Desenvolvimento de microesferas de vidro fosfato contendo hólmio para uso em radioterapia interna seletiva

A radioterapia interna seletiva é uma alternativa para o tratamento de alguns tipos de cânceres como o carcinoma hepatocelular (CHC), ou câncer de fígado primário. Neste tratamento, microesferas de vidro ou polimérica contendo em sua estrutura radionuclídeos emissores de partículas β- são introduzidas no fígado por meio da artéria hepática e migram, preferencialmente, para regiões hipervascularizadas, que são características da presença de tecido canceroso. Neste trabalho, foram propostos o desenvolvimento de vidros fosfato contendo hólmio para produção de microesferas e sua aplicação em radioterapia interna seletiva no Brasil. O vidro desenvolvido apresentou durabilidade química adequada, densidade de 2,7(3)g/cm3, alta estabilidade térmica e as impurezas encontradas não inviabilizam o tratamento. As microesferas foram produzidas pelos métodos da chama e da queda gravitacional e foram caracterizadas por diversas técnicas em que se observaram forma, granulometria, atividade e biocompatibilidade apropriados para o tratamento pretendido. Propõe-se que as microesferas possam ser submetidas a testes in vivo.

IL28B e vitamina D : preditadores da resposta terapêutica na hepatite C crónica

Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2014

Cost-effectiveness of combination peginterferon alpha-2a and ribavirin compared with interferon alpha-2b and ribavirin in patients with chronic hepatitis C

BACKGROUND: Sustained virological response (SVR) is the primary objective in the treatment of chronic hepatitis C (CHC). Results from a recent clinical trial of patients with previously untreated CHC demonstrate that the combination of peginterferon alpha-2a and ribavirin produces a greater SVR than interferon alpha-2b and ribavirin combination therapy. However, the cost-effectiveness of peginterferon alpha-2a plus ribavirin in the U.S. setting has not been investigated. METHODS: A Markov model was developed to investigate cost-effectiveness in patients with CHC using genotype to guide treatment duration. SVR and disease progression parameters were derived from the clinical trials and epidemiologic studies. The impact of treatment on life expectancy and costs were projected for a lifetime. Patients who had an SVR were assumed to remain virus-free for the rest of their lives. In genotype 1 patients, the SVRs were 46% for peginterferon alpha-2a plus ribavirin and 36% for interferon alpha-2b plus ribavirin. In genotype 2/3 patients, the SVRs were 76% for peginterferon alpha-2a plus ribavirin and 61% for interferon alpha-2b plus ribavirin. Quality of life and costs were based on estimates from the literature. All costs were based on published U.S. medical care costs and were adjusted to 2003 U.S. dollars. Costs and benefits beyond the first year were discounted at 3%. RESULTS: In genotype 1, peginterferon alpha-2a plus ribavirin increases quality-adjusted life expectancy (QALY) by 0.70 yr compared to interferon alpha-2b plus ribavirin, producing a cost-effectiveness ratio of $2,600 per QALY gained. In genotype 2/3 patients, peginterferon alpha-2a plus ribavirin increases QALY by 1.05 yr in comparison to interferon alpha-2b plus ribavirin. Peginterferon alpha-2a combination therapy in patients with HCV genotype 2 or 3 is dominant (more effective and cost saving) compared to interferon alpha-2b plus ribavirin. Results weighted by genotype prevalence (75% genotype 1; 25% genotype 2 or 3) also show that peginterferon alpha-2a plus ribavirin is dominant. Peginterferon alpha-2a and ribavirin remained cost-effective (below $16,500 per QALY gained) under sensitivity analyses on key clinical and cost parameters. CONCLUSION: Peginterferon alpha-2a in combination with ribavirin with duration of therapy based on genotype, is cost-effective compared with conventional interferon alpha-2b in combination with ribavirin when given to treatment-naive adults with CHC.

