Definição de uma lista com relevância para o ambulatório

Dissertação para obtenção do grau de Mestre no Instituto Superior de Ciências da Saúde Egas Moniz

Produção e caracterização de compostos bioativos utilizando fungos endófitos

O potencial biotecnológico dos fungos endófitos é actualmente reconhecido, contudo a sua utilização à escala industrial é ainda muito limitada. Isso deve-se, sobretudo ao facto do seu crescimento e composição de metabolitos formados ser dependente e variar de acordo com as condições de crescimento e da influência e interacções com a sua planta hospedeira. É fundamental, por isso, que se criem estratégias e condições simples, mas eficazes, que possibilitem o cultivo destes fungos e consequentemente a produção de compostos biologicamente activos. É importante a par de estratégias de isolamento e caracterização de novas espécies de microrganismos endofíticos sejam também optimizadas condições de crescimento e produção dos seus metabolitos e posteriormente a sua purificação e caracterização. O trabalho experimental teve como principal objectivo optimizar as condições de crescimento e de formação de produtos com actividade antimicrobiana do fungo endófito Fusarium oxysporum isolado da oliveira. As condições estudadas e variadas foram a concentração inicial de glucose (1, 2 e 3%), pH (5,5; 6,5 e 7,5), temperatura (20, 25 e 30 ºC) e agitação (80, 160 e 240 rpm). Verificou-se que as condições que permitiram um maior crescimento do fungo Fusarium oxysporum foram 25 ºC, 30 g/L de glucose inicial, 240 rpm e pH 5,5. No entanto, não se verificou uma diferença significativa no crescimento do fungo relativamente à temperatura de 30 ºC, à concentração inicial de glucose de 20 g/L, a uma agitação de 160 rpm e ao pH 7,5. A formação de compostos com actividade antibacteriana foi favorecida quando as condições de fermentação foram 25 ºC, 10 g/L de glucose inicial, uma agitação de 80 rpm e um pH inicial de 7,5. Contudo, a concentração de compostos com poder antibacteriano presentes nos extractos fúngicos foi muito reduzida, dificultando a sua purificação e caracterização. Os resultados obtidos parecem indicar que se deveria utilizar condições de fermentação diferentes em termos de agitação e concentração inicial de glucose, quando se pretende optimizar o crescimento e a formação de compostos bioactivos, Contudo, será necessário a realização de mais experiências para se conseguir estipular as condições óptimas e um crescimento mais homogéneo dos fungos de fermentação para fermentação.

Terapêutica antiretroviral e metabolismo lipídico

Dissertação para obtenção do grau de Mestre no Instituto Superior de Ciências da Saúde Egas Moniz

Xilanas de sabugo de milho como agente antioxidante, citotóxico, anticoagulante e imunomodulador

Prospecting pharmacological active polysaccharides from agricultural byproducts, such as corncobs, is an underexplored practice in the scientific community. Thus, this work aims to expand knowledge about pharmacological activities of polysaccharides extracted from corncobs. From corn cob flour a extract was obtained by ultrasound waves in an alkaline medium, and the end of the process the product was termed PECC (polysaccharidic extract from corncobs). This extract was physicochemical characterized and evaluated by in vitro assays as an antioxidant, cytotoxic, anticoagulant and imunomodulator agent. Results indicated significant activity metal chelating by PECC, and the use of PECC in cell culture cells showed no toxic effects to normal cell lines, but toxic action against HeLa tumor cells due promoting cell death by apoptosis. In addition, other pharmacological effects were observed, the PECC decreased nitric oxide (NO) production by activated macrophages, and prolonged blood clotting time through APTT assay. Then methanolic, ethanolic and ketone fractions were obtained from fractionation of PECC polysaccharides. Five methanolic fractions, six ethanolic fractions and two ketones were obtained; and all fractions were evaluated for antioxidant, cytotoxic, anticoagulant, immunomodulatory activities. E1.4 fraction exhibited significant metal chelating effect, a toxic action to induce apoptosis in HeLa cells, decreased NO production by activated macrophages, and extended blood clotting time. These results showed that the PECC pharmacological active polysaccharides would be present in the fraction E1.4. From fractionation of E1.4 polysaccharide six subfractions with different sizes were obtained: <3; 3-10; 10-30; 30-50; 50-100 and >100 KDa. About 80% of E1.4 polysaccharides had lower size to 10 KDa, and all the subfractions showed over 61% sugar in their chemical compositions. These subfractions exhibited different monosaccharide compositions, but xylose was presented in all of them. The subfractions exhibited distinct pharmacological effects in in vitro assays. Smaller subfractions (<30 KDa) had highest metal chelating activity and greater toxic action in tumor cells. The intermediate fractions (between 30-100 KDa) decreased more NO production of activated macrophages, for other side, the larger size (>100 KDa) modulated a greater number of inflammatory cytokines, and the had greatest anticoagulant effect. Therefore, when analyzing all the results together it is evident that the PECC pharmacological polysaccharides are heteroxylans, and were concentrated in E1.4 fraction, and heteroxilanas pharmacological effects depends on their molecular size. Thus, corncobs could be used as source from molecules with biotechnology potential

