Envelhecimento e dependência: desafios a serem enfrentados = Aging and dependence: challenges to be faced

O envelhecimento da população mundial e a questão da dependência são dois importantes desafios que os países terão que enfrentar neste século. Esses desafios requerem maiores exigências econômicas e sociais e necessitam de políticas e programas adequados para que a seguridade social possa continuar atendendo as necessidades das pessoas com mais de 65 anos e das que sofrem de algum tipo de dependência. A Organização Mundial da Saúde (OMS) sustenta que todos os países e, principalmente, os em vias de desenvolvimento precisam fazer planos e agir, pois as medidas para ajudar que as pessoas de mais idade continuem ativas devem ser tratadas prioritariamente. As taxas de dependência das pessoas idosas mudam rapidamente em todo mundo (a tendência é de que quase dupliquem até 2025) e mostram o prognóstico das políticas previdenciárias ao longo dos anos. Este estudo bibliográfico tem por objetivo mostrar a importância da seguridade social no Brasil, nas formas de aposentadoria, pensão e benefícios. Para tanto fará uso de dados secundários colhidos através do Instituto Brasileiro de Geografia e Estatística IBGE (2002

COMPARISON BETWEEN THE DOUBLE BUFFER METHOD AND THE EQUIVALENT RECTANGLE METHOD FOR THE QUANTIFICATION OF DISCREPANCIES BETWEEN LINEAR FEATURES

Currently, in Brazil, for the assessment of the Positional Accuracy of non-point features (lines and polygons), there is no standard norm of execution. This work aims to compare the results of two methodologies that allow determining the average value of the discrepancies between linear features. The first, Equivalent Rectangle Method, aims to determine the discrepancy by considering an equivalent rectangle for the polygon obtained from the two homologous lines. The second, Double Buffer Method applies a buffer on both lines and obtains the average discrepancy value based on the relation of the areas of the generated polygons. These methods were compared in two steps. Initially, an experiment was performed with features of known measurements, where the displacement of the homologous lines was controlled in azimuth and distance. In this step, it was verified that the shape of the feature and the direction of the displacement interfere in the results of both methods when compared to the traditional procedure of measurement of discrepancies by homologous points. In the second stage, we evaluated the vector data of the OpenStreetMap (class of roads), with reference to a more accurate vector dataset produced for the Mapping of the State of Bahia. As a result, for the 1:25,000, 1:50,000, 1:100,000 and 1:250,000 scales, it was obtained, respectively, the PEC-PCD for the Equivalent Rectangle Method "C", "B", "A" and "A" and the PEC-PCD for the Double Buffer Method "R", "C", "B" and "A", where "R" means that it has not achieved the minimum PEC-PCD classification

Immunological pathways triggered by porphyromonas gingivalis and fusobacterium nucleatum: Therapeutic possibilities?

Porphyromonas gingivalis (P. gingivalis) and Fusobacterium nucleatum (F. nucleatum) are Gram-negative anaerobic bacteria possessing several virulence factors that make them potential pathogens associated with periodontal disease. Periodontal diseases are chronic inflammatory diseases of the oral cavity, including gingivitis and periodontitis. Periodontitis can lead to tooth loss and is considered one of the most prevalent diseases worldwide. P. gingivalis and F. nucleatum possess virulence factors that allow them to survive in hostile environments by selectively modulating the host\u27s immune-inflammatory response, thereby creating major challenges to host cell survival. Studies have demonstrated that bacterial infection and the host immune responses are involved in the induction of periodontitis. The NLRP3 inflammasome and its effector molecules (IL-1β and caspase-1) play roles in the development of periodontitis. We and others have reported that the purinergic P2X7 receptor plays a role in the modulation of periodontal disease and intracellular pathogen control. Caspase-4/5 (in humans) and caspase-11 (in mice) are important effectors for combating bacterial pathogens via mediation of cell death and IL-1β release. The exact molecular events of the host\u27s response to these bacteria are not fully understood. Here, we review innate and adaptive immune responses induced by P. gingivalis and F. nucleatum infections and discuss the possibility of manipulations of the immune response as therapeutic strategies. Given the global burden of periodontitis, it is important to develop therapeutic targets for the prophylaxis of periodontopathogen infections

