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1.
Long-term oncological and surgical outcomes after Video Endoscopic Inguinal Lymphadenectomy (VEIL) in patients with penile cancer
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Tobias-Machado, Marcos
; Ornellas, Antonio A.
; Hidaka, Alexandre K.
; Medina, Luis G.
; Mattos, Pablo A. L.
; Besio, Ruben S.
; Abreu, Diego
; Castro, Pedro R.
; Nishimoto, Ricardo H.
; Astigueta, Juan
; Dourado, Aurus
; Machado, Roberto D.
; Magnabosco, Wesley J.
; Corona-Montes, Victor
; Villoldo, Gustavo M.
; Zampolli, Hamilton C.
; Taha, Anis
; Auad, Pericles R.
; Faria, Eliney F.
; Arantes, Paulo B. O.
; Tavares, Alessandro
; Nascimento, Francisco S. M. S.
; Brazão Jr., Eder S.
; Rocha, Maurício M.
; Costa, Walter H.
; Panico, Vinicius
; Reis, Leonardo O.
; Almeida-Carrera, Roberto J.
; Silva, Rafael C.
; Zequi, Stênio C.
; Calixto, José R. R.
; Sotelo, Rene
.
ABSTRACT Objective: To report outcomes from the largest multicenter series of penile cancer patients undergoing video endoscopic inguinal lymphadenectomy (VEIL). Materials and Methods: Retrospective multicenter analysis. Authors of 21 centers from the Penile Cancer Collaborative Coalition-Latin America (PeC-LA) were included. All centers performed the procedure following the same previously described standardized technique. Inclusion criteria included penile cancer patients with no palpable lymph nodes and intermediate/high-risk disease and those with non-fixed palpable lymph nodes less than 4 cm in diameter. Categorical variables are shown as percentages and frequencies whereas continuous variables as mean and range. Results: From 2006 to 2020, 210 VEIL procedures were performed in 105 patients. Mean age was 58 (45-68) years old. Mean operative time was 90 minutes (60-120). Mean lymph node yield was 10 nodes (6-16). Complication rate was 15.7%, including severe complications in 1.9% of procedures. Lymphatic and skin complications were noted in 8.6 and 4.8% of patients, respectively. Histopathological analysis revealed lymph node involvement in 26.7% of patients with non-palpable nodes. Inguinal recurrence was observed in 2.8% of patients. 10y- overall survival was 74.2% and 10-y cancer specific survival was 84.8%. CSS for pN0, pN1, pN2 and pN3 were 100%, 82.4%, 72.7% and 9.1%, respectively. Conclusion: VEIL seems to offer appropriate long term oncological control with minimal morbidity. In the absence of non-invasive stratification measures such as dynamic sentinel node biopsy, VEIL emerged as the alternative for the management of non-bulky lymph nodes in penile cancer.
2.
How many species of Mollusca are there in Brazil? A collective taxonomic effort to reveal this still unknown diversity
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Machado, Fabrizio M.
; Miranda, Marcel S.
; Salvador, Rodrigo B.
; Pimenta, Alexandre D.
; Côrtes, Mariana O.
; Gomes, Jaime A.J.
; Miyahira, Igor C.
; Agudo-Padrón, Ignacio
; Oliveira, Cléo D.C.
; Caetano, Carlos H.S.
; Coelho, Paulo R.S.
; D’Ávila, Sthefane
; Arruda, Eliane P. de
; Almeida, Sérgio M. de
; Gomes, Suzete R.
; Alvim, Juliana
; Galvão-Filho, Hilton
; L. Ferreira-Júnior, Augusto
; Marques, Rodrigo C.
; Martins, Inês
; Souza, Leonardo S. de
; Arruda, Janine O.
; Cavallari, Daniel C.
; Santos, Sonia B. dos
; Pedro, Natan C.
; Salles, Anna C. de A.
; Dornellas, Ana P.S.
; Lima, Tarcilla C. de
; Amaral, Vanessa S. do
; Silva, Fernanda S.
; Passos, Flávio D.
; Thiengo, Silvana S.
; Leite, Tatiana S.
; Simone, Luiz R.L.
.
ABSTRACT The expression ‘you need to know to conserve’ is a well-known cliche among biologists. Documenting the richness of a group of organisms is the first step towards understanding biodiversity and preparing efficient conservation plans. In this context, many efforts have been made to quantify the number of species on Earth and estimate the number of species still unknown to science. A few countries have complete and integrated databases estimating the approximate number of species recorded for their territory, particularly in the Global South. In Brazil, a country of continental dimensions, revealing the richness of the second most diverse clade of invertebrates (=Mollusca) has been a goal of taxonomists. Recently, in an unprecedented, collective, and integrated effort among Brazilian malacologists, it was possible to estimate how many valid species of molluscs are there in Brazil. In this effort, more than 30 mollusc experts joined together to update the Taxonomic Catalogue of the Brazilian Fauna (TCBF), a governmental website that allows a quick and real-time updating of all Metazoan. So far, more than 5,000 updates have been made in TCBF, indicating the presence of 3,552 valid species of molluscs in Brazil, distributed among the main clades as follows: Caudofoveata (10 spp.), Solenogastres (6 spp.), Polyplacophora (35 spp.), Scaphopoda (43 spp.), Cephalopoda (92 spp.), Bivalvia (629 spp.) and Gastropoda (2,737 spp.). The present study, in addition to demonstrating for the first time the richness of Brazilian molluscs, also presents the state of the art of this important phylum of invertebrates highlighting its most representative and neglected groups.
3.
Synthesis and Anticancer Activity of Homodimeric Morita-Baylis-Hillman Adducts Based on 3-Hydroxyindolin-2-one Core
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Coelho, Maísa C.
; Castro, Aleff
; Olegário, Tayná R.
; Cristiano, Rodrigo
; Vaz, Boniek G.
; Santos, Gabriel F. dos
; Machado, Lucas S.
; Militão, Gardênia C. G.
; Silva, Paulo B. N. da
; Vasconcellos, Mário L. A. A.
; Lima-Junior, Claudio G.
.
Cancer treatment represents one of the main scientific study targets today, mainly due to the pronounced side effects arising from chemotherapy. This study reports the synthesis, characterization, and anticancer activity of ten compounds from the Morita-Baylis-Hillman reaction. Ethylene glycol diacrylate was used as a double Michael acceptor in reactions with isatin derivatives to give homodimers of 3-hydroxyindolin-2-one core, recognized in the literature for its extensive pharmacological profile. The use of 1,4-diazabicyclo[2,2,2]octane (DABCO) as a catalyst and room temperature were the optimal conditions for the study reaction. The isolated yields were up to 63%, with most reaction times inferior to 24 h, some as fast as 15 min. The anticancer potential of the synthesized dimers was evaluated in vitro against three cancer strains, resulting in average inhibitory concentrations up to 0.72 µM. It was also found that the best performing homodimers are more active than their monomeric counterparts. Considering the promising selectivity indices observed, the preliminary results obtained here act as a basis for broader tests regarding the effectiveness of homodimeric adducts against cancer cells.