Quintosana e seus derivados conjugados com ácido gálico: avaliação de seu potencial antioxidante e de interferência na formação de cristais de oxalato de cálcio

Chitin is the second most abundant polysaccharide in nature and its derivative chitosan has been widely studied due to its unique chemical and pharmacological properties. However, studies show that when this molecule is used as food, drug, etc. it tends to accumulate in renal tissue and promotes an increase in calcium excretion. Nevertheless, the effect of chitosan on the formation of calcium oxalate (OxCa) crystals has never been evaluated. The formation of kidney stones (urolithiasis) is the disease that most often affects the kidneys and the urinary system. In addition, this is a disease with high prevalence and recurrence. Many molecules with antioxidant activity have been shown to decrease the potential for in vitro OxCa crystals formation. Thus, the aim of this study was to evaluate the effect of low molecular weight chitosan and its derivatives conjugated to gallic acid (AG) as antioxidant and inhibitor of OxCa crystals formation. The physico-chemical analysis confirmed the identity of chitosan. This molecule was subjected to five antioxidant tests and showed an excellent copper chelating activity. However, chitosan did not show other significant antioxidant activity. When chitosan was subjected to in vitro crystal formation tests, it increased the number of OxCa monohydrate crystals, modified the morphology of the crystals, modified the proportions between populations of crystals in solution and increased the zeta potential of these crystals formed. Four molecules of chitosan conjugated with GA were obtained. The physico-chemical analysis confirmed that chitosan and AG were covalently bonded. However, the amount of GA liked to chitosan did not increase even when 10 times more GA was used in experiment. When these derivatives were subjected to antioxidant tests, all chitosan conjugates showed higher antioxidant potential than their precursors. However, they showed different activity between them, which indicating that the position where AG is conjugated is an important factor for chitosan-GA activity. When conjugated chitosans were submitted to in vitro crystal formation tests, a reduction in the crystals number was observed when compared with those formed in the presence of unconjugated chitosan. Chitosan has a strong capacity for inducing OxCa monohydrate crystal formation, as well as modify their morphology and zeta potential. Over all, the process of conjugating AG to chitosan led to an increase in antioxidant potential of this molecule and was also able to decrease its capacity of inducing in vitro crystal formation

Avaliação funcional e estrutural de um novo peptídeo antimicrobiano do escorpião Tityus stigmurus