Lateral Interbody Fusion for Treatment of Discogenic Low Back Pain: Minimally Invasive Surgical Techniques

Low back pain is one of the most common ailments in the general population, which tends to increase in severity along with aging. While few patients have severe enough symptoms or underlying pathology to warrant surgical intervention, in those select cases treatment choices remain controversial and reimbursement is a substancial barrier to surgery. The object of this study was to examine outcomes of discogenic back pain without radiculopathy following minimally-invasive lateral interbody fusion. Twenty-two patients were treated at either one or two levels (28 total) between L2 and 5. Discectomy and interbody fusion were performed using a minimallyinvasive retroperitoneal lateral transpsoas approach. Clinical and radiographic parameters were analyzed at standard pre- and postoperative intervals up to 24 months. Mean surgical duration was 72.1 minutes. Three patients underwent supplemental percutaneous pedicle screw instrumentation. Four (14.3%) stand-alone levels experienced cage subsidence. Pain (VAS) and disability (ODI) improved markedly postoperatively and were maintained through 24 months. Segmental lordosis increased significantly and fusion was achieved in 93% of levels. In this series, isolated axial low back pain arising from degenerative disc disease was treated with minimally-invasive lateral interbody fusion in significant radiographic and clinical improvements, which were maintained through 24 months

Temporal expression pattern of the insulin-like growth factor II and fibroblast growth factor transcripts in avian embryogenesis

In this study, the abundance of IGF–II and bFGF transcripts was estimated in the chicken embryos using the competitive RT-PCR analysis. Significant enhancements in the abundance of IGF-II mRNA were observed at stages HH1 and 5, and a new accumulation in these levels was observed at stage HH18 in comparison to the basal levels. The abundance of bFGF mRNA increased significantly at stages HH18 and 20, followed by an upregulation in the expression of these transcripts at stage HH26. These findings provided important information about the temporal expression pattern of IGF-II and bFGF transcripts in the whole chicken embryos during in ovo development515949955FUNDAÇÃO DE AMPARO À PESQUISA DO ESTADO DE SÃO PAULO - FAPESPsem informaçãoFatores de crescimento coordenam múltiplas vias de sinalização durante o desenvolvimento embrionário. Neste estudo, a abundância de mRNA dos genes IGF-II e bFGF foi estimada em embriões de galinha por análises de RT-PCR competitiva. Aumentos na abundância de mRNA de IGF-II foram observados nos estádios HH1, 5. Os níveis de mRNA de bFGF exibiram aumentos a partir dos estádios HH18 e 20, seguido por uma acentuada redução a níveis basais no estádio HH24 e por um segundo pico na expressão destes transcritos no estádio HH26. Tais descobertas proporcionam importantes informações sobre o padrão de expressão destes fatores de crescimento durante a embriogênese de ave

Temporal expression pattern of the insulin-like growth factor II and fibroblast growth factor transcripts in avian embryogenesis

In this study, the abundance of IGF-II and bFGF transcripts was estimated in the chicken embryos using the competitive RT-PCR analysis. Significant enhancements in the abundance of IGF-II mRNA were observed at stages HH1 and 5, and a new accumulation in these levels was observed at stage HH18 in comparison to the basal levels. The abundance of bFGF mRNA increased significantly at stages HH18 and 20, followed by an upregulation in the expression of these transcripts at stage HH26. These findings provided important information about the temporal expression pattern of IGF-II and bFGF transcripts in the whole chicken embryos during in ovo development.Fatores de crescimento coordenam múltiplas vias de sinalização durante o desenvolvimento embrionário. Neste estudo, a abundância de mRNA dos genes IGF-II e bFGF foi estimada em embriões de galinha por análises de RT-PCR competitiva. Aumentos na abundância de mRNA de IGF-II foram observados nos estádios HH1, 5. Os níveis de mRNA de bFGF exibiram aumentos a partir dos estádios HH18 e 20, seguido por uma acentuada redução a níveis basais no estádio HH24 e por um segundo pico na expressão destes transcritos no estádio HH26. Tais descobertas proporcionam importantes informações sobre o padrão de expressão destes fatores de crescimento durante a embriogênese de avesFundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP

