903 resultados para Climatología médica


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ATP binding cassette (ABC) and solute carrier (SLC) transporters are responsible for the majority of the transcellular movement of various substrates, including drugs, among epithelial cells. Despite the well characterized regulation of influx (SLC) and efflux (ABC) transporters by endogenous mediators, such as inflammatory cytokines, little is known about how changes in oxygen levels may affect expression of these transporters. In this study we showed that the expression of SLC22A4, SLC22A5, SLC22A1, SLC02B1, SLC10A2, ABCC2 and ABCC3 transporters is upregulated by hypoxia in HT29 colon carcinoma cells, but not in HepG2 hepatocarcinoma cells. Moreover, OCTN1 (SLC22A4), OCT1 (SLC22A1) and OATP-B (SLC02B1) transporter expression is also induced by inflammatory cytokines but in a smaller extent than in hypoxia. Furthermore our experiments indicate that there is no cross talk between HIF-1 and NF-κB pathways in HT-29 cells, but these two pathways act simultaneously activating common genes, such as, some SLC and ABC transporters. Our preliminary results from studies with an in vivo murine model of colitis, suggest that HIF-1is stabilized and OCTN1 is strongly induced during severe inflammation, which can be relevant for a recovery from the inflammatory process. We have also been interested in the distribution of HIF-1α variants among different ethnic groups as well as their contribution for cancer risk. Thus, we have demonstrated that there is an ethnicity-related variation in the frequency of the C1772T (P582S) single nucleotide polymorphism (SNP) in the HIF-1α gene. Furthermore, we performed a case-control study in a breast cancer population and our results suggest that there is no association between this SNP or the rare G1790A (A588T) SNP and the incidence of breast cancer. Taken together, the results obtained in this study contribute to a better knowledge of drug influx and efflux during hypoxia and inflammation as well as to the understanding of the pharmacogenetic variability of the HIF-1.

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The human genome has millions of genetics variants that can affect gene expression. These variants are known as cis-regulatory variants and are responsible for intra-species phenotypic differences and individual susceptibility to disease. One of the diseases affected by cis-regulatory variants is breast cancer. Breast cancer is one of the most common cancers, with approximately 4500 new cases each year in Portugal. Breast cancer has many genes mutated and TP53 has been shown to be relevant for this disease. TP53 is one of the most commonly mutated genes in human cancer and it is involved in cell cycle regulation and apoptosis. Previous work by Maia et al has shown that TP53 has differential allelic expression (DAE), which suggests that this gene may be under the influence of cis-regulatory variants. Also, its DAE pattern is totally altered in breast tumours with normal copy number. We hypothesized that cis-regulatory variants affecting TP53 may have a role in breast cancer development and treatment. The present work aims to identify the cis-regulatory variants playing a role in TP53 expression, using in silico, in vitro and in vivo approaches. By bioinformatic tools we have identified candidate cis-regulatory variants and predicted the possible transcription factor binding sites that they affect. By EMSA we studied DNA-protein interactions in this region of TP53. The in silico analysis allowed us to identified three candidate cis-regulatory SNPs which may affect the binding of seven transcription factors. However, the EMSA experiments have not been conclusive and we have not yet confirmed whether any of the identified SNPs are associated with gene expression control of TP53. We will carry out further experiments to validate our findings.

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Dissertação de mestrado, Ciências Farmacêuticas, Faculdade de Ciências e Tecnologia, Universidade do Algarve, 2015

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Dissertação de mestrado, Ciências Farmacêuticas, Faculdade de Ciências e Tecnologia, Universidade do Algarve, 2015