Contrasting mutual sexual selection on homologous signal traits in Drosophila serrata

The nature of male mating preferences, and how they differ from female mating preferences in species with conventional sex roles, has received little attention in sexual selection studies. We estimated the form and strength of sexual selection as a consequence of male and female mating preferences in a laboratory-based population of Drosophila serrata. The differences between sexual selection on male and female signal traits (cuticular hydrocarbons [CHCs]) were evaluated within a formal framework of linear and nonlinear selection gradients. Females tended to exert linear sexual selection on male CHCs, whereas males preferred intermediate female CHC phenotypes leading to convex (stabilizing) selection gradients. Possible mechanisms determining the nonlinear nature of sexual selection on female CHCs are proposed.

Measuring natural and sexual selection on breeding values of male display traits in Drosophila serrata

Fundamental to many theories of sexual selection is the expectation that sexual traits, which males use in an attempt to increase mating success, confer costs as well as benefits to individual males. Although evolution of exaggerated male traits is predicted to be halted, by costs applied by natural selection, there is a lack of empirical work devoted to quantitatively establishing whether natural selection opposes sexual selection generated by the preferences of females. In this study, we quantified natural and sexual selection gradients on breeding values for cuticular hydrocarbon (CHC) components of male contact pheromones in Drosophila serrata. As male sexual traits may often be environmentally condition dependent, breeding values were used in the selection analysis to remove the possibility of environmental correlations between the measured trait and fitness biasing estimates of selection. The direction of natural selection was found to oppose sexual selection on a subset of CHCs examined. Opposing natural and sexual selection suggests that further evolution of the male pheromone may in part be limited by costs associated with attractive male CHC blends.

Relationship between steatosis, inflammation, and fibrosis in chronic hepatitis C: A meta-analysis of individual patient data

Background & Aims: Steatosis is a frequent histologic finding in chronic hepatitis C (CHC), but it is unclear whether steatosis is an independent predictor for liver fibrosis. We evaluated the association between steatosis and fibrosis and their common correlates in persons with CHC and in subgroup analyses according to hepatitis C virus (HCV) genotype and body mass index. Methods: We conducted a meta-analysis on individual data from 3068 patients with histologically confirmed CHC recruited from 10 clinical centers in Italy, Switzerland, France, Australia, and the United States. Results: Steatosis was present in 1561 patients (50.9%) and fibrosis in 2688 (87.6%). HCV genotype was 1 in :1694 cases (55.2%), 2 in 563 (18.4%), 3 in 669 (21.8%), and 4 in :142 (4.6%). By stepwise logistic regression, steatosis was associated independently with genotype 3, the presence of fibrosis, diabetes, hepatic inflammation, ongoing alcohol abuse, higher body mass index, and older age. Fibrosis was associated independently with inflammatory activity, steatosis, male sex, and older age, whereas HCV genotype 2 was associated with reduced fibrosis. In the subgroup analyses, the association between steatosis and fibrosis invariably was dependent on a simultaneous association between steatosis and hepatic inflammation. Conclusions: In this large and geographically different group of CHC patients, steatosis is confirmed as significantly and independently associated with fibrosis in CHC. Hepatic inflammation may mediate fibrogenesis in patients with liver steatosis. Control of metabolic factors (such as overweight, via lifestyle adjustments) appears important in the management of CHC.

Hepatite C crônica em serviço de referência no nordeste do Brasil: um estudo retrospectivo de dezoito anos de acompanhamento

