Avaliação de fatores virológicos associados ao desenvolvimento de carcinoma hepatocelular (CHC) em pacientes com hepatite B crônica

O objetivo principal deste estudo foi avaliar fatores virais associados com a evolução para o carcinoma hepatocelular (CHC) em pacientes com hepatite B crônica. Para tanto caracterizamos os subgenótipos do HBV, investigamos a ocorrência de mutações nos genes pré-core/core do HBV associadas à presença de CHC avaliamos por análise filogenética a associação de linhagens virais com a ocorrência de CHC e por fim a associação de outros fatores de risco com o desenvolvimento de CHC. Foram incluídos 119 amostras de soro de pacientes com infecção crônica pelo HBV, destas amostras 60 pertencem ao grupo 1 (CHC), que são pacientes com diagnóstico confirmado de carcinoma hepatocelular e 59 amostras pertencem ao grupo 2 (sem CHC) que são pacientes com hepatite crônica sem detecção prévia de nódulos hepáticos. Foram obtidas informações acerca da idade, sexo e naturalidade. Além disso, os pacientes responderam a um questionário sobre fatores de riscos associados ao desenvolvimento de CHC. Foram realizados exames bioquímicos, sorológicos, determinação da carga viral, e amplificação por nested PCR e sequenciamento das regiões S/polimerase e pré-core/core do genoma viral para posterior caracterização dos genótipos/subgenótipos do HBV e pesquisa de mutações associadas com evolução da doença hepática. Em relação à idade e sexo não houve grande variação entre os grupos. Quanto à naturalidade a maioria era procedente da região sudeste, seguido pela região nordeste; e por fim seis pacientes eram procedentes de outros países. Com base no sobrenome dos pacientes avaliou-se também a frequência de etnia oriental na casuística estudada, que foi similar nos 2 grupos. O perfil sorológico HBeAg negativo foi o mais frequente nos dois grupos de pacientes, assim como níveis de carga viral abaixo de 2.000 UI/mL. Em relação aos exames bioquímicos foram observadas diferenças estatisticamente significantes nos níveis séricos de AFP (p= 0,0013), FA (p= 0,0003) e GGT (p= 0,005). Dentre os fatores de risco analisados neste estudo, o consumo de amendoim foi o único que apresentou significância estatística (p= 0,003). A região S/pol foi amplificada e sequenciada com sucesso em 58 amostras (28 do grupo 1 e 30 do grupo 2). Entre as 58 amostras analisadas 4 genótipos e 8 subgenótipos do HBV foram identificados, sendo o subgenótipo A1 o mais frequente nos dois grupos. Não se observou diferença estatisticamente significante na distribuição dos subgenótipos entre os dois grupos de pacientes. Na topologia da árvore filogenética construída com sequências do HBV isoladas dos pacientes incluídos neste estudo e sequências disponíveis no GenBank não se observou padrões de agrupamento associados com o perfil clinico do paciente (com e sem CHC). Foram obtidas sequências de boa qualidade da região précore/ core em 44 amostras, sendo 20 amostras do grupo 1 e 24 do grupo 2. Diversas das mutações investigadas foram identificadas na região précore/ core, as quais foram avaliadas estatisticamente para verificar a existência de diferença na frequência das mesmas entre os grupos de pacientes estudados. Entre as mutações identificadas se destacaram com significância estatística as seguintes mutações: T1768A (p= 0,006), a combinação das mutações C1766T + T1768A (p= 0,043) e G1888H (p= 0,05). Na análise de regressão logística simples foi possível identificar que a chance de um paciente do grupo 2 desenvolver CHC aumenta 14,7 vezes na presença de infecção por cepas do HBV com a mutação T1768A, enquanto que a infecção com cepas do HBV que albergam a mutação G1888H reduz tal chance 2,5 vezes

Multiclassificador inteligente de falhas no domínio do tempo em motores de indução trifásicos alimentados por inversores de frequência

