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Dissertação para obtenção do Grau de Mestre em Engenharia Química e Bioquímica

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Dissertação para obtenção do Grau de Mestre em Logica Computicional

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INTRODUCTION: The article describes the epidemiologic profile of dengue cases in Vitória, the capital of Espírito Santo, Brazil, from 2000 to 2009, aimed at identifying risk groups regarding the incidence and severity of the disease. METHODS: Confirmed cases of dengue among city residents during ten years were classified as dengue fever, dengue hemorrhagic fever, dengue shock syndrome and dengue with complications, and analyzed according to sex, age, race-color and education. RESULTS: The proportion of dengue cases was highest among women aged 20 to 29 years-old and similar between whites and blacks. A gradual decrease occurred in the percentage of dengue cases in the population aged 15 years-old or more, in the historical series of 10 years, and a growing increase in individuals less than 15 years-old, showing statistical significance. The fatality rate ranged from zero to 0.3% for all forms of dengue and from 0.2% to 18.2% for severe forms. CONCLUSIONS: The profile of those affected by the disease in the municipality is similar to those affected in Brazil. The increasing number of cases in individuals under 15 years-old corroborates the results of recent studies in other Brazilian municipalities.

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RESUMO: Na descrição deste estudo foi utilizada a terminologia anatómica da Sociedade Brasileira de Anatomia adaptada ao português por J. A. Esperança-Pina de acordo com o tratado Anatomia Humana da Relação. Os actuais estudos sobre hipoacusia sensorioneural implicam um grupo crescente de situações, em que a lesão se situa ao nível da microvascularização coclear, daí que o conhecimento exacto da angiomorfologia normal se torne essencial na fase actual do conhecimento. A autora tem vindo a estudar, desde 1986, a angiomorfologia do ouvido Interno no modelo experimental, o Cobaio, utilizando várias técnicas microvasculares. sendo dado enfâse particular neste estudo à técnica de microscopia electrónica de varrimento em moldes vasculares. Os animais usados no presente estudo pertencem à espécie cavia porcellus, cobaio, por serem considerados na comunidade cientifica internacional como o melhor modelo experimental para estudo do ouvido interno, pelo facto de a morfologia coclear ser muito semelhante à do Homem e por isso ser um modelo fiável para cirurgia experimental e microdissecção. Este estudo foi realizado em 100 cobaios, cavia porcellus, de ambos os sexos com peso médio de 450g. A vascularização do ouvido interno, no cobaio como no homem, faz-se através dos ramos de divisão da artéria auditiva interna ou labiríntica. A artéria labiríntica origina-se como ramo colateral da artéria cerebelosa ântero-inferior a qual tem origem na artéria basilar ou na artéria vertebral. Embora no homem a artéria auditiva interna possa também destacar-se da artéria basilar e até da artéria vertebral, no cobaio em todos os casos estudados a sua origem verificou-se sempre na artéria cerebelosa ântero-inferior. A artéria labiríntica, ao passar abaixo do meato auditivo interno, divide-se na artéria vestibular anterior e na artéria coclear comum.A artéria vestibular anterior dirige-se para o nervo vestibular, emite vasa nervorum para este nervo e vasculariza o utrículo e os canais semicirculares. A artéria coclear comum origina dois ramos principais, a artéria vestíbulo‑coclear ou vestibular posterior no cobaio, a qual se destaca junto à espira basal da cóclea e a artéria coclear, como ramo terminal, que passa a denominar-se de artéria modiolar ou espiralada, após entrar no modíolo. A artéria modiolar ascende no modíolo promovendo através dos seus ramos colaterais e dos seus ramos terminais a microvascularização coclear, numa vascularização de órgão de tipo terminal. Ao longo do seu trajecto verificou‑se de modo constante uma redução gradual de calibre em cada uma das espiras, por emissão de ramos colaterais, sendo que o calibre da artéria na base da cóclea apresenta um valor que diminui gradualmente até ao ápice. A artéria modiolar origina em todo o seu trajecto ramos colaterais, cujo número diminui em valor absoluto da base para o ápice: Arteríolas radiárias internas, arteríolas de trajecto flexuoso que caminham junto às estruturas sensorioneurais da parede interna da cóclea, junto ao lábio timpânico da lâmina espiral óssea e na parede do próprio modíolo, que se relacionam intimamente com este. As arteríolas radiárias internas originam‑se no flanco da artéria modiolar espiralada. Contam‑se dez a doze em cada espira, extraordinariamente flexuosas desde a sua origem. As arteríolas radiárias internas originam