999 resultados para SINDROME DE INMUNODEFICIENCIA ADQUIRIDA


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Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

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A exploração da atividade biológica de compostos secundários presentes nas tinturas ou em óleos essenciais de plantas podem representar, ao lado da indução de resistência, mais uma forma potencial de controle de doenças em plantas cultivadas. O presente trabalho objetivou avaliar o potencial de tinturas de Lippia alba, Lippia sidoides, Mikania glomerata, Equisetum sp. e Hedera helix e óleos essenciais de Rosmarinus officinalis e Cinnamomum zeylanicum nas atividades in vitro, in vivo e na produção de proteínas na indução de resistência, em plantas de feijão vagem cultivar Bragança. Os resultados obtidos demonstraram que as tinturas de L. alba e L. sidoides e os óleos essenciais (R. officinalis e C. zeylanicum) apresentaram atividade in vitro aos isolados de Xanthomonas axonopodis pv. phaseoli. Todas as tinturas ensaiadas apresentaram menores valores do progresso da doença (AACPD), em relação à testemunha, merecendo destaque a tintura de L. alba, que estavam correlacionadas com os maiores teores de polifenoloxidase, peroxidase e proteínas solúveis totais, evidenciando uma possível indução de resistência. Os óleos essenciais não apresentaram diferença na AACPD e nem na indução de proteínas.

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Bioethics studies human behavior in the fields ofbiological sciences and health care. Tt strives for humanization in health services along with promoting the rights of patients. In view of the lack of dental research dealing with this topic, the present study was undertaken to identify, from the viewpoint of dental surgeons, ethical problems experienced in dental practice,understand how they occur and how professionals deal with them. It is a descriptive exploratory investigation within a qualitative approach. Empirical material was collected through semi-structured interviews performed with 15 dental surgeons who work both in private and public practice in the state of Rio Grande do Norte, Brazil. The content of the interviews was systemized and organized, resulting in the identification of topics, from which were grouped the ethical problems reported by the participants. The resu1ts indicate that many of the ethical problems coincide with infringements of the norms and mIes of the Dental Code of Ethics, confirming a dental ethic acquired during professional formation and therefore, inadequate for solving the problems that emerge in professional practice. Other questions stand out such as low salaries, competition and poor working conditions. Associated to these problems are lack of commitment and professional responsibility with the patients. Concem with maintaining user autonomy, guaranteeing access to specialized services, and the need for performing only procedures for which they are technically qualified arise in the responses, leading to difficulties in consolidating the principIes proclaimed by bioethics: autonomy, justice, nonmaleficence and beneficence. We concluded that the ethical problems identified in professional practice need to be understood beyond the dental dimension, towards a human approach. It is therefore necessary to incorporate health care management technologies into health practices, including dentistry, which implies recognizing the difTerent dimensions that surround individuaIs, that is, social, economic, political and cultural

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The most common malignant neoplasm of the oral cavity and oropharynx are squamous cell carcinoma. Injuries to the same stage and subjected to the same treatment protocol have sometimes different evolutionary courses. The scope of this study was to investigate, through a retrospective cohort, associations between the number of CD8 + T cells and natural killer, identified immunohistochemically in the inflammatory infiltrate in a series of cases of oral squamous cell carcinoma and orofaringeano, and the level of tumor response to radiotherapy and chemotherapy, overall survival and relapse-free survival of patients. We identified 54 patients with unresectable disease were treated exclusively with radiotherapy and chemotherapy. The median follow-up was 22 months. The sample was characterized by the predominance of male subjects, median age 60 years, all were smokers. The most frequent site was the tongue and 81.5% were in stage IV. Patients with disease in the oral cavity had a worse response to treatment (p = 0.006), worse relapse-free survival (p = 0.007), worse overall survival (p = 0.007). The advanced T stage was shown a negative prognostic factor (p= 0.006) for the clinical treatment response made. Immunohistochemistry was performed to select CD8 + cells (anti-CD8) and NK cells (anti-CD57). Lymphocytes positive and negative markings were counted using the program ImageJ ®. Two groups were created for each marking evaluated: Group I patients with more than 50% cells positive, Group II: less than 50% of labeled cells. For CD8 + cells detected in 38 (70.3%) of Group I were CD8 + and 16 (29.7%) Group II CD8 +. For NK cells, 26 (48.15%) Group I NK and 28 (51.85%) Group II NK. Regarding the clinical response to treatment, we observed that 39% of patients achieved a complete response and 25.9% remained without recurrence at the end of follow-up. These results were better in Group I CD8 + (p = 0.2). Identified that 72.2% of patients progressed to death, this finding had no association with the immunohistochemical data. There was no statistically significant differences between the number of CD8 + and NK cells and the ability of tumor response to radiotherapy and chemotherapy, or with overall survival and relapse-free survival of patients. However, especially in relation to a learned response, we found that this group of patients with advanced disease have a low count of CD8 + T cells active. Believing in the role that the immune response plays in the local fight against neoplastic cells, however, our results do not support the use of quantitative analysis of CD8 + T cells and NK cells as a prognostic factors for oral squamous cell carcinoma and oropharynx

