162 research outputs found

    Brassicaceae Burnett no município de Santa Maria, Rio Grande do Sul, Brasil

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    Brassicaceae (Cruciferae) includes invasive species as well as widely cultivated horticultural species. In Santa Maria, Cruciferae species usually occur in environments that have undergone urbanization such as sidewalks, roadsides, walls, near energy poles, etc. The last listing of species of this family in the area was performed by Romeu Beltr√£o in 1962 and supplemented in 1965. The objective of the current study was to update the number of records of Brassicaceae species that occur in the municipality of Santa Maria, RS, as well as to provide keys for the identification for native and naturalized genera and species. Bibliographic surveys, field collections, herbarium material analysis and data from databases of speciesLink and Flora of Brazil 2020 were carried out, as well as complementary collections from August 2018 to April 2019. The species found were photographed and identified based on the existing literature. Identification keys for genera and species, as well as illustrations, were prepared. All genera had only one representative species in Santa Maria with the exception of Lepidium, which presented three species. There was an addition of three species and one genus in relation to the last survey carried out.Brassicaceae (Cruciferae) possui esp√©cies invasoras e esp√©cies amplamente cultivadas como hort√≠colas. Em Santa Maria, ocorrem em ambientes que sofreram urbaniza√ß√£o como cal√ßadas, beira de rodovias, muros, pr√≥ximas a postes de energia, entre outros locais. O √ļltimo levantamento de esp√©cies dessa fam√≠lia no munic√≠pio foi realizado por Romeu Beltr√£o em 1962 e complementado em 1965. Com base nisso, o objetivo desse estudo foi o de atualizar os registros de Brassicaceae que ocorrem no munic√≠pio de Santa Maria, RS, bem como fornecer chaves para identifica√ß√£o para g√™neros e esp√©cies nativos e naturalizados. Foram realizados levantamentos bibliogr√°ficos, coletas de campo, an√°lises de materiais de herb√°rio e banco de dados dos s√≠tios speciesLink e Flora do Brasil 2020, bem como coletas complementares de agosto de 2018 a abril de 2019. As esp√©cies foram fotografadas e identificadas com base na literatura especializada. Foram elaboradas chaves de identifica√ß√£o para g√™neros e esp√©cies, bem como ilustra√ß√Ķes. Ao todo, foram registradas 10 esp√©cies nativas ou naturalizadas pertencentes a oito g√™neros. Todos os g√™neros apresentaram apenas uma esp√©cie representante em Santa Maria com exce√ß√£o de Lepidium que apresentou tr√™s esp√©cies. Houve um acr√©scimo de tr√™s esp√©cies e um g√™nero em rela√ß√£o ao √ļltimo levantamento realizado

    Strategic management of new drugs in oncology: the importance of an ethical and interdisciplinar framework

