990 resultados para contrast factor


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Dissertação para a obtenção do grau de doutor em Biologia pelo Instituto de Tecnologia Química e Biológica. Universidade Nova de Lisboa.

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A Work Project, presented as part of the requirements for the Award of a Masters Degree in Finance from the NOVA – School of Business and Economics

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A thesis to obtain a Master degree in Structural and Functional Biochemistry

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A capacidade que os organismos possuem de alterar os seus padrões de expressão de genes em resposta a alterações no meio ambiente é essencial para a sua viabilidade. A levedura Saccharomyces cerevisiae, em particular, possui um programa complexo e muito flexível de expressão de genes quando exposta a mudanças agressivas do seu meio ambiente. As células mantêm a sua homeostase através de mecanismos coordenados de regulação de vários factores de transcrição, cada um desempenhando funções específicas. Neste trabalho foi estudada a relevância do factor de transcrição da família Yap de S. cerevisiae, o Yap5, na destoxificação do excesso de ferro na célula. Os resultados obtidos neste trabalho mostram que após a incubação com elevadas quantidades de sulfato de ferro, embora o potencial de transactivação do Yap5 aumente, os níveis da proteína diminuem, sendo esta diminuição dependente da concentração de ferro. Demonstrámos também que embora a expressão do gene CCC1 (que codifica para o único transportador vacuolar de ferro conhecido) seja dependente do Yap5 em condições de excesso de ferro, os níveis basais de expressão deste gene são suficientes para a sobrevivência nessas condições. Observámos ainda que, ao contrário do que acontece em Schizosaccharomyces pombe, o factor de transcrição Hap4, não parece estar envolvido nesta regulação. Através de delecções sequenciais da região promotora do CCC1, verificámos que os níveis de expressão ditados por uma região de 58pb a montante do codão de iniciação, ATG, são suficientes para a célula sobreviver sob concentrações elevadas de ferro. Verificámos ainda que a região 3’UTR do gene é importante para a sobrevivência celular. Nessa região, identificámos uma estrutura em forma de “hairpin” que poderá estar envolvida na regulação do gene.

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Dissertation presented to obtain the Ph.D degree in Biology.

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Dissertação para obtenção do Grau de Doutor em Nanotecnologias e Nanociências

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Reinfections with Trypanosoma cruzi in patients from endemic areas have been claimed to be an aggravation factor of cardiac manifestations in Chagas' disease. In the present study, the influence of triple infections with strains of different biodemes, on cardiac and skeletal muscle lesions was experimentally tested. Fifty eight mice chronically infected with the Colombian strain (Biodeme Type III) were successively reinfected as follows: 1st group - reinfected with 21 SF strain (Type II) followed by Y strain (Type I ); 2nd - group reinfections with Y strain followed by 21SF strain. Isoenzyme analysis of parasites from hemocultures obtained from triple infected mice, revealed the patterns of three distinct zymodemes in the same animal. Each Trypanosoma cruzi strain was reisolated after four passages in mice on either the 7th, 14th or 30th day after inoculation with the blood of triple infected mice. Histopathology results demonstrated a significant exacerbation of cardiac and skeletal muscle inflammatory lesions, confirmed by morphometric evaluation, in mice with triple infection. No aggravation of parasitism was detected. The possibility of an enhancement of cellular response in the triple infected mice is suggested.

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This study compared the serum levels of IL-6, TNF-alpha and IFN-gamma, in children under 1 year of age with and without dengue. Sera were collected from a total of 41 children living in the Department of Antioquia, Colombia (27 patients with dengue and 14 controls). The results showed higher cytokine levels in children with dengue than without dengue, with statistically significant differences for IL-6 and IFN-gamma. No statistically significant differences were found between clinical forms, although IL-6 and IFN-gamma levels were higher in dengue fever cases than in dengue hemorrhagic fever cases. On the other hand, TNF-alpha levels were higher in dengue hemorrhagic fever than in dengue fever. The levels of IL-6 and TNF-alpha were higher in secondary infection than in primary infection, although IFN-gamma levels were higher in primary infection. These results suggest that IL-6, TNF-alpha and IFN-gamma are involved in dengue infection independently of the clinical form.