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Cancer has been affecting people all around the world; disregard sex, ethnicity or social class. Despite the fact it is not always deadly, to be diagnosed and treated of cancer brings a lot of physical, emotional and social suffering, specially for those with less economic resources. Considering the complexity of the problem, there has been perceived that medical treatment is not enough to support cancer patients. There is an increasing understanding about their necessity of integral care, supposed to be given by a multidisciplinary health care equip that can consider all the different aspects involved in the illness process. Everyone has a particular way of been ill or healthy, and gives different meanings to the experienced events. The starting point of the research was the contact with a called work `group of shelter', developed with cancer patients by a multidisciplinary health care equip working on the LIGA Norte Riograndense Contra o Câncer. The research goal is to identify meanings people give to the shelter they receive in the group and to understand the way they experience the disease. Considering it singularity of this process, one worked with individually half-structuralized interviews, carried through with nine patients of the chemotherapy clinics and suck, that they had passed for the experience of the group of shelter, having approached getting ill, the treatment, the shelter and the recreation of the psychosocial processes (or not) after all this process. It was chosen as focus of analysis the creation of psychosocial processes and production of felt of these social actors through its discourse analysis perspective, boarded in accordance with the following thematic axles: the experience of the cancer, the shelter and recreation of the psychosocial processes the life. It was found that shelter has an extensive meaning going beyond the the group and involving others besides the multidisciplinary health care equip, and being important to give each patient the best possible benefit. It was also identified the importance of other social actors, such as relatives, friends and neighbors; added of religious faith, mentioned by all interviewees. It is to be considered the recovering capacity shown by eight interviewees, demonstrated by changing the way of interacting with others, getting new values and behaviors, and demonstrating more wisdom. We can consider the possibility of making this strategy to become part of the everyday practices of others health services working with cancer patients, what we think can help to minimize their suffering

