Adesão ao tratamento, acesso e qualidade da assistência em Aids no Brasil

A adesão à terapia antirretroviral (TARV) é crucial para a efetividade e o impacto do tratamento da Aids. Este artigo discute as relações entre adesão e qualidade dos serviços de assistência a pessoas vivendo com Aids (PVA), evidenciando a qualidade como elo central entre adesão e acesso. Está baseado nos resultados de pesquisas que conduzimos sobre a atenção a PVA no Brasil. Nossos estudos apontam que os grupos de pacientes acompanhados em serviços com número inferior a 100 pacientes apresentam risco estimado de não adesão maior do que os grupos acompanhados em serviços com mais de 500 pacientes. Apontam também que serviços com menos de 100 pacientes têm risco estimado maior de pertencer a grupos de má qualidade. Isto está relacionado à baixa complexidade observada nos serviços de menor porte caracterizada por: dificuldades em manter uma estrutura mínima de recursos humanos e materiais, simplificação da organização dos processos de trabalho, centramento no trabalho autônomo do profissional médico e gerenciamento sem projeto técnico. Há necessidade de pautar novos estudos sobre adesão e qualidade. As evidências existentes já apontam, porém, a necessidade de revisão na alocação dos serviços de assistência a PVA, bem como a de homogeneizar a qualificação destes serviços, condições necessárias para a manutenção de taxas aceitáveis de adesão à TARV no país.

Influência genética na degeneração do disco intervertebral

As doenças que afetam o sistema músculo-esquelético acometem centenas de milhões de pessoas no mundo e estão entre as causas mais comuns de invalidez e sofrimento crônico. A doença vertebral degenerativa constitui uma exacerbação do processo de envelhecimento, podendo estar envolvidos os fatores genéticos, ambientais ou lesões traumáticas, deformidades e doenças preexistentes. Muito se tem discutido sobre os múltiplos fatores envolvidos na degeneração discal, mas sua etiologia permanece indeterminada. Contudo, atualmente a participação da genética parece muito mais forte do que se suspeitava anteriormente. Neste artigo, é abordada a participação de alguns genes no processo discogênico, bem como o que isso representa para o melhor entendimento da etiopatogênese da doença e na melhora de seu tratamento.

Fatores genéticos e ambientais envolvidos na degeneração do disco intervertebral

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Lipoperoxidation and cyclooxygenase enzyme inhibitory piperidine alkaloids from Cassia spectabilis green fruits

Phytochernical work in the search for bioactive metabolites from the methanolic extract of Senna spectabilis green fruits led to the isolation of a new piperidine alkaloid, (+)-3-O-feruloylcassine (1), in addition to the known (-)-spectaline (2) and (-)-3-O-acetylspectaline (3). The isolates were submitted to in vitro evaluation of lipoperoxidation (LPO) and cyclooxygenase enzymes (COX-1 and -2) inhibitory properties and showed moderate antioxidant activities (40-70%) at 100 ppm when compared to commercial standards BHT and vitamin E and moderate inhibition of COX-1 (ca. 40%) and marginal inhibition of COX-2 enzymes (< 10%) at 100 ppm when compared to nonsteroidal anti-inflammatory drugs (NSAIDs) aspirin, rofecoxib, and celecoxib, respectively.

Lipoperoxidation and cyclooxygenases 1 and 2 inhibitory compounds from Iryanthera juruensis

Plants from Iryanthera genus have been traditionally used as food supplements by South American Indians. The MeOH extract of leaves of Iryanthera juruensis, one of the plants endemic to the Amazon region and consumed in Brazil, and the hexane extract from its seeds inhibited lipid peroxidation (LPO) and cyclooxygenase (COX-1 and -2)) enzymes in in vitro assays. Further analyses of these extracts yielded 5-deoxyflavones (1-5) from the leaf extract and sargachromenol (6), sargaquinoic acid (7), a novel juruenolic acid (8), omega-arylalkanoic acids (9a-c), and the lignan guaiacin (10) from the seed extract. Compounds 3-5 inhibited LPO by 86%, 77%, and 88% at 10 ppm, respectively, and compounds 6 and 9a-c showed inhibition at 76% and 78% at 100 ppm, respectively. However, compounds 7 and 8 were inactive and lignan 10 exhibited LPO inhibitory activity by 99% at 100 ppm compared to commercial antioxidants butylated hydroxyanisole (BHA), butylated hydroxytoluene (BHT), and vitamin E. The flavones 1-5 also inhibited COX-1 and -2 enzymes by 50-65% at 100 ppm. Compound 6 showed high but nonselective inhibition of COX-1 and COX-2 enzymes, when compared to aspirin and Celebrex, a nonsteroidal anti-inflammatory drug (NSAID). Compounds 7 and 10 inhibited COX-1 by 60% and 65% and COX-2 by 37% and 18%, respectively, whereas compounds 8 and 9a-c showed little or no activity against these enzymes.