4.
CYP450 Metabolism of a Semisynthetic Naphthoquinone, an Anticancer Drug Candidate, by Human Liver Microsomes
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Costa, Edna M. A.
; Carrão, Daniel B.
; Bucci, Jade L. M.
; Oliveira, Anderson R. M.
; Machado, Tallita M.
; Ferreira, Vitor F.
; Lima, Émerson S.
; Vasconcellos, Marne C.
; Magalhães, Igor R. S.
.
Journal of the Brazilian Chemical Society
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CNFD (6b,7-dihydro-5H-cyclopenta[b]naphtho[2,1-d]furan-5,6(9aH)-dione) is a semisynthetic naphthoquinone derived from lawsone that has cytotoxic action in different tumor lines and anticancer activity in vivo. Therefore, this molecule is a relevant candidate for drug development, but there is still no information on its human metabolism and systemic elimination. This study aimed to investigate the in vitro metabolism of this naphthoquinone by human liver microsomes. Initially, in order to determine the in vitro enzymatic kinetic parameters, a high performance liquid chromatography (HPLC) method to quantify the CNFD was developed and validated. In addition, the enzymatic kinetic data, the predicted pharmacokinetic in vivo parameters and the phenotyping study were presented. The main metabolism sites and metabolites have been suggested in silico. The developed HPLC method was linear, reproducible, selective, accurate, and stable. The enzymatic kinetic parameters revealed a sigmoidal profile. In vitro to in vivo extrapolation hepatic metabolic clearance was 10.39 mL min-1 kg-1 protein and the liver extraction rate was 51%. The clearance in vivo associated with a hepatic extraction ratio indicates that the hepatic metabolism is the main route of elimination. Although all cytochrome P450 enzymes evaluated metabolized CNFD, CYP2C9 and CYP3A4 showed higher metabolic capacity. For the first time, metabolism studies of CNFD were demonstrated.
5.
Small mammals in high fragmented landscape in Cerrado/Atlantic Forest ecotone, Southeastern Brazil
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Machado, Felipe S.
; Moura, Aloysio S.
; Mariano, Ravi F.
; Santos, Rubens Manoel dos
; Garcia, Paulo O.
; Oliveira, Izabela R. C.
; Fontes, Marco Aurélio L.
.
RESUMO Pequenos mamíferos em paisagem altamente fragmentada em ecótono Cerrado/Mata Atlântica, Sudeste do Brasil. Atividades humanas exploratórias resultaram na formação de pequenos fragmentos inseridos em uma matriz inóspita para pequenos mamíferos não-voadores. Os efeitos das mudanças na paisagem alteram os padrões de distribuição das espécies. Os padrões de fragmentação da paisagem para pequenos mamíferos são controversos, especialmente considerando pequenos fragmentos e regiões ecotonais. Com base nesses argumentos, investigamos os padrões de diversidade de pequenos mamíferos em pequenos fragmentos na região ecotonal Cerrado / Mata Atlântica. Vinte e quatro fragmentos (<40 ha) foram estudados, usando armadilhas de grade, chapa e de queda. Encontramos baixa riqueza de espécies (11 espécies, seis marsupiais e cinco roedores), o que não era esperado por se tratar de uma região ecotonal. Verificamos que a composição e a estrutura da comunidade são simplificadas pela presença de espécies generalistas e com o aumento do turnover de espécies. Os pequenos fragmentos florestais apresentam uma estrutura de microhabitat com lianas e riachos como principais filtros ambientais de grupos com semelhanças ecológicas. Nossos resultados sugerem que esses fragmentos devem ser manejados para conservar a biodiversidade local e manter as características dentro dos fragmentos para possibilitar a ocorrência de diferentes grupos ecológicos.
ABSTRACT Exploratory human activities have resulted in small fragments inserted into a matrix which is inhospitable to small non-flying mammals. The effects of landscape changes alter the distribution patterns of species. Landscape fragmentation patterns for small mammals are controversial, especially considering small fragments and ecotonal regions. Based on these arguments, we investigated the diversity patterns of small mammals in small fragments in the ecotonal Cerrado/Atlantic Forest region. A total of 24 fragments (<40 ha) were studied using tomahawk, sherman and pitfall traps. We found low species richness (11 species, six marsupials and five rodents), which was not expected because it is an ecotonal region. It was verified that composition and community structure are simplified by the marked presence of generalist species and with the increase of species turnover. The small forest fragments present a microhabitat structure with lianas and streams as main environmental filters of groups with ecological similarities. Our findings suggest that these fragments must be managed in order to conserve the local biodiversity and maintain the needed characteristics to enable the occurrence of different ecological groups.
https://doi.org/10.1590/1678-4766e2021022
213 downloads
6.
Cross-cultural adaptation of the City Birth Trauma Scale for the Brazilian context
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DONADON, MARIANA FORTUNATA
; DARWIN, ANA CAROLINA R.
; BOMBONATTI, EDUARDO A.
; PEREIRA-LIMA, KARINA
; SANTOS, RAFAEL GUIMARÃES
; MACHADO-DE-SOUSA, JOÃO PAULO
; SILVA, THIAGO DORNELA APOLINÁRIO DA
; POLI NETO, OMERO B.
; GASPARDO, CLAUDIA MARIA
; CANTILINO, AMAURY
; SOUZA, LUCIANO DIAS DE MATTOS
; AYRES, SUSAN
; OSÓRIO, FLÁVIA L.
.
Archives of Clinical Psychiatry (São Paulo)
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Abstract Background Posttraumatic stress disorder consists of a set of symptoms that occurs in response to one or more traumatic events and can occur in postpartum, from traumatic situations related to the birth or to the baby’s health in the first days of life. It is important tracking the presence of birth trauma, but there is not available instruments in the Brazilian context for this purpose. Objectives To present the cross-cultural adaptation of City Birth Trauma Scale (BiTS) into Brazilian portuguese. Methods Cross-cultural adaptation involved independent translations, synthesis,back-translation, and submission to the original author’s appreciation. After the scale was subjected to face validity, followed by a pilot study with postpartum mothers. Results All steps were performed for the cross-cultural adaptation. Regarding face validity, items evaluated concerning different types of equivalence, presented satisfactory agreement values (≥4.20). Most of the expert’s suggestions were followed, being the main ones related to adjustments in prepositions, pronouns and verbal subjects. Pilot study showed that the mothers had been able to understand and respond to the instrument without adjustments. Discussion BiTS’s Brazilian version proved to be cross-culturally adapted, ensuring the possibility of intercultural data comparison from the semantic, idiomatic, cultural, and conceptual perspectives. New studies are being conducted to attest its psychometric adequacy.
https://doi.org/10.1590/0101-60830000000243
794 downloads
7.
