Tradu����o e valida����o para o portugu��s do Medication Regimen Complexity Index

FUNDAMENTO: A complexidade da farmacoterapia consiste de m��ltiplas caracter��sticas do regime prescrito, incluindo o n��mero de diferentes medica����es no esquema, o n��mero de unidades de dosagem por dose, o n��mero total de doses por dia e os cuidados na administra����o dos medicamentos. O Medication Regimen Complexity Index (MRCI) �� um instrumento espec��fico, validado e utilizado para medir a complexidade da farmacoterapia, desenvolvido originalmente em l��ngua inglesa. OBJETIVO: Tradu����o transcultural e valida����o desse instrumento para o portugu��s do Brasil. M��TODOS: Foi desenvolvido um estudo transversal envolvendo 95 pacientes com diabete do tipo 2 utilizando m��ltiplas medica����es. O processo de valida����o teve in��cio pela tradu����o, retrotradu����o e pr��-teste do instrumento, gerando uma vers��o adaptada chamada ��ndice de Complexidade da Farmacoterapia (ICFT). Em seguida foram analisados par��metros psicom��tricos, incluindo validade convergente, validade divergente, confiabilidade entre avaliadores e teste-reteste. RESULTADOS: A complexidade da farmacoterapia medida pelo ICFT obteve m��dia de 15,7 pontos (desvio padr��o = 8,36). O ICFT mostrou correla����o significativa com o n��mero de medicamentos em uso (r = 0,86; p < 0,001) e a idade dos pacientes (r = 0,28; p = 0,005). A confiabilidade entre avaliadores obteve correla����o intraclasse igual a 0,99 (p < 0,001) e a confiabilidade teste-reteste obteve correla����o de 0,997 (p < 0,001). CONCLUS��O: Os resultados demonstraram que o ICFT apresenta bom desempenho de validade e confiabilidade, podendo ser utilizado como ferramenta ��til na pr��tica cl��nica e em pesquisas envolvendo an��lise da complexidade da terapia.

The rational search for natural neolignans

A rational method of search for natural neolignans of desired structures is outlined. This involves consultation of a collection of chemical profiles of plant families. The profiles are assembled considering the biosynthetic class (in the present case lignoids), subclass (neolignans), structural types (neolignan skeleta) and relative frequency of substitutional derivatives belonging to each type (known compounds). The method is of course applicable to ani class of natural products. Its use in the case of neolignans is here selected as an exemple in view of the recently discovered antagonism towards PAF of kadsurenone, a representative of this subclass of phytochemicals. Application of the chemical profiles to phylogenetic studies is illustrated.

V-region-related and -unrelated immunosupression accompanying infections

This paper discusses current evidence for the relationship between polyclonal lymphocyte activation, specific immunossupression with decreased resistance, and autoimmune pathology, that are all often found associated with infections by a variety of virus, bacteria and parasites . The central question of class determination of immune effector activities is considered in the context of the cellular targets for nonspecific mitogenic activities associated with infection. A model is presented to integrate these findings: mitogenens produced by the microorganism or the infected cells are preferentially active on CD5 B cells, the resulting over-production of IL-10 will tend to bias all immune activities in to a Th-2mode of effector functions, with high titers of polyclonal antibodies and litle or no production of gamma IFN and other "inflamatory"lymphokines that often mediate resistance. In turn these conditions allow for parasite persistence and the corresponding long-term disregulation of self-directed immune reactivities, resulting in autoimmunity in the chronic phase. This model would predict that selective immunization with the mitogenic principles involved in desregulation, could stand better chances than strategies of vaccination based on immunopotentiation against othere, functionally neutral antigenic epitopes. It is argued, however, that the complexity of immune responses and their regulation together with our ignorance on the genetic controls of class-determination, offer poor prospects for a scientifically-based, rational development of vaccines in the near future. It is suggested that empirically-based and technologically developed vaccines might suceed, while basic scientific approaches are reinforced and given the time provide a better understanding of those process.