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    JEL Classification System: I1; I14; I15; I18; O32Introduction: Portugal is the paradigm of the European crisis since has both an economic and demographic crisis. We aimed to establish the impact of the economic restrains in Portugal for the reimbursement of new oncological drugs, accordingly with the different stakeholders and to establish the importance of an ethical and interdisciplinary framework as a strategic measure to minimize the problems detected. Methodology: A qualitative approach was used, supported by 27, tape recorded, semi-structured interviews to representatives of the different healthcare stakeholders. The interviews content analysis were done with the support of Tropes¬ģ software. Results: The content analysis results showed that economic restrains are leading to a policy of cost control, a delay in reimbursement of new drugs, lack of transparency, serious limitations and inequities between hospitals. Changes in the reimbursement process are being made with an increase of risk sharing mechanisms and implementation of a new system of health technological evaluation (SINATS). Treatment protocols are also being revised and public hospitals are trying to increase the number of clinical trials but there is still much bureaucracy. In this qualitative approach, the factors with impact on survival are: innovation and technological development, government funding, the price of drugs and the type of cancer. Conclusions: In order to consider the strategic vision in which the patient is the center of all efforts, the process of innovation reimbursement should be faster and more transparent. An interdisciplinary framework for reimbursement decisions, seems to be a strategic measure to allow NHS sustainability.Introdu√ß√£o: Portugal vive o paradigma da crise europeia devido √† crise econ√≥mica e demogr√°fica. O objetivo do estudo foi determinar o impacto da crise econ√≥mica em Portugal para o reembolso dos novos medicamentos oncol√≥gicos e identificar a import√Ęncia de um modelo √©tico e interdisciplinar como medida estrat√©gica para minimizar os problemas identificados. Metodologia: Foi utilizada uma abordagem qualitativa, apoiada por 27 entrevistas semiestruturadas e gravadas, aos representantes dos diferentes stakeholders do Sistema de Sa√ļde portugu√™s. A an√°lise de conte√ļdo referente √†s entrevistas foi efetuada com o apoio do software Tropes¬ģ. Resultados: Os resultados da an√°lise de conte√ļdo mostraram que as restri√ß√Ķes econ√≥micas est√£o a originar uma pol√≠tica de controlo de custos; um atraso na aprova√ß√£o de novos medicamentos, falta de transpar√™ncia, bem como s√©rias limita√ß√Ķes e desigualdades entre os hospitais. Est√£o a ser implementadas altera√ß√Ķes no processo de reembolso com um aumento de mecanismos de partilha de risco e implementa√ß√£o de um novo sistema de avalia√ß√£o tecnol√≥gica em sa√ļde (SINATS). Os protocolos de tratamento est√£o tamb√©m a ser revistos e os hospitais p√ļblicos est√£o a tentar aumentar o n√ļmero de ensaios cl√≠nicos embora a burocracia excessiva seja uma limita√ß√£o. Nesta abordagem qualitativa, foram identificados os seguintes fatores com impacto na sobreviv√™ncia: inova√ß√£o e desenvolvimento tecnol√≥gico, o financiamento, o pre√ßo dos medicamentos e o tipo de doen√ßas oncol√≥gicas. Conclus√Ķes: Considerando que o paciente √© a principal preocupa√ß√£o, o processo de aprova√ß√£o de reembolso de novos medicamentos deve ser mais r√°pido e mais transparente. Um modelo interdisciplinar para decis√Ķes de aprova√ß√£o de reembolso, parece ser uma medida estrat√©gica vi√°vel e urgente de forma a manter a sustentabilidade do SNS

    HERPES ZOSTER E ASSOCIAÇÃO COM DOENÇA OCULTA NEOPLASIA E VIH

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    Introduction: Herpes zoster (HZ) is caused by the varicella zoster virus, with an estimated incidence in the general population of 3.64 cases per 1000 person-years. Its incidence increases in older age and immunosuppression states such as infection with the human immunodeficiency virus (HIV) and malignancy.Material and methods: The authors reviewed the literature in order to study the correlation between the diagnosis of HZ and occult malignancy or HIV infection.Results: In most of the studies, the evidence clearly points to the existence of an association between HZ and occult malignancy, however, the flaws of the study designs preclude the extrapolation of guidelines for clinical practice. In developed countries, data suggests that HZ has a predictive value for HIV infection only in individuals belonging to high risk groups. In countries with limited resources for HIV screening, HZ may serve as a sentinel disease to help in the decision of taking the exam, especially in endemic areas.Conclusion: There are few practical recommendations for what complementary investigation should be offered to patients with HZ. It is necessary to conduct more studies to ascertain if the implementation of sometimes complex or invasive complementary examinations is cost-effective.Introdu√ß√£o: O Herpes Zoster (HZ) √© uma doen√ßa provocada pelo V√≠rus Varicela Zoster, com uma incid√™ncia estimada na popula√ß√£o geral de 3,64 casos por 1000 pessoas-ano. A sua incid√™ncia aumenta em idades avan√ßadas e em estados de imunossupress√£o como a infec√ß√£o pelo v√≠rus da imunodefici√™ncia humana (VIH) e neoplasias, principalmente de origem hematol√≥gica.Material e M√©todos: Os autores reviram a literatura dispon√≠vel com o intuito de perceber qual o grau de evid√™ncia da associa√ß√£o do diagn√≥stico de HZ e doen√ßa neopl√°sica oculta ou infec√ß√£o VIH e, quais as implica√ß√Ķes na abordagem complementar diagn√≥stica do doente com HZ.Resultados: Na maioria dos trabalhos analisados a evid√™ncia aponta claramente no sentido da exist√™ncia de associa√ß√£o entre HZ e neoplasia oculta, no entanto, as limita√ß√Ķes inerentes aos desenhos de estudo impedem a extrapola√ß√£o de guidelines para a pr√°tica cl√≠nica. Em pa√≠ses desenvolvidos os dados sugerem que o HZ tem um valor preditivo para infec√ß√£o VIH apenas para indiv√≠duos pertencentes a grupos de risco. Em pa√≠ses com escassez de meios para rastreio de VIH, o quadro de HZ pode servir de sentinela para a realiza√ß√£o do exame, principalmente em √°reas end√©micas.Conclus√Ķes: S√£o escassas as recomenda√ß√Ķes pr√°ticas relativas √† investiga√ß√£o complementar do doente com HZ, sendo necess√°ria a realiza√ß√£o de mais estudos que averiguem se a realiza√ß√£o de exames complementares, por vezes, complexos ou invasivos, tem uma boa rela√ß√£o custo-efetividade