como ramos colaterais, vários grupos de arteríolas de menor calibre, que vascularizam distintas regiões da parede interna da cóclea, as arteríolas do gânglio espiral, a rede espiral interna, as arteríolas de origem dos glomérulos de Schwalbe e a arteríola da lâmina basilar. As arteríolas radiárias externas importantes ramos colaterais da artéria modiolar espiralada promovem a vascularização de importantes estruturas da parede externa. Ao atingir o limite externo do ligamento espiral, as arteríolas radiárias externas dividem‑se em vários ramos arteriolares de menor calibre, ao longo da convexidade do limite externo do ligamento espiral, originando a rede capilar pós-estriada que ocupa a porção lateral do ligamento espiral e a rede capilar ad‑ -estriada, na sua porção mais medial em íntima relação com a estria vascular. A espira basal da cóclea apresenta grande riqueza de vascularização, com características particulares apenas a esta espira, a qual é metabolicamente a mais exigente. A arteríola da janela da cóclea aborda a janela da cóclea pela sua convexidade e divide-se numa rica rede vascular da qual emergem arteríolas pré-capilares que se ramificam em capilares, os quais se dirigem em profundidade penetrando a rampa timpânica da cóclea ao nível da espira basal. Importou neste estudo verificar quais as semelhanças em termos de calibre de estruturas análogas, na parede interna e na parede externa da cóclea, com particular incidência na rede capilar. Do estudo estatístico realizado com testes paramétricos de Tamahane e não paramétricos de Mann-Whitney, verifica-se que comparando todas as estruturas consideradas estas têm calibres diferentes, com excepção dos capilares da estria vascular e do ligamento espiral, pertencentes à parede externa da cóclea que têm calibres iguais aos capilares da rede espiral interna e aos capilares da parede interna da cóclea, dependentes das arteríolas da rede espiral interna. As redes capilares dependentes das arteríolas radiárias internas que vascularizam as estruturas sensorioneurais junto á parede interna do modiolo são em tudo semelhantes em termos de calibre às redes capilares da parede externa da cóclea, incluindo os capilares da estria vascular. Esta particularidade traduz num órgão com vascularização de tipo terminal,um mecanismo de controlo do fluxo sanguíneo coclear tão importante na parede interna como na parede externa da cóclea. ------------ ABSTRACT:Current studies on sensorineural hearing loss, imply a growing group of situations in which the lesion is located at the level of the cochlear microvasculature, hence the exact knowledge of normal angiomorfology becomes essential in current state of knowledge. The author has been studying since 1986, the angiomorfology of inner on the experimental model, the guinea pig, using various microvascular techniques being given particular emphasis in this study to the results of the technique of scanning electron microscopy on corrosion casts. The animals used in this study belong to the species cavia porcellus, guinea pig, to be considered in the international scientific community as the best experimental model for the study of the inner ear, the cochlear morphology is very similar to human and therefore a reliable model for experimental surgery and microdissection. This study was performed in 100 guinea pigs of both sexes with average weight of 450g. There shall be a brief description of embryology, anatomy and cochlear physiology in the light of developmental biology, regarding also the spatial location of the cochlea and the determinism of morphogenetic fields in their development and function. The cochlear transduction mechanism converts the sound wave in stimuli sound and so afferent auditory nerve fibres and deafness are closely related to the cochlear microvasculature. Cochlear ischemia is accompanied by immediate hearing loss. The different type of cochlear injury that leads to sensorineural deafness is well studied in presbycusis where an objective link with the audiometric pattern as been established. The sensory type of deafness, is closely related to the degeneracy of the organ of Corti and damage to the outer hair cells at the basal turn of the cochlea. Keeping in mind cochlear tonotopy with location of high frequency sounds at the level of the base of the cochlea, it explains the audiometric pattern with loss in high frequencies. The neural type of deafness, is characterized by neuronal loss with loss of descendant important neuronal afferents, with audiometric translation on a gradually curve with important loss of auditory discrimination. The metabolic type of deafness results in atrophy of the vascular stria, with consequent change in the potential of the endolymph by decreasing the vascular stria cells and changes in K + recycling mechanism. There is also a change in the morphology of the spiral ligament and the audiometric patern as a