Gestão da Assistência Farmacêutica: módulo transversal 1: unidade 3: avaliação em saúde e avaliação da assistência farmacêutica - parte 1

Esta unidade trata da avaliação, pois não há como fazer gestão sem avaliar se o resultado está sendo alcançado. Inicialmente apresenta-se o primeiro conceito para o termo “Avaliar” e suas variações. Não há uma definição única para avaliação, pois o termo “avaliação”, para ganhar significado, necessita estar acompanhado de outros termos que informem sobre o objeto e o sujeito da avaliação, além dos seus propósitos, objetivos e modos de proceder. A Unidade aborda a avaliação em saúde na lição 2, afim de fazer com que o aluno consiga relacionar os principais conceitos de avaliação em saúde. Para tanto, apresenta os termos da avaliação dos resultados (eficácia, eficiência e efetividade). Na lição 3, são fornecidas informações para que o aluno consiga classificar e diferenciar as diferentes tipologias de avaliação. Apresenta o modelo de Donabedian, considerado como sendo um dos mais empregados para avaliação da qualidade em saúde, principalmente referente aos cuidados médicos, além de retomar o conceito de Imagem-objetivo, proposto por Matus.

Gestão da Assistência Farmacêutica: módulo transversal 1: unidade 3: avaliação em saúde e avaliação da assistência farmacêutica - parte 2

Nesta unidade serão discutidas as diferentes possibilidades para a avaliação de uma política pública como a assistência farmacêutica. O conteúdo inicia com uma abordagem baseada em alguns questionamenteo para avaliação, como “O que está sendo avaliado?; Quem avalia? Neste momento são apresentadas as vantagens e desvantagens entre o envolvimento de avaliadores internos e/ou externos durante o processo e a influencia destes; Como se avalia?; Avaliar para quê? – etapa na qual serão definidas as metodologias adequadas a cada objetivo e cada realidade e os diferentes tipos de avaliação: Investigação Avaliativa, Avaliação para Gestão, e Avaliação para Decisão. Na sequência, o conteúdo define indicadores para avaliação e suas aplicações; dados primários e secundários e os critérios de seleção para um indicador. Ao final da Unidade apresenta-se um modelo metodológico para avaliação da gestão da assistência farmacêutica, com aplicabilidade no exercício didático-pedagógico proposto pelo Curso (Plano Operativo). A intenção desse modelo é detectar dificuldades e obstáculos e produzir recomendações, aproximando o aluno da pesquisa avaliativa Policy Oriented e suas etapas: Formulação; Operacionalização e Síntese: parametrização dos indicadores e leitura dos indicadores.

Novel electroluminescent devices containing Eu(3+)-(2-acyl-1,3-indandionate) complexes with TPPO ligand

Fabrication and electroluminescent properties of devices containing europium complexes of general formula [Eu(ACIND)(3)(TPPO)(2)], where ACIND, 2-acyl-1,3-indandionate ligands: and TPPO, triphenylphosphine oxide. as emitter layers are discussed. The double-layer devices based on these complexes present the following configurations: device 1: ITO/TPD/[Eu(AlND)(3)(TPPO)(2)]/Al: device 2: ITO/TPD/[Eu(ISOV-IND)(3)(TPPO)(2)]/Al and device 3: ITO/TPD/[Eu(BIND)(3)(TPPO)(2)]/Al, where AlND, 2-acetyl-1,3-indandionate; ISOVIND, 2-isovaleryl-1,3-indandionate; and BIND, 2-benzoyl-1,3-indandionate, respectively. These devices exhibited photo and electroluminescent emissions. An important characteristic presented by devices is that their electroluminescent (EL) spectra, in the region of (5)D(0) -> (7)F(J) (J = 0, 1, 2, 3 and 4) transitions of Eu(3+) ion, show profiles that are different from photoluminescent (PL) ones. In addition to narrow bands arising from intraconfigurational-4f(6) transitions, devices 1 and 2 also exhibited a broad band with maximum at around 500 nm which is assigned to electrophosphorescence from the indandionate ligands. On the other hand, EL spectra of device 3 present only narrow bands from (5)D(0) -> (7)F(J) transitions. [Eu(ACIND)(3)(TPPO)(2)] complexes are promising candidates to prepare efficient organic light-emitting devices (OLEDs) when compared with those containing Eu(3+)-complexes of aliphatic beta-diketonate anions. (C) 2009 Elsevier B.V. All rights reserved.