Chronic Hepatitis C is the leading cause of chronic liver disease in advanced final stage of hepatocellular carcinoma (HCC) and of death related to liver disease. Evolves progressively in time 20-30 years. Evolutionary rates vary depending on factors virus, host and behavior. This study evaluated the impact of hepatitis C on the lives of patients treated at a referral service in Hepatology of the University Hospital Onofre Lopes - Liver Study Group - from May 1995 to December 2013. A retrospective evaluation was performed on 10,304 records, in order to build a cohort of patients with hepatitis C, in which all individuals had their diagnosis confirmed by gold standard molecular biological test. Data were obtained directly from patient charts and recorded in an Excel spreadsheet, previously built, following an elaborate encoding with the study variables, which constitute individual data and prognostic factors defined in the literature in the progression of chronic hepatitis C. The Research Ethics Committee approved the project. The results were statistically analyzed with the Chi-square test and Fisher's exact used to verify the association between variable for the multivariate analysis, we used the Binomial Logistic regression method. For both tests, it was assumed significance p < 0.05 and 95%. The results showed that the prevalence of chronic hepatitis C in NEF was 4.96 %. The prevalence of cirrhosis due to hepatitis C was 13.7%. The prevalence of diabetes in patients with Hepatitis C was 8.78 % and diabetes in cirrhotic patients with hepatitis C 38.0 %. The prevalence of HCC was 5.45%. The clinical follow-up discontinuation rates were 67.5 %. The mortality in confirmed cases without cirrhosis was 4.10% and 32.1% in cirrhotic patients. The factors associated with the development of cirrhosis were genotype 1 (p = 0.0015) and bilirubin > 1.3 mg % (p = 0.0017). Factors associated with mortality were age over 35 years, abandon treatment, diabetes, insulin use, AST> 60 IU, ALT> 60 IU, high total bilirubin, extended TAP, INR high, low albumin, treatment withdrawal, cirrhosis and hepatocarcinoma. The occurrence of diabetes mellitus increased mortality of patients with hepatitis C in 6 times. Variables associated with the diagnosis of cirrhosis by us were blood donor (odds ratio 0.24, p = 0.044) and professional athlete (odds ratio 0.18, p = 0.35). It is reasonable to consider a revaluation in screening models for CHC currently proposed. The condition of cirrhosis and diabetes modifies the clinical course of patients with chronical hepatitis C, making it a disease more mortality. However, being a blood donor or professional athlete is a protective factor that reduces the risk of cirrhosis, independent of alcohol consumption. Public policies to better efficient access, hosting and resolution are needed for this population.

Shared mechanism of teratogenicity of anti-angiogenic drugs identified in the chicken embryo model

This study was supported by a Wellcome Trust-NIH PhD Studentship to SB, WDF and NV. Grant number 098252/Z/12/Z. SB, CHC and WDF are supported by the Intramural Research Program, NCI, NIH. NHG and WL are supported by the Intramural Research Program, NIA, NIH.

Komputerowe gry edukacyjne dla dzieci z trudnościami w czytaniu – doświadczenia polskie i irlandzkie.

W latach 2011-13 przeprowadziliśmy projekt badawczy, którego celem była ocena skuteczności komputerowych gier edukacyjnych jako narzędzia do treningu tempa czytania w pracy z dziećmi wolno czytającymi. W projekcie napotkaliśmy szereg nieprzewidzianych trudności; niniejszy artykuł stanowi refleksję nad nimi z perspektywy praktycznych możliwości i ograniczeń korzystania z komputerowych gier edukacyjnych w terapii pedagogicznej. Powolne czytanie rozumiemy jako trudność w automatyzacji procesu dekodowania. Zakładamy, że natura treningu komputerowego może służyć zaprojektowaniu skutecznego narzędzia do poprawy automatyzacji dekodowania. W tekście opisujemy przebieg trzykrotnej próby wdrożenia treningu tempa czytania dla dzieci z klas 3-6 na podstawie edukacyjnej gry komputerowej GraphoGame-Fluent. Okazało się, że zebrane w rezultacie dane były niewystarczające do odpowiedzi na postawione przez nas pytania dotyczące efektywności treningu i jego poszczególnych parametrów (tj. rodzaj trenowanego materiału – sylaba / wyraz, frekwencja w języku pisanym). W związku z powyższym, przedstawiamy krytyczne uwagi na temat trudności stojących przed badaczem (a także terapeutą) chcącym stosować edukacyjne gry komputerowe w terapii. Trudności mogą dotyczyć etapu wyboru gry (czy jest odpowiednia do problemu ucznia, skuteczna i motywująca), technicznych trudności ze sprzętem (dostępność komputerów i akcesoriów) oraz organizacji treningu (ograniczenia wynikające ze sztywnego stosowania systemu klasowo-lekcyjnego). Opis trudności w prowadzeniu badań w polskich szkołach zestawiamy z opisem takiego samego badania prowadzonego przez nas w szkołach w Irlandii.

