31 resultados para Special complexity
em Scielo Saúde Pública - SP
Resumo:
Results obtained with catches performed at several sites of the Ribeira Valley, SP (Brazil) are reported. Collections with Shannon type traps showed a concentration of An.albitarsis s.l. in the Experimental Farm of Pariquera-Açu County, associated with the development of irrigated rice cultivation. Two species of the complex, named A and B, were recognized. Species B predominated in the samples. Indoor and outdoor crepuscular human bait captures were performed a the domiciliary environment. The two species showed a generally low William's media valve of 0.2, the highest value obtained was 1.6. No differences were found between indoor and outdoor behaviours between the two species of the complex.
Resumo:
Review of the early literature as well as more recent results show that sulfonamides possess a distinct antimalarial activity. However, when give alone, their action is less marked and slower than that of the antimalarials commonly used in the treatment of the acute attack. Combinations with pyrimethamine provide better results, even in cases of pyrimethamine and chloroquine resistance. This warrants further investigations in an attempt to develop a therapeutic agent suitable for the treatment of such resistant cases. It may also be possible with an appropriate combination of pyrimethamine with a sulfonamide to achieve a satisfactory method for suppressive treatment both in areas with and without pyrimethamine resistance. Three main points must still be carefully studied: 1) the risk of developing malaria resistance against one or both of the components of the combination. 2) The risk of developing bacterial resistance to sulfonamides if these substances are used on a large scale in too low doses. It seems indeed that antimalarial effect with the combination of sufonamides + pyrimethamine can be obtained with doses of sulfonamides which are below those usually employed in bacterial diseases. Since the range of the ratios providing potentiation is rather large, only ratios of the combination sulfonamides: pyrimethamine should be chosen in which an antfbacterial sulfonamidemia is guaranteed. 3) It goes without sayinq that, although both pyrimethamine and modem sulfonamides, when given by themselves, have proved tc possess a large margin of safety, long term administration of their combination should be careful studied from the point of view of possible side effects. Substantial evidence has already been produced to show that the long acting sulfonamide Fanasil (Ro 4-4393) given once or once weekly possesses marked schizonticidal activity against P. falciparum. Although its action is slower than that of 4-aminoquinolines, it may be useful as a second choice drug in semi-immune subjects for the therapy of falciparum malaria. Preliminary results show that, when combined with pyrimethamine, Fanasil is highly effective in suppressing fever and asexual parasitemia due to P. falciparum. Single doses of 1 g Fanasil together with 50 mg pyrimethamine seem to be adequate for the treatment of acute falciparum malaria in semi-immune patients. The onset of action of the combination is much more rapid than that of the single components. Weekly doses of 500 mg Fanasil and 25 mg pyrimeihamine appear to provide satisfactory suppressive effects against P. falciparum at least in East Africa. This combination is active on strains which do not respond satisfactorily to the standard doses of pyrimethamine and/or chloroquine and seems to have a satisfactory sporontocidal effect. Preliminary results indicate that Fanasil alone cannot be recommended for use against the other human malaria parasites. The combination with pyrimethamine appears to be much more effective. East African strains of P. malariae seem to respond better to the combination than do Malayan strains of P. vivax but further trials are required before definite assessment can be made. Fanasil by itself has no gametocytoddal or sporontocidal action but seems to potentiate the effect of pyrimethamine at least on sporogony of P. falciparum.
Resumo:
We aimed to assess and synthesize the information available in the literature regarding the treatment of American tegumentary leishmaniasis in special populations. We searched MEDLINE (via PubMed), EMBASE, LILACS, SciELO, Scopus, Cochrane Library and mRCT databases to identify clinical trials and observational studies that assessed the pharmacological treatment of the following groups of patients: pregnant women, nursing mothers, children, the elderly, individuals with chronic diseases and individuals with suppressed immune systems. The quality of evidence was assessed using the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) approach. The available evidence suggests that the treatments of choice for each population or disease entity are as follows: nursing mothers and children (meglumine antimoniate or pentamidine), patients with renal disease (amphotericin B or miltefosine), patients with heart disease (amphotericin B, miltefosine or pentamidine), immunosuppressed patients (liposomal amphotericin), the elderly (meglumine antimoniate), pregnant women (amphotericin B) and patients with liver disease (no evidence available). The quality of evidence is low or very low for all groups. Accurate controlled studies are required to fill in the gaps in evidence for treatment in special populations. Post-marketing surveillance programs could also collect relevant information to guide treatment decision-making.
