Necessidades de saúde, políticas públicas e gênero: a perspectiva das práticas profissionais

Examina-se a relação entre políticas públicas e práticas dos profissionais, relativamente às necessidades de saúde. Em abordagem teórico-conceitual, as práticas são definidas como desempenhos permeados por determinantes técnico-cien­tíficos e sócio-históricos para a produção social de um trabalho, analisando-se suas possibilidades de mudanças culturais, éticas e políticas, para um agir crítico das desigualdades de gênero. Tomando-se a atenção integral à saúde dos homens, examina-se a relevância da distinção entre necessidades masculinas e femininas, enquanto realidades parciais não necessariamente convergentes na (re)produção daquelas desigualdades. Igualmente se examinam as práticas profissionais, como realidade parcial e distinta das políticas, estabelecendo relações não imediatas. Desenvolve-se que são obstáculos simbólicos e práticos para mudanças: a normalização biomédica redutora das necessidades, a cultura do trabalho autônomo e da abordagem individualizante das necessidades, a cultura tradicional de gênero conservando práticas desiguais para homens e mulheres e a ausência de inscrição dos direitos como parte do agir profissio­nal. Isto exige propostas específicas às práticas de saúde e às necessidades masculinas para maior convergência com as reformas das políticas.

Fish Oil Supplementation Reduces Cachexia and Tumor Growth While Improving Renal Function in Tumor-Bearing Rats

The objective of the present work was to study the renal function of healthy and tumor-bearing rats chronically supplemented with fish oil (FO), a source of n-3 polyunsaturated fatty acids. Weanling male rats were divided in two groups, one control (C) and another orally supplemented for 70 days with FO (1 g/kg body weight). After this time, half the animals of each group were injected in the right flank with a suspension of Walker 256 tumor cells (W and WFO). The W group had less proteinemia reflecting cachectic proteolysis, FO reversed this fact. Tumor weight gain was also reduced in WFO. Glomerular filtration rate (GFR) was not different in FO or W compared to C, but was higher in WFO. Renal plasma flow (RPF) was higher in the FO supplemented groups. The W group had lower plasma osmolality than the C group, but FO supplementation resulted in normalization of this parameter. Fractional sodium excretion (FENa+) of FO rats was similar to C. Proximal Na+ reabsorption, evaluated by lithium clearance, was similar among the groups. Urinary thromboxane B-2 (TXB2) excretion was lower in the supplemented groups. The number of macrophages in renal tissue was higher in W compared to C rats, but was lower in WFO rats compared to W rats. In conclusion, FO supplementation resulted in less tumor growth and cachexia, and appeared to be renoprotective, as suggested by higher RPF and GFR.

rpb2 is a reliable reference gene for quantitative gene expression analysis in the dermatophyte Trichophyton rubrum

The selection of reference genes used for data normalization to quantify gene expression by real-time PCR amplifications (qRT-PCR) is crucial for the accuracy of this technique. In spite of this, little information regarding such genes for qRT-PCR is available for gene expression analyses in pathogenic fungi. Thus, we investigated the suitability of eight candidate reference genes in isolates of the human dermatophyte Trichophyton rubrum subjected to several environmental challenges, such as drug exposure, interaction with human nail and skin, and heat stress. The stability of these genes was determined by geNorm, NormFinder and Best-Keeper programs. The gene with the most stable expression in the majority of the conditions tested was rpb2 (DNA-dependent RNA polymerase II), which was validated in three T. rubrum strains. Moreover, the combination of rpb2 and chs1 (chitin synthase) genes provided for the most reliable qRT-PCR data normalization in T. rubrum under a broad range of biological conditions. To the best of our knowledge this is the first report on the selection of reference genes for qRT-PCR data normalization in dermatophytes and the results of these studies should permit further analysis of gene expression under several experimental conditions, with improved accuracy and reliability.