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This study discusses some fundamental issues so that the development and diffusion of services based in cloud computing happen positively in several countries. For exposure of this subject is discusses public initiatives by the most advanced countries in terms of cloud computing application and the brazilin position in this context. Based on presented evidences here it appears that the essential elements for the development and diffusion of cloud computing in Brazil made important steps and show evidence of maturity, as the cybercrime legislation. However, other elements still require analysis and specifically adaptations for the cloud computing case, such as the Intellectual Property Rights. Despite showing broadband services still lacking, one cannot disregard the government effort to facilitate access for all society. In contrast, the large volume of the Brazilian IT market is an interest factor for companies seeking to invest in the country.

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RESUMO: O presente estudo, enquadra-se, no domínio do exercício profissional dos enfermeiros e na formação em serviço destes profissionais e teve por objectivo avaliar, num grupo de enfermeiros de um serviço de medicina, o impacto de uma intervenção educativa na melhoria dos procedimentos a executar na prática da terapêutica inalatória. A amostra do estudo (amostra por conveniência) foi constituída por oito enfermeiros do serviço de medicina do Hospital Curry Cabral (idades compreendidas entre os 24 a 43 anos de idade), sem anterior formação específica na área da terapêutica inalatória, mas com experiencia profissional prévia com doentes respiratórios. O estudo decorreu em dois momentos de avaliação: avaliação 0 (antes da intervenção educativa) e avaliação 1 (após a intervenção educativa). Entre estes dois momentos, foi ministrada, a todos os enfermeiros, uma acção de formação sobre terapêutica inalatória, com componente teórico-prática. Antes e depois da intervenção educativa foram aplicados dois instrumentos: para avaliação dos conhecimentos teóricos, construi-se e aplicou-se, um questionário de auto-avaliação de conhecimentos sobre terapêutica inalatória ao grupo dos enfermeiros, e para avaliação dos conhecimentos práticos e execução de procedimentos, uma grelha de observação da demonstração da técnica de inalação com três dispositivos inalatórios: MDI, MDI com câmara expansora ACE e DPI turbohaler®. Os resultados do estudo mostraram que o grupo dos enfermeiros da nossa amostra detinha já alguns conhecimentos de carácter teórico, de âmbito geral, sobre a terapêutica inalatória, mas conhecimentos pouco sólidos, nomeadamente no que concerne aos fármacos utilizados por via inalatória. Verificou-se, ainda, um deficiente domínio de conteúdos de carácter mais específico e prático sobre terapêutica inalatória, por exemplo a importância de determinados procedimentos - agitação do inalador, tempo de pausa entre cada inalação, cuidados de manutenção da câmara expansora, higienização da cavidade bucal após a inalação dos corticosteróides. Quanto à observação da técnica de inalação, o grupo dos enfermeiros revelou algumas lacunas, quer relativamente à técnica de inalação com MDI, quer do MDI com câmara expansora, observando-se a execução de passos incorrectos e mesmo omissão de passos por parte dos enfermeiros, antes da intervenção educativa.Não nos foi possível realizar a observação da técnica de inalação com dispositivo de pó seco turbohaler®, dado que nenhum dos enfermeiros da nossa amostra se sentiu capaz de manusear de forma correcta este dispositivo, antes e após a formação. Em termos globais, achamos que a formação dada sobre terapêutica inalatória, mostrou melhorar os conhecimentos teóricos e práticos dos enfermeiros neste âmbito. Esta melhoria ficou claramente demonstrada no aumento do número de respostas correctas dadas pelos enfermeiros no questionário efectuado, após a formação. Do mesmo modo, após a formação, registou-se uma melhoria considerável dos conhecimentos específicos e práticos, no que concerne à importância de determinados procedimentos na prática da terapêutica inalatória - agitação do inalador, tempo de pausa entre cada inalação, cuidados de manutenção da câmara expansora, higienização da cavidade bucal após a inalação dos corticosteróides - observando-se, um maior número de respostas correctas assinaladas no questionário. Em contrapartida, os conhecimentos sobre fármacos administrados por via inalatória, ficaram um pouco aquém das expectativas, pois o número de respostas correctas dadas pelos enfermeiros após a formação não foi significativo. Poderemos mesmo dizer que, a acção de formação com maior grau de especificidade sobre fármacos não se revelou eficaz e gerou até alguma ―confusão‖ neste grupo de enfermeiros, parecendo que os conhecimentos anteriores sobre fármacos por via inalatória não estariam consolidados antes da formação. De igual modo, após a formação, registou-se no grupo dos enfermeiros do estudo uma melhoria na performance da técnica de inalação com o MDI e MDI com a câmara expansora. Os enfermeiros do estudo, não só corrigiram os passos ou itens de avaliação da técnica inalatória, anteriormente executados incorrectamente, mas também, mostraram um melhor conhecimento dos passos ou itens de avaliação da técnica de inalação, com menor número de passos ou itens de avaliação omissos, após a formação. Em contrapartida, a acção de formação, no que diz respeito ao dispositivo de pó seco turbohaler®, não cumpriu o seu objectivo, dado que nenhum dos enfermeiros da amostra foi capaz de demonstrar a técnica de inalação com este dispositivo, antes e após