Resumo:
A Subclasse Alismatidae nos neotrópicos é composta de nove famílias com 11 gêneros das quais, nove ocorrem na bacia amazônica e cinco no Brasil extra-amazônico. Apenas duas famílias não estão presentes no Brasil e mais duas ausentes da Amazônia brasileira. Este trabalho apresenta descrições detalhadas das famílias e gêneros, além de comentários sobre distribuição geográfica dos gêneros. As famílias estão organizadas na sequência sistemática que nós aceitamos. Os gêneros de cada família estão organizados em ordem alfabética i=sem significado sistemático. Fornecemos desenhos de pelo menos um gênero para cada família. Referências importantes -- tais como revisões genéricas, levantamentos da literatura, ou monografias de áreas neotropicais — estão relacionadas no início de cada tratamento a nível de família. As excelentes coleções do Projeto Flora Amazônica foram de importância decisiva para nosso trabalho-, sem elas não poderiamoi fazer um tratamento genérico completo para toda a região neotrópica.
Resumo:
FUNDAMENTO: A complexidade da farmacoterapia consiste de múltiplas características do regime prescrito, incluindo o número de diferentes medicações no esquema, o número de unidades de dosagem por dose, o número total de doses por dia e os cuidados na administração dos medicamentos. O Medication Regimen Complexity Index (MRCI) é um instrumento específico, validado e utilizado para medir a complexidade da farmacoterapia, desenvolvido originalmente em língua inglesa. OBJETIVO: Tradução transcultural e validação desse instrumento para o português do Brasil. MÉTODOS: Foi desenvolvido um estudo transversal envolvendo 95 pacientes com diabete do tipo 2 utilizando múltiplas medicações. O processo de validação teve início pela tradução, retrotradução e pré-teste do instrumento, gerando uma versão adaptada chamada Índice de Complexidade da Farmacoterapia (ICFT). Em seguida foram analisados parâmetros psicométricos, incluindo validade convergente, validade divergente, confiabilidade entre avaliadores e teste-reteste. RESULTADOS: A complexidade da farmacoterapia medida pelo ICFT obteve média de 15,7 pontos (desvio padrão = 8,36). O ICFT mostrou correlação significativa com o número 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 correlação intraclasse igual a 0,99 (p < 0,001) e a confiabilidade teste-reteste obteve correlação de 0,997 (p < 0,001). CONCLUSÃO: Os resultados demonstraram que o ICFT apresenta bom desempenho de validade e confiabilidade, podendo ser utilizado como ferramenta útil na prática clínica e em pesquisas envolvendo análise da complexidade da terapia.
Resumo:
Cardiovascular diseases are the main causes of mortality and morbidity in Brazil. Their primary and secondary preventions are a priority for the health system and require multiple approaches for increased effectiveness. Biomarkers are tools used to identify with greater accuracy high-risk individuals, establish a faster diagnosis, guide treatment, and determine prognosis. This review aims to highlight the importance of biomarkers in clinical cardiology practice and raise relevant points regarding their application and perspectives for the next few years. This document was divided into two parts. This second part addresses the application of biomarkers in coronary heart disease, valvular diseases, cardio-oncology, pulmonary embolism, and cardiorenal syndrome.
Resumo:
The genus Thylamys Gray, 1843 lives in the central and southern portions of South America inhabiting open and shrub-like vegetation, from prairies to dry forest habitats in contrast to the preference of other Didelphidae genera for more mesic environments. Thylamys is a speciose genus including T. elegans (Waterhouse, 1839), T. macrurus (Olfers, 1818), T. pallidior (Thomas, 1902), T. pusillus (Desmarest, 1804), T. venustus (Thomas, 1902), T. sponsorius (Thomas, 1921), T. cinderella (Thomas, 1902), T. tatei (Handley, 1957), T. karimii (Petter, 1968), and T. velutinus (Wagner, 1842) species. Previous phylogenetic analyses in this genus did not include the Brazilian species T. karimii, which is widely distributed in this country. In this study, phylogenetic analyses were performed to establish the relationships among the Brazilian T. karimii and all other previously analyzed species. We used 402-bp fragments of the mitochondrial cytochrome b gene, and the phylogeny estimates were conducted employing maximum parsimony (MP), maximum likelihood (ML), Bayesian (BY), and neighbor-joining (NJ). The topologies of the trees obtained in the different analyses were all similar and pointed out that T. karimii is the sister taxon of a group constituted of taxa from dry and arid environments named the dryland species. The dryland species consists of T. pusillus, T. pallidior, T. tatei, and T. elegans. The results of this work suggest five species groups in Thylamys. In one of them, T. velutinus and T. kariimi could constitute a sister group forming one Thylamys clade that colonized Brazil.