Os Percentis e Pontos de Corte da Circunferência Abdominal para Obesidade em uma Ampla Amostra de Estudantes de 6 a 10 Anos de Idade do Estado de São Paulo, Brasil
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Santos, José Luiz F
; Valério, Valentin P.
; Fernandes, Rafael N.
; Duarte, Ligia
; Assumpção, Antonio C.
; Guerreiro, Jayme
; Sickler, Antonio L.
; Lemos, Álvaro A. R.
; Goulart Filho, Jayro G
; Cesar, Luiz Antonio Machado
; Pinto, Ibraim Masciarelli
; Magalhães, Carlos
; Hussid, Maria Fernanda
; Camacho, Cleber
; Avezum, Alvaro
; Sangaleti, Carine T.
; Consolim-Colombo, Fernanda Marciano
.
Resumo Fundamento A prevalência da obesidade vem aumentando sistematicamente na população, inclusive nas crianças e adolescentes, ao redor do mundo. Objetivos Descrever curvas percentílicas de referência para a circunferência abdominal (CA) nas crianças brasileiras e fornecer pontos de corte da CA para identificar crianças com risco de obesidade. Métodos Um estudo multicêntrico, prospectivo, tranversal foi realizado em crianças com idades entre 6 e 10 anos, matriculadas no ensino fundamental de escolas públicas e particulares de 13 cidades do estado de São Paulo. A estatura, o peso e a CA foram medidos em duplicata em 22.000 crianças (11.199 meninos). Para estabelecer o melhor ponto de corte da CA para o diagnóstico da obesidade, foram calculadas curvas ROC com crianças classificadas como com peso normal e obesas, de acordo com as curvas do IMC, estratificadas por gênero e idade, e o índice Youden foi utilizado como a eficácia potencial máxima desse biomarcador. Valores de p < 0,05 foram considerados estatisticamente significativos. Resultados Os valores da CA aumentaram com a idade, tanto nos meninos quanto nas meninas. A prevalência de obesidade em cada grupo variou de 17% (6 anos de idade) a 21,6 % (9 anos de idade), dentre os meninos, e de 14,1% (7 anos de idade) a 17,3 % (9 anos de idade), dentre as meninas. As análises ROC mostraram o percentil 75 como ponto de corte para o risco de obesidade, e o diagnóstico de obesidade está classificado no percentil 85 ou acima. Conclusão Curvas de referência da CA específicas para idade e sexo em crianças brasileiras e pontos de corte para o risco de obesidade podem ser usados em triagem nacional e estudos intervencionais para reduzir a carga da obesidade no Brasil. (Arq Bras Cardiol. 2020; 114(3):530-537)
Abstract Backgroud The prevalence of obesity has systematically been increased in the population, including children and adolescents, around the world. Objectives To describe reference percentile curves for waist circumference (WC) in Brazilian children and provide cut-off values of WC to identify children at risk for obesity. Methods A multicenter, prospective, cross-sectional study was performed with children aged from 6 to 10 years old, enrolled in public and private elementary schools from 13 cities of the São Paulo State. Height, weight, and WC were measured in duplicate in 22,000 children (11,199 boys). To establish the WC best cut-off value for obesity diagnosis, ROC curves with children classified as normal weight and obese were calculated, according to BMI curves, stratified by gender and age, and the Youden Index was utilized as the maximum potential effectiveness of this biomarker. A p < 0.05 was considered statistically significant. Results WC values increased with age in both boys and girls. The prevalence of obesity in each age group varied from 17% (6 years old) to 21.6% (9 years old) among boys, and from 14.1% (7 years old) to 17.3 % (9 years old) among girls. ROC analyses have shown the 75th percentile as a cut-off for obesity risk, and the diagnosis of obesity is classified on the 85th percentile or more. Conclusion Age and gender specific reference curves of WC for Brazilian children and cut-off values for obesity risk may be used for national screening and interventional studies to reduce the obesity burden in Brazil. (Arq Bras Cardiol. 2020; 114(3):530-537)
https://doi.org/10.36660/abc.20190043
2020 downloads
8.
Effect of racial crossing on the scrotum-testicular biometry in sheep submitted to scrotal insulation
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Lisboa-Neto, Antônio F.S.
; Mariano-Filho, Paulo G.
; Carvalho, Jean R.
; Araújo, Morgana S.
; Santos, Amilton C.
; Machado, Felicianna C.F.
; Silva-Filho, Manoel L.
; Machado-Júnior, Antônio A.N.
.
RESUMO: Objetivou-se neste trabalho avaliar o efeito do cruzamento sobre as características biométricas escroto-testiculares de carneiros da raça Santa Inês e mestiços (Santa Inês x Dorper), submetidos à insulação escrotal, acompanhando o retorno dessas características aos valores previamente observados. Para isso, foram realizadas duas mensurações referentes à circunferência escrotal (CE), comprimento (C) e largura testicular (L), antes da insulação. O volume testicular (V) foi calculado pela fórmula V=2 [(r2) x π x h]. As bolsas de insulação foram fixadas ao redor do funículo espermático e escroto com fita adesiva e esparadrapo, permanecendo por sete dias. Após o período de insulação, as mensurações foram realizadas a cada sete dias, totalizando 15 mensurações durante todo o experimento. Os dados obtidos foram submetidos à análise de variância (ANOVA) para um delineamento em blocos casualizados, com dois blocos, 15 tratamentos e quatro repetições. As variáveis analisadas foram submetidas ao teste de Dunnett a 5% de probabilidade, para comparar os valores obtidos antes e após a insulação. Para a comparação entre as raças, as variáveis foram submetidas ao teste de Tukey a 5% de probabilidade. Todos os animais estudados sofreram influência significativa (P<0,05) após a insulação escrotal, porém os carneiros da raça Santa Inês retornaram aos valores anteriormente observados em um espaço de tempo mais curto do que os mestiços. Conclui-se que carneiros da raça Santa Inês apresentam maior resistência do que animais mestiços quando submetidos ao estresse térmico induzido pela insulação escrotal.