    Sarcoma de Kaposi em Receptores de Transplante de √ďrg√£o S√≥lido: Um Caso Desafiador

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    Kaposi sarcoma is a low-grade vascular tumor, associated with human herpesvirus-8 infection. Solid organ transplant recipients have a much higher risk of this malignancy, with estimated incidence rates increased 84 to 500 times. The risk is even higher in some ethnic groups, already with a higher incidence of this disease. We report a case of a 37-year-old African male, a kidney transplant recipient, with a Kaposi sarcoma refractory to different treatment options. The present case puts in evidence the challenges associated with the management of this disease in this high-risk population and highlights the role of a multidisciplinary approach to achieve effective treatment, particularly in advanced and refractory forms.O sarcoma de Kaposi √© um tumor vascular de baixo grau, associado √† infe√ß√£o pelo herpesv√≠rus humano 8. Os doentes com transplante de √≥rg√£o s√≥lido t√™m um elevado risco desta neoplasia, com taxas de incid√™ncia estimadas 84 a 500 vezes superiores √†s da popula√ß√£o geral. O risco √© ainda maior em grupos √©tnicos com incid√™ncias intrinsecamente mais elevadas. Apresentamos o caso de um doente de 37 anos, natural de um pa√≠s africano, transplantado renal, com sarcoma de Kaposi refrat√°rio a diferentes op√ß√Ķes terap√™uticas. O caso coloca em evid√™ncia os desafios associados ao tratamento desta neoplasia em popula√ß√Ķes de altorisco e enfatiza a import√Ęncia da abordagem multidisciplinar para o sucesso terap√™utico, particularmente em formas avan√ßadas e refrat√°rias de doen√ßa

