como as citocinas: IL-1β, IL-10 e TNF-α, que provoca a destruição dos tecidos gengivais e osso alveolar, causando perda de inserção dentária e posterior perda dental. A perda óssea é causada pela ativação de prostaglandinas oriundas do ácido araquidônico, através da ação da enzima ciclooxigenase 2 (COX-2), promovendo a liberação de enzimas proteolíticas, as metaloproteinases de matriz, principalmente a MMP-2 e MMP-9, que promovem reabsorção óssea. Além disso, ocorre o desequilíbrio entre a ação de RANKL e OPG, havendo uma maior ativação de RANKL, e por consequência a maior ativação de osteoclastos e maior reabsorção óssea. Mediadores inflamatórios e espécies reativas de oxigênio (ROS) produzidos localmente possuem potencial para disseminar na corrente sanguínea e iniciar ou exacerbar doenças sistêmicas como as cardiovasculares. O tratamento atual da doença consiste em terapêutica local, mas a necessidade de estudos sobre fármacos de atuação sistêmica culminou nesta pesquisa, que realizou a avaliação dos fármacos: atorvastatin, carvedilol, olmesartan e telmisartan, quanto a sua ação anti-inflamatória sobre a doença periodontal induzida por ligadura em ratos Wistar. Os animais foram divididos em 5 grupos, para cada fármaco, separadamente: (NL) grupo não ligado, (L) grupo ligado sem tratamento, (1mg/Kg) grupo ligado que recebeu dose de 1mg/Kg de fármaco, (5 ou 6 mg/Kg) grupo ligado que recebeu dose de 5 ou 6 mg/Kg de fármaco, (10 mg/Kg) grupo ligado que recebeu dose de 10mg/Kg de fármaco. Foram realizadas avaliações: histopatológica, perda óssea alveolar, imuno-histoquímica (para COX-2, MMP-2, MMP-9, RANK-L, RANK e OPG), e ELISA (para mieloperoxidase, glutationa, malonaldeído e as citocinas: IL-1β, IL-10 e TNF-α). Os grupos tratados com olmesartana a 6 mg/Kg, e atorvastatin, carvedilol e telmisartan a 10mg/Kg, mostraram diminuição da perda óssea, redução de: MPO, MDA, IL-1β, TNF-α, MMP-2, MMP-9, COX-2, RANKL/RANK, e aumento na expressão da OPG e da IL-10.

Consanguinidade e efeito fundador da mutação G377S da doença de Gaucher em população de Tabuleiro do Norte – Ceará – Brasil

Gaucher’s disease (GD) is caused by a β-glucocerebrosidase deficiency, leading to the accumulation of glucocerebroside in the reticuloendothelial system. The prevalence of GD in Tabuleiro do Norte (TN) (1:4000) is the highest in Brazil. The purpose of this study was to present evidence of consanguinity and founder effect for the G377S mutation (c.1246G>A) among GD patients in TN based on enzyme, molecular and genealogical studies. Between March 2009 and December 2010, 131 subjects at risk for GD (GC in dried blood ≤2.19 nmol/h/ml) and 5 confirmed GD patients from the same community were submitted for molecular analysis to characterize the genetic profile of the population. Based on the enzymatic and molecular analysis, the subjects were classified into three categories: affected (n=5), carrier (n=20) and non-carrier (n=111). All carriers were (G377S/wt). Affected subjects were homozygous (G377S/G377S). The identification of a single mutation in carriers and homozygotes from different generations, the history of the community and the genealogy study suggest that the high prevalence of GD in this population may be due to a combination of consanguinity and founder effect for the G377S mutation

Novos protocolos teóricos utilizados nos estudos das ligações hidrogênio-hidrogênio, na estabilidade do tetraedrano, seus derivados e das reações de diels-alder e na quantificação da afinidade de fármacos

This thesis was performed in four chapters, at the theoretical level, focused mainly on electronic density. In the first chapter, we have applied an undergraduate minicourse of Diels-Alder reaction in Federal University of Rio Grande do Norte. By using computational chemistry tools students could build the knowledge by themselves and they could associate important aspects of physical-chemistry with Organic Chemistry. In the second chapter, we studied a new type of chemical bond between a pair of identical or similar hydrogen atoms that are close to electrical neutrality, known as hydrogen-hydrogen (H-H) bond. In this study performed with complexed alkanes, provides new and important information about their stability involving this type of interaction. We show that the H-H bond playing a secondary role in the stability of branched alkanes in comparison with linear or less branched isomers. In the third chapter, we study the electronic structure and the stability of tetrahedrane, substituted tetrahedranes and silicon and germanium parents, it was evaluated the substituent effect on the carbon cage in the tetrahedrane derivatives and the results indicate that stronger electron withdrawing groups (EWG) makes the tetrahedrane cage slightly unstable while slight EWG causes a greater instability in the tetrahedrane cage. We showed that the sigma aromaticity EWG and electron donating groups (EDG) results in decrease and increase, respectively, of NICS and D3BIA aromaticity indices. In addition, another factor can be utilized to explain the stability of tetra-tert-butyltetrahedrane as well as HH bond. GVB and ADMP were also used to explain the stability effect of the substituents bonded to the carbon of the tetrahedrane cage. In the fourth chapter, we performed a theoretical investigation of the inhibitory effect of the drug abiraterone (ABE), used in the prostate cancer treatment as CYP17 inhibitor, comparing the interaction energies and electron density of the ABE with the natural substrate, pregnenolone (PREG). Molecular dynamics and docking were used to obtain the CYP1ABE and CYP17-PREG complexes. From molecular dynamics was obtained that the ABE has higher diffusion trend water CYP17 binding site compared to the PREG. With the ONIOM (B3LYP:AMBER) method, we find that the interaction electronic energy of ABE is 21.38 kcal mol-1 more stable than PREG. The results obtained by QTAIM indicate that such stability is due a higher electronic density of interactions between ABE and CYP17