FINDING FOSSIL GROUPS: OPTICAL IDENTIFICATION AND X-RAY CONFIRMATION

We report the discovery of 12 new fossil groups (FGs) of galaxies, systems dominated by a single giant elliptical galaxy and cluster-scale gravitational potential, but lacking the population of bright galaxies typically seen in galaxy clusters. These FGs, selected from the maxBCG optical cluster catalog, were detected in snapshot observations with the Chandra X-ray Observatory. We detail the highly successful selection method, with an 80% success rate in identifying 12 FGs from our target sample of 15 candidates. For 11 of the systems, we determine the X-ray luminosity, temperature, and hydrostatic mass, which do not deviate significantly from expectations for normal systems, spanning a range typical of rich groups and poor clusters of galaxies. A small number of detected FGs are morphologically irregular, possibly due to past mergers, interaction of the intra-group medium with a central active galactic nucleus (AGN), or superposition of multiple massive halos. Two-thirds of the X-ray-detected FGs exhibit X-ray emission associated with the central brightest cluster galaxy (BCG), although we are unable to distinguish between AGN and extended thermal galaxy emission using the current data. This sample representing a large increase in the number of known FGs, will be invaluable for future planned observations to determine FG temperature, gas density, metal abundance, and mass distributions, and to compare to normal (non-fossil) systems. Finally, the presence of a population of galaxy-poor systems may bias mass function determinations that measure richness from galaxy counts. When used to constrain power spectrum normalization and Omega(m), these biased mass functions may in turn bias these results.

Multi-criteria analysis in the strategic environmental assessment of the sugar and alcohol sector

The Strategic Environmental Assessment (SEA) of the sugar and alcohol sector guides a territorial and sectoral planning that benefits most of the local society and supports this economic activity in all its stages. In this way, the present work aims to determine an index of aggregation of the indicators generated in the baseline of the SEA process, called Index of Sustainability of Expansion of the Sugar and Alcohol Sector (IScana). For this, it was used the normalization of the indicators of each city by the fuzzy logic and attribution of weights by the Analytic Hierarchy Process (AHP). Then, the IScana values had been spatialized in the region of 'Grande Dourados'-Mato Grosso do Sul State. The northern portion concentrated the highest values of IScana, 0.48 and 0.55, referring to the cities of Nova Alvorada do Sul and Rio Brilhante, while, in the central portion, the city of Dourados presented the lowest value, 0.10. The selection of the set of indicators forming the IScana, and their relative importance, was satisfactory for the application of fuzzy logic and AHP techniques. The IScana index supplies objective information regarding the diagnosis of the region for the application of SEA.

Influence of adenotonsillectomy on hard palate dimensions

Objective: To evaluate hard palate width and height in mouth-breathing children pre- and post-adenotonsillectomy. Methods: We evaluated 44 children in the 3-6 year age bracket, using dental study casts in order to determine palatal height, intercanine width, and intermolar width. The children were divided into two groups: nasal breathing (n = 15) and mouth breathing (n = 29). The children in the latter group underwent adenotonsillectomy. The study casts were obtained prior to adenotonsillectomy, designated time point 1(11), at 13 months after adenotonsillectomy (T2), and at 28 months after adenotonsillectomy (13). Similar periods of observation were obtained for nasal breathing children. Results: At T1, there was a significantly lower intercanine width in mouth breathing children; intermolar width and palate height were similar between groups. After surgery, there was a significant increase in all the analyzed parameters in both groups, probably due to facial growth. Instead, the increase in intercanine width was substantially more prominent in mouth breathing children than in nasal breathing children, and the former difference failed in significance after the procedure. Conclusions: There were no significant differences between the nasal-breathing and mouth-breathing children in terms of intermolar width and palatal height prior to or after tonsillectomy. Although intercanine width was initially narrower in the mouth-breathing children, it showed normalization after the surgical procedure. These results confirm that the restoration of nasal breathing is central to proper occlusal development. (C) 2012 Elsevier Ireland Ltd. All rights reserved.