The Flotation of Niobium Oxide Minerals from Carbonatite Ores

Global niobium production is presently dominated by three operations, Araxá and Catalão (Brazil), and Niobec (Canada). Although Brazil accounts for over 90% of the world’s niobium production, a number of high grade niobium deposits exist worldwide. The advancement of these deposits depends largely on the development of operable beneficiation flowsheets. Pyrochlore, as the primary niobium mineral, is typically upgraded by flotation with amine collectors at acidic pH following a complicated flowsheet with significant losses of niobium. This research compares the typical two stage flotation flowsheet to a direct flotation process (i.e. elimination of gangue pre-flotation) with the objective of circuit simplification. In addition, the use of a chelating reagent (benzohydroxamic acid, BHA) was studied as an alternative collector for fine grained, highly disseminated pyrochlore. For the amine based reagent system, results showed that while comparable at the laboratory scale, when scaled up to the pilot level the direct flotation process suffered from circuit instability because of high quantities of dissolved calcium in the process water due to stream recirculation and fine calcite dissolution, which ultimately depressed pyrochlore. This scale up issue was not observed in pilot plant operation of the two stage flotation process as a portion of the highly reactive carbonate minerals was removed prior to acid addition. A statistical model was developed for batch flotation using BHA on carbonatite ore (0.25% Nb2O5) that could not be effectively upgraded using the conventional amine reagent scheme. Results showed that it was possible to produce a concentrate containing 1.54% Nb2O5 with 93% Nb recovery in ~15% of the original mass. Fundamental studies undertaken included FT-IR and XPS, which showed the adsorption of both the protonized amine and the neutral amine onto the surface of the pyrochlore (possibly at niobium sites as indicated by detected shifts in the Nb3d binding energy). The results suggest that the preferential flotation of pyrochlore over quartz with amines at low pH levels can be attributed to a difference in critical hemimicelle concentration (CHC) values for the two minerals. BHA was found to be absorbed on pyrochlore surfaces by a similar mechanism to alkyl hydroxamic acid. It is hoped that this work will assist in improving operability of existing pyrochlore flotation circuits and help promote the development of niobium deposits globally. Future studies should focus on investigation into specific gangue mineral depressants and inadvertent activation phenomenon related to BHA flotation of gangue minerals.

Ruxia i Ruxianos w romansach rycerskich autorstwa Feliciano de Silva

W niniejszym artykule przeanalizowany został sposób wykorzystania przez Feliciano de Silva autentycznego toponimu Ruxia (Ruś) przy konstruowaniu świata przedstawionego w romansie rycerskim. Jak zostaje wykazane, Feliciano de Silva jedynie częściowo wpisuje się w tendencję zaobserwowaną wcześniej m.in. u Garci Rodrigueza de Montalvo, który w swoich dziełach nakreśla jasną opozycję pomiędzy chrześcijańskim światem błędnego rycerstwa a złym i nikczemnym pogaństwem. Autor z Ciudad Rodrigo, chcąc nawiązać do chwały średniowiecznego Konstantynopola, powraca do czasów konfliktu bizantyńsko-ruskiego, który twórczo wykorzystuje w aż trzech księgach Florisel de Niquea. Ruxia, jeden z głównych przeciwników greckiego rodu, przedstawiona zostaje jako pogańska potęga militarna, której przewodzą władcy odważni, lecz zarazem owładnięci żądzą, niemoralni i okrutni.