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Introdução: A profusão de informação na área médica cria problemas de gestão, sendo necessários métodos sistematizados para armazenamento e recuperação. Quando a informação se insere no contexto do processo clínico, os métodos devem integrar terminologias biomédicas controladas e igualmente devem integrar as características desejáveis dirigidas à estrutura, conteúdo e resultados clínicos. O objectivo deste artigo é testar a aplicabilidade e capacidade de recuperação, de um sistema multidimensional desenvolvido para classificação e gestão de informação em saúde. Métodos: A partir das questões recebidas em seis anos (Serviço de Informação de Medicamentos, Serviços Farmacêuticos, Hospitais da Universidade de Coimbra), seleccionaram-se 300 questões sobre informação clínica, por método aleatório informatizado. Caracterizou-se e avaliou-se a aplicabilidade pela quantidade classificada e pela necessidade de alterações ao sistema que é constituído por várias dimensões independentes e que englobam conceitos por vezes hierarquizados. A recuperação das questões foi testada pesquisando informação numa dimensão ou cruzamento de dimensões. Resultados: Todas as questões foram classificadas: 53% são casos clínicos com incidência nas doenças geniturinárias; doenças metabólicas, nutricionais e endócrinas; neoplasias; infecções e doenças do sistema nervoso. Em 81%, o objecto é o medicamento, sobretudo anti-infecciosos e anti-neoplásicos. As áreas de terapêutica e segurança foram as mais solicitadas, incidindo principalmente sobre os assuntos: utilização, reacções adversas, identificação de medicamentos e tecnologia farmacêutica. Na aplicabilidade, foi necessário adicionar alguns conceitos e modificar alguns grupos hierárquicos que não modificaram a estrutura base, nem colidiram com as características desejáveis. As limitações prenderam-se com os sistemas de classificação externos integrados. A pesquisa na dimensão assunto, do conceito administração de medicamentos, recuperou 19 questões. O cruzamento de duas dimensões: anti-infecciosos (externa) e teratogenicidade (assunto), recuperou três questões. Nos dois exemplos recupera-se informação a partir de qualquer um dos níveis da hierarquia, do mais geral ao mais específico e mesmo a partir de dimensões externas. Conclusões: A utilização do sistema nesta amostra demonstrou aplicabilidade na classificação e arquivo de informação clínica, capacidade de recuperação e flexibilidade, sofrendo alterações sem interferir com as características desejáveis. Esta ferramenta permite a recuperação da evidência que interessa orientada para o doente. Introduction: The large amount of information in the medical area creates management problems, being necessary systematic methods for filing and retrieval. With information on the context of clinical records, methods must integrate controlled biomedical terminologies and desirable characteristics oriented to the structure, content and clinical results. The objective is to test the applicability and capacity for retrieval of a multidimensional system developed for classification and management of health information. Methods: Three hundred questions were randomly selected, by computerized method, from the questions received in six years (Medicine Information Service, Pharmaceutical Department, Coimbra University Hospitals). They were characterized and applicability evaluated by classified amount and need to alter the system, which is composed of various independent dimensions, incorporating concepts sometimes hierarchical. Questions retrieval was tested searching information in a dimension or between dimensions. Results: All questions were classified: 53% are clinical cases with illnesses incidence in the genitourinary system; metabolic, nutritional and endocrine disease; cancer; infections and nervous system. In 81%, the object is a drug, mostly anti-infectious and anti-neoplastic agents. The therapeutic and safety areas had been the most requested, regarding the subjects: use, adverse reactions, drug identification and pharmaceutical technology. As to applicability, it was necessary to add some concepts and modify same hierarchical groups, that didn’t modify the basic structure, nor had collided with the desirable characteristics. The limitations were related with the incorporated external classification systems. The search in the subject dimension of the concept drug administration retrieved 19 questions. The search between two dimensions: antiinfectious (external) and teratogenicity (subject) retrieved three questions. In the two examples, it was possible to retrieve information from any one of the levels of the hierarchy, from the most general to the most specific and even from external dimensions. Conclusions: The use of the system in this sample showed its applicability in clinical information classification and filing, retrieval capacity and flexibility, supporting modifications without interfering with desirable characteristics. This tool allows retrieval of patient-oriented evidence that matters.

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Tese de doutoramento, Ciências Biomédicas (Bioquímica Médica), Universidade de Lisboa, Faculdade de Medicina, 2014

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Tese de mestrado, Cuidados Farmacêuticos, Universidade de Lisboa, Faculdade de Farmácia, 2013

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Tese de doutoramento, Ciências Biomédicas (Bioquímica Médica), Universidade de Lisboa, Faculdade de Medicina, 2014

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Tese de doutoramento, História e Filosofia das Ciências, Universidade de Lisboa, Faculdade de Ciências, 2015

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Tese de mestrado em Engenharia Biomédica e Biofísica, apresentada à Universidade de Lisboa, através da Faculdade de Ciências, 2015

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Tese de doutoramento, Ciências Biomédicas (Bioquímica Médica), Universidade de Lisboa, Faculdade de Medicina, 2016

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Tese de mestrado, Bioética, Faculdade de Medicina, Universidade de Lisboa, 2014

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© Ordem dos Médicos 2016

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Tese de mestrado, Cuidados Paliativos, Faculdade de Medicina, Universidade de Lisboa, 2015