Parathyroid adenoma apoplexy as a temporary solution of primary hyperparathyroidism: a case report

Abstract Introduction The natural history of patients with spontaneous parathyroid necrosis is unknown. In this case report we describe the clinical course, laboratory, radiographic, bone densitometry tests, parathyroid ultrasonography and scintigraphy examinations of a patient performed over a period of eight years after she first presented with a sudden episode of spontaneous resolution of primary hyperparathyroidism (PHPT). Case presentation A 24-year-old woman with a clinical history and laboratory and radiographic tests compatible with PHPT suffered a sudden episode of cervical pain and presented with clinical evidence of hypocalcemia. Biopsy of a cervical nodule revealed necrotic material compatible with ischemia of the parathyroid. The follow-up of the patient presented four distinct phases: the first, which lasted two years, was compatible with a period of bone hunger during which it was necessary to introduce calcitriol and calcium carbonate. During this period, the patient showed bone mass gain. The second phase was characterized by normalization of calcium and parathyroid hormone levels and its end was difficult to define. During the third phase there was a recurrence of hypercalcemia associated with elevated parathyroid hormone (PTH) levels and loss of bone mass. The last phase corresponded to the interval after parathyroidectomy, which was characterized by normalization of serum levels of calcium and PTH, as well as bone mass gain. Conclusion This case report indicates that spontaneous resolution of PHPT by adenoma necrosis is potentially temporary. Thus, in cases in which a conservative approach is chosen, clinical and laboratory follow-up is indispensable. Bone mass measurement is a useful tool in the follow-up of these cases. However, this option exposes the patient to a potential roller-coaster ride of bone mass gain and loss, whose long term consequences are still unknown.

ENDNOTE: A EXPERIÊNCIA DA FMVZ/USP NA CAPACITAÇÃO E NORMALIZAÇÃO DE TRABALHOS

O presente trabalho relata a experiência da Biblioteca Virginie Buff D’Ápice da FMVZ/USP na capacitação do uso do software EndNote e sua aplicabilidade por seus usuários; objetiva ainda demonstrar o potencial de uso dessa ferramenta na normalização de trabalhos científicos e acadêmicos. Com dados preliminares obtidos entre os anos de 2009 e 2010, além da experiência vivenciada nesse período, foi possível constatar que o uso do EndNote pelos estudantes que participaram da capacitação oferecida pela biblioteca promoveu um índice de acerto na normalização de seus trabalhos muito acima daqueles que não foram capacitados e/ou não o utilizaram o programa. Dessa forma, pode-se considerar que uma capacitação efetiva e o uso adequado do EndNote facilitam o trabalho do pesquisador que, ao utilizá-lo, pode focar mais seus esforços na escrita do trabalho, bem como o da biblioteca responsável pela normalização de trabalhos científicos/acadêmicos

Pituitary tumors in patients with MEN1 syndrome

We briefly review the characteristics of pituitary tumors associated with multiple endocrine neoplasia type 1. Multiple endocrine neoplasia type 1 is an autosomal-dominant disorder most commonly characterized by tumors of the pituitary, parathyroid, endocrine-gastrointestinal tract, and pancreas. A MEDLINE search for all available publications regarding multiple endocrine neoplasia type 1 and pituitary adenomas was undertaken. The prevalence of pituitary tumors in multiple endocrine neoplasia type 1 may vary from 10% to 60% depending on the studied series, and such tumors may occur as the first clinical manifestation of multiple endocrine neoplasia type 1 in 25% of sporadic and 10% of familial cases. Patients were younger and the time between initial and subsequent multiple endocrine neoplasia type 1 endocrine lesions was significantly longer when pituitary disease was the initial manifestation of multiple endocrine neoplasia type 1. Tumors were larger and more invasive and clinical manifestations related to the size of the pituitary adenoma were significantly more frequent in patients with multiple endocrine neoplasia type 1 than in subjects with non-multiple endocrine neoplasia type 1. Normalization of pituitary hypersecretion was much less frequent in patients with multiple endocrine neoplasia type 1 than in subjects with non-multiple endocrine neoplasia type 1. Pituitary tumors in patients with multiple endocrine neoplasia type 1 syndrome tend to be larger, invasive and more symptomatic, and they tend to occur in younger patients when they are the initial presentation of multiple endocrine neoplasia type 1.