Caraterização molecular de anemias hipocrómicas e microcíticas com HB A2 normal

Introdução - As anemias hipocrómicas e microcíticas, não sideropénicas, são, na sua maioria, de origem talassémica. As talassémias são hemoglobinopatias caraterizadas pela redução ou ausência da produção de cadeias globínicas, provocadas por mutações nos genes globínicos. A β-talassémia está mais frequentemente associada a mutações pontuais e pequenas deleções ou inserções no gene HBB, enquanto que a α-talassémia normalmente resulta de deleções que eliminam os genes HBA2 e/ou HBA1. Deleções de um só gene, -α3.7 e -α4.2, são frequentes entre africanos, mediterrânicos e asiáticos enquanto que grandes deleções que removem ambos os genes alfa, como a deleção do Sudeste Asiático (--SEA), são comuns nas populações asiáticas. Grandes deleções nos clusters alfa e beta são condições raras, geralmente associadas a fenótipos severos. A identificação destas deleções é realizada através da técnica de MLPA (multiplex ligation-dependent probe amplification). Objetivos - O objetivo principal deste trabalho foi estudar um grupo de indivíduos com hipocromia e microcitose e Hb A2 normal, com suspeita de possuirem deleções nos clusters α ou β. Pretendeu-se, ainda, caraterizar a extensão das deleções encontradas e, quando possível, determinar a localização dos seus breakpoints. Materiais e Métodos - Cinquenta e oito indivíduos (28 homens e 30 mulheres), com hipocromia e microcitose de origem desconhecida, seguidos na Consulta de Hematologia do Hospital Pediátrico e do Hospital Geral do CHC, ou enviados de outros centros, foram testados para a presença de deleções nos clusters α e β. Foram efetuados hemogramas a todas as amostras e os estudos de hemoglobina foram realizados por cromatografia líquida de alta performance (HPLC). Os estudos moleculares incluiram GAP-PCR, MLPA, sequenciação genética e PCR / hibridização reversa. Resultados - Foi possível obter o padrão do rácio das sondas MLPA para as deleções α e β conhecidas ou já caraterizadas. Foram encontradas 6 deleções HBA desconhecidas que removem os genes α ou as regiões reguladoras desse cluster. Detetou-se, também, uma deleção no cluster β, que elimina praticamente todos os seus genes. Conclusões - A identificação de grandes delções nos clusters α e β-globínicos em indivíduos com hipocromia e microcitose, com HbA2 normal, é crucial para o aconselhamento genético. A metodologia de MLPA é uma abordagem simples e fiável, muito útil para o diagnóstico de casos de talassemia, em que não são detetadas mutações α ou β através das técnicas convencionais

Etapas de cambio comportamental frente al consumo de drogas ilegales, tabaco y alcohol en escolares de 9 a 17 años de Bogotá – Colombia

Objetivo: El propósito del estudio fue describir estadísticamente las etapas de cambio comportamental frente al consumo de sustancias psicoactivas –SPA– (alcohol, tabaco y drogas ilegales) en escolares entre 9 y 17 años de Bogotá- Colombia, pertenecientes al estudio FUPRECOL. Método: Se trata de un estudio descriptivo y transversal en 6.965 niños y adolescentes entre 9 y 17 años, pertenecientes a 24 instituciones educativas oficiales de Bogotá - Colombia. La medición de los procesos de cambio propuestos por el Modelo Transteórico (MTT), aplicados al consumo de drogas, tabaco y alcohol se aplicaron de manera auto-diligenciada mediante un cuestionario estructurado. Resultados: De la muestra evaluada, el 58,4% fueron mujeres con un promedio de edad 12,74 ± 2.38 años. En la población en general, frente al consumo de drogas, el 6% de los escolares se encontraban en etapa de pre-contemplación, 44 % en contemplación; 30% en preparación/acción, 20% en mantenimiento. Con relación al consumo de alcohol, el 5% de los niños y adolescentes se encontraban en etapa de pre-contemplación, 36 % en contemplación; 12% en preparación/acción, 46% en mantenimiento. Frente al tabaco, el 4% de los niños y adolescentes se encontraban en etapa de pre-contemplación, 33 % en contemplación; 12% en preparación/acción, 51% en mantenimiento. Conclusiones: En los escolares evaluados, un importante porcentaje se ubica en la etapa de mantenimiento frente a la intención de consumo de tabaco y alcohol. Frente al consumo de drogas ilegales los niños y adolescentes están en la etapa de contemplación. Se requieren esfuerzos mayores para fomentar programas preventivos que enseñen sobre el riesgo del abuso/dependencia de este tipo de sustancias psicoactiva sobre la salud; dándole prioridad en las agendas y políticas públicas dentro del ámbito escolar.