a formação. Poderemos dizer que, não sendo um dispositivo da sua prática clínica, os enfermeiros não sentiram necessidade de adquirir estes conhecimentos. Em síntese, podemos concluir que na sua globalidade, a formação dada (com informação actualizada sobre as orientações mais adequadas neste domínio) e o treino formal dos enfermeiros neste âmbito, foi bastante proveitoso, uma vez que, mostrou melhorar os conhecimentos teóricos e práticos na prática da terapêutica inalatória do grupo de enfermeiros doserviço de medicina. Realça-se, no entanto, a importância de uma formação adequada, sentida como útil pelos enfermeiros, faseada, ligada à prática dos profissionais e alternando com momentos de exercício profissional. Os conhecimentos e os procedimentos dos enfermeiros deverão ainda ser monitorizados e avaliados ao longo do tempo, para a detecção de eventuais desvios que a rotina pode introduzir e para levantamento de novas necessidades de formação.-------------------ABSTRACT: This study fits in the domain of in-service training of professional nurses. It was aimed to assess the impact of an educational intervention and the consequent improvement of the practice of inhalation therapy in a group of nurses from a medical service The study sample (convenience sample) was consituted by eight nurses from the medical service, Hospital Curry Cabral (aged 24-43 years) without previous special training in the field of inhalation therapy, but with prior experience with patients with respiratory diseases. The study ran in two moments of evaluation: evaluation 0 (before the educational intervention) and evaluation 1 (post-intervention). Between these two moments, a training program about therapeutic inhalation was administered to all nurses, with a double component of theory and practice. Before and after the educational intervention two evaluation tools were applied: for the assessment of theoretical knowledge, the nurses had to fill a self-assessment questionnaire and in order to evaluate their knowledge related to procedural skills as well as their performance, they were observed (and their behaviour recorded on a check-list) during a demonstration of three inhalation techniques with devices: metered dose inhaler, metered dose inhaler with a spacer device ACE® and device turbohaler® The study results showed that the group of nurses in our sample had already some knowledge of theoretical nature (general scope of the inhalation therapy) but little solid knowledge, particularly in regard to drugs used in inhalation. In fact, a relatively weaker knowledge was registerd in what concerns specific and practical knowledge about inhalation therapy, for example, the importance of certain procedures - shaking the inhaler, pause between each inhalation, maintenance care of spacer device, mouth cavity hygiene after inhalation of corticosteroids. As for the observation of the inhaler technique, it was found that the group of nurses had a poor inhalation technique, in what concerns inhalation technique with MDI or MDI with spacer device, with a performance with several incorrect steps, or even omission of steps by nurses before the educational intervention. Finally, as the observation technique of the dry powder device turbohaler ®, we were unable to analyze the observation concerning this device, since none of the nurses in our sample, wast able to handlle it correctly, before and after training.In general terms, we found that the training given on inhalation therapy had a positive impact either in the theorical or the pratical knowledge on inhalation therapy (higher number of correct answers after training). Similarly, after training, there was the considerable improvement of specific and practical skills, namely the importance of certain procedures in the practice of inhalation therapy - shaking the inhaler, pause time between each inhalation, maintenance care of spacer device, sanitizing the buccal cavity after inhalation of corticosteroids. In contrast, knowledge about drugs administered by inhalation, were slightly below expectations, showing a lower number of correct answers given by the nurses after training. The training seemed to be a factor of "confusion" for this group of nurses, whose prior knowledge in this domais was not probably very solid to begin with. After training, the group of nurses in the study improved the performance of inhalation technique with MDI and MDI with spacer device. They not only correcty performed the steps or itens for the assessment of inhalation technique, previously performed incorrectly, but also showed a better understanding of the steps or itens for assessing the inhalation technique, with fewer steps missing (after training). In contrast, training with regard to the device turbohaler ® dry powder, was also below expectations, given that none of the nurses in the sample was able to demonstrate inhaler technique with this device before and after training. This was probably due to the fact that, the nurses did not feel the need to acquire this knowledge and the related practice. In summary, we can say that, overall, the training (with updated information on the appropriate policies in this field) showed an improvement in knowledge and performance in the practice of inhalation therapy. It is however crucial to underline the importance of in-service adequate training programmes, perceived as useful by the nurses, developped in different phases, linked to the nurses’ practice and combining with professional practices. The nurses’ knowledge and skills should also be further monitorized and evaluated in order to detect deviations introduced by the rotinization of procedures and to identify new training needs.