Romper el ciclo de la invisibilidad. El empleo como vía para favorecer la inclusión

"[ES] En España las posibilidades de empleo de las personas en riesgo de exclusión social no son satisfactorias. Se trata de un problema que centramos en las concepciones educativas de la enseñanza-aprendizaje inicial, que orientan minoritariamente a la formación para el empleo como a la oferta y demanda de trabajo de esos colectivos. En nuestro sistema educativo de la desatención y marginación del alumnado en riesgo de exclusión social se pasó a la educación especial; luego, a la normalización e integración, lo que condujo a la inclusión educativa. En ese momento final que nos encontramos aparecen visiones innovadoras como la escuela para todos, empleo con apoyo, y vida con apoyo que desarrollan el paradigma de la autonomía y vida independiente. [EN] Employment chances for people in risk of social exclusion are not satisfactory in Spain. This has been a problem at the core of educational conceptions concerning primary education, scarcely orientated towards the employment of such groups. In our system, from margination and neglect of our pupils in risk of social exclusion, we sent them to special education first, then to normalization and integration and finally to inclusive education. Nowadays, innovative visions such as school for all, employment and life with support are developing the model of autonomy and independent life. "

The topic normalized impact factor

[EN] The journal impact factor is not comparable among fields of science because of systematic differences in publication and citation behaviour across disciplines. In this work, a source normalization of the journal impact factor is proposed. We use the aggregate impact factor of the citing journals as a measure of the citation potential in the journal topic, and we employ this citation potential in the normalization of the journal impact factor. An empirical application in a set of 224 journals from four different fields shows that our normalization, using the citation potential in the journal topic, reduces the between-group variance with respect to the within-group variance in a higher proportion than the rest of indicators analysed.