Biotecnologia animal

A biotecnologia animal tem fornecido novas ferramentas para os programas de melhoramento e, dessa forma, contribuído para melhorar a eficiência da produção dos produtos de origem animal. No entanto, os avanços têm sido mais lentos do que antecipados, especialmente em razão da dificuldade na identificação dos genes responsáveis pelas características fenotípicas de interesse zootécnico. Três estratégias principais têm sido utilizadas para identificar esses genes - mapeamento de QTL, genes candidatos e sequenciamento de DNA e mRNA - e cada uma tem suas vantagens e limitações. O mapeamento de QTL permite determinar as regiões genômicas que contêm genes, mas o intervalo de confiança do QTL pode ser grande e conter muitos genes. A estratégia de genes candidatos é limitada por causa do conhecimento ainda restrito das funções de todos os genes. Os sequenciamentos de genomas e de sequências expressas podem auxiliar na identificação da posição de genes e de vias metabólicas associadas à característica de interesse. A integração dessas estratégias por meio do desenvolvimento de programas de bioinformática permitirá a identificação de novos genes de interesse zootécnico. Assim, os programas de melhoramento genético se beneficiarão pela inclusão da informação obtida diretamente do DNA na avaliação do mérito genético dos plantéis disponíveis.Animal biotechnology is providing new tools for animal breeding and genetics and thus contributing to advances in production efficiency and quality of animal products. However, the progress is slower than anticipated, mainly because of the difficulty involved in identifying genes that control phenotypic characteristics of importance to the animal industry. Three main strategies: QTL mapping, candidate genes and DNA and mRNA sequencing have been used to identify genes of economic interest to animal breeding and each has advantages and disadvantages. QTL mapping allows identification of the genomic region that contains the genes, but the confidence interval of the regions is usually large and may contain several genes. Candidate gene approach is limited to our restricted knowledge of the biological function of the genes. Sequencing of genomes and expressed sequences tags can provide identifying gene position and metabolic pathways associated with phenotypic trait. Integrating these strategies using bioinformatics software will allow identifying of novel genes for animal production. Then, animal breeding programs will include the information from DNA directly on evaluation of genetic value of livestock production

Unsuspected colon adenocarcinoma revealed after laparoscopic cholecystectomy

A particularly rapid and fatal outcome has been noted in cases of malignant soft-tissue metastases occurring after cancer surgery. Abdominal wall metastases occurring in scars after laparotomy for cancer resection show a similar poor outcome. On the other hand, neoplasm seeding at trocar sites after laparoscopy has been reported with an increasing frequency. A case is presented of a 68-years-old woman with metastatic seeding of non-diagnosed colon cancer at the umbilical trocar site used for a laparoscopic cholecystectomy. The gallbladder was extracted through the umbilical incision. Pathological examination confirmed chronic cholecystitis. Eight months latter, the patient was seen with a tender umbilical mass protruded through a 4,5 cm the umbilical incision site. Biopsies of this tissue were taken and histopathological examination showed metastatic adenocarcinoma, probably of a gastrointestinal origin. A colonoscopy performed at the same time revealed a 2-cm lesion at the hepatic flexur which was shown to be a differentiated adenocarcinoma. An 8.0 x 6.0 x 6.0-cm pelvic mass without signs of liver metastases was identified by computerised tomography. Diagnostic laparoscopy showed a diffuse peritoneal carcinomatosis. The pelvis could not be approached, except for simple biopsy, and no surgical procedure was performed. It is presumed that the primary colon cancer existed prior to cholecystectomy. Laparoscopy is the procedure of choice to perform cholecystectomy and fundoplication. It has also been increasingly used to diagnose, resect and perform the staging of malignant tumours. As in any relatively new technique, questions arising about its safety and risk of complications must be extensively studied. Many questions about the specific features of laparoscopy promoting cancer growth remain unanswered.UNIFESP-EPM Departamento de CirurgiaHospital do Servidor Público Estadual de São PauloUNIFESP, EPM, Depto. de CirurgiaSciEL