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One of the main applications of methane is in the production of syngas, a mixture of hydrogen and carbon monoxide. Procedures used in this process are steam reforming, CO2 reforming, partial oxidation and autothermal reforming. The present study evaluated and compared the behavior of nickel catalysts supported on mixed oxides of cerium and manganese in the partial oxidation of methane with that of nickel catalysts supported on mixed oxides of cerium and zirconium. Mixed oxides of cerium and zirconium or cerium and manganese were synthesized using two different preparation methods, the polymeric precursor based on Pechini method and combustion reaction using a microwave. This was followed by impregnation with nickel content of 15 %. Samples were calcined at 300, 800 and 900 °C and characterized by specific surface area (SSA), X-ray fluorescence (XRF), X-ray diffraction (XRD), scanning electron microscopy (SEM), temperature programmed reduction (TPR) and the reaction of partial oxidation of methane. The specific areas of samples decrease with the rise in calcination temperature and after nickel impregnation. Metal-cerium solid solution was formed and the presence of other manganese species outside the solid solution structure was confirmed in the compound with the highest amounts of manganese oxides showed. With regard to scanning electron microscopy, supports based on cerium and zirconium prepared by Pechini method exhibited agglomerated particles without uniform geometry or visible pores on the surface. However, compounds containing manganese presented empty spaces in its structure. Through synthesis by combustion reaction, morphology acquired independently of the proposed composition demonstrated greater porosity in relation to Pechini synthesis. Although catalysts were prepared using different synthesis methods, the insertion of nickel showed very similar reduction profiles (TPR). In relation to nickel catalysts supported on mixed oxide of cerium and zirconium, there is an initial reduction of NiO species that present certain interaction with the support. This is followed by the reduction of Ce4+ in Ce3+ surface, with subsequent bulk reduction. For catalysts containing manganese, a reduction of nickel oxide species occurs, followed by two stages of reduction for species Mn2O3 in Mn3O4 and Mn3O4 in MnO, with subsequent reduction of bulk. With respect to partial oxidation reactions, the nickel catalyst supported on mixed oxide of cerium and zirconium, prepared using the Pechini method, exhibited CH4 conversion of approximately 80 %, with conversion of 81 % when prepared by combustion. This behavior continued for 10 hours of reaction. Manganese content was also found to directly influence catalytic activity of materials; the greater the manganese oxide content, the faster deactivation and destabilization occurred in the catalyst. In both synthesis methods, the nickel catalyst supported on mixed oxide of cerium and zirconium maintained an H2/CO ratio very close to 2 during the 10 hours of partial oxidation reaction. Samples containing manganese displayed smaller H2/CO ratios and lower performance in partial oxidation.

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A infecção por HIV/Aids (vírus da imunodeficiência humana/síndrome da imunodeficiência adquirida) constitui um importante problema mundial de Saúde Pública. Dados do último boletim apresentado pela UNAIDS (Organização das Nações Unidas para Aids) em 2013, apontam que mais de 35 milhões de pessoas vivem com HIV em todo mundo. No Brasil, a epidemia é concentrada, com prevalência de infecção menor que 1% na população de 15 a 49 anos, porém chegando a 10,5% entre homens que fazem sexo com homens (HSH). O diagnóstico precoce do HIV se associa a uma redução da morbidade, mortalidade e também da transmissão desta infecção. O presente estudo tem o objetivo de avaliar a prevalência e fatores associados à testagem prévia para HIV na população de HSH dos municípios de Natal/RN e Parnamirim/RN. Os participantes respondiam a um questionário contendo perguntas referentes a dados sociodemográficos, padrões de relacionamento sexual, conhecimentos sobre HIV/Aids, uso de preservativo, consumo de álcool, drogas e busca de testagem para HIV e sífilis. Em seguida, os que desejassem poderiam realizar teste rápido para HIV e sífilis. No total, foram pesquisados 101 sujeitos, destes, 70 foram recrutados com a utilização da técnica Respondent Driving Sample, e 31 com uma amostra de conveniência. O teste de HIV havia sido realizado por 63,3% dos homens pelo menos uma vez na vida. A testagem prévia para HIV foi associada à idade (27 anos ou mais), realização prévia do teste para sífilis, conhecimento sobre locais onde o teste de HIV é feito gratuitamente e resultado positivo para sífilis no momento da pesquisa. A prevalência de testagem para HIV na amostra foi baixa, semelhante ao verificado em outros estudos com a população HSH. Ações que priorizem a divulgação de locais onde o anti-HIV pode ser realizado gratuitamente e direcionadas para o público jovem parecem ser as mais adequadas para a ampliação da testagem entre os HSH na nossa realidade

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It analyses the approach given by health professionals (social workers, nurses and doctors) against woman violence at the Medical Unities of Felipe Camarão and Quintas of the City of Natal and searches to identify if the domestic violence is (in)visible at the Public Health Assistance System attendance. and It refers to the grandiosity of this violence and its consequences to the women health, recognizing it as a public health problem. To the comprehension of the relationship between violent acts against women and their health serious damages, exposes the battle history of the feminist movements and the brazilian women, demonstrating the visibility acquired by theses conquests of the questions related to the women and how the gender study becomes the central category to (re) think the social relations involving women and men, specially, the violent relationships between them. It analyses, mainly, those practiced by the husbands, partners, boyfriends or lovers. It refers, at the end, about the public politics of violence combat adopted at police stations at health centers, showing the difficulties to establish the legislation that exists to combat the violence suffered by the women that look for assistance at the health unities. It intends, with this way, to give more visibility to the domestic questions at the marital relations and ask attention from the public power and health professionals between them, the social worker to the (in) visibility of this problems at the attendances practiced