flattened curve with loss at all frequencies. Bearing in mind cochlear tonotopy and being characterized all types of sensorineural deafness, we may inquire to what extent the cochlear microvasculature, considering not only the cochlea as a whole but different regions of the inner wall and the outer wall of the cochlea, contributes to deafness. We analysed the entire cochlear morphology on scanning electron microscopy with particular emphasis on bone and membranous cochlea. The inner wall of the cochlea and intramodiolar structures such as the spiral ganglion, the morphology of its cell bodies and their axons are analyzed. The morphology of Corti’s organ is described in detail, with description and large detail of the inner and outer hair cells. Is then presented the study of the microvasculature itself. The spiral modiolar artery is observed with the diaphanization technique and the technique of scanning electron microscopy on corrosion vascular casts. After emergence of collateral branches of the greatest importance, the radiating internal and external arterioles, the modiolar artery gives rise to its terminal branches, the arterioles of the cochear apex. Arterial vasa vasorum and vasa nervorum are displayed with a great detail, which was not yet described in such detail in previous microvascular studies. The arterial radiating arterioles originate in the flank of the spiral modiolar artery in number of ten to twelve in each loop, and they vascularize through their branches the inner wall cochlear sensorineural structures located in the modiolus as the spiral ganglion and structures near the organ of Corti. Their caliber is above 20 μm on the basal turn and in the second loop it decreases to values between 12 and 20 μm, decreasing progressively to the apex of the cochlea.They arise near the modiolus or on their way in the spiral lamina forming vascular loops, and divide without presenting vascular constrictions in their divisions, originating new vascular loops of lower caliber. Internal ratiating arterioles originate as collateral branches several groups of smaller caliber arterioles, which vascularize distinct regions of the inner wall of the cochlea namely, the arterioles of the spiral ganglion, the internal spiral network, the arterioles of origin of the glomeruli of Schwalbe and the arterioles of the basilar membrane. The glomeruli of Schwalbe play an important functional role as relay-stations, in hemodynamic terms, to control the cochlear microvasculature. External radiating arterioles have their origin in the spiral modiolar artery, they are directed towards the outer wall of the cochlea and run through the roof of the scala vestibuli. Above the insertion of Reissner’s membrane on the external wall the external radiating arterioles originate the spiral ligament arterioles, which vascularize the spiral ligament, they divide into several arteriolar branches of smaller caliber, along the convexity of the outer edge of the spiral ligament. The connective tissue of the spiral ligament forms a mesh with supporting function of the highly specialized epithelium, where pericytes were identifiable. Next to its base there is the microvascular network of stria vascularis. The adstriated vascular network which is divided into a capillary network, the capillary network of stria vascularis. The stria vascularis, the only vascularized epithelium of the human body, plays an important role, forming an haemato-labyrintine barrier to assure labyrinthine endocochlear potential and transport of ions, essential for the mechanism of transduction of external hair cells. The cochlear basal turn has a special feature on its external wall, the region of the windows, the round windows giving access to scala tympani and the oval window thatleads into scala vestibuli, and so it is metabolic demanding. For their role in cochlear tonotopy the sensorineural structures and those of the external wall of the cochlea, are particularly vulnerable to hypoxia. Although the complementarity of all the techniques was important for three- -dimensional reconstruction of the microvasculature of the cochlea, the scanning electron microscopy technique, especially when we used the system Semafore was fundamental to perform precise morphometric mesures regarding all vascular structures.Regarding the capillaries of the inner and outer wall of the cochlea networks this technique allowed their characterization in morphometric terms. To conclude the capillaries of the inner wall and of the external wall of the cochlea have similar size. So although located at different cochlear regions, with a different functional role, in cochlear physiology these networks consist of capillaries of similar caliber. It seems to translate a cochlear blood flow control mechanism that is so important in the inner wall as in and the external wall of the cochlea to provide for in inner ear homeosthasia.