ABSTRACT: The objective of this study was to evaluate the effect of the racial crossing on scrotum-testicular biometric characteristics of four sheep Santa Ines and four crossbred (Santa Ines x Dorper) submitted to scrotal insulation, following the return of these characteristics to values previously reported. For this, two measurements were made regarding the scrotal circumference (SC), length (L) and testicular width (W) before treatments. The testicular volume (V) was calculated by the formula V=2 [(r2) x π x H]. The pouches were made with double-layer plastic, internally lined with cotton, and fixed around the spermatic funiculus and scrotum with adhesive tape and bandage remaining in this position for seven days. Measurements were made every seven days, totaling 15 measurements throughout the experiment. The data were submitted to analysis of variance (ANOVA) to a randomized block design with two blocks, 15 treatments and four replications. The variables analyzed were subjected to Dunnett test at 5% probability, to compare the values obtained before and after insulation. For comparison between the breeds, the variables were submitted to Tukey test at 5% probability. All animals studied suffered significant influence (P<0.05) after scrotal insulation, but Santa Ines returned to the values previously observed in a shorter period than the crossbred. In summary, sheep Santa Ines have a higher resistance than crossbred animals when subjected to thermal stress induced by scrotal insulation.
https://doi.org/10.1590/s0100-736x2017000300014
677 downloads
9.
Synthesis, Antitubercular and Leishmanicidal Evaluation of Resveratrol Analogues
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Coimbra, Elaine S.
; Santos, Juliana A.
; Lima, Larissa L.
; Machado, Patrícia A.
; Campos, Débora L.
; Pavan, Fernando R.
; Silva, Adilson D.
.
Journal of the Brazilian Chemical Society
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In this paper we continue our efforts in the search for new Schiff bases as resveratrol analogues as promising antitubercular and antileishmanial agents. Compounds were evaluated in vitro against Mycobacterium tuberculosis and Leishmania species. Compounds showed varying activity against promastigotes of all Leishmania species tested (concentration leading to reduction of 50% of parasite growth-IC50 values ranging from 1.60 to 15.53 µg mL-1). Majority of compounds exhibited good results against Leishmania species with IC50 values below 10.00 µg mL-1, with no cytotoxicity against macrophages. One of the analogues showed the best activity against amastigotes of L. amazonensis (IC50 = 5.73 µg mL-1). Furthermore, the compounds showed comparable or better effect than drugs commonly used in tuberculosis treatment such as Cycloserine®. The analogue that was the most active for M. tuberculosis had minimal inhibitory concentration MIC90 = 0.78 µg mL-1. The in vitro cytotoxicity on Vero cells (CC50), as well as the selectivity index (SI = CC50/MIC) were also evaluated, and showed that the synthesized analogues are not cytotoxic.
https://doi.org/10.5935/0103-5053.20160107
1001 downloads
10.
Growing knowledge: an overview of Seed Plant diversity in Brazil
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Zappi, Daniela C.
; Filardi, Fabiana L. Ranzato
; Leitman, Paula
; Souza, Vinícius C.
; Walter, Bruno M.T.
; Pirani, José R.
; Morim, Marli P.
; Queiroz, Luciano P.
; Cavalcanti, Taciana B.
; Mansano, Vidal F.
; Forzza, Rafaela C.
; Abreu, Maria C.
; Acevedo-Rodríguez, Pedro
; Agra, Maria F.
; Almeida Jr., Eduardo B.
; Almeida, Gracineide S.S.
; Almeida, Rafael F.
; Alves, Flávio M.
; Alves, Marccus
; Alves-Araujo, Anderson
; Amaral, Maria C.E.
; Amorim, André M.
; Amorim, Bruno
; Andrade, Ivanilza M.
; Andreata, Regina H.P.
; Andrino, Caroline O.
; Anunciação, Elisete A.
; Aona, Lidyanne Y.S.
; Aranguren, Yani
; Aranha Filho, João L.M.
; Araújo, Andrea O.
; Araújo, Ariclenes A.M.
; Araújo, Diogo
; Arbo, María M.
; Assis, Leandro
; Assis, Marta C.
; Assunção, Vivian A.
; Athiê-Souza, Sarah M.
; Azevedo, Cecilia O.
; Baitello, João B.
; Barberena, Felipe F.V.A.
; Barbosa, Maria R.V.
; Barros, Fábio
; Barros, Lucas A.V.
; Barros, Michel J.F.
; Baumgratz, José F.A.
; Bernacci, Luis C.
; Berry, Paul E.
; Bigio, Narcísio C.
; Biral, Leonardo
; Bittrich, Volker
; Borges, Rafael A.X.
; Bortoluzzi, Roseli L.C.
; Bove, Cláudia P.
; Bovini, Massimo G.
; Braga, João M.A.
; Braz, Denise M.
; Bringel Jr., João B.A.
; Bruniera, Carla P.
; Buturi, Camila V.
; Cabral, Elza
; Cabral, Fernanda N.
; Caddah, Mayara K.
; Caires, Claudenir S.
; Calazans, Luana S.B.
; Calió, Maria F.
; Camargo, Rodrigo A.
; Campbell, Lisa
; Canto-Dorow, Thais S.
; Carauta, Jorge P.P.
; Cardiel, José M.
; Cardoso, Domingos B.O.S.
; Cardoso, Leandro J.T.
; Carneiro, Camila R.
; Carneiro, Cláudia E.
; Carneiro-Torres, Daniela S.
; Carrijo, Tatiana T.
; Caruzo, Maria B.R.
; Carvalho, Maria L.S.
; Carvalho-Silva, Micheline
; Castello, Ana C.D.
; Cavalheiro, Larissa
; Cervi, Armando C.
; Chacon, Roberta G.
; Chautems, Alain
; Chiavegatto, Berenice
; Chukr, Nádia S.
; Coelho, Alexa A.O.P.
; Coelho, Marcus A.N.
; Coelho, Rubens L.G.
; Cordeiro, Inês
; Cordula, Elizabeth
; Cornejo, Xavier
; Côrtes, Ana L.A.
; Costa, Andrea F.
; Costa, Fabiane N.
; Costa, Jorge A.S.
; Costa, Leila C.
; Costa-e-Silva, Maria B.
; Costa-Lima, James L.
; Cota, Maria R.C.
; Couto, Ricardo S.
; Daly, Douglas C.
; De Stefano, Rodrigo D.
; De Toni, Karen
; Dematteis, Massimiliano
; Dettke, Greta A.
; Di Maio, Fernando R.
; Dórea, Marcos C.
; Duarte, Marília C.
; Dutilh, Julie H.A.
; Dutra, Valquíria F.
; Echternacht, Lívia
; Eggers, Lilian
; Esteves, Gerleni
; Ezcurra, Cecilia
; Falcão Junior, Marcus J.A.
; Feres, Fabíola
; Fernandes, José M.
; Ferreira, D.M.C.
; Ferreira, Fabrício M.
; Ferreira, Gabriel E.
; Ferreira, Priscila P.A.
; Ferreira, Silvana C.
; Ferrucci, Maria S.
; Fiaschi, Pedro
; Filgueiras, Tarciso S.