    CHEMOPROPHYLAXIS OF GENITAL HERPES

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    O herpes genital é uma das doenças sexualmente transmissíveis mais comuns, com distribuição mundial. Os episódios recorrentes desta doença estão associados a um grau de morbilidade importante pelo que a quimioprofilaxia das recorrências assume um papel relevante na qualidade de vida dos doentes. Não existem guidelines definidas quanto aos critérios para início de terapêutica profilática, apesar de existir evidência que legitíma o início a partir das 6 recorrências anuais. Os fármacos aprovados para o efeito são o aciclovir, valaciclovir e famciclovir em diferentes esquemas e com eficácias semelhantes. Nos doentes co-infetados com os vírus herpes símplex (VHS) e vírus da imunodeficiência humana (VIH) estes fármacos mantém-se eficazes em esquemas com doses mais elevadas. O perfil de segurança destas terapêuticas foi comprovado em estudos com tempos de seguimento até 18 anos e o aparecimento de resistências, apesar de raro na população imunocompetente (1%), é um fator preocupante em doentes imunocomprometidos nos quais pode chegar aos 10,9%. Várias terapêuticas alternativas têm vindo a ser estudadas no controlo desta doença, como a vacina terapêutica, novos fármacos com mecanismos de atuação diferente, mas todas permanecem em fase de investigação.Genital herpes is among the most common sexually transmitted diseases worldwide. Recurrent genital herpes is associated with major morbidity. Therefore, suppressive therapy plays an important role in the life quality of these patients. There are no established guidelines regarding the criteria for initiation of prophylactic therapy, although there is evidence for it after 6 recurrences per year. Drugs approved for this purpose are acyclovir, valacyclovir and famciclovir in different regimens with similar efficacy. In patients co-infected with human immunodeficiency virus (HIV) and herpes simplex virus (HSV), these drugs remain effective with higher doses regimens. The safety profile of this therapy has been proven in studies with follow-up times up to 18 years and the appearance of resistance although rare in the immunocompetent population (1%), is a fator of concern in immunocompromised patients reaching 10.9%. Several alternative therapies have been studied, such as therapeutic vaccine or new drugs with different action targets, but all remain under investigation

    Interstitial macrophages lead early stages of bleomycin-induced lung fibrosis and induce fibroblasts activation

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    A progressive fibrosing phenotype is critical in several lung diseases. It is irreversible and associated with early patient mortality. Growing evidence has revealed pulmonary macrophages’ role as modulators of the fibrotic processes. The proportion, phenotype, and function of alveolar (AM) and interstitial macrophages (IM) at the early stages of bleomycin-induced pulmonary fibrosis have not been clearly described. In this way, our study aimed to characterize these macrophage populations and investigate the effect on fibroblast activation. C57BL/6 mice were intratracheally injected with bleomycin and were sacrificed at day 3, 5, and 7 for the performance of flow cytometry and fluorescent-activated cell sorting analysis for protein and gene expression quantification. After bleomycin administration, the proportion of IM was significantly higher than that of AM, which showed a decay during the inflammatory phase, and peaked at day 7. At day 7 of the inflammatory phase, AM started shifting their phenotype from M1-like towards M2, while IM showed a M2-like phenotype. Conditioned medium derived from IM sorted at day 7 induced fibroblast activation and differentiation in myofibroblasts in vitro. Our findings indicate that IM are the largest macrophage population at the early stages of experimental pulmonary fibrosis and are secreted mediators able to activate fibroblasts, pointing to macrophage modulation as a potential therapeutic strategy to restrain progressive fibrosing lung disorders.This research was funded by the Programa Operacional Potencial Humano (POPH) and Programa Investigador Fundação para a Ciência e Tecnologia (FCT) (IF/00959/2014); by Programa Operacional Fatores de Competitividade (COMPETE) and national funds of FCT (POCI-01-0145-FEDER-028113); and by national funds of FCT (UIDB/50026/2020, UIDP/50026/2020)

    Science, society, politics, and the media: joining efforts to manage the risk of termite infestation in the Azores