Resumo:
It is well-known that diverse groups of vegetation with an analogous but not identical floristic composition show an ecological similarity which leads to a determined type of vegetation. Starting from this fact it becomes evident that the scope of phytosociological work is the establishing of the significance of the species within the association and the discovery of the rules which govern associations. The floristic surveys made in the field have to be analysed statistically so as to obtain satisfactory results. The usefulness of this method depends largely on the possibilities of comparing the results with previous studies of the same kind, in the same country, or elsewhere. The method used in this paper is that of measuring circumferences and counting individuals in the different associations studied because it permits the presentation of the results in tables which show the phytosociological complexity of the Brazilian rain-forests. The classical method of characteristics is valuable because the more evolved an association is the less sociable are the species it contains, so that such groups do not show clear differences between species but rather between sinusia or strata of individuals. Five tables are presented in which several of the qualitative and quantitative characteristics are studied with a view to discussing their value in relation to groups and species. They are: I - Abundance (number of individuals). II - Density (distance in meters between the individuals belonging to each stratum). III - Basal coverture (circles measured in square meters of the mean projection of the individuals on the surface). IV - Basal area (mean circle in square meters occupied by individuals on the surface). V - Frequency, abundance and sociability in relation to occurrence. TABLE I. This table indicates first the number of individuals in relation to the sinusia studied: next, the sum total of the individuals belanging to the strata are given for each association, thus providing the numeric value of the sinusia: finally, the relation between the total number of individuals in the association and the total for the sinusium thus fursnishing the abundance per sinusium, in the classic sence, that is the percentage, or rather the relative number, of the elements which compose the group. CONCLUSIONS. The general character of abundance of the regional vegetation of Ilheos may be summed up in the following way: as an association evolves towards permanent equilibirum the number of individuals the inferior strata diminishes in relation to those of the superior strata which increase. For the shrub sinusium, two important facts were observed: a) in a given association the number of elements of the inferior strata diminishes as the diameter of the individuals increases; b) the percentage of individuals belonging to the shrub sinusium in the sere diminishes as the association evolve. In the subarboreal sinusium it is seen that: in the sere the number of subarboreal individuals does not vary much; whereas in the climax or the prisere there is a fall owing to the equilibrum of the biologic forms. In the arboreal sinusium the following conclusion can be deduced from analogous facts: the number of individuals of the lower strata diminishes as circumference increases. Also, in the sere there is a progressive sequence for the individuals belonging to the superior strata. TABLE II. The relation between the mean distances of individuals belonging to the same stratum and the area of an association is equal to the density. The table shows that the mean density of the association and the distance between the individuals belonging to the strata of the same sinusium in relation to the total number of individuals belonging to the association. CONCLUSIONS. As rule, the density of individuals in the associations studied follows a very general character or at least a regional one: the distance between the individuals in the diverse strata varies according to their abundance and sociability. Two other facts of some sociological importance are: a) in identical strata of the same sere the density of individuals oscillates in an analogous manner in teh subclimaces and varies in the stages which have reached equilibrium. b) the density of individuals varias in accordance with the sinusium and the distances between individuals of the same sinusium varg in accordance with the strata. TABLE III. This table presents the mean basal individual coverture, that is the mean projection of the frond of the various individuals belonging to the same stratum. The means were obtained by measurement in the field, of 100 individuals belonging to each stratum and their projection on the surface. In the latoratory these measurements were converted into mean circles (in square meters) and the result was multiplied by the individuals belonging to the strata corresponding to the sinusium of each association. The result obtained is named basal coverture. CONCLUSIONS. As a rule, the basal coverture of the vegetation of the county of Ilhéus indicates that: in the evolution of the vegetation the basal coverture of the arbustive sinusium diminishes progressively whereas that of the arboreal one increases. The special norms obtained are: 1) in the shrub sinusium the basal coverture seems to follow a uniform norm, that is, in stages of evolution of the subclimax the basal coverture oscillates with a certain uniformity. 2) in the subarboreal sinusium this fact is related to the vitality and age of the species, as in the subclimax the number of young trees is large and the vitality of the species very variable. This permits the conclusion that: in the sere the basal coverture increases with the evolution of the vegetation and diminishes when an equilibrium is reached. 3) in the tree sinusium the climax association of the prisere and subsere seem to obey a binomial rule, as the coverture (density-abundance) increases until a determined stratum is reached and...