; Firens, Marcela
; Flores, Andreia S.
; Forero, Enrique
; Forster, Wellington
; Fortuna-Perez, Ana P.
; Fortunato, Reneé H.
; Fraga, Cléudio N.
; França, Flávio
; Francener, Augusto
; Freitas, Joelcio
; Freitas, Maria F.
; Fritsch, Peter W.
; Furtado, Samyra G.
; Gaglioti, André L.
; Garcia, Flávia C.P.
; Germano Filho, Pedro
; Giacomin, Leandro
; Gil, André S.B.
; Giulietti, Ana M.
; A.P.Godoy, Silvana
; Goldenberg, Renato
; Gomes da Costa, Géssica A.
; Gomes, Mário
; Gomes-Klein, Vera L.
; Gonçalves, Eduardo Gomes
; Graham, Shirley
; Groppo, Milton
; Guedes, Juliana S.
; Guimarães, Leonardo R.S.
; Guimarães, Paulo J.F.
; Guimarães, Elsie F.
; Gutierrez, Raul
; Harley, Raymond
; Hassemer, Gustavo
; Hattori, Eric K.O.
; Hefler, Sonia M.
; Heiden, Gustavo
; Henderson, Andrew
; Hensold, Nancy
; Hiepko, Paul
; Holanda, Ana S.S.
; Iganci, João R.V.
; Imig, Daniela C.
; Indriunas, Alexandre
; Jacques, Eliane L.
; Jardim, Jomar G.
; Kamer, Hiltje M.
; Kameyama, Cíntia
; Kinoshita, Luiza S.
; Kirizawa, Mizué
; Klitgaard, Bente B.
; Koch, Ingrid
; Koschnitzke, Cristiana
; Krauss, Nathália P.
; Kriebel, Ricardo
; Kuntz, Juliana
; Larocca, João
; Leal, Eduardo S.
; Lewis, Gwilym P.
; Lima, Carla T.
; Lima, Haroldo C.
; Lima, Itamar B.
; Lima, Laíce F.G.
; Lima, Laura C.P.
; Lima, Leticia R.
; Lima, Luís F.P.
; Lima, Rita B.
; Lírio, Elton J.
; Liro, Renata M.
; Lleras, Eduardo
; Lobão, Adriana
; Loeuille, Benoit
; Lohmann, Lúcia G.
; Loiola, Maria I.B.
; Lombardi, Julio A.
; Longhi-Wagner, Hilda M.
; Lopes, Rosana C.
; Lorencini, Tiago S.
; Louzada, Rafael B.
; Lovo, Juliana
; Lozano, Eduardo D.
; Lucas, Eve
; Ludtke, Raquel
; Luz, Christian L.
; Maas, Paul
; Machado, Anderson F.P.
; Macias, Leila
; Maciel, Jefferson R.
; Magenta, Mara A.G.
; Mamede, Maria C.H.
; Manoel, Evelin A.
; Marchioretto, Maria S.
; Marques, Juliana S.
; Marquete, Nilda
; Marquete, Ronaldo
; Martinelli, Gustavo
; Martins da Silva, Regina C.V.
; Martins, Ângela B.
; Martins, Erika R.
; Martins, Márcio L.L.
; Martins, Milena V.
; Martins, Renata C.
; Matias, Ligia Q.
; Maya-L., Carlos A.
; Mayo, Simon
; Mazine, Fiorella
; Medeiros, Debora
; Medeiros, Erika S.
; Medeiros, Herison
; Medeiros, João D.
; Meireles, José E.
; Mello-Silva, Renato
; Melo, Aline
; Melo, André L.
; Melo, Efigênia
; Melo, José I.M.
; Menezes, Cristine G.
; Menini Neto, Luiz
; Mentz, Lilian A.
; Mezzonato, A.C.
; Michelangeli, Fabián A.
; Milward-de-Azevedo, Michaele A.
; Miotto, Silvia T.S.
; Miranda, Vitor F.O.
; Mondin, Cláudio A.
; Monge, Marcelo
; Monteiro, Daniele
; Monteiro, Raquel F.
; Moraes, Marta D.
; Moraes, Pedro L.R.
; Mori, Scott A.
; Mota, Aline C.
; Mota, Nara F.O.
; Moura, Tania M.
; Mulgura, Maria
; Nakajima, Jimi N.
; Nardy, Camila
; Nascimento Júnior, José E.
; Noblick, Larry
; Nunes, Teonildes S.
; O'Leary, Nataly
; Oliveira, Arline S.
; Oliveira, Caetano T.
; Oliveira, Juliana A.
; Oliveira, Luciana S.D.
; Oliveira, Maria L.A.A.
; Oliveira, Regina C.
; Oliveira, Renata S.
; Oliveira, Reyjane P.
; Paixão-Souza, Bruno
; Parra, Lara R.
; Pasini, Eduardo
; Pastore, José F.B.
; Pastore, Mayara
; Paula-Souza, Juliana
; Pederneiras, Leandro C.
; Peixoto, Ariane L.
; Pelissari, Gisela
; Pellegrini, Marco O.O.
; Pennington, Toby
; Perdiz, Ricardo O.
; Pereira, Anna C.M.
; Pereira, Maria S.
; Pereira, Rodrigo A.S.
; Pessoa, Clenia
; Pessoa, Edlley M.
; Pessoa, Maria C.R.
; Pinto, Luiz J.S.
; Pinto, Rafael B.
; Pontes, Tiago A.
; Prance, Ghillean T.
; Proença, Carolyn
; Profice, Sheila R.
; Pscheidt, Allan C.
; Queiroz, George A.
; Queiroz, Rubens T.
; Quinet, Alexandre
; Rainer, Heimo
; Ramos, Eliana
; Rando, Juliana G.
; Rapini, Alessandro
; Reginato, Marcelo
; Reis, Ilka P.
; Reis, Priscila A.
; Ribeiro, André R.O.
; Ribeiro, José E.L.S.
; Riina, Ricarda
; Ritter, Mara R.
; Rivadavia, Fernando
; Rocha, Antônio E.S.
; Rocha, Maria J.R.
; Rodrigues, Izabella M.C.
; Rodrigues, Karina F.
; Rodrigues, Rodrigo S.
; Rodrigues, Rodrigo S.
; Rodrigues, Vinícius T.
; Rodrigues, William
; Romaniuc Neto, Sérgio
; Romão, Gerson O.
; Romero, Rosana
; Roque, Nádia
; Rosa, Patrícia
; Rossi, Lúcia
; Sá, Cyl F.C.
; Saavedra, Mariana M.
; Saka, Mariana
; Sakuragui, Cássia M.
; Salas, Roberto M.
; Sales, Margareth F.
; Salimena, Fatima R.G.