Chronic Trypanosoma cruzi-elicited cardiomyopathy: from the discovery to the proposal of rational therapeutic interventions targeting cell adhesion molecules and chemokine receptors - how to make a dream come true

One hundred years ago, Carlos Chagas discovered a new disease, the American trypanosomiasis. Chagas and co-workers later characterised the disease's common manifestation, chronic cardiomyopathy, and suggested that parasitic persistence coupled with inflammation was the key underlying pathogenic mechanism. Better comprehension of the molecular mechanisms leading to clinical heart afflictions is a prerequisite to developing new therapies that ameliorate inflammation and improve heart function without hampering parasite control. Here, we review recent data showing that distinct cell adhesion molecules, chemokines and chemokine receptors participate in anti-parasite immunity and/or detrimental leukocyte trafficking to the heart. Moreover, we offer evidence that CC-chemokine receptors may be attractive therapeutic targets aiming to regain homeostatic balance in parasite/host interaction thereby improving prognosis, supporting that it is becoming a non-phantasious proposal.

Detection of the B"-GWGR variant in the southernmost region of Brazil: unveiling the complexity of the human immunodeficiency virus-1 subtype B epidemic

Typical human immunodeficiency virus-1 subtype B (HIV-1B) sequences present a GPGR signature at the tip of the variable region 3 (V3) loop; however, unusual motifs harbouring a GWGR signature have also been isolated. Although epidemiological studies have detected this variant in approximately 17-50% of the total infections in Brazil, the prevalence of B"-GWGR in the southernmost region of Brazil is not yet clear. This study aimed to investigate the C2-V3 molecular diversity of the HIV-1B epidemic in southernmost Brazil. HIV-1 seropositive patients were ana-lysed at two distinct time points in the state of Rio Grande do Sul (RS98 and RS08) and at one time point in the state of Santa Catarina (SC08). Phylogenetic analysis classified 46 individuals in the RS98 group as HIV-1B and their molecular signatures were as follows: 26% B"-GWGR, 54% B-GPGR and 20% other motifs. In the RS08 group, HIV-1B was present in 32 samples: 22% B"-GWGR, 59% B-GPGR and 19% other motifs. In the SC08 group, 32 HIV-1B samples were found: 28% B"-GWGR, 59% B-GPGR and 13% other motifs. No association could be established between the HIV-1B V3 signatures and exposure categories in the HIV-1B epidemic in RS. However, B-GPGR seemed to be related to heterosexual individuals in the SC08 group. Our results suggest that the established B"-GWGR epidemics in both cities have similar patterns, which is likely due to their geographical proximity and cultural relationship.

Os produtos naturais e a qu��mica medicinal moderna

Natural products have been utilized by humans since ancient times and the relief and cure of their diseases was the first purpose for using natural products in medicine. The history of the oriental and occidental civilizations is very rich in examples of the utilization of natural products in medicine and health care. Chinese traditional medicine is one of the most important examples of how natural products can be efficient in the treatment of diseases, and it points to the importance of scientific research on natural products, concerning the discovery of new active chemical entities. The complexity, chemical diversity and biological properties of natural products always fascinated people, and during the last 200 years, this led to the discovery of important new drugs. In the last 30 years, the development of new bioassay techniques, biotechnology methods, bio-guided phytochemical studies, automated high throughput screening and high performance analytical methods, have introduced new concepts and possibilities of rational drug design and drug discovery. In this context, natural products have played an important and decisive role in the development of modern medicinal chemistry.

Love and rationality: on some possible rational effects of love

In this paper I defend the idea that rather than disrupting rationality, as the common-sense conception has done it, love may actually help us to develop rational ways of thinking and acting. I make the case for romantic or erotic love, since this is the kind of love that is more frequently associated with irrationality in acting and thinking. I argue that this kind of love may make us develop epistemic and practical forms of rationality. Based on an analysis of its characteristic action tendencies, I argue that love may help us to develop an instrumental form of rationality in determining the best means to achieve the object of love. It may also narrow down the number of practical considerations that may help us to achieve our goals. Finally, love may generate rational ways of belief-formation by framing the parameters taken into account in perception and attention, and by bringing into light only a small portion of the epistemic information available. Love may make us perceive reality more acutely.