In Brazil, there is a high incidence of venomous animals. Among them, scorpions are highlighted by their medical importance, and for being their venom a source of several molecules with biological and pharmacological activity not yet fully understood, including several bioactive peptides. Antimicrobial peptides (AMPs) are components of the immune system in prokaryotes and eukaryotes, used in the first line of defense against microorganisms. In the present study, we characterized the first PAM previously identified through transcriptome of the venom gland of the scorpion Tityus stigmurus, named Stigmurin. The characteristics of Stigmurin were investigated by computational modeling and construction of dendrogram. In vitro tests investigated the antibacterial, antifungal, haemolytic and cytotoxic effects of crude venom and Stigmurin. In addition, the structural characteristics of Stigmurin were investigated by circular dochroism in water, 2, 2 , 2- trifluoethanol (TFE) and sodium dodecyl sulfate (SDS) and the models were refined by molecular dynamics simulations. The results showed that the selected sequence encodes a mature protein of 17 amino acid residues and the dendrogram reveals a case of convergent evolution. The crude venom showed no antimicrobial activity, however, Stigmurin exhibited a broad spectrum of antibacterial activity, with minimal inhibitory concentrations (MIC) ranging from 31.25 and 250 µg/mL for different strains, while the hemolytic activity at these concentrations was low. In cytotoxicity studies, the crude venom was unable to reduce cell viability in VERO E6 cells; in contrast, its activity in SiHa cells was significantly higher, corresponding to IC50 of 3.6 µg/mL. For Stigmurin the concentration sable to decrease cell viability of Vero E6 and SiHa cells in 50% were 275.67 µg/mL and 212.54 µg/mL, respectively. The dichroism spectra revealed the conformational flexibility, with predominating extended and β–sheet structures, as well as a remark able renaturation ability. The results suggest that Stigmurin could be considered as a potential antiinfective drug

Estudo fitoquímico de Waltheria ferruginea

The Waltheria genus belonging to the Sterculiaceae family, it is reported as a prolific source of flavonoids and quinolone alkaloids, substances of great interest due to several associated biological activities. This work describes a novel phytochemical study from Waltheria ferruginea, aiming to contribute to the chemical knowledge of this specie and the isolation of substances with biological potential. For the phytochemical study were used chromatography techniques on silica gel and molecular exclusion in Sephadex LH-20.The structural elucidation of the isolated compounds was performed through spectrometric techniques 1H and 13C NMR, including uni and bidimensional pulse sequences, and comparison with data from literature. Five substances were isolated, namely: the flavonids kaempferol-3-O-β-(6''-cumaroil)-glucopyranoside (F1) and kaempferol -3 -O- β - glucopyranoside (F2), both analyzes with pharmacological properties, the flavonol quercetin-3-O-β-glucopyranoside (F3 ) pure and in the epimeric mixture α (F3') and (F3), the terpenegeranyl - geranyl (G1) and the 12-hydroxi-octadecanoic acid, all no previous reported in the literature.

Dextranas e seus derivados fosforilados: obtenção e avaliação do potencial antioxidante, imunomodulatório e anticoagulante

Glucans are polysaccharides with different pharmacological and biological activities described. However, there are some reports about the activities of the glucan type α (alpha). In this context, a group of α-D-glucans called dextrans extracted from Leuconostoc mesenteroides bacteria, with molecular weights of 10 (D10), 40 (D40) and 147 (D147) kDa and their phosphorylated derivatives P10, P40 and P147, were evaluated as for their antioxidant, anticoagulant and immunomodulatory potential for the first time, in order to elucidate compounds with potent activities and low toxicity. Infrared spectroscopy analysis, monosaccharide composition and chemical dosages showed that these dextrans are the same polysaccharide, but with different molecular weights, besides confirming the success of phosphorylation. None presented with anticoagulant features. The reducing power test showed that D147 was twice as potent as other dextrans. On the other hand, all six samples showed similar activity (50%) when it came to scavenging the OH radical. To the superoxide ion scavenging, only D10 had a pronounced activity (50%). D40 was the single native dextran that presented with immunomodulatory features since it double stimulated the proliferation of murine macrophages (RAW 264.7) and double the release of nitric oxide by the cells, both in the absence and presence of lipopolysaccharides (LPS). In addition, D40 showed a greater scavenging activity (50%) for the hydrogen peroxide, which caused it to also be the more potent dextran when it came to inhibiting lipid peroxidation (70%). On other hand, P147 showed the highest iron and copper ion chelation activity (~85%). P10 proved be the most effective compound to macrophage proliferation. The results point toward dextrans with a 40 kDa weight as being ideal for antioxidant and immunomodulatory use, could be supplemented with phosphorylated derivatives. However, future studies with the D40 and other similarly dextrans are to confirm this hypothesis.