Os motores de indução desempenham um importante papel na indústria, fato este que destaca a importância do correto diagnóstico e classificação de falhas ainda em fase inicial de sua evolução, possibilitando aumento na produtividade e, principalmente, eliminando graves danos aos processos e às máquinas. Assim, a proposta desta tese consiste em apresentar um multiclassificador inteligente para o diagnóstico de motor sem defeitos, falhas de curto-circuito nos enrolamentos do estator, falhas de rotor e falhas de rolamentos em motores de indução trifásicos acionados por diferentes modelos de inversores de frequência por meio da análise das amplitudes dos sinais de corrente de estator no domínio do tempo. Para avaliar a precisão de classificação frente aos diversos níveis de severidade das falhas, foram comparados os desempenhos de quatro técnicas distintas de aprendizado de máquina; a saber: (i) Rede Fuzzy Artmap, (ii) Rede Perceptron Multicamadas, (iii) Máquina de Vetores de Suporte e (iv) k-Vizinhos-Próximos. Resultados experimentais obtidos a partir de 13.574 ensaios experimentais são apresentados para validar o estudo considerando uma ampla faixa de frequências de operação, bem como regimes de conjugado de carga em 5 motores diferentes.

Contribuição ao estudo do efeito de combinação de veículos de carga sobre pontes rodoviárias de concreto

O crescente desenvolvimento na indústria de transporte tornou-se um tema de pesquisa em diversos países, uma vez que as obras de arte especiais até então construídas não foram projetadas para as elevadas cargas atualmente transportadas. Mostra-se necessária uma reavaliação de como a ação do carregamento móvel é levada em consideração. Dessa forma, elaborou-se um estudo de normas e códigos de diversos países sobre o tema. Definem-se algumas combinações de veículos de cargas (CVCs) e analisam-se as conseqüências e a viabilidade do tráfego das mesmas. Essa análise é realizada através da comparação dos esforços solicitantes provocados pelas CVCs e pelos veículos previstos por normas em diversos sistemas estruturais e por meio da verificação da capacidade portante de um projeto típico. Objetivando-se encontrar uma solução que se adequasse à realidade brasileira, é elaborado um estudo sobre como outros países vêm tratando a questão das combinações de veículos de cargas especiais. Ao final do trabalho, constata-se a existência de CVCs que, apesar de atenderem às exigências estabelecidas pelo Conselho Nacional de Trânsito (CONTRAN), são incompatíveis com a as pontes da malha viária nacional.

Frequência de resistência a múltiplos fármacos em pseudomonas aeroginosa

A multirresistência bacteriana tem crescido significativamente nos últimos anos. Entre os gram negativos a P. aeruginosa demonstra facilidade de desenvolvimento de resistência aos antibióticos. O objetivo deste estudo foi determinar a frequência de resistência a múltiplos fármacos em isolados de Pseudomonas aeruginosa e detectar cepas multirresistentes em um hospital público de Maceió/AL. De forma retrospectiva, descritiva e transversal, entre janeiro de 2012 a dezembro de 2013, iniciou-se uma ampla análise documental dos registros de atendimento no setor de Microbiologia do Hospital Universitário Professor Alberto Antunes (HUPAA/UFAL) para avaliar o material obtido de pacientes que apresentaram cultura positiva para P. aeruginosa. Vários espécimes clínicos foram obtidos e as cepas identificadas fenotipicamente pelo método automatizado Vitek®, bem como as análises do perfil de susceptibilidade aos antimicrobianos, seguindo os critérios adotados pelo National Committee for Clinical and Laboratory Standards (NCCLS). Foram obtidas 78 culturas com isolados positivos para P. aeruginosa, sendo a maioria procedente de pacientes da UTI geral (47,4%), seguida da Clínica cirúrgica (16,7%). Entre as amostras clínicas analisadas, a secreção traqueal foi a de maior incidência com 25,6%, seguida de secreção de ferida (20,5%) e escarro (18%). O composto mais ativo contra a P. aeruginosa foi a Colistina (100,0%). Detectou-se elevada multirresistência de P. aeruginosa aos betalactâmicos, cefalosporinas e carbapenêmicos. Baseando-se nos dados apresentados, torna-se evidente a necessidade de um monitoramento rotineiro do perfil de sensibilidade desta bactéria em ambiente hospitalar, sendo de extrema utilidade para a escolha adequada na terapêutica empírica, proporcionando conhecimento prévio dos antimicrobianos que apresentam boa eficácia diante deste patógeno, favorecendo o uso racional de antimicrobianos. PALAVRAS-CHAVE: Multirresistência; Pseudomonas aeruginosa;Sensibilidade; Antimicrobianos.