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    SRA 2008 Annual Meeting. Sunday, 7 December 2008 to Wednesday, 10 December 2008.Termites are well-established and serious pests of structural wood infestation in different parts of the world. Presently, in the Azores archipelago (Portugal), the drywood termite Cryptotermes brevis (Insecta, Isoptera) has been referred to four of the nine islands, and the damages to the buildings and other artefacts are severe and constitute a serious threat, especially in its main towns. In order to control the situation there has been a considerable scientific and political investment to survey and classify the infestation, and to develop mitigation strategies, over the last five years. Nevertheless, the infestation is far from being controlled and, also, most of the Azorean citizens are still unaware of the dangers and risks associated to this urban pest. If, however, effective educational and management practices are initiated soon, the losses from C. brevis can be greatly reduced. Therefore, the major aims of this research project are: (i) to understand people’s perspectives about the consequences of the termite infestation and their appraisal about the effectiveness of the proposed and existing management strategies; (ii) to understand the functions of the media in the making of public opinion; (iii) to develop simple ways of communicating complex technical information according to people’s perception of who is accountable and trustworthy, in order to avoid misunderstandings between science, politics, managers and society; (iv) to develop and implement devices focused on the communication between the population and the main stakeholders, to promote the involvement of citizens and their commitment as essential partners of the termite control. This paper aims to integrate data from the abovementioned stakeholders in order to identify communication problems, to create adequate strategies to solve conflicts, to facilitate dialogue and partnerships among stakeholders and to promote termite risk literacy. Data was gathered using several techniques, including interviews, descriptive-interpretative analysis of media, scientific discourses and existing operational programs. Data shows that the lack of integration among stakeholders is the most obvious barrier to be overcome by the communication devices to implement

    Patologias Vulvares que Necessitaram de Biopsia: Estudo Retrospetivo

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    Introduction: The vulvar area may be affected by many noninfectious conditions with similar clinical appearance, requiring a cutaneous biopsy. Our goal was to characterize the noninfectious vulvar diseases that required a biopsy in a southwestern Europe Central Hospital during a 10-year period. Methods: A retrospective study of all the noninfectious vulvar diseases with histological confirmation diagnosed in our institution was conducted between January 1, 2008 and December 31, 2017. Results: The sample included a total of 323 biopsies from 317 patients, aged between 11 and 98 years (mean age of 54.2 years). A total of 36 vulvar diseases was identified. Neoplastic conditions were the most frequently found, particularly melanotic macules (22.3%). The most frequent malignant tumor was vulvar intraepithelial neoplasia (6.2%) and squamous cell carcinoma (5.6%). The most common dermatosis was lichen sclerosus (12.7%). Conclusion: Neoplasms were the most frequently diagnosed conditions affecting the vulvar area that required a biopsy. Ruling out malignancy was also the main reason to perform a biopsy. This study highlights the variety of noninfectious diseases that may affect the vulva and require a biopsy. Since vulvar diseases may be serious and carry high levels of patient distress a correct understanding of these conditions is crucial.IntroducŐßaŐÉo: Diversas patologias naŐÉo infeciosas podem afetar a vulva, por vezes necessitando de realizacŐßaŐÉo de biopsia cutaŐānea. O objetivo deste trabalho foi caracterizar todas as patologias vulvares naŐÉo infeciosas em que foi realizada biopsia cutaŐānea, num Hospital Central, durante um periŐĀodo de 10 anos. MeŐĀtodos: Foi realizado um estudo retrospetivo de todas as patologias vulvares naŐÉo infeciosas com confirmacŐßaŐÉo histoloŐĀgica na nossa instituicŐßaŐÉo, entre 1 de janeiro de 2008 e 31 de dezembro de 2017. Resultados: A amostra incluiu 323 bioŐĀpsias de 317 doentes, entre os 11 e os 98 anos (meŐĀdia de idades de 54,2 anos), tendo sido identificadas 36 patologias distintas. As patologias neoplaŐĀsicas foram as mais frequentes, nomeadamente as maŐĀculas pigmentadas da vulva (22,3%). A neoplasia maligna mais diagnosticada foi a neoplasia intraepitelial da vulva (6,2%) e o carcinoma espinocelular (5,6%). JaŐĀ a dermatose inflamatoŐĀria mais frequente foi o liŐĀquen escleroso (12,7%). ConclusaŐÉo: A maior parte das biopsias envolveu patologias neoplaŐĀsicas sendo a exclusaŐÉo de malignidade o principal motivador da sua realizacŐßaŐÉo. Este estudo evidencia a grande diversidade de patologias naŐÉo infeciosas que podem afetar a vulva e que saŐÉo fonte de sofrimento e anguŐĀstia, o que torna o seu correto diagnoŐĀstico e orientacŐßaŐÉo essenciais
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