Implementation of the Eclipse Process Framework Composer Tool for the Documentation of Quality Management Systems: A Case Applied in Healthcare Services

This document presents the implementation of the Eclipse Process Framework Composer EPFC tool, in a company in the health sector, which where it were using physical documentation to register the processes QMS Quality Management Systems, in this one it is explained the process of adapting the tool, to migrate the documentary structure of the company, through the application of a model that correlates the attributes of the tool with the documentary structure. The proposed model allows the construction of document structures for the QMS that guide the user in their processes and procedures within the organization. Therefore, it is proposed that by promoting knowledge management and reducing the execution time of the processes, it will be possible for companies to be more productive, improve customer service, failure rates in the development of activities be minimized and, and reduces the lead time in the processes. Finally, it was obtained a documentary platform developed under a process approach that implements interactive diagrams that aim to facilitate the understanding of each of the elements that make up the QMS

Optimized Enzymatic Synthesis of Hesperidin Fatty Acid Esters in a Two-Phase System Containing Ionic Liquid

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Response surface methodology (RSM) based on a five-level, three-variable central composite design (CCD) was employed for modeling and optimizing the conversion yield of the enzymatic acylation of hesperidin with decanoic acid using immobilized Candida antarctica lipase B (CALB) in a two-phase system containing [bmim]BF(4). The three variables studied (molar ratio of hesperidin to decanoic acid, [bmim]BF(4)/acetone ratio and lipase concentration) significantly affected the conversion yield of acylated hesperidin derivative. Verification experiments confirmed the validity of the predicted model. The lipase showed higher conversion degree in a two-phase system using [bmim] BF4 and acetone compared to that in pure acetone. Under the optimal reaction conditions carried out in a single-step biocatalytic process when the water content was kept lower than 200 ppm, the maximum acylation yield was 53.6%.16871717182Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)FAPESP [09/09224-3

A gastrointestinal rotavirus infection mouse model for immune modulation studies

<p>Abstract</p> <p>Background</p> <p>Rotaviruses are the single most important cause of severe diarrhea in young children worldwide. The current study was conducted to assess whether colostrum containing rotavirus-specific antibodies (Gastrogard-R^®) could protect against rotavirus infection. In addition, this illness model was used to study modulatory effects of intervention on several immune parameters after re-infection.</p> <p>Methods</p> <p>BALB/c mice were treated by gavage once daily with Gastrogard-R^®from the age of 4 to 10 days, and were inoculated with rhesus rotavirus (RRV) at 7 days of age. A secondary inoculation with epizootic-diarrhea infant-mouse (EDIM) virus was administered at 17 days of age. Disease symptoms were scored daily and viral shedding was measured in fecal samples during the post-inoculation periods. Rotavirus-specific IgM, IgG and IgG subclasses in serum, T cell proliferation and rotavirus-specific delayed-type hypersensitivity (DTH) responses were also measured.</p> <p>Results</p> <p>Primary inoculation with RRV induced a mild but consistent level of diarrhea during 3-4 days post-inoculation. All mice receiving Gastrogard-R^®were 100% protected against rotavirus-induced diarrhea. Mice receiving both RRV and EDIM inoculation had a lower faecal-viral load following EDIM inoculation then mice receiving EDIM alone or Gastrogard-R^®. Mice receiving Gastrogard-R^®however displayed an enhanced rotavirus-specific T-cell proliferation whereas rotavirus-specific antibody subtypes were not affected.</p> <p>Conclusions</p> <p>Preventing RRV-induced diarrhea by Gastrogard-R^®early in life showed a diminished protection against EDIM re-infection, but a rotavirus-specific immune response was developed including both B cell and T cell responses. In general, this intervention model can be used for studying clinical symptoms as well as the immune responses required for protection against viral re-infection.</p

Evolución de las infecciones de transmisión sexual en la ciudad de Valencia. Periodo 2004-2009

Las infecciones de transmisi&oacute;n sexual (ITS) han aumentado en los &uacute;ltimos a&ntilde;os en toda la Uni&oacute;n Europea. La puesta en marcha de sistemas de notificaci&oacute;n y registro de las enfermedades de declaraci&oacute;n obligatoria (AVE) y sistemas de notificaci&oacute;n automatizada de resultados de microbiolog&iacute;a(RedMiVa) han permitido una mejora de la exhaustividad en la detecci&oacute;n de casos y por tanto una mejor identificaci&oacute;n y prevenci&oacute;n de la transmisi&oacute;n de estas enfermedades.Un dise&ntilde;o cl&aacute;sico de vigilancia de salud p&uacute;blica para los registros de S&iacute;filis del periodo 2005-2009 y de Infecci&oacute;n gonoc&oacute;cica del periodo 2004-2009, nos permite analizar las caracter&iacute;sticas de los sujetos, su evoluci&oacute;n temporal y h&aacute;bitos sexuales en la ciudad de Valencia. Durante el periodo fueron notificados 321 casos de S&iacute;filis y 596 de Infecci&oacute;n Gonoc&oacute;cica. La evoluci&oacute;n temporal de la incidencia pas&oacute; de 2,13 (2005) a 15,60 (2009) para la S&iacute;filis; y de 2,13 (2004) a 26,36 (2009) para la Infecci&oacute;n gonoc&oacute;cica. La introducci&oacute;n de la notificaci&oacute;n microbiol&oacute;gica increment&oacute; la detecci&oacute;n de nuevos casos de ITS.La desproporci&oacute;n por g&eacute;nero muestra una evoluci&oacute;n creciente de la Raz&oacute;n de masculinidad. La S&iacute;filis presenta cifras superiores entre los inmigrantes tanto en varones como en mujeres, mientras que para la Infecci&oacute;n Gonoc&oacute;cica destaca una incidencia superior en mujeres aut&oacute;ctonas que entre las inmigrantes. El factor sexual de riesgom&aacute;s frecuente para ambas enfermedades fue la existencia de parejas m&uacute;ltiples. El 42,68% de los pacientes con S&iacute;filis y el 36,91% de los pacientes con Infecci&oacute;n Gonoc&oacute;cica indicaron esta conducta.La tendencia creciente observada, con independencia de lo anterior, es concordante con informes de similar origen en nuestro pa&iacute;s. No obstante, nuestras cifras de Incidencia Anual son sustancialmente mayores que las registradas en el conjunto de la naci&oacute;n.Esta evoluci&oacute;n sugiere la necesidad de incrementar las&nbsp; estrategias activas de prevenci&oacute;n y uso de preservativos. De igual modo la detecci&oacute;n temprana y el tratamiento correcto de las ITS requieren, en nuestra opini&oacute;n, unamayor difusi&oacute;n de la informaci&oacute;n epidemiol&oacute;gica sobre ITS a los profesionales cl&iacute;nicos