Enhanced Mixed Integer Programming Techniques and Routing Problems

Mixed integer programming is up today one of the most widely used techniques for dealing with hard optimization problems. On the one side, many practical optimization problems arising from real-world applications (such as, e.g., scheduling, project planning, transportation, telecommunications, economics and finance, timetabling, etc) can be easily and effectively formulated as Mixed Integer linear Programs (MIPs). On the other hand, 50 and more years of intensive research has dramatically improved on the capability of the current generation of MIP solvers to tackle hard problems in practice. However, many questions are still open and not fully understood, and the mixed integer programming community is still more than active in trying to answer some of these questions. As a consequence, a huge number of papers are continuously developed and new intriguing questions arise every year. When dealing with MIPs, we have to distinguish between two different scenarios. The first one happens when we are asked to handle a general MIP and we cannot assume any special structure for the given problem. In this case, a Linear Programming (LP) relaxation and some integrality requirements are all we have for tackling the problem, and we are ``forced" to use some general purpose techniques. The second one happens when mixed integer programming is used to address a somehow structured problem. In this context, polyhedral analysis and other theoretical and practical considerations are typically exploited to devise some special purpose techniques. This thesis tries to give some insights in both the above mentioned situations. The first part of the work is focused on general purpose cutting planes, which are probably the key ingredient behind the success of the current generation of MIP solvers. Chapter 1 presents a quick overview of the main ingredients of a branch-and-cut algorithm, while Chapter 2 recalls some results from the literature in the context of disjunctive cuts and their connections with Gomory mixed integer cuts. Chapter 3 presents a theoretical and computational investigation of disjunctive cuts. In particular, we analyze the connections between different normalization conditions (i.e., conditions to truncate the cone associated with disjunctive cutting planes) and other crucial aspects as cut rank, cut density and cut strength. We give a theoretical characterization of weak rays of the disjunctive cone that lead to dominated cuts, and propose a practical method to possibly strengthen those cuts arising from such weak extremal solution. Further, we point out how redundant constraints can affect the quality of the generated disjunctive cuts, and discuss possible ways to cope with them. Finally, Chapter 4 presents some preliminary ideas in the context of multiple-row cuts. Very recently, a series of papers have brought the attention to the possibility of generating cuts using more than one row of the simplex tableau at a time. Several interesting theoretical results have been presented in this direction, often revisiting and recalling other important results discovered more than 40 years ago. However, is not clear at all how these results can be exploited in practice. As stated, the chapter is a still work-in-progress and simply presents a possible way for generating two-row cuts from the simplex tableau arising from lattice-free triangles and some preliminary computational results. The second part of the thesis is instead focused on the heuristic and exact exploitation of integer programming techniques for hard combinatorial optimization problems in the context of routing applications. Chapters 5 and 6 present an integer linear programming local search algorithm for Vehicle Routing Problems (VRPs). The overall procedure follows a general destroy-and-repair paradigm (i.e., the current solution is first randomly destroyed and then repaired in the attempt of finding a new improved solution) where a class of exponential neighborhoods are iteratively explored by heuristically solving an integer programming formulation through a general purpose MIP solver. Chapters 7 and 8 deal with exact branch-and-cut methods. Chapter 7 presents an extended formulation for the Traveling Salesman Problem with Time Windows (TSPTW), a generalization of the well known TSP where each node must be visited within a given time window. The polyhedral approaches proposed for this problem in the literature typically follow the one which has been proven to be extremely effective in the classical TSP context. Here we present an overall (quite) general idea which is based on a relaxed discretization of time windows. Such an idea leads to a stronger formulation and to stronger valid inequalities which are then separated within the classical branch-and-cut framework. Finally, Chapter 8 addresses the branch-and-cut in the context of Generalized Minimum Spanning Tree Problems (GMSTPs) (i.e., a class of NP-hard generalizations of the classical minimum spanning tree problem). In this chapter, we show how some basic ideas (and, in particular, the usage of general purpose cutting planes) can be useful to improve on branch-and-cut methods proposed in the literature.

Study of the helicity dependence of single pion photoproduction on the deuteron

Der erste experimentelle Test der GDH-Summenregel für das Proton wurde 1998 am MAMI-Beschleuniger der Universität Mainz durchgeführt. Ferner wurde ein Pilot-Experiment mit einem polarisierten Deuteron-Target vorgenommen. Dieselbe Kollaboration führte 2003 ein auf das Deuteron ausgerichtetes Experiment durch mit der Absicht, die GDH-Summenregel für das Neutron zu untersuchen. Der in beiden Experimenten verwendete Aufbau erlaubt nicht nur die Messung des totalen Wirkungsquerschnitts, sondern auch gleichzeitig einzelne Teilreaktionen zu studieren. In dieser Arbeit werden die Daten des Deuteron-Pilot-Experiments von 1998 analysiert. Desweiteren wird eine Studie der Helizitätsabhängigkeit der differenziellen Wirkungsquerschnitte für drei Pion-Photoproduktionskanäle des Deuterons in der oberen Hälfte der Delta-Resonanz präsentiert. Diese Ergebnisse werden mit einem theoretischen Modell verglichen. Dabei wurde eine hinreichend gute Übereinstimmung für die unpolarisierten Reaktionen gefunden, während für die polarisierten Kanäle kleinere Diskrepanzen beobachtet wurden. Der Targetpolarisationsgrad ist einer der relevanten Parameter, der für eine absolute Normalisierung der Wirkungsquerschnitte notwendig ist. Die Analyse dieses Parameters für die 2003er Daten wird in der vorliegenden Arbeit vorgestellt. Zur Zeit ist in Mainz ein Frozen-Spin-Target im Bau. Es wird als Target für polarisierte Protonen oder polarisierte Deuteronen für zukünftige Experimente mit dem Crystal Ball zur Verfügung stehen. Die Vorbereitungen der verschiedenen Subsysteme dieses Aufbaus stellten einen wichtigen Teil dieser Arbeit dar. Die fundamentalen Grundlagen der Methode und deren technische Umsetzung, sowie der momentane Status der Aufbauarbeiten am Target werden im Detail präsentiert.