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Porphyria cutanea tarda (PCT) is caused by inherited or acquired partial deficiency of the uroporphyrinogen-decarboxylase (Uro-D) enzyme activity. It is the most common form of porphyria. The main triggering factors to the development of porphyria cutanea tarda are alcohol, hepatitis C virus and human immunodeficiency virus. There are several reports of PCT associated with drugs, among them, antiretroviral therapy. We describe three HIV-positive patients, which showed photosensitivity as well as the emergence of tense blisters on sun-exposed areas during the use of highly active antiretroviral therapy (HAART) and discuss the possibility of PCT after the use of these drugs by those patients.

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Introduction The progression of human papillomavirus (HPV) infection in the anogenital tract has been associated with the involvement of cells with regulatory properties. Evidence has shown that glucocorticoid-induced tumor necrosis factor receptor (GITR) is an important surface molecule for the characterization of these cells and proposes that GITR ligand may constitute a rational treatment for many cancer types. We aimed to detect the presence of GITR and CD25 in cervical stroma cells with and without pathological changes or HPV infection to better understand the immune response in the infected tissue microenvironment. Methods We subjected 49 paraffin-embedded cervical tissue samples to HPV DNA detection and histopathological analysis, and subsequently immunohistochemistry to detect GITR and CD25 in lymphocytes. Results We observed that 76.9% of all samples with high GITR expression were HPV-positive regardless of histopathological findings. High GITR expression (77.8%) was predominant in samples with ≥1,000 RLU/PCB. Of the HPV-positive samples negative for intraepithelial lesion and malignancy, 62.5% had high GITR expression. High GITR expression was observed in both carcinoma and high-grade squamous intraepithelial lesion (HSIL) samples (p = 0.16). CD25 was present in great quantities in all samples. Conclusions The predominance of high GITR expression in samples with high viral load that were classified as HSIL and carcinoma suggests that GITR+ cells can exhibit regulatory properties and may contribute to the progression of HPV-induced cervical neoplasia, emphasizing the importance of GITR as a potential target for immune therapy of cervical cancer and as a disease evolution biomarker.