Alterações morfológicas pancreáticas induzidas pelo ruído de baixa frequência – Resultados preliminares

Poster apresentado na XLIX Reunião Científica da Sociedade Portuguesa de Anatomia / II Reunião Científica da Associação Anatómica Portuguesa, 16 Maio 2015, NOVA Medical School /Faculdade de Ciências Médicas - Universidade Nova de Lisboa.

A vitamina K em combinação com outros marcadores bioquímicos no diagnóstico da osteoporose

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

Frequência e significado clínico da expressão da glicoproteína P e da proteína relacionada a resistência a múltiplas drogas na leucemia mielóide aguda

Despite the advances in the cure rate for acute myeloid leukemia, a considerable number of patients die from their disease due to the occurrence of multidrug resistance (MDR). Overexpression of the transporter proteins P-glycoprotein (Pgp) and multidrug resistance-associated protein (MRP) confer resistance to the treatment these leukemias. OBJECTIVE: To analyze the expression of the Gpp and MRP1 in patients with AML by flow cytometry (FC) and to determine the correlation between expression and demographic and also clinical and laboratorial variables. METHODS: Bone marrow and peripheral blood samples from 346 patients with a diagnosis of AML were assessed for the expression of Pgp and MRP1 by FC. RESULTS: The expression of Pgp and MRP1 was found in 111 (32.1%) and 133 (38.4%) patients, respectively, with greater prevalence in older patients and lower in adolescents, observing also a high incidence in patients with refractory disease, recurrence and secondary in comparison with the cases of de novo AML. Regarding the laboratory findings, we observed a higher correlation statistically significant between the expression of Pgp and MRP1 in AML CD34+ and FAB AML M7, M5A and M2 and lower the M3 subtype, not observed statistically significant correlation between the phenotype MDR and other laboratory data such with hemoglobin, leukocyte count, platelet count, aberrant expression of lymphoid antigens (CD2, CD7 and CD19) and clinical signs related to the disease. CONCLUSIONS: The results showed that the detection of MDR phenotype by flow cytometry can be a molecular marker for prognosis independent patients diagnosed with AML.

Análise das mutações C288Y, S65C e H63D e frequência alélica do gene HFE em pacientes com hiperferritinemia, em uma cidade do Nordeste, Brasil

Background & Aims: HFE-associated Hereditary Hemochromatosis (HH) is one of the most frequent autosomal recessive disease in the caucasian population, caused by the high absorption and deposition of iron in several organs. This accumulation results in several clinical complications such as cirrhosis, arthritis, cardiopathies, diabetes, sexual disorders and skin darkening. Although most of the cases are homozygous individuals for the C282Y mutation, another two mutations, H63D and S65C, have been reported to be associated with milder forms of the disease. The objective is to avaluate the distribution of C282Y, H63D and S65C mutations in the HFE gene in patients with suspected HH in the state of Rio Grande do Norte, Brazil. Methods: Samples of peripheral blood were taken from 335 patients originating from Natal-RN, a city in northeastern Brazil with suspected of HH and which were screened for the HFE gene C282Y, H63D and S65C mutations, using molecular genetics assays (Polymerase Chain Reaction- Restriction Fragments Length Polymorphism). The main criterion for including such patients in the study was the increasing of persistent serum ferritin in individuals aged between 18 and 70 or older, both males and females. As to the exclusion criteria, individuals holding hemolytical anemia, talassemy and previously report of blood transfusion did not take part of the study. Results: Out of the 335 patients studied, 143 patients showed absence of mutation and 195 showed some kind of mutation in the HFE gene: 07/335 (2,08%) were homozigous C282Y, 25/335 heterozygous C282Y, 25/335 (7,46%) were homozigous H63D, 115/335 (34,32%) heterozygous H63D, 5/335 (1,48%) heterozygous S65D, 11/ 335 (3,28%) and were double heterozygous (H63D/C282Y). None patients were Homozygous S65D and S65D heterozygous (S65D/H63D and S65D/C282Y). Conclusions. The distribution of the HFE gene C282Y, H63D and S65C mutations found in our group matches the tendencies observed in other European countries. Due to the high prevalence of hemochromatosis, its seriousness and easy treatment, the genetic diagnosis of HH has become a dream, especially in the high risk group.