Functionalization of (2S)-Isopropyl-5-iodo-2,3-dihydro-4(H)-pyrimidin-4-ones by a Suzuki-Miyaura Cross-Coupling Reaction Using Aryltrifluoroborate Salts: Convenient Enantioselective Preparation of alpha-Substituted beta-Amino Acids

A simple protocol for the Pd(OAc)(2)-catalyzed cross-coupling reaction of 1-benzoyl-(2S)-isopropyl-5-iodo-2,3-dihydro-4(H)-pyrimidin-4-ones with potassium aryltrifluoroborates was developed. The reaction is performed at 110 degrees C with a ligand-free catalyst. In all cases, complete conversion of the 1-benzoyl-(2S)-isopropyl-5-iodo-2,3-dihydro-4(H)-pyrimidin-4-ones and aryltrifluoroborates into the C-C coupling products was observed within 30-360 min. It is noteworthy that a large variety of groups present in the potassium aryltrifluoroborates (-CF(3), -OMe, -SEt, -CN, -CHO, -Cl, -Cbz, -NCbz, -OH, -CO(2)H) could be tolerated. Hydrogenation of the endocyclic double bonds in the Suzuki-Miyaura products followed by acid hydrolysis afforded highly enantioenriched alpha-aryl-substituted beta-amino acids.

Synthesis of naturally occurring diene and trienes by Te/Li exchange on (1Z,3Z)-butyltelluro-4-methoxy-1,3-butadiene

(1Z,3Z)-Butyltelluro-o-4-methoxy-1,3-butadiene 2 was obtained by the hydrotelluration of(Z)-1-methoxy-but-1-en-3-ynes 1. The butadienyllithium 3 obtained by the Te/Li exchange reaction in the (1Z,3Z)-1-butyltelluro-4-methoxy-1.3-butadiene 2 reacted with aldehydes to form the corresponding alcohols 4a-d with total retention of configuration. The alcohols formed undergo hydrolysis, resulting in the alpha,beta,gamma,delta-unsaturated aldehydes of (E,E) configuration, which are precursors of trienes obtained from natural sources. The products of this reaction were employed in the synthesis of methyl-(2E,4E)-decadienoate 7, which is a component of the flavor principles of ripe Bartlett pears. Performing the Wittig reaction of the methyl triphenylphosphorane with the deca-(2E,4E)-dienal 5a, we were able to synthesize the undeca-(1,3E,5E)-triene 6a. This compound is a sex-pheromone component of the marine brown algae Fucus serratus, Dictyopteris plagiograma, and Dictyopteris australis. Performing the Wittig reaction of methyl triphenylphosphorane with the octa-(2E,4E)-dienal 5c, the nona-(1,3E,5E)-triene 6b was synthesized. The compound obtained is a sex-pheromone component of the marine brown alga Sargassum horneri. The octa-( 1,3E,5E)-triene 6c was easily obtained from hepta-(2E,4E)-dienal 5d by the Wittig reaction with methyl triphenylphophorane. This compound is a sex-pheromone component of the marine brown alga Fucus serratus. (C) 2010 Elsevier Ltd. All rights reserved.