The absolute configuration of 1-(3 ',4 '-dihydroxycinnamoyl)cyclopentane-2,3-diol from the Amazonian tree Chimarrhis turbinata

An antioxidant, 1-(3',4'-dihydroxycinnamoyl) cyclopentane-2,3-diol [ or ( E)-2,3-dihydroxycyclopentyl-3-(3',4'-dihydroxyphenyl) acrylate ( 1)], and two known trans- and cis-chlorogenic acid methyl esters were isolated from the ethanolic extract of the leaves of Chimarrhis turbinata. The relative configuration of 1 was determined by NMR and by comparison of the circular dichroic spectrum ( CD) with those of the enantiomers of synthetic 3', 4'-dimethoxycinnamoyl analogues. The absolute configuration of one of the synthetic enantiomers was determined using the CD exciton chirality method. This established the structure of naturally occurring 1 as (E)- 2,3-dihydroxycyclopentyl- 3-(3', 4'-dihydroxyphenyl) acrylate.

Effects of genetic polymorphisms CYP1A1, GSTM1, GSTT1 and GSTP1 on urinary 1-hydroxypyrene levels in sugarcane workers

Sugarcane workers in Brazil are exposed to various genotoxic compounds, including polycyclic aromatic hydrocarbons (PAHs), derived from an incomplete combustion process of burnt sugarcane fields. The effects of the occupational exposure to sugarcane fields burning were measured in urine samples of sugarcane workers from the northwest of the State of São Paulo when exposed (harvesting) and when non-exposed (non-harvesting). The urinary levels of 1-hydroxypyrene (1-OHP) and the influence of the genetic polymorphisms CYP1A1, GSTM1, GSTT1 and GSTP1 were evaluated. Our results showed that the 1-OHP levels were significantly higher (P < 0.0000) in the exposed sugarcane workers (0.318 mu mol mol(-1) creatinine) than in the non-exposed workers (0.035 mu mol mol(-1) creatinine). In an unvaried analysis, no influence regarding the polymorphisms was observed. However, multivariate regression analysis showed that the CYP1A1*4 polymorphism in the exposed group, and age and the GSTP1 polymorphism in the non-exposed group significantly influenced urinary 1-OHP excretion levels (P < 0.10). The same group of sugarcane workers was significantly more exposed to PAHs during the harvesting period than during the non-harvesting period. (c) 2006 Elsevier B.V. All rights reserved.

4 '-Aminochalcones As Novel Inhibitors of the Chlorinating Activity of Myeloperoxidase

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Effect of the order and disorder of BaMoO4 powders in photoluminescent properties

The study of the photoluminescent properties affected by order and disorder of the BaMoO4 powders is the principal objective in this work. BaMoO4 compounds were prepared using soft chemical process called Complex Polymerization Method. In this work, different deagglomeration types and different heating rates were used to promote different disorder degrees. Scheelite type phase (BaMoO4) was determined by X-ray Diffraction (XRD), Fourier Transformed Infra-Red (FTIR) and Raman spectroscopy after heat treating the sample at 400 degrees C. The room temperature luminescence spectra revealed an intense single-emission band in the visible region. Based on XRD and Raman data it was observed that the transition between the completely disordered structure to completely ordered structure is a good condition for photoluminescence (PL) emission. The best PL emission is obtained when the material possesses short range disorder, i.e., is periodically ordered (XRD), but some disorder as measured by Raman spectroscopy. The excellent optical properties observed for disordered BaMoO4 suggested that this material is a highly promising candidate for optical applications.

High resolution ultra high pressure liquid chromatography-time-of-flight mass spectrometry dereplication strategy for the metabolite profiling of Brazilian Lippia species

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Shape controlled synthesis of CaMoO4 thin films and their photoluminescence property

CaMoO4 (CMO) disordered and ordered thin films were prepared by the complex polymerization method (CPM). The films were annealed at different temperatures and time in a conventional resistive furnace (RF) and in a microwave (MW) oven. The microstructure and surface morphology of the structure were monitored by atomic force microscopy (AFM) and high-resolution scanning electron microscopy (HRSEM). Order and disorder were characterized by X-ray diffraction (XRD) and optical reflectance. A strong photoluminescence (PL) emission was observed in the disordered thin films and was attributed to complex cluster vacancies. The experimental results were compared with density functional and Hartree-Fock calculations. (C) 2008 Elsevier B.V. All rights reserved.

Lanthanum-based perovskites obtained by the polymeric precursor method

Cobalt oxides, specially the ones with perovskite structure, are of a high technological interest, due to their interesting optical, electrical and magnetic properties. La(1 -x)Ca(x)CoO(3) powder samples were synthesized by the polymeric precursor method, with x varying from 0 to 0.4. The powder precursors were characterized by TG/DTA, XRD and IR. The TG curves showed several thermal decomposition steps; the first one is ascribed to the loss of water and the remaining steps are related to the combustion of the organic matter. The XRD patterns indicated only the presence of the perovskite phase. Moreover, the structure changes from rhombohedral to cubic, as calcium is added to the perovskite and the calcination temperature increases.