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OBJECTIVE: To analyze the correlation of risk factors to the occurrence of urinary tract infection in full-term newborn infants. PATIENTS AND METHODS: Retrospective study (1997) including full-term infants having a positive urine culture by bag specimen. Urine collection was based on: fever, weight loss > 10% of birth weight, nonspecific symptoms (feeding intolerance, failure to thrive, hypoactivity, debilitate suction, irritability), or renal and urinary tract malformations. In these cases, another urine culture by suprapubic bladder aspiration was collected to confirm the diagnosis. To compare and validate the risk factors in each group, the selected cases were divided into two groups: Group I - positive urine culture by bag specimen collection and negative urine culture by suprapubic aspiration, and Group II - positive urine culture by bag specimen collection and positive urine culture by suprapubic aspiration . RESULTS: Sixty one infants were studied, Group I, n = 42 (68.9%) and Group II, n = 19 (31.1%). The selected risk factors (associated infectious diseases, use of broad-spectrum antibiotics, renal and urinary tract malformations, mechanical ventilation, parenteral nutrition and intravascular catheter) were more frequent in Group II (p<0.05). Through relative risk analysis, risk factors were, in decreasing importance: parenteral nutrition, intravascular catheter, associated infectious diseases, use of broad-spectrum antibiotics, mechanical ventilation, and renal and urinary tract malformations. CONCLUSION: The results showed that parenteral nutrition, intravascular catheter, and associated infectious diseases contributed to increase the frequency of neonatal urinary tract infection, and in the presence of more than one risk factor, the occurrence of urinary tract infection rose up to 11 times.

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PURPOSE: Hyperhomocyst(e)inaemia is an important risk factor for atherosclerosis, which is currently a major cause of death in renal transplant patients. The aim of this study was to assess the influence of immunosuppressive therapy on homocyst(e)inemia in renal transplant recipients. METHODS: Total serum homocysteine (by high performance liquid chromatography), creatinine, lipid profile, folic acid (by radioimmunoassay-RIA) and vitamin B12 (by RIA) concentrations were measured in 3 groups. Group I patients (n=20) were under treatment with cyclosporine, azathioprine, and prednisone; group II (n=9) were under treatment with azathioprine and prednisone; and group III (n=7) were composed of renal graft donors for groups I and II. Creatinine, estimated creatinine clearance, cyclosporine trough level, lipid profile, folic acid, and vitamin B12 concentrations and clinical characteristics of patients were assessed with the aim of ascertaining determinants of hyperhomocyst(e)inemia. RESULTS: Patient ages were 48.8 ± 15.1 yr (group I), 43.3 ± 11.3 yr (group II); and 46.5 ± 14.8 yr (group III). Mean serum homocyst(e)ine (tHcy) concentrations were 18.07 ± 8.29 mmol/l in renal transplant recipients; 16.55 ± 5.6 mmol/l and 21.44 ± 12.1 mmol/l respectively for group I (with cyclosporine) and group II (without cyclosporine) (NS). In renal donors, tHcy was significantly lower (9.07 ± 3.06 mmol/l; group I + group II vs. group III, p<0.008). There was an unadjusted correlation (p<0.10) between age (r=0.427; p<0.005) body weight (r=0.412; p<0.05), serum creatinine (r=0.427; p<0.05), estimated creatinine clearance (r=0.316; p<0.10), and tHcy in renal recipients (group I +II). Independent regressors (r²=0.46) identified in the multiple regression model were age (coefficient= 0.253; p=0.009) and serum creatinine (coefficient=8.07; p=0.045). We found no cases of hyperhomocyst(e)inemia in the control group. In contrast, 38% of renal recipients had hyperhomocyst(e)inemia: 7 cases (35%) on cyclosporine and 4 (45%) without cyclosporine, based on serum normal levels. CONCLUSIONS: Renal transplant recipients frequently have hyperhomocyst(e)inemia. Hyperhomocyst(e)inemia in renal transplant patients is independent of the scheme of immunosuppression they are taking. The older the patients are and the higher are their serum creatinine levels, the more susceptible they are to hyperhomocyst(e)inemia following renal transplantation.