Better CD4+T Cell Recovery in Brazilian HIV-Infected Individuals Under HAART Due to Cumulative Carriage of SDF-1-3`A, CCR2-V64I, CCR5-D32 and CCR5-Promoter 59029A/G Polymorphisms

Polymorphisms of chemokines and chemokine-receptors genes have been shown to influence the rate of progression to AIDS; however, their influence on response to HAART remains unclear. We investigated the frequency of the SDF-1-3`A, CCR2-64I, CCR5-D32 and CCR5-Promoter-59029-A/G polymorphisms in Brazilian HIV-1-infected and uninfected individuals and their influence on CD4+ T-cell evolution HIV-1 infected individuals before and during HAART. Polymorphism detection was done in a transversal study of 200 HIV-1-infected and 82 uninfected individuals. The rate of CD4+ T cell increase or decrease was studied in a cohort of 155 HIV-1 infected individuals on pre and post-HAART. Polymorphisms were determined by PCR associated with RFLP. The rate of CD4+ T-cell decline or increase was also determined. HIV-1 infected and uninfected subjects showed, respectively, frequencies of 0.193 and 0.220 for SDF-1-3`A, of 0.140 and 0.110 for CCR2-V64I, of 0.038 and 0.055 for CCR5-D32, and of 0.442 and 0.390 for CCR5-P-59029-A/G. HIV-1-infected subjects carrying one, two or three of these four polymorphisms showed better CD4+ T-cell recovery than HIV-1-infected subjects carrying the four wild-type alleles (+2.7, +1.6, +3.5, and -0.9 lymphocytes/mu l/month, respectively). Regression logistic analysis showed that the CCR5-D32/CCR2-V64I association was predictor of positive CD4+ T cell slope after HAART. The distribution of polymorphisms did not differ between HIV-1-infected and uninfected individuals, but differed from more homogenous ethnic groups probably reflecting the miscegenation of the Brazilian population. We add further evidence of the role of these polymorphisms by showing that the CD4 gain was influenced by carriage of one or more of the polymorphisms studied here. These results highlight the possibility that these genetic traits can be useful to identify patients at risk for faster progression to AIDS or therapeutic failure.

Protein phosphatases 1 and 2A promote Raf-1 activation by regulating 14-3-3 interactions

Raf-1 activation is a complex process which involves plasma membrane recruitment, phosphorylation, protein-protein and lipid-protein interactions, We now show that PP1 and PP2A serine-threonine phosphatases also have a positive role in Ras dependent Raf-1 activation, General serine-threonine phosphatase inhibitors such sodium fluoride, or beta-glycerophosphate and sodium pyrophosphate, or specific PP1 and PP2A inhibitors including microcystin-LR, protein phosphatase 2A inhibitor I-1 or protein phosphatase inhibitor 2 all abrogate H-Ras and K-Ras dependent Raf-1 activation in vitro. A critical Raf-1 target residue for PP1 and PP2A is S259. Serine phosphatase inhibitors block the dephosphorylation of S259, which accompanies Raf-1 activation, and Ras dependent activation of mutant Raf259A is relatively resistant to serine phosphatase inhibitors. Sucrose gradient analysis demonstrates that serine phosphatase inhibition increases the total amount of 14-3-3 and Raf-1 associated with the plasma membrane and significantly alters the distribution of 14-3-3 and Raf-1 across different plasma membrane microdomains, These observations suggest that dephosphorylation of S259 is a critical early step in Ras dependent Raf-1 activation which facilitates 14-3-3 displacement. Inhibition of PP1 and PP2A therefore causes plasma membrane accumulation of Raf-1/14-3-3 complexes which cannot be activated.