Queilite actínica: expressão imuno-histoquímica da cox-2 e avaliação do diclofenaco sódico gel como uma terapia alternativa

Actinic cheilitis (AC) is a potentially malignant disorder which affects the lip vermilion and results from chronic exposure to sunlight. Currently, it is not possible to predict which cases of AC may progress to squamous cell carcinoma, and therefore, some biomolecular markers have been researched. Cyclooxygenase 2 (COX-2) is an enzyme associated with inflammatory response which is overexpressed in oral cancer; however, little is known about the role of this protein in actinic cheilitis. About the treatment of this lesion, currently available therapeutic modalities to AC may cause cytotoxic effects and deleterious results to patients. Therefore, the aim of this study was to evaluate the immunoexpression of COX-2 in AC of different risks of malignant transformation and analyse, through clinical follow-up, the efficacy of diclofenac sodium 3% gel in the treatment of this condition. Epithelial immunoexpression of COX-2 was analysed semi-quantitatively in 90 cases of AC classified as low risk (n = 55) and high risk (n = 35) of malignant transformation, in which the scores were assigned: (0) 0 to 5% of positive cells - Negative; (1) 6 to 30% of positive cells - Low expression; (2) 31 to 100% of positive cells - High expression. The chi-square test of Pearson was conducted to verify possible associations between immunoexpression of COX-2 and histologic grade of actinic cheilitis. The weighted kappa coefficient denoted a good interobserver agreement (0.677). Nineteen patients diagnosed with AC were instructed to perform topical application of the gel three times a day for a period of 90 days. In each biweekly visit, a follow-up record was accomplished through digital photographs and after treatment was completed, two researchers analysed all the images to assess clinical aspects of the lip. Furthermore, tolerability to the drug and patient satisfaction after treatment were evaluated. COX-2 was overexpressed in 74.4% of AC cases. Both low and high-risk groups revealed predominance of score 3, followed by scores 2 and 1. There was no significant association (p = 0.315) between COX-2 expression and histological grading. Among the total number of participants of this clinical study, ten showed total remission of all clinical features of the lesion and three had partial improvement of these characteristics. One participant presented worsening of the clinical condition. In five cases, the treatment was discontinued due to development of mild adverse effects at the site of gel application. Regarding analysis of satisfaction and tolerability to the drug, most patients were fully satisfied with the therapy (n = 11) and reported that the drug was not irritating to the lips (n = 9). Our study demonstrates that high expression of COX-2 is common in AC; however, this protein was not associated with malignant transformation risk of the analysed cases. Topical application of diclofenac sodium 3% gel provided a convenient and well tolerated approach in most cases, and may be a promising alternative for the treatment of actinic cheilitis.

Perfil das condições de seguimento terapêutico em portadores de hipertensão arterial

A proposta foi investigar os aspectos comportamentais referentes ao seguimento da terapêutica farmacológica e não farmacológica e o grau de adesão ao tratamento anti-hipertensivo de um grupo específico. Estudo observacional descritivo com análise quantitativa, realizado no Centro de Referência da Assistência Social em Fortaleza-CE, de agosto/2008 a maio/2009. Dados obtidos de 49 indivíduos por entrevista e exame físico. Mais de 50% dos participantes seguiam as terapêuticas não farmacológicas. Prevaleceram a terapia combinada (53%) e as classes medicamentosas de diuréticos (72%) e inibidores da enzima conversora de angiotensina (55%). Muitos participantes (49%) referiram reações adversas. Destas, as mais citadas foram poliúria e tontura (29%). Quanto ao grau de adesão, a média correspondeu ao conceito não adesão leve. A avaliação dos comportamentos de seguimento terapêutico e a caracterização clínico-epidemiológica são necessárias para o enfermeiro planejar estratégias educativas. Ambas possibilitam ajustes no planejamento das intervenções, contribuindo para a melhor adesão terapêutica dos indivíduos