Resumo:
Six species of Leishmania are at present known to cause cutaneous and/or mucocutaneous leishamniasis in Brazil, and they are all to be found in the Amazon region of this country. The eco-epidemiology of each is discussed, with the observation that the Amazonian leishmaniases are all zoonoses, with their source in silvatic mammals and phlebotomine sandfly vectors. With man's destruction of the natural forest in southern Brazil, some sandfly species have survived by adapting to a peridomestic or domiciliary habitat in rural areas. Some domestic animals, such as dogs and equines are seemingly now involved in the epidemiology of the disease. No such process has yet been reported in the Amazon region, but may well take place with the continuing devastation of its forest.
Resumo:
The systematic screening of more than 250 molecules against Plasmodium falciparum in vitro has previously shown that interfering with phospholipid metabolism is lethal to the malaria parasite. These compounds act by impairing choline transport in infected erythrocytes, resulting in phosphatidylcholine de novo biosynthesis inhibition. A thorough study was carried out with the leader compound G25, whose in vitro IC50 is 0.6 nM. It was very specific to mature parasites (trophozoïtes) as determined in vitro with P. falciparum and in vivo with P. chabaudi -infected mice. This specificity corresponds to the most intense phase of phospholipid biosynthesis activity during the parasite cycle, thus corroborating the mechanism of action. The in vivo antimalarial activity (ED50) against P. chabaudi was 0.03 mg/kg, and a similar sensitivity was obtained with P. vinckei petteri, when the drug was intraperitoneally administered in a 4 day suppressive test. In contrast, P. berghei was revealed as less sensitive (3- to 20-fold, depending on the P. berghei-strain). This difference in activity could result either from the degree of synchronism of every strain, their invasion preference for mature or immature red blood cells or from an intrinsically lower sensitivity of the P. berghei strain to G25. Irrespective of the mode of administration, G25 had the same therapeutic index (lethal dose 50 (LD50)/ED50) but the dose to obtain antimalarial activity after oral treatment was 100-fold higher than after intraperitoneal (or subcutaneous) administration. This must be related to the low intestinal absorption of these kind of compounds. G25 succeeded to completely inhibiting parasitemia as high as 11.2% without any decrease in its therapeutic index when administered subcutaneously twice a day for at least 8 consecutive days to P. chabaudi -infected-rodent model. Transition to human preclinical investigations now requires a synthesis of molecules which would permit oral absorption.
Resumo:
Field work research on population dynamic of snails from the regions of Belo Horizonte and Lagoa Santa give much information about interactions among two or more species of mollusks: Pomacea haustrum, Biomphalaria glabrata, B. tenagophila, B. straminea and Melanoides tuberculata. Data ranging from two years to several decades ago suggest that the Pampulha reservoir is like a cemetery of B. glabrata and B. straminea, species that coexist for more than 14 years in a small part of a stream, whereas only B. glabrata lives in all the streams of the basin. In the last ten to twenty years B. tenagophila has coexisted with P. haustrum and M. tuberculata in the Serra Verde ponds and in the Pampulha dam. However these species have not settled in any of the brooks, except temporarily. The data suggest that the kind of biotope and the habitat conditions are decisive factors for the permanence of each species in its preferencial biotope. B. glabrata, natural from streams and riverheads, quickly disappears from the reservoirs and ponds where it coexists with other species for a short time, independently of the competitive process. Competition needs to be better studied, since in Central America and Caribean islands this kind of study has favored the biological control of planorbid species.