The linker domain of the Ha-Ras hypervariable region regulates interactions with exchange factors, Raf-1 and phosphoinositide 3-kinase

Ha-Ras and Ki-Ras have different distributions across plasma membrane microdomains. The Ras C-terminal anchors are primarily responsible for membrane microlocalization, but recent work has shown that the interaction of Ha-Ras with lipid rafts is modulated by GTP loading via a mechanism that requires the hypervariable region (HVR). We have now identified two regions in the HVR linker domain that regulate Ha-Ras raft association. Release of activated Ha-Ras from lipid rafts is blocked by deleting amino acids 173-179 or 166-172. Alanine replacement of amino acids 173-179 but not 166-172 restores wild type micro-localization, indicating that specific N-terminal sequences of the linker domain operate in concert with a more C-terminal spacer domain to regulate Ha-Ras raft association. Mutations in the linker domain that confine activated Ha-RasG12V to lipid rafts abrogate Raf-1, phosphoinositide 3-kinase, and Akt activation and inhibit PC 12 cell differentiation. N-Myristoylation also prevents the release of activated Ha-Ras from lipid rafts and inhibits Raf-1 activation. These results demonstrate that the correct modulation of Ha-Ras lateral segregation is critical for downstream signaling. Mutations in the linker domain also suppress the dominant negative phenotype of Ha-RasS17N, indicating that HVR sequences are essential for efficient interaction of Ha-Ras with exchange factors in intact cells.

Síntese de algicidas da família da bacilamida e rearranjos de dióximas-1,3 cíclicas com vista a dessimetrização funcional

Dissertação para obtenção do Grau de Doutor em Química Orgânica

Observações sôbre a terapêutica da ascaridiose com o hidroclorato e com o ciclamato de 2,3,5,6 – Tetrahidro - 6 fenil - imidazo (2,1-b) tiazol

Os autores estudam a ação do ciclamato e do cloridrato de 2, 3, 5, 6, - Tetrahidro-6-fenil-imidazo (2,1-b) tiazol no tratamento da ascaridiose. Foram tratados ao todo 84 indivíduos sendo 48 com o cloridrato e 36 com o ciclamato. O índice de cura com o primeiro foi de 83,9% e com o segundo de 76,4%. Nenhuma reação colateral foi observada com o emprêgo do cloridrato sendo que com o ciclamato 53,6 dos pacientes apresentaram sintomas discretos de intolerância. Os índices de cura assemelham-se aos observados com a piperazina que é a medicação clássica para terapêutica da ascaridiose.

Interpretação de resultados analíticos de fósforo pelos extratores Mehlich-1 e Mehlich-3 em solos do Rio Grande do Sul

As soluções extratoras multielementares possibilitam avaliar a disponibilidade de vários nutrientes de plantas no mesmo extrato; dentre estes o P merece especial atenção. As soluções Mehlich-1 (M1) e Mehlich-3 (M3) enquadram-se nesta categoria. Neste estudo, foram comparados os teores de P extraídos por estas soluções em 360 amostras de solos do Estado do Rio Grande do Sul. Os coeficientes de correlação entre os teores de P extraído pelas mesmas indicaram alto grau de associação e de significância. Os teores de P extraído pela solução Mehlich-3 foram, em média, 50 % maiores que os extraídos pela solução Mehlich-1. O teor de argila, entretanto, influenciou a capacidade extrativa de P pela solução Mehlich-3, sendo necessária uma tabela de ajuste para a interpretação dos valores do P extraído por esta solução.

Healthy Aging Update, April 1, 2008, Vol. 3, no. 3

This bimonthly electronic newsletter will provide information and resources on nutrition and health promotion and disease prevention. The Healthy Aging Update is produced for informal and educational purposes only. The newsletter will be distributed electronically and posted on the Department’s website at www.state.ia.us/elderaffairs.

Healthy Aging Update, April 1, 2009, Vol. 4, no. 3

This bimonthly electronic newsletter will provide information and resources on nutrition and health promotion and disease prevention. The Healthy Aging Update is produced for informal and educational purposes only. The newsletter will be distributed electronically and posted on the Department’s website at www.state.ia.us/elderaffairs.

Healthy Aging Update, April 1, 2011, Vol. 6, no. 3

This bimonthly electronic newsletter will provide information and resources on nutrition and health promotion and disease prevention. The Healthy Aging Update is produced for informal and educational purposes only. The newsletter will be distributed electronically and posted on the Department’s website at www.state.ia.us/elderaffairs.