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The way to deal with information assets means nowadays the main factor not only for the success but also for keeping the companies in the global world. The number of information security incidents has grown for the last years. The establishment of information security policies that search to keep the security requirements of assets in the desired degrees is the major priority for the companies. This dissertation suggests a unified process for elaboration, maintenance and development of information security policies, the Processo Unificado para Políticas de Segurança da Informação - PUPSI. The elaboration of this proposal started with the construction of a structure of knowledge based on documents and official rules, published in the last two decades, about security policies and information security. It's a model based on the examined documents which defines the needed security policies to be established in the organization, its work flow and identifies the sequence of hierarchy among them. It's also made a model of the entities participating in the process. Being the problem treated by the model so complex, which involves all security policies that the company must have. PUPSI has an interative and developing approach. This approach was obtained from the instantiation of the RUP - Rational Unified Process model. RUP is a platform for software development object oriented, of Rational Software (IBM group). Which uses the best practice known by the market. PUPSI got from RUP a structure of process that offers functionality, diffusion capacity and comprehension, performance and agility for the process adjustment, offering yet capacity of adjustment to technological and structural charges of the market and the company

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OBJETIVO: Comparar características clínicas e evolução de pacientes com e sem injúria renal aguda adquirida em unidade de terapia intensiva geral de um hospital universitário terciário e identificar fatores de risco associados ao desenvolvimento de injúria renal aguda e à mortalidade. MÉTODOS: Estudo prospectivo observacional com 564 pacientes acompanhados diariamente durante a internação em unidade de terapia intensiva geral do Hospital das Clínicas da Faculdade de Medicina de Botucatu por 2 anos consecutivos (de maio de 2008 a maio de 2010), divididos em 2 grupos: com injúria renal aguda adquirida (G1) e sem injúria renal aguda adquirida (G2). RESULTADOS: A incidência de injúria renal aguda foi 25,5%. Os grupos diferiram quanto à etiologia da admissão em unidade de terapia intensiva (sepse: G1:41,6% x G2:24,1%, p<0,0001 e pós operatório neurológico 13,8% x 38,1%, p<0,0001), idade (56,8±15,9 x 49,8± 17,8 anos, p< 0,0001), APACHE II (21,9±6,9 x 14,1±4,6, p<0,0001), ventilação mecânica (89,2 x 69,1%, p<0,0001) e uso de drogas vasoativas (78,3 x 56,1%, p<0,0001). Com relação aos fatores de risco e às comorbidades, os grupos foram diferentes quanto à presença de diabetes mellitus, insuficiência cardíaca congestiva, insuficiência renal crônica e uso de anti-inflamatórios não hormonais (28,2 x 19,7%, p=0,03; 23,6 x 11,6%, p=0,0002, 21,5 x 11,5%, p< 0,0001 e 23,5 x 7,1%, p<0,0001, respectivamente). O tempo de internação e a mortalidade foram superiores nos pacientes que adquiriram injúria renal aguda (6,6 ± 2,7 x 12,9± 5,6 dias p<0,0001 e 62,5 x 16,4%, p<0,0001). À análise multivariada foram identificados como fatores de risco para injúria renal aguda, idade>55 anos, APACHE II>16, creatinina (cr) basal>1,2 e uso de anti-inflamatórios não hormonais (OR=1,36 IC:1,22-1,85, OR=1,2 IC:1,11-1,33, OR=5,2 IC:2,3-11,6 e OR=2,15 IC:1,1-4,2, respectivamente) e a injúria renal aguda esteve independentemente associada ao maior tempo de internação e à mortalidade (OR=1,18 IC:1,05-1,26 e OR=1,24 IC:1,09-1,99 respectivamente). À análise da curva de sobrevida, após 30 dias de internação, a mortalidade foi de 83,3% no G1 e 45,2% no G2 (p<0,0001). CONCLUSÃO: A incidência de injúria renal aguda é elevada em unidade de terapia intensiva, os fatores de riscos independentes para adquirir injúria renal aguda são idade >55 anos, APACHE II>16, Cr basal >1,2 e uso de anti-inflamatórios não hormonais e a injúria renal aguda é fator de risco independente para o maior tempo de permanência em unidade de terapia intensiva e mortalidade.