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INTRODUCTION: Operational classification of leprosy based on the number of skin lesions was conceived to screen patients presenting severe forms of the disease to enable their reception of a more intense multidrug regimen without having to undergo lymph smear testing. We evaluated the concordance between operational classification and bacilloscopy to define multibacillary and paucibacillary leprosy. METHODS: We selected 1,213 records of individuals with leprosy, who were untreated (new cases) and admitted to a dermatology clinic in Recife, Brazil, from 2000 to 2005, and who underwent bacteriological examination at diagnosis for ratification of the operational classification. RESULTS: Compared to bacilloscopy, operational classification demonstrated 88.6% sensitivity, 76.9% specificity, a positive predictive value of 61.8%, and a negative predictive value of 94.1%, with 80% accuracy and a moderate kappa index. Among the bacilloscopy-negative cases, 23% had more than 5 skin lesions. Additionally, 11% of the bacilloscopy-positive cases had up to 5 lesions, which would have led to multibacillary cases being treated as paucibacillary leprosy if the operational classification had not been confirmed by bacilloscopy. CONCLUSIONS: Operational classification has limitations that are more obvious in borderline cases, suggesting that in these cases, lymph smear testing is advisable to enable the selection of true multibacillary cases for more intense treatment, thereby contributing to minimization of resistant strain selection and possible relapse.

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Introduction Leishmania braziliensis infection induces a large spectrum of lesions that clinically manifest as nodules or papules that progress to ulcers. Although it is already known that T helper cells predominate in the lesions, cytotoxic T cells have also been reported to be present, and their role in leishmaniasis immunopathogenesis is not well known. This study investigated the amounts of CD8+ and granzyme B+ cells in different clinical forms of human cutaneous leishmaniasis (CL). Methods Forty tissue fragments from early (E-CL) and late CL (L-CL) lesions and from disseminated leishmaniasis (DL) - papules and ulcers - were characterized. The inflamed area per fragment was calculated, and the CD8 and granzyme B expression levels in the infiltrates were quantified by counting positive cells in 15 fields. The localization of CD8 and granzyme B was graded subjectively. Results Inflammation was higher in L-CL and DL ulcers. CD8 expression was increased in late ulcerated lesions compared to recent lesions. The increase in CD8+ cells also correlated with the duration of the lesion. Papules had a higher frequency of granzyme B+ cells than E-CL lesions, although the frequency was similar to those for late and DL ulcers. CD8+ cells were mostly found in the papillary dermis. Conclusions CD8+ T and granzyme B+ cells are present in the inflammatory infiltrates of CL and DL and may participate in the immunopathogenesis of Leishmania infection.

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Although, the word “Love” in organizations is seen as a rare concept, but it has gained importance in management theoretical foundation. This study seeks to explore the companionate love in distinct of organizational forms (Private companies; Social organizations; NGO and IPSS) through interviews. The results propose that it is a tensional concept with a complex dynamic: tension of personal behavior, tension of professional behavior; tension of individual impact and tension of community impact. The love dynamic has common points to all organizations, but its expression depends on the specific form of the organization.