Influência do tipo de abrigo e da frequência de oferta alimentar no comportamento do camarão Macrobrachium rosenbergii (De Man 1879)

Macrobrachium rosenbergii is a freshwater prawn which presents agonistic behavior and heterogeneous growth. It is known that captive conditions can intensify agonism causing injuries and decreased survival, generating a condition of poor welfare. Based on this, we aim to investigate the behavior of M. rosenbergii in the juvenile phase according to different types of shelter and frequencies of feed offer, emphasizing their agonistic behavior. For this, juveniles were observed in the laboratory in three steps. At step I we characterized the behavioral profile; prawns were kept in eight aquariums (27 prawns/m2 ), identified and observed four times along both phases of 24 h light cycle. At step II (2 experiments), we evaluated the use of shelters (brick or polyethylene rolls) and their influence on agonism by the animals. For classification of animals in dominance rank, the method used was David's Score. At step III (3 experiments), we evaluated different frequencies of feed offer on the behavior of individuals, in particular agonism. Results showed that juveniles do not present a pattern activity/inactivity between the phases of the light cycle. We identified a dominance hierarchy among individuals taking advantage of access to food by the dominant, which showed greater weight gain although the frequency of intake did not differ between individuals. The type of shelter influenced the behavior of animals. Brick shelter generated a higher frequency of permanence and a reduction in the frequency of agonistic interactions. The distribution of food more frequently throughout the day, decreased the motivation of animals for food, as well as to fight. Prawns fed four times showed lower frequency of feed intake and agonistic interactions. Thus, we conclude the shelters which reduce animal’s detection by coespecifics and offer the food four times along the day reduce agonistic behavior. This result causes na improvement in life quality of the prawns and also in its quality as final product.

Análise de superfícies seletivas em frequência com geometria multifractal

Frequency Selective surfaces are increasingly common structures in telecommunication systems due to their geometric and electromagnetic advantages. As a matter of fact, the frequency selective surfaces with fractal geometry type would allow an even bigger reduction of the electrical length which provided greater flexibility in the design of these structures. In this work, we investigated the use of multifractal geometry in frequency selective surfaces. Three structures with different multifractal geometries have been proposed and analyzed. The first structure allowed the design of multiband structures with greater flexibility in controlling the resonant frequencies and bandwidth. The second structure provided a bandwidth increase even with the rising of the fractal level. The third structure showed response with angle stability, dual polarization and provided room for a bandwidth increase with the rising of the structural multifractality. Furthermore, the proposed structures increased the degree of freedom in the multiband designs because they have multiple resonant frequencies ratios between adjacent bands and are easy to deploy. The validation of the proposed structures was initially verified through simulations in Ansoft Designer software and then the structures were constructed and the experimental results obtained

Projeto de absorvedores de micro-ondas integrados com superfícies seletivas em frequência