; Sampaio, Daniela
; Sancho, Gisela
; Sano, Paulo T.
; Santos, Alessandra
; Santos, Élide P.
; Santos, Juliana S.
; Santos, Marianna R.
; Santos-Gonçalves, Ana P.
; Santos-Silva, Fernanda
; São-Mateus, Wallace
; Saraiva, Deisy P.
; Saridakis, Dennis P.
; Sartori, Ângela L.B.
; Scalon, Viviane R.
; Schneider, Ângelo
; Sebastiani, Renata
; Secco, Ricardo S.
; Senna, Luisa
; Senna-Valle, Luci
; Shirasuna, Regina T.
; Silva Filho, Pedro J.S.
; Silva, Anádria S.
; Silva, Christian
; Silva, Genilson A.R.
; Silva, Gisele O.
; Silva, Márcia C.R.
; Silva, Marcos J.
; Silva, Marcos J.
; Silva, Otávio L.M.
; Silva, Rafaela A.P.
; Silva, Saura R.
; Silva, Tania R.S.
; Silva-Gonçalves, Kelly C.
; Silva-Luz, Cíntia L.
; Simão-Bianchini, Rosângela
; Simões, André O.
; Simpson, Beryl
; Siniscalchi, Carolina M.
; Siqueira Filho, José A.
; Siqueira, Carlos E.
; Siqueira, Josafá C.
; Smith, Nathan P.
; Snak, Cristiane
; Soares Neto, Raimundo L.
; Soares, Kelen P.
; Soares, Marcos V.B.
; Soares, Maria L.
; Soares, Polyana N.
; Sobral, Marcos
; Sodré, Rodolfo C.
; Somner, Genise V.
; Sothers, Cynthia A.
; Sousa, Danilo J.L.
; Souza, Elnatan B.
; Souza, Élvia R.
; Souza, Marcelo
; Souza, Maria L.D.R.
; Souza-Buturi, Fátima O.
; Spina, Andréa P.
; Stapf, María N.S.
; Stefano, Marina V.
; Stehmann, João R.
; Steinmann, Victor
; Takeuchi, Cátia
; Taylor, Charlotte M.
; Taylor, Nigel P.
; Teles, Aristônio M.
; Temponi, Lívia G.
; Terra-Araujo, Mário H.
; Thode, Veronica
; Thomas, W.Wayt
; Tissot-Squalli, Mara L.
; Torke, Benjamin M.
; Torres, Roseli B.
; Tozzi, Ana M.G.A.
; Trad, Rafaela J.
; Trevisan, Rafael
; Trovó, Marcelo
; Valls, José F.M.
; Vaz, Angela M.S.F.
; Versieux, Leonardo
; Viana, Pedro L.
; Vianna Filho, Marcelo D.M.
; Vieira, Ana O.S.
; Vieira, Diego D.
; Vignoli-Silva, Márcia
; Vilar, Thaisa
; Vinhos, Franklin
; Wallnöfer, Bruno
; Wanderley, Maria G.L.
; Wasshausen, Dieter
; Watanabe, Maurício T.C.
; Weigend, Maximilian
; Welker, Cassiano A.D.
; Woodgyer, Elizabeth
; Xifreda, Cecilia C.
; Yamamoto, Kikyo
; Zanin, Ana
; Zenni, Rafael D.
; Zickel, Carmem S
.
Resumo Um levantamento atualizado das plantas com sementes e análises relevantes acerca desta biodiversidade são apresentados. Este trabalho se iniciou em 2010 com a publicação do Catálogo de Plantas e Fungos e, desde então vem sendo atualizado por mais de 430 especialistas trabalhando online. O Brasil abriga atualmente 32.086 espécies nativas de Angiospermas e 23 espécies nativas de Gimnospermas e estes novos dados mostram um aumento de 3% da riqueza em relação a 2010. A Amazônia é o Domínio Fitogeográfico com o maior número de espécies de Gimnospermas, enquanto que a Floresta Atlântica possui a maior riqueza de Angiospermas. Houve um crescimento considerável no número de espécies e nas taxas de endemismo para a maioria dos Domínios (Caatinga, Cerrado, Floresta Atlântica, Pampa e Pantanal), com exceção da Amazônia que apresentou uma diminuição de 2,5% de endemicidade. Entretanto, a maior parte das plantas com sementes que ocorrem no Brasil (57,4%) é endêmica deste território. A proporção de formas de vida varia de acordo com os diferentes Domínios: árvores são mais expressivas na Amazônia e Floresta Atlântica do que nos outros biomas, ervas são dominantes no Pampa e as lianas apresentam riqueza expressiva na Amazônia, Floresta Atlântica e Pantanal. Este trabalho não só quantifica a biodiversidade brasileira, mas também indica as lacunas de conhecimento e o desafio a ser enfrentado para a conservação desta flora.
Abstract An updated inventory of Brazilian seed plants is presented and offers important insights into the country's biodiversity. This work started in 2010, with the publication of the Plants and Fungi Catalogue, and has been updated since by more than 430 specialists working online. Brazil is home to 32,086 native Angiosperms and 23 native Gymnosperms, showing an increase of 3% in its species richness in relation to 2010. The Amazon Rainforest is the richest Brazilian biome for Gymnosperms, while the Atlantic Rainforest is the richest one for Angiosperms. There was a considerable increment in the number of species and endemism rates for biomes, except for the Amazon that showed a decrease of 2.5% of recorded endemics. However, well over half of Brazillian seed plant species (57.4%) is endemic to this territory. The proportion of life-forms varies among different biomes: trees are more expressive in the Amazon and Atlantic Rainforest biomes while herbs predominate in the Pampa, and lianas are more expressive in the Amazon, Atlantic Rainforest, and Pantanal. This compilation serves not only to quantify Brazilian biodiversity, but also to highlight areas where there information is lacking and to provide a framework for the challenge faced in conserving Brazil's unique and diverse flora.
https://doi.org/10.1590/2175-7860201566411
33340 downloads
11.
The effect of essential oil of Syzygium cumini on the development of granulomatous inflammation in mice
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Machado, Rachel R. P.
; Jardim, Deborah F.
; Souza, Andrezza R.
; Scio, Elita
; Fabri, Rodrigo L.
; Carpanez, Arthur G.
; Grazul, Richard M.
; Mendonça, José Paulo R. F. de
; Lesche, Bernhard
; Aarestrup, Fernando M.
.