Valoración clínica de felinos de Borneo en programas de conservación: pantera nebulosa sunda (Neofelis diardi) y gato leopardo (Prionailurus bengalensis)

El hábitat de los felinos del Sudeste Asiático está sufriendo grandes cambios debidos a la acción del hombre. La pérdida de hábitat supone la principal amenaza para las poblaciones salvajes de estas especies y es necesaria la creación de programas de conservación que aseguren su supervivencia. Los aspectos veterinarios en estos programas son de gran utilidad y relevancia para el manejo adecuado y seguro de estas especies tanto en vida libre como en cautividad. Los objetivos del trabajo de campo (in-sito) realizado en esta tesis fueron: evaluar la eficacia y las características anestésicas y los efectos fisiológicos de dos combinaciones farmacológicas (tiletamina-zolacepam; medetomidina-ketamina) empleadas en dos felinos salvajes de Borneo (pantera nebulosa Sunda - Neofeiis diardi- y gato leopardo - Prionailurus bengaleusis borneoensis-) así como evaluar la hematología y bioquímica sérica en estas especies tras la captura mediante jaula-trampa...

Caracterización de un modelo murino de glaucoma: implicación funcional de la señalización del receptor P2X7 en procesos neurodegenerativos de la retina

El glaucoma es una de las causas más comunes de discapacidad visual y una de las enfermedades neurodegenerativas oculares más frecuentes de pérdida irreversible de visión. La afectación originada en la retina se caracteriza por la degeneración de las células ganglionares y la pérdida de axones. La presión intraocular es un factor de riesgo importante en el glaucoma, entre otros factores, implicando mecanismos bioquímicos que desencadenan la muerte de las células ganglionares. El ratón DBA/2J es un modelo de hipertensión ocular y de degeneración de las células ganglionares de la retina (CGR). Las características principales de éste son la dispersión del pigmento del iris (IPD) y la atrofia del estroma del iris (ISA) que conducen a la patogénesis del glaucoma. Los mecanismos bioquímicos que comprometen al sistema purinérgico en procesos patológicos como la degeneración glaucomatosa han sido estudiados en los últimos años, siendo de gran relevancia como posibles dianas farmacológicas para el tratamiento de diferentes neuropatías. Los receptores P2X comprenden una familia de siete canales iónicos de membrana activados por ligando (P2X1-7) que se activan por el ATP extracelular (ATPe). En particular, los receptores P2X7 podrían estar involucrados en la regulación de la transmisión sináptica y la muerte neuronal en la retina. Además, la excitotoxicidad mediada por ATP a través de la activación del receptor P2X7 sugiere su posible implicación en la degeneración neuronal y la pérdida de la función visual en las retinas glaucomatosas. Tan importante como la presencia de este receptor purinérgico es estudiar los niveles de ATP extracelular de la retina, así como evaluar los cambios en la expresión del transportador de nucleótidos vesicular (VNUT) y los niveles de ecto-nucleotidasa (E-NPP1) en este modelo murino de glaucoma durante el desarrollo de la enfermedad...

Applicability of non-pharmacological strategies for pain relief in parturient: integrative review

MORAES, Maísa Suares Teixeira; ROLIM, Lariane Thays Albuquerque; ENDERS, Bertha Cruz; FARIAS, Glaucea Maciel de; DAVIM, Rejane Marie Barbosa. Applicability of non-pharmacological strategies for pain relief in parturient: integrative review. Revista de Enfermagem UFPE on line, v.4, n.especial, p.131-136, May/June 2010. Disponivel em:< http://www.ufpe.br/revistaenfermagem/index.php/revista/>.