Considering the fact that, the use of wireless communication systems has grown too fast, investigations concerning absorbers of electromagnetic waves has called closer attention of researchers. It is applicable from indoor systems to military applications. Paralleling with this growth, some extremely relevant investigations through Frequency Selective Surfaces (FSS) allows its filter property to be applicable in several systems, for example: reflector antennas, band-pass radomes, and absorbers, which are the main objective of this work. Therefore, the main goal of this work concerns to design micro-waves absorbers through FSS. Thus, the methodology consists basically in two steps: the first step concerns a theoretical and numerical analysis of the structures involved in the process of absorption, the second step, the analysis of the cascaded structures. In order to carry out the analysis, the Equivalent Circuit Method will be used. This method provides characteristics of transmission from the structure, for a plane wave incidence and it requires an extremely limited computing resource in relation if compared to full wave analyses method. Hence, it is useful to allow fast predictions of the development of the structures. Furthermore, a spreading matrix will be used in order to cascade the conductive FSS and the resistive FSS achieving absorption characteristics in the designed band. The experimental results used for the analysis are found in the literature due to the difficulty of building soon, given that it is not a simple construction technique. To conclude, a mathematical development through the Equivalent Circuit Method of a FSS modeling with cross-dipole geometry and a resistive FSS will be presented, as well as the cascading involving the two structures. The same setting is used with a square loop geometry. Besides it, the next steps will be discussed in the conclusion.

Caracterização de superfícies seletivas de frequência de periódicas e não-periódicas

The past years have seen a great interest in the use of frequency selective surfaces (FSS), as spatial filters, in many microwave applications. Among these, we highlight applications in telecommunication systems (such as satellite communications and radar), high gain antennas (combined with planar antennas) and (home and industrial) microwave ovens. The FSS is usually composed of two-dimensional periodic arrays, with equally spaced elements, which may be metallic patches (printed on dielectric substrates) or aperture (holes in thin metal surfaces). Using periodic arrays, the FSS have been able to meet the demands of the telecommunications industry. However, new demands are finding technological limitations. In this context, adverse filtering requirements have forced designers to use FSS optimization methods to find specific formats of FSS elements. Another alternative that has been used to increase the selectivity of the FSS is the cascaded FSS, a simple technique that has as main drawback the increased dimensions of the structure, as well as its weight. This work proposes the development of a new class of selective surfaces frequency (FSS) composed of quasi-periodic (or non-periodic) arrangements. The proposed FSS have no array periodicity, in relation with the spatial position of their elements. The frequency responses of these structures were simulated using commercial softwares that implement full-wave methods. For the purpose of validation of this study, FSS prototypes were built and measured, being possible to observe a good agreement between simulated and measured results. The main conclusions of this work are presented, as well as suggestions for future works.

Estudo da variação da periodicidade e do acoplamento entre superfícies seletivas de frequência com elementos fractais e helicoidais em estruturas de multicamadas

This work aims to investigate the behavior of fractal and helical elements structures in planar microstrip. In particular, the frequency selective surfaces (FSSs) had changed its conventional elements to fractal and helical formats. The dielectric substrate used was fiberglass (FR-4) and has a thickness of 1.5 mm, a relative permittivity 4.4 and tangent loss equal to 0.02. For FSSs, was adopting the Dürer’s fractal geometry and helical geometry. To make the measurements, we used two antennas horns in direct line of sight, connected by coaxial cable to the vector network analyzer. Some prototypes were select for built and measured. From preliminary results, it was aimed to find practical applications for structures from the cascading between them. For FSSs with Dürer’s fractal elements was observed behavior provided by the multiband fractal geometry, while the bandwidth has become narrow as the level of iteration fractal increased, making it a more selective frequency with a higher quality factor. A parametric analysis allowed the analysis of the variation of the air layer between them. The cascading between fractal elements structure were considered, presented a tri-band behavior for certain values of the layer of air between them, and find applications in the licensed 2.5GHz band (2.3-2.7) and 3.5GHz band (3.3-3.8). For FSSs with helical elements, six structures were considered, namely H0, H1, H2, H3, H4 and H5. The electromagnetic behavior of them was analyzed separately and cascaded. From preliminary results obtained from the separate analysis of structures, including the cascade, the higher the bandwidth, in that the thickness of the air layer increases. In order to find practical applications for helical structures cascaded, the helical elements structure has been cascaded find applications in the X-band (8.0-12.0) and unlicensed band (5.25-5.85). For numerical and experimental characterization of the structures discussed was used, respectively, the commercial software Ansoft Designer and a vector network analyzer, Agilent N5230A model.