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Buruli Ulcer (BU) is a neglected infectious disease caused by Mycobacterium ulcerans that is responsible for severe necrotizing cutaneous lesions that may be associated with bone involvement. Clinical presentations of BU lesions are classically classified as papules, nodules, plaques and edematous infiltration, ulcer or osteomyelitis. Within these different clinical forms, lesions can be further classified as severe forms based on focality (multiple lesions), lesions' size (>15 cm diameter) or WHO Category (WHO Category 3 lesions). There are studies reporting an association between delay in seeking medical care and the development of ulcerative forms of BU or osteomyelitis, but the effect of time-delay on the emergence of lesions classified as severe has not been addressed. To address both issues, and in a cohort of laboratory-confirmed BU cases, 476 patients from a medical center in Allada, Benin, were studied. In this laboratory-confirmed cohort, we validated previous observations, demonstrating that time-delay is statistically related to the clinical form of BU. Indeed, for non-ulcerated forms (nodule, edema, and plaque) the median time-delay was 32.5 days (IQR 30.0-67.5), while for ulcerated forms it was 60 days (IQR 20.0-120.0) (p = 0.009), and for bone lesions, 365 days (IQR 228.0-548.0). On the other hand, we show here that time-delay is not associated with the more severe phenotypes of BU, such as multi-focal lesions (median 90 days; IQR 56-217.5; p = 0.09), larger lesions (diameter >15 cm) (median 60 days; IQR 30-120; p = 0.92) or category 3 WHO classification (median 60 days; IQR 30-150; p = 0.20), when compared with unifocal (median 60 days; IQR 30-90), small lesions (diameter =15 cm) (median 60 days; IQR 30-90), or WHO category 1+2 lesions (median 60 days; IQR 30-90), respectively. Our results demonstrate that after an initial period of progression towards ulceration or bone involvement, BU lesions become stable regarding size and focal/multi-focal progression. Therefore, in future studies on BU epidemiology, severe clinical forms should be systematically considered as distinct phenotypes of the same disease and thus subjected to specific risk factor investigation.

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Uno de los efectos más deletéreos del actual proceso de globalización de los capitales es el conflicto que surge, para poblaciones migrantes, de la necesidad de asimilarse a sociedades ajenas. Este es el escenario donde los derechos de los extranjeros, de los extraños, están en permanente riesgo de violación. Además de la dominante tendencia de las migraciones, con dirección sur-norte, aumentan los desplazamientos entre países "del sur". Las asimetrías en el desarrollo sumadas a las crecientes restricciones para el ingreso a los países centrales, hacen prever que en las próximas décadas algunos países de América Latina -con Argentina como polo regional de importancia- seguirán consolidándose como destino para los extranjeros tanto regionales como extraregionales. Este trabajo se ocupa de la necesidad de identificar los prejuicios y desconocimientos que sostienen las actitudes discriminatorias y las justifican de manera espuria, en el particular ámbito de la escuela. La escuela, como microcosmos donde se reproducen las prácticas de la sociedad en su conjunto, es un espacio fértil para la transmisión de las actitudes prejuiciosas y excluyentes de lo diferente. Los docentes de nivel primario se encuentran en una posición en la que pueden contribuir a atenuar o a exacerbar la discriminación. Esto sucede tanto por su función simbólica "ejemplar" como por su rol de mediador de las relaciones entre alumnos. Además, los prejuicios de los docentes sobre las diferentes potencialidades de los alumnos -ligadas a rasgos étnicos o raciales- tienen altas posibilidades de incidir en su rendimiento efectivo (efecto Pigmalión). Cuando es considerada en el aula, debe destacarse que la discriminación reconoce un doble efecto: directo e indirecto. El primero, al tratar de manera diferencial a los alumnos sobre la base de reperesentaciones prejuiciosas (rasgos físicos, origen nacional o étnico, religión o extracción social), a veces de manera explícita, pero con mucha más frecuencia implícitamente se afecta el derecho a la igualdad. El efecto indirecto es la reproducción del prejuicio entre los alumnos, la posición simbólica -de poder- que el docente ocupa, dota de autoridad no solo a sus expresiones, sino también a sus actitudes. Desde esa posición no solo se enseña a través de las palabras, los prejuicios se transmiten con actos, gestos, silencios, no necesariamente conscientes para quien los protagoniza, pero indudablemente legibles y efectivos.