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The Curimataú estuary is located in the oriental coast of Rio Grande do Norte State in Brazil. Its importance resides in the fact that this region possesses one of the last portions of preserved mangrove in the Rio Grande do Norte State. Nevertheless, it has been severely affected by many anthropogenic activities, as sugarcane monoculture and shrimp farming. Former works demonstrated that an accumulation of heavy metals is occurring in oysters in this estuary, and perhaps it could be explained by the input of metals in this ecosystem deriving from the shrimp farming. To better understanding the origin of these metals, bottom sediment samples, cores and suspended particulate matter were collected for a characterization of metal concentrations (Al, Ba, Cd, Cu, Cr, Fe, Mn, Ni, Pb, Zn) and to determine the potentially bioavailable metals. Additionally, the enrichment ratio for each element analyzed was calculated. The mineralogical composition of sediment samples and cores were obtained by X-ray diffraction. Moreover, data of orbital remote sensing were used in order to detect and quantify suspended matter by applying a logarithmic algorithm. Geochemical data of bottom sediments and cores revealed that, excepting Ba and Pb, the elements analyzed presented concentrations characteristic of an unpolluted ecosystem (Al: 0,25 - 8,76 %; Ba: 3,03 - 870 µg.g-1; Cd: < 0,25 µg.g-1; Cr: 1,72 - 82,4 µg.g-1; Cu: 0,12 -25,3 µg.g-1; Pb: 0,38 - 23,7 µg.g-1; Fe: 0,10 - 5,82 %; Mn: 15,1 - 815 µg.g-1; Ni: 0,14 - 36,1 µg.g-1; Zn: 1,37 - 113 µg.g-1). During the dry season a distribution pattern was observed, with higher metal concentrations in the margins, decreasing toward the central portion of the channel. These metal concentrations were well correlated with mineralogical compositions, with clay minerals prevailing at the margins, and quartz and feldspar in the center. However, this pattern was not observed during the wet season, probably because of the high water flux that disturbed bottom sediments. But, as observed for the dry season, a good correlation between metal concentrations and mineralogical composition was also observed for the wet season, with high metal concentrations where there were high quantities of clay minerals. Low enrichment ratios were obtained for the majority of elements analyzed, excepting for Mn, Ba and Pb. Manganese presented the higher ratios downstream for both seasons, and it can be an evidence of anthropogenic impact by shrimp farming. As barium and lead concentrations in sediment samples presented analytical problems during the total sample digestion, one cannot be sure that the ratios obtained correspond to the reality. The highest metal concentrations in particulate matter were obtained in the portion dominated by fluvial transport for all metals analyzed, excepting for copper. Barium and zinc were the only elements that presented elevated concentrations that are not common of unpolluted ecosystems (Ba: 5730 - 8355 µg.g-1; Zn: 3899 - 4348 µg.g-1). However, these high concentrations could not be related to the shrimp farming and waste waters from the town of Canguaretama, once they were obtained from the fluvial particulate matter, that is upstream from the activities above mentioned. The application of the logarithmic algorithm to the processed LANDSAT image was well succeeded, although the acquired image does not correspond exactly to the field campaigns. The IKONOS image provided very detailed views of the suspended sediment concentration at the estuary, as the mixture of distinct water flows at the confluence of Cunhaú and Curimataú rivers, with more turbid waters from Cunhaú river, that is directly affected by effluents from shrimp farming and urban waste waters deriving from the town of Canguaretama