The anti-inflammatory and apoptotic activity of the essential oil of Syzygium cumini (L.) Skeels, Myrtaceae, leaves was investigated in vivo. The anti-inflammatory action and chronic granulomatous inflammation in BALB/c mice, intravenously infected with Mycobacterium bovis, BCG, (Bacillo Calmet Guerim), was judged by measuring and classifying the granulomas formed in the hepatic parenchyma. The degree of apoptosis in the inflammatory cells was also measured. A reduction in the granulomatous area and a change in the pattern of the granulomas were found. Anti-mycobacterial activity of the essential oil against M. bovis was detected in vitro by an interferometric method in liquid culture medium. The chemical constituents of the essential oil were determined by GC/MS. Higher yields of the essential oil of S. cumini leaves were obtained by extraction in a Clevenger apparatus when the fresh leaves were previously frozen as a pre-processing step. The essential oil obtained from this plant demonstrated a statistically significant and dramatic effect in the chosen model system.
2824 downloads
12.
Constituintes químicos de Vernonia scorpioides (Lam) Pers. (Asteraceae)
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Machado, Adalva Lopes
; Aragão, Fabiana Martins
; Bandeira, Paulo N.
; Santos, Hélcio Silva dos
; Albuquerque, Maria Rose Jane R.
; Pessoa, Otília Deusdênia L.
; Silveira, Edilberto R.
; Nunes, Edson Paula
; Braz-Filho, Raimundo
.
The chemical investigation of hexane and ethanol extracts from the aerial parts of Vernonia scorpioides resulted in the isolation and characterization of a new polyacetylene lactone, rel-4-dihydro-4β-hydroxy-5a-octa-2,4,6-triynyl-furan-2-(5H)-one, along with the new ethyl 3,4-dihydroxy-6,8,10-triynyl-dodecanoate, and seven known compounds: taraxasteryl acetate, lupeyl acetate, lupeol, lupenone, β-sitosterol, stigmasterol and luteolin. The structure of all compounds was determined by spectrometric techniques (HR-ESI-MS, ¹H and 13C NMR and IV) and comparison with published spectral data.
3556 downloads
13.
The influence of behavioral enrichment on dry food consumption by the black tufted-ear marmoset, Callithrix penicillata (Mammalia: Callithricidae): a pilot study
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Vilela, Janice de M. V.
; Miranda-Vilela, Ana L.
; Stasieniuk, Erika Von Z.
; Alves, Gabriela M.
; Machado, Felipe N.
; Ferreira, Walter M.
; Saad, Flávia M. de O. B.
; Machado, Paulo A. R.
; Coelho, Camila C. G. M.
; Silva, Natascha A. M. da
.
Stereotyped behaviors in captive primates are often caused by unsuitable conditions. Environmental enrichment has been used to reduce these behaviors, and also to increase the frequency of behaviors appropriate to the species. In this pilot study we evaluated whether behavioral enrichment influences food intake by the black tufted-ear marmoset, Callithrix penicillata (É. Geoffroy Saint-Hilaire, 1812), by calculating energy maintenance requirements. We evaluated 16 individually housed, healthy adult black tufted-ear marmosets, randomly divided into two treatment groups, one with behavioral enrichment and one without. The enrichment techniques included structural aspects, such as placing fixed and mobile objects in the cage and supplying dry foods in an enriched form, in order to stimulate cognition. Based on the metabolic weight of the animals, we calculated the energy requirements for their maintenance. The animals that received behavioral enrichment consumed more food than those that did not. We also observed that the animals that did not receive enrichment consumed 9.85% less food than had been calculated for energy maintenance requirements, while the animals that received enrichment consumed 24.97% more food than had been calculated. Results indicate that the use of behavioral enrichment items raised the energy requirements of the black tufted-ear marmoset and, therefore, the consumption of dry food, suggesting that environmental enrichment plays a role in stimulating food consumption. This conclusion should alert scientists, technicians and primatologists to the importance of controlling body weight of marmosets when introducing environmental enrichment to avoid overfeeding and obesity. To verify this conclusion, a study is needed with a longer time frame and more parameters, such as behavior observation and body weight.
3129 downloads
14.
Consenso de especialistas (SBC/SBHCI) sobre o uso de stents farmacológicos: recomendações da sociedade brasileira de cardiologia/sociedade brasileira de hemodinâmica e cardiologia intervencionista ao sistema único de saúde
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Lima, Valter C.
; Mattos, Luiz Alberto P.
; Caramori, Paulo R. A.
; Perin, Marco A.
; Mangione, José A.
; Machado, Bruno M.
; Coelho, Wilson M. C.
; Bueno, Ronaldo R. L.
.
Os autores revisam a evolução da intervenção coronariana percutânea, a sua crescente aplicação na revascularização miocárdica de pacientes portadores de doença arterial coronariana, seja no Brasil, seja no âmbito mundial. Desde a introdução do método, em 1977, com a utilização isolada do cateter-balão, a constatação de que o mesmo tinha limitações (oclusão aguda e reestenose), a adoção dos stents coronarianos e, mais recentemente, o advento dos stents farmacológicos, idealizados para reduzir ainda mais as taxas de reestenose, possibilitaram o crescimento exponencial da aplicação da intervenção coronariana percutânea (ICP) no Brasil, superando a cirurgia de revascularização e tornando-se o tratamento majoritário para enfermos sintomáticos, acometidos de aterosclerose obstrutiva coronariana. Esta preferência se salienta, a partir do ano 2000, após o início do reembolso dos stents pelo Sistema de Único de Saúde Brasileiro. Este fato demonstra a importância do Sistema Público de Saúde, quando este incorpora os avanços médicos, e passa a oferecer bons padrões de tratamento cardiovascular a grande número de brasileiros. Destaca-se a complexidade da profilaxia da reestenose intra-stent, por sua ocorrência imprevisível e ubíqua. O controle deste fenômeno melhora a qualidade de vida, reduzindo o retorno da angina do peito, a realização de novos procedimentos de revascularização e a re-internação hospitalar. Os stents farmacológicos lograram êxito sólido e consistente na conquista deste objetivo de forma abrangente, beneficiando todas as apresentações clínicas e angiográficas, em maior ou menor grau. Sua adoção e critérios para sua utilização em outros países são discutidos, assim como a formalização das indicações preconizadas pela Sociedade Brasileira de Hemodinâmica e Cardiologia Intervencionista, para o seu reembolso pelo SUS. A incorporação de novas tecnologias em saúde é um processo que compreende duas etapas distintas: na primeira, o registro do produto é efetivado na Agência Nacional de Vigilância Sanitária (ANVISA). Nesta etapa, a empresa interessada submete ao nosso órgão regulatório os resultados dos estudos clínicos que demonstram a eficácia e segurança do novo produto, seja ele um fármaco ou um novo dispositivo. Freqüentemente, além dos estudos clínicos, também são apresentados os registros de aprovação para uso clínico obtido nas agências regulatórias de outros países, principalmente dos Estados Unidos da América e da Comunidade Européia. O cumprimento bem sucedido desta etapa significa que o medicamento ou o dispositivo pode ser prescrito ou utilizado pelos médicos no Brasil. A segunda etapa da incorporação de novas tecnologias em saúde envolve o reembolso ou o financiamento do tratamento aprovado na etapa anterior, com base na sua eficácia e segurança. Esta etapa pode ser mais complexa do que a primeira, pois as novas tecnologias, sejam elas de substituição ou de introdução de novas modalidades de tratamento, são habitualmente de custo mais elevado. Incorporar novas tecnologias exige a avaliação de custo efetividade, para permitir que os gestores dos recursos possam tomar decisões que atendam ao cenário universal de recursos limitados, para financiar a saúde com tratamentos cada vez mais onerosos. As dificuldades de gestão dos recursos são agravadas pelas implicações de ética médica e social, que ocorrem quando um tratamento aprovado com base na sua eficácia e segurança não é disponibilizado para pacientes com grande potencial de benefício. No Brasil, a avaliação da incorporação de novas tecnologias, visando a seu reembolso ou financiamento, ainda não está devidamente amadurecida, seja no Sistema Único de Saúde (SUS) ou no privado. A adoção destas tecnologias, nos dois sistemas, ainda ocorre lentamente e, freqüentemente, como reação à exigência dos pacientes ou de organizações que os representam, às vezes com ações judiciais, ou por pressão política dos médicos e de suas respectivas sociedades científicas. Nosso objetivo é revisar a evolução da intervenção coronariana percutânea (ICP) no Brasil, sua situação atual com o advento dos stents farmacológicos, e a crescente participação destes como modalidade de revascularização miocárdica de pacientes portadores de doença arterial coronariana, assim como comparar as normas regulatórias brasileiras e de outros paises, em relação à incorporação desta nova tecnologia, e as recomendações para sua utilização.