A Mudança Narrativa e a Formação Parental: estudo exploratório

A presente investigação tem como objectivo analisar e descrever as mudanças ocorridas, em particular a transformação narrativa nos pais que frequentaram um grupo de Formação Parental, aplicando para tal, a Grelha de Análise do Processo Terapêutico (GAPT) enquanto instrumento de avaliação da mudança narrativa, ao longo das sessões do programa. A GAPT é constituída por 5 dimensões, que, correspondem aos eixos considerados importantes na transformação narrativa, ou seja na mudança dos sistemas. Nesse sentido foram transcritas e cotadas em painel de peritos, 10 sessões do Programa “Incredible Years”, tendo em conta os 4 subsistemas parentais que o frequentaram. Verificou-se que ocorreram Singularidades, em grande número, desde o início da intervenção e que estas tendiam gradualmente em diversificar-se, flexibilizando a narrativa: no Eixo das Interacções, na Forma como é Narrada a História, na sua Conotação e nos seus Temas Centrais. Em suma a amplificação das Singularidades possibilita a reorganização e reconceptualização coerente das experiências do sujeito, que quanto mais complexa for mais coerente é o seu significado

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

Sedação consciente em Odontopediatria

O medo e a ansiedade estão estreitamente relacionados com o tratamento dentário e, infelizmente, na população infantil este facto assume uma magnitude aumentada traduzindo-se muitas vezes de forma negativa no comportamento da criança comprometendo ou mesmo inviabilizando a execução do mesmo. O tratamento dentário de pacientes pediátricos com problemas comportamentais pode ser um verdadeiro desafio para o médico dentista e as tradicionais técnicas de controlo comportamental não farmacológicas nem sempre são suficientes para conseguir a cooperação da criança pelo que, em muitos casos, é necessária a associação dos mesmos a técnicas farmacológicas. A sedação consciente é utilizada em odontopediatria como uma técnica de controlo comportamental farmacológica, que visa induzir na criança, um estado mínimo de depressão da consciência, tornando-a passível de cooperar e viabilizando que os tratamentos necessários sejam efectuados com segurança. Existem inúmeros fármacos, técnicas e associações das mesmas que podem ser utilizadas para o efeito sendo que actualmente, em odontopediatria, predomina a prática da sedação consciente inalatória com protóxido de azoto e a utilização de benzodiazepinas como o midazolam. Apesar das muitas técnicas descritas, nenhuma delas é passível de ser administrada a todos os pacientes, pelo para cada caso, tendo em conta todas as particularidades, haverá uma técnica mais adequada. Apesar prática da sedação consciente ser uma mais-valia em odontopediatria, não é isenta de riscos e o médico dentista deve ter formação adequada para a providenciar de forma segura. Diferentes entidades publicaram guidelines que visam orientar a prática segura da sedação e minimizar o risco de incidentes.

Techniques for batch reinforcement learning in robotics

This thesis addresses the Batch Reinforcement Learning methods in Robotics. This sub-class of Reinforcement Learning has shown promising results and has been the focus of recent research. Three contributions are proposed that aim to extend the state-of-art methods allowing for a faster and more stable learning process, such as required for learning in Robotics. The Q-learning update-rule is widely applied, since it allows to learn without the presence of a model of the environment. However, this update-rule is transition-based and does not take advantage of the underlying episodic structure of collected batch of interactions. The Q-Batch update-rule is proposed in this thesis, to process experiencies along the trajectories collected in the interaction phase. This allows a faster propagation of obtained rewards and penalties, resulting in faster and more robust learning. Non-parametric function approximations are explored, such as Gaussian Processes. This type of approximators allows to encode prior knowledge about the latent function, in the form of kernels, providing a higher level of exibility and accuracy. The application of Gaussian Processes in Batch Reinforcement Learning presented a higher performance in learning tasks than other function approximations used in the literature. Lastly, in order to extract more information from the experiences collected by the agent, model-learning techniques are incorporated to learn the system dynamics. In this way, it is possible to augment the set of collected experiences with experiences generated through planning using the learned models. Experiments were carried out mainly in simulation, with some tests carried out in a physical robotic platform. The obtained results show that the proposed approaches are able to outperform the classical Fitted Q Iteration.