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El presente proyecto de investigación está interesado en explorar y describir determinadas formas de sociabilidad de varones de clase media auto definidos como homosexuales entre el inicio de la última dictadura (1976) y la formación de un circuito de discos y pubs gays en la ciudad de Córdoba durante el llamado “destape alfonsinista” (1986). La investigación contempla la descripción densa de dos series de prácticas de sociabilidad. Por una parte, se analizará la sociabilidad de varones homosexuales, especialmente de un conjunto de sujetos que desempeñaban determinadas profesiones como “decoradores”, “modistos”, “cocineros”, “anticuarios” y organizadores de fiestas, contratados por las elites locales y clases medias acomodadas para diseñar sus formas de diversión durante el período. ¿Cómo estos sujetos se relacionaban con quienes no forman parte del “ambiente” homosexual y cómo gestionaban el “secreto público” de su identidad erótico-sexual en sus relaciones con las elites cordobesas? El estudio de estas formas de sociabilidad homosexual escasamente trabajadas por la literatura internacional se relacionará con un análisis de las formas de sociabilidad entre varones homosexuales y la formación de un “ambiente”. Para ello se estudiarán espacios colectivos de socialización como baños públicos, plazas, calles, fiestas privadas, bares, boliches y saunas. Los códigos de comunicación verbal y gestual utilizados en esos espacios, y la caracterización de las redes de personas que componían el “ambiente” también serán objeto de análisis. Dado el carácter inicial de esta investigación, ya que no se cuenta con estudios previos para Córdoba, proponemos la siguiente hipótesis de tipo exploratorio en relación a las formas de sociabilidad de determinados varones homosexuales: Estos sujetos habrían asegurado su reproducción social tanto como la posesión de ciertos salvoconductos para el ejercicio de su identidad sociosexual produciendo fiestas de las elites locales. A partir de erigirse en árbitros del “buen gusto” dichos sujetos habrían asegurado ciertos privilegios, entre ellos “feminizar” sus gustos y producirse como “locas”. Dada las nuevas condiciones impuestas por la recuperación democrática, los salvoconductos se hicieron cada vez menos valiosos al mismo tiempo que se formaba una identidad “gay” que, aunque buscó distanciarse del modelo negativo de “la loca”, continuó reclamando su dominio sobre el “buen gusto”. De esta manera, el cultivo experto del “buen gusto” sería parte de las prácticas que organizaban las formas de sociabilidad de varones homosexuales con sujetos heterosexuales de las elites. En relación a las formas de sociabilidad entre homosexuales proponemos que durante la dictadura, “el ambiente” se habría organizado en torno a un circuito callejero y una territorialidad de eventos privados (fiestas negras). Las diferentes performances sociales desarrolladas en tales espacios formaron parte de prácticas que desafiaron el estado de sitio impuesto. Reprimidas por la dictadura, estas prácticas no podían formar parte de un consumo cultural mercantilizado. La recuperación democrática y los cambios en las políticas del Estado con relación a los derechos y los reclamos de las minorías articulados con la expansión de un mercado gay global, habrían producido un cambio en las formas de sociabilidad homosexual. El ejercicio de esta sociabilidad supuso cada vez más el consumo de ciertas mercancías culturales asociadas con “la noche”. Así, la formación de una identidad “gay”, como opuesta al modelo “loca/chongo” dominante hasta los años ´80, aparecería fuertemente relacionada con la formación y segmentarización de un mercado del entretenimiento nocturno. Para la recolección de datos se recurrirá a entrevistas focalizadas e historias de vida de sujetos que trabajaron dando forma a las prácticas de divertimento nocturno de las elites locales y participaron en las redes de personas que componían el “ambiente”. This research project aims at exploring and describing determined forms of sociability among middle class self-identified as homossexual males betwwen the beginning of the last dictatorial period (1976) and the establishment of a network of disco and gay pubs in Cordoba, AR, during the so called “destape alfonsinista” (1986). This research will deal with the thick description of two series of sociability practices. On the one hand, it will analyze male homossexuals sociability practices themselves, barely studied in international literature, mainly those of a set of subjects whose professional careers were those of interior decorators, dressmakers, kitchen chefs, antiquarians and party promoters hired by the local elites and upper middle classes to design their forms of leisure durign that period. On the other, we will deal with the forms of sociability between male homossexuals and the the set of a social environment. This rearch will study collective spaces of socialization such as restrooms, squares, streets, private parties, pubs, discos and saunas. The communication codes in those spaces, both verbal and gestural, as well as the description of the social networks componing that enviroment will also be considered. Focused interviews with and life histories of those who worked structuring night leisure local elite practices and were part of that environment social networks will be the main techniques used in data collection.