The authors review percutaneous coronary intervention (PCI) evolution and its growing application in myocardial revascularization for patients with coronary heart disease in Brazil and worldwide. PCI was introduced in 1977 using only the catheter balloon. Limitations of this method (acute occlusion and coronary restenosis) led to the adoption of coronary stents and more recently the advent of drug-eluting stents², which were developed to drastically reduce restenosis rates. These developments allowed the exponential growth of percutaneous coronary intervention (PCI) procedures in Brazil which have replaced many bypass surgery procedures and have become the gold standard for the majority of symptomatic patients suffering from coronary artery disease. The preference for this procedure gained new dimensions in 2000 when the Brazilian Public Healthcare System (SUS) began reimbursing for stent procedures. This measure exemplified the importance of the Public Healthcare System's participation in incorporating medical advances and offering a high standard of cardiovascular treatment to a large portion of the Brazilian population. It is emphasized that prevention of in-stent restenosis is complex due to its unpredictable and ubiquitous occurrence. Control of this condition improves quality of life and reduces the recurrence of angina pectoris, the need to perform new revascularization procedures and hospital readmissions. The overall success of the drug-eluting stents has proven to be reliable and consistent in overcoming restenosis and has some beneficial impact for all clinical and angiographic conditions. This paper discusses the adoption and criteria for the use of drug-eluting stents in other countries as well as the recommendations established by the Brazilian Society of Interventional Cardiology for their reimbursement by SUS. The incorporation of new healthcare technology involves two distinct stages. During the first stage, the product is registered with the National Health Surveillance Agency (ANVISA). During this stage the interested company submits to the regulatory agency, results from clinical studies that demonstrate the efficacy and safety of the new device or pharmaceutical product. Frequently, in addition to clinical studies, approval records for clinical use from the regulatory agencies of other countries, mainly the United States of America and the European Community are also submitted. The successful completion of this stage means that the medication or device may be prescribed or used by the physicians in Brazil. The second stage in the incorporation of new healthcare technology involves the reimbursement or financing of the treatment that was approved in the previous stage based on its efficacy and safety. This stage can be more complex than the first one since the new technology, whether a substitution for established treatment methods or the introduction of a new treatment concept, are usually more expensive. The incorporation of new technology requires a cost-effectiveness analysis so that fund administrators can make decisions based on the universal scenario of limited resources to finance healthcare with treatments that are more and more burdensome. The difficulties of funding management are aggravated by medical and social ethical implications that arise when a treatment is approved based on its efficacy and safety but is not made available to patients who could benefit greatly from it. In Brazil, assessment methods for the incorporation of new technology based on reimbursement or financing have not been fully developed for either the private healthcare plans or the Brazilian Public Healthcare System (SUS). The implementation of new technology in both healthcare systems is a slow process and frequently the implementation is a result of the requirements of patients or the organizations that represent them and at times is the result of legal proceedings or political pressure imposed by physicians and their respective scientific societies. Our objective is to review the evolution of percutaneous coronary intervention (PCI) in Brazil and its current status in view of the advent of drug-eluting stents, the growing participation of drug-eluting stents in myocardial revascularization to treat patients with coronary heart disease, as well as, to compare the regulatory standards from Brazil and other countries regarding the incorporation and recommendations for the use of this new technology.
7196 downloads
15.
Mecanismos de resposta imune às infecções
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O conhecimento dos principais mecanismos de defesa imune contra os diversos agentes infecciosos permite a compreensão da patogênese das doenças infectoparasitárias e das várias estratégias do hospedeiro e do parasita. O sistema imunológico atua numa rede de cooperação, envolvendo a participação de muitos componentes estruturais, moleculares e celulares. Nesse cenário encontra-se o delicado equilíbrio entre a saúde e a doença, em que tanto a deficiência quanto o exagero resultam em dano tecidual. Este artigo explora esses aspectos e algumas abordagens terapêuticas que surgem desse entendimento.
Knowledge acquired about the main immune mechanisms protecting against various infectious agents leads to a better understanding of the pathogenesis of infectious/parasitic diseases and of various strategies specific to the host and parasite. The immune system performs along a cooperation network, which involves the participation of several structural, molecular and cellular components. The fine balance between health and disease is found in this scenario, in which deficiency as much as excess may result in tissue damage. This article explores such aspects and a number of therapies arising from the knowledge acquired.
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ab | abstract |
ta | journal short title (e.g. Cad. Saúde Pública) |
journal_title | journal full title (e.g. Cadernos de Saúde Pública) |
la | publication language code (e.g. pt - Portuguese, es - Spanish) |
type | document type |
pid | publication identifier |
publication_year | publication year of publication |
sponsor | sponsor |
aff_country | country code of the author's affiliation |
aff_institution | author affiliation institution |
volume | article volume |
issue | article issue |
elocation | elocation |
doi | DOI number |
issn | journal ISSN |
in | SciELO colection code (e.g. scl - Brasil, col - Colômbia) |
use_license | article usage license code |