THE LOGICAL SYSTEM OF FREGE'S GRUNDGESTZE: A RATIONAL RECONSTRUCTION

This paper aims at clarifying the nature of Frege's system of logic, as presented in the first volume of the Grundgesetze . We undertake a rational reconstruction of this system, by distinguishing its propositional and predicate fragments. This allows us to emphasise the differences and similarities between this system and a modern system of classical second-order logic.

Rational use of water in a poultry slaughterhouse in the state of Paran��, Brazil: a case study

Agroindustries are major consumers of water. However, to adapt to environmental trends and be competitive in the market, they have sought rational use of water through water management in their activities. Cleaner Production can result in economic, environmental and social benefits, and in actions that promote reduction in water consumption. This case study was conducted in a slaughterhouse and poultry cold storage processing plant and aimed to identify points of excessive water consumption, and to propose alternatives for managing water resources by reducing consumption. Consumption data are presented in relation to the processing stages with alternatives proposed for the rational use of water, such as closure of mains water during shift changes. Following the implementation of recommendations, a reduction in water consumption of approximately 11,137 m�� per month was obtained, which equates to a savings of US$ 99,672 per year. From this study, it was concluded that the company under review could develop various improvement actions and make an important contribution to the preservation of water resources in the region where it operates.

Understanding the complexity in low dimensional systems

Complex System is any system that presents involved behavior, and is hard to be modeled by using the reductionist approach of successive subdivision, searching for ''elementary'' constituents. Nature provides us with plenty of examples of these systems, in fields as diverse as biology, chemistry, geology, physics, and fluid mechanics, and engineering. What happens, in general, is that for these systems we have a situation where a large number of both attracting and unstable chaotic sets coexist. As a result, we can have a rich and varied dynamical behavior, where many competing behaviors coexist. In this work, we present and discuss simple mechanical systems that are nice paradigms of Complex System, when they are subjected to random external noise. We argue that systems with few degrees of freedom can present the same complex behavior under quite general conditions.

The use of protein structure/activity relationships in the rational design of stable particulate delivery systems

The recombinant heat shock protein (18 kDa-hsp) from Mycobacterium leprae was studied as a T-epitope model for vaccine development. We present a structural analysis of the stability of recombinant 18 kDa-hsp during different processing steps. Circular dichroism and ELISA were used to monitor protein structure after thermal stress, lyophilization and chemical modification. We observed that the 18 kDa-hsp is extremely resistant to a wide range of temperatures (60% of activity is retained at 80��C for 20 min). N-Acylation increased its ordered structure by 4% and decreased its ��-T1 structure by 2%. ELISA demonstrated that the native conformation of the 18 kDa-hsp was preserved after hydrophobic modification by acylation. The recombinant 18 kDa-hsp resists to a wide range of temperatures and chemical modifications without loss of its main characteristic, which is to be a source of T epitopes. This resistance is probably directly related to its lack of organization at the level of tertiary and secondary structures.

Heart rate recovery after exercise: relations to heart rate variability and complexity

Physical exercise is associated with parasympathetic withdrawal and increased sympathetic activity resulting in heart rate increase. The rate of post-exercise cardiodeceleration is used as an index of cardiac vagal reactivation. Analysis of heart rate variability (HRV) and complexity can provide useful information about autonomic control of the cardiovascular system. The aim of the present study was to ascertain the association between heart rate decrease after exercise and HRV parameters. Heart rate was monitored in 17 healthy male subjects (mean age: 20 years) during the pre-exercise phase (25 min supine, 5 min standing), during exercise (8 min of the step test with an ascending frequency corresponding to 70% of individual maximal power output) and during the recovery phase (30 min supine). HRV analysis in the time and frequency domains and evaluation of a newly developed complexity measure - sample entropy - were performed on selected segments of heart rate time series. During recovery, heart rate decreased gradually but did not attain pre-exercise values within 30 min after exercise. On the other hand, HRV gradually increased, but did not regain rest values during the study period. Heart rate complexity was slightly reduced after exercise and attained rest values after 30-min recovery. The rate of cardiodeceleration did not correlate with pre-exercise HRV parameters, but positively correlated with HRV measures and sample entropy obtained from the early phases of recovery. In conclusion, the cardiodeceleration rate is independent of HRV measures during the rest period but it is related to early post-exercise recovery HRV measures, confirming a parasympathetic contribution to this phase.