Effect of hypoxia and hyperglycemia on cell bioenergetics

Mitochondria have a central role in energy supply in cells, ROS production and apoptosis and have been implicated in several human disease and mitochondrial dysfunctions in hypoxia have been related with disorders like Type II Diabetes, Alzheimer Disease, inflammation, cancer and ischemia/reperfusion in heart. When oxygen availability becomes limiting in cells, mitochondrial functions are modulated to allow biologic adaptation. Cells exposed to a reduced oxygen concentration readily respond by adaptive mechanisms to maintain the physiological ATP/ADP ratio, essential for their functions and survival. In the beginning, the AMP-activated protein kinase (AMPK) pathway is activated, but the responsiveness to prolonged hypoxia requires the stimulation of hypoxia-inducible factors (HIFs). In this work we report a study of the mitochondrial bioenergetics of primary cells exposed to a prolonged hypoxic period . To shine light on this issue we examined the bioenergetics of fibroblast mitochondria cultured in hypoxic atmospheres (1% O2) for 72 hours. Here we report on the mitochondrial organization in cells and on their contribution to the cellular energy state. Our results indicate that prolonged hypoxia cause a significant reduction of mitochondrial mass and of the quantity of the oxidative phosphorylation complexes. Hypoxia is also responsible to damage mitochondrial complexes as shown after normalization versus citrate synthase activity. HIF-1α plays a pivotal role in wound healing, and its expression in the multistage process of normal wound healing has been well characterized, it is necessary for cell motility, expression of angiogenic growth factor and recruitment of endothelial progenitor cells. We studied hypoxia in the pathological status of diabetes and complications of diabetes and we evaluated the combined effect of hyperglycemia and hypoxia on human dermal fibroblasts (HDFs) and human dermal micro-vascular endothelial cells (HDMECs) that were grown in high glucose, low glucose concentrations and mannitol as control for the osmotic challenge.

Hydrodynamical simulations of galaxy clusters in dark energy cosmologies

In this work we investigate the influence of dark energy on structure formation, within five different cosmological models, namely a concordance $\Lambda$CDM model, two models with dynamical dark energy, viewed as a quintessence scalar field (using a RP and a SUGRA potential form) and two extended quintessence models (EQp and EQn) where the quintessence scalar field interacts non-minimally with gravity (scalar-tensor theories). We adopted for all models the normalization of the matter power spectrum $\sigma_{8}$ to match the CMB data. For each model, we perform hydrodynamical simulations in a cosmological box of $(300 \ {\rm{Mpc}} \ h^{-1})^{3}$ including baryons and allowing for cooling and star formation. We find that, in models with dynamical dark energy, the evolving cosmological background leads to different star formation rates and different formation histories of galaxy clusters, but the baryon physics is not affected in a relevant way. We investigate several proxies for the cluster mass function based on X-ray observables like temperature, luminosity, $M_{gas}$, and $Y_{X}$. We confirm that the overall baryon fraction is almost independent of the dark energy models within few percentage points. The same is true for the gas fraction. This evidence reinforces the use of galaxy clusters as cosmological probe of the matter and energy content of the Universe. We also study the $c-M$ relation in the different cosmological scenarios, using both dark matter only and hydrodynamical simulations. We find that the normalization of the $c-M$ relation is directly linked to $\sigma_{8}$ and the evolution of the density perturbations for $\Lambda$CDM, RP and SUGRA, while for EQp and EQn it depends also on the evolution of the linear density contrast. These differences in the $c-M$ relation provide another way to use galaxy clusters to constrain the underlying cosmology.