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OBJETIVO: Analisar comparativamente características clínicas e evolução de pacientes com e sem IRA adquirida em UTI geral de um hospital universitário terciário. MÉTODO: Estudo prospectivo observacional com 263 pacientes acompanhados diariamente durante a internação em UTI Geral do Hospital das Clínicas da Faculdade de Medicina de Botucatu no período de julho de 2007 a abril de 2008. RESULTADOS: A incidência de IRA foi de 31,2%. Os grupos foram semelhantes quanto ao sexo e diferiram quanto à etiologia da admissão em UTI (sepse: 31,7% x 13,1%, p < 0,0001, pós-operatório: 11% x 43%, p < 0,0001), idade (59,6 ± 18,1 x 50,2 ± 18,6 anos, p < 0,0001), APACHE II: (21 ± 11,1 x 11 ± 4,8, p = 0,002), oligúria (67,7% x 4,5%, p < 0,0001), presença de ventilação mecânica (81,7 x 57,7%, p = 0,0014), uso de drogas vasoativas (62,2 x 32,6%, p < 0,0001) e enfermaria de procedência (PS: 22 x 14,5%, p = 0,02 e centro cirúrgico: 42,7 x 62,6%, p = 0,03). Quanto às comorbidades, os grupos foram diferentes quanto à presença de HAS e IRC (42,6 x 35,9%, p = 0,005 e 15,8 x 2,1%, p = 0,04, respectivamente) e semelhantes quanto à presença de diabetes e ICC (19,5 x 11%, ns e 6 x 1,1%, ns, respectivamente). A mortalidade foi superior nos pacientes que contraíram IRA (62,1 x 16,5%, p < 0,0001). CONCLUSÃO: A incidência de IRA é elevada em UTI e presente em pacientes com parâmetros clínicos e índices prognósticos de maior gravidade, o que justifica a maior mortalidade observada neles.

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A degeneração hepatocerebral adquirida (AHD) e a degeneração hepatolenticular podem ter apresentações clínicas semelhantes, mas quando uma doença hepática crônica e achados motores atípicos coexistem, a distinção entre AHD e encefalopatia hepática (HE) pode ser ainda mais complicada. Descrevemos três casos de AHD (dois tendo HE) com diferentes achados em neuroimagem, doenças hepáticas distintas e apresentações motoras semelhantes, todos com hipertensão arterial e perda de peso antes das manifestações motoras. O diagnóstico e a fisiopatologia são comentados e comparados com relatos prévios. Concluímos que existem muitas correlações entre HE, degeneração hepatolenticular e AHD, mas a sobreposição de HE e AHD pode ser mais comum dependendo do conhecimento clínico e da acurácia dos critérios diagnósticos adotados para cada enfermidade. Como a AHD não é considerada prioridade na lista de transplante hepático, o prognóstico dos pacientes com AHD permanece ruim, e a interrupção do fluxo nos shunts portossistêmicos deve ser sempre considerada.

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OBJETIVO: Avaliar os resultados do teste tuberculínico e relacioná-los com a presença ou não de tuberculose em atividade e com a contagem de linfócitos T CD4+/CD8+. MÉTODOS: Foram revisados 802 prontuários de pacientes com síndrome da imunodeficiência adquirida atendidos no período de agosto de 1985 a março de 2003. Cento e oitenta e cinco pacientes realizaram o teste tuberculínico (23,1%) e, destes, 107 eram do sexo masculino (57,8%). A média de idade no grupo de reatores ao teste tuberculínico foi de 30,6 anos, com desvio-padrão de 6,62 anos, e entre os não reatores de 34,45 anos com desvio-padrão de 10,32 anos. Foram constituídos dois grupos de estudo: reatores ao teste tuberculínico, com 28 pacientes, e não reatores ao teste tuberculínico, com 157 pacientes. RESULTADOS: Grande parte dos indivíduos foi pouco responsiva ao teste tuberculínico. Constatou-se, no grupo de reatores, maior porcentagem de indivíduos com tuberculose ativa à época da realização do teste, quando se comparou com os não reatores. Dez pacientes entre os reatores e onze entre os não reatores apresentavam alguma forma clínica de tuberculose em atividade à época da realização do teste, sendo que seis do primeiro grupo e oito do segundo tinham contagem de linfócitos T CD4+ menor que 200 células/mm³. CONCLUSÃO: Indurações maiores do que 5 mm não se relacionaram com contagens absolutas mais altas de células T CD4+.