Quedas em idosos assistidos na estratégia saúde da família: frequência e fatores associados

The growth of the elderly population is a global phenomenon and, in Brazil, this transformation is happening in a very rapid rhythm. With the current population aging, this emerging age group will need more health care and attention. One of the characteristics of the population aging is the progressive accumulation of disabilities, which makes it more vulnerable to falls. This study was developed with the purpose of knowing the episode falls in the scope of an elderly population treated at a Family Health Unit. It is a research with cross-sectional nature, and its sample was composed by 121 elderly. The research was approved by the Ethics Committee of HUOL, with Opinion nº 816.022. We applied a questionnaire to the participants, and the results were statistically analyzed by using Chi-square test and Fisher’s exact test to verify the association between variables. In order to perform a multivariate analysis, we used the method of the Binomial Logistic Regression. For both tests, we accepted significance p<0,05 and CI of 95%. The results prove that the majority belongs to the female gender (76,9%); the age group of elderly reaches 88,4% and 11,6% is over-aged; regarding the marital status, 35,3% are married and 29,4% widowed; 92,1% with family income between one and two minimum wages; and 91,8% live with their partners and/or children. Regarding the frequency of falls, we found that 61,2% of the surveyed elderly suffered one or more falls in 2014. As associated factors, it became clear that 73,8% were due to extrinsic factors, 6,4% to intrinsic factors and 21,4% to both factors. As a consequence of the fall, we found that 89,2% have fear of falling again, 37,3% showed anxiety and 13,3% had their ambulation affected. Concerning the exposure to the risk factors, the most prevalent places were: street/avenue (31,0%), pavement (19,0%), living room (14,3%) and courtyard/backyard (10,7%). The study has proven a statistically significant association among female gender (p=0,001), rubble/objects in the backyard (p=0,015) and furniture that may cause accidents (p=0,005). It was evident among the elderly people surveyed, 72.7% receive little information about falls, being a risk factor for falls. We conclude that there is a high frequency of falls in the surveyed elderly, thereby constituting a worrisome data because this event in the elderly population is a serious matter, which raises the need to ensure them a safe environment in their homes and, above all, outside them. The information provided by the Family Health Strategy team are important to avoid these occurrences, which reinforces the need for developing health education activities together with the population as a way to prevent and reduce the occurrence of falls, thereby improving the quality of life of elderly.

Efeitos dos exercícios aeróbio contínuo e intervalado na variabilidade da frequência cardíaca em adultos jovens saudáveis. Ensaio clínico aleatório

The high-intensity interval exercise has been described as an option for increasing physical activity and its use also being suggested in the therapeutic management of many conditions such as diabetes mellitus and heart failure. However, the knowledge of its physiological effects and parameters that can assure greater safety for interval exercise prescription; especially its effect on short- and medium-term (24 hours after exercise) exercise recovery, need to be clarified. This study objective was to evaluate the effect of continuous and interval aerobic exercise on the cardiac autonomic control immediate and medium term (24 hours), by assessing heart rate variability (HRV). The present study is a randomized crossover clinical trial in which healthy young individuals with low level of physical activity had the VFC 24 hours measured by a heart rate sensor and portable accelerometer (3D eMotion HRV, Kuopio, Finland) before and after continuous aerobic exercise (60-70% HR max, 21 min.) and interval exercise (cycle 1 min. 80-90% HR max, 2 min. at 50-60% HR max, duration 21 min.). HRV was measured in the time and frequency domain and the sympathovagal balance determined by the ratio LF / HF. Nonlinear evaluation was calculated by Shannon entropy. The data demonstrated delayed heart rate recovery immediate after exercise and lower HR after 24 hours compared to pre intervention values, especially in the interval exercise group. There was a tendency to higher predominance and representatives index values of sympathetic stimulation during the day in interval exercise group; however, without statistical significance. The study results help to clarify the effects of interval exercise on the 24 hours following interval exercise, setting parameters for prescription and for further evaluation of groups with metabolic and cardiovascular diseases.