Preparation methods of chitosan nanoparticles: a review

El quitosano es un polisacárido natural que ha sido utilizado frecuentemente en el desarrollo de distintos materiales, debido a sus excepcionales propiedades fisicoquímicas y biológicas. Las nanopartículas de quitosano son generalmente producidas por estrategias denominadas de construcción (del inglés “bottom up”), donde el ensamblado polimérico es promovido por distintas interacciones moleculares. Sin embargo, un grupo de estrategias llamadas de deconstrucción (del inglés “top-down”) basadas en la fragmentación de estructuras macroscópicas, han generado un gran interés recientemente como alternativa para la obtención de nanomateriales. El presente trabajo hace una revisión bibliográfica de los resultados obtenidos por distintas investigaciones sobre la producción de sistemas de nanopartículas basadas en quitosano durante las últimas décadas. Las evidencias demostraron que las nanopartículas de quitosano juegan un papel preponderante en la investigación de los nanomateriales poliméricos con aplicaciones biomédicas y farmacéuticas, debido a la gran diversidad de métodos de obtención existentes que determinan las propiedades de los materiales, tales como tamaño de partícula, capacidad de incorporación y liberación de compuestos bioactivos, carga superficial, mucoadhesividad, entre otras

IL28B SNP rs8099917 Is Strongly Associated with Pegylated Interferon-α and Ribavirin Therapy Treatment Failure in HCV/HIV-1 Coinfected Patients

Recent genome-wide association studies report that the SNP rs8099917, located 8.9 kb upstream of the start codon of IL28B, is associated with both disease chronicity and therapeutic response to pegIFN-α and RBV in patients infected with genotype 1 HCV. To determine the effect of rs8099917 variation on the response of HCV to therapy, we genotyped this variant in a cohort of 160 HCV/HIV-1 coinfected patients in our clinic unit who received combined peg-IFN-α/RBV therapy. The rs8099917 T/G or G/G genotypes were observed in 56 patients (35%). Treatment failure occurred in 80% of G-allele carriers versus 48% of non-carriers (P<0.0001). This result reveals that the G allele was strongly associated with treatment failure in this patient cohort. Importantly, a highly significant association was found between the G-allele and response to therapy in HCV genotype 1-infected patients (P<0.0001) but not in HCV genotype 3-infected patients. Multivariate analysis (odds ratio; 95% confidence interval; P value) indicated that the rs8099917 TT genotype was a strong predictor of treatment success (5.83; 1.26–26.92; P = 0.021), independent of baseline plasma HCV-RNA load less than 500 000 IU/ml (4.85; 1.18–19.95; P = 0.025) and absence of advanced liver fibrosis (5.24; 1.20–22.91; P = 0.025). These results reveal the high prevalence of the rs8099917 G allele in HCV/HIV-1 coinfected patients as well as its strong association with treatment failure in HCV genotype 1-infected patients. rs8099917 SNP genotyping may be a valid pre-treatment predictor of which patients are likely to respond to treatment in this group of difficult-to-treat HCV/HIV-infected patients

Ten-year follow-up of giant basilar aneurysm treated by sole stenting technique: a case report

<p>Abstract</p> <p>Introduction</p> <p>The sole stenting technique has emerged as a new tool for the management of intracranial aneurysms. However, several concerns have emerged about the long-term behavior of intracranial stents, particularly their safety and efficacy.</p> <p>Case presentation</p> <p>We present the first case of an intracranial aneurysm intentionally treated with the sole stenting technique. After ten years of clinical and imaging follow-up, the lesion has healed and no intrastent stenosis is observed.</p> <p>Several issues concerning this technique are discussed. For instance, the modification of the angle and intra-aneurysmal thrombosis may account as positive effects; negative outcomes include in-stent thrombosis or stenosis.</p> <p>Conclusions</p> <p>This case report, involving a long clinical and imaging follow-up, provides an example of the effectiveness, safety, durability and simplicity of the sole stenting technique in the management of intracranial aneurysms.</p

Living Invisible: HTLV-1-Infected Persons and the Lack of Care in Public Health

Human T-cell lymphotropic virus type 1 (HTLV-1) infection is commonly confounded with Human Immunodeficiency Virus (HIV) infection and it is unknown to many health professionals. It is endemic in many countries and there is no effective treatment available. Although a few individuals have severe symptoms, most patients remain asymptomatic throughout their lives. Further, HTLV-1 is considered a neglected public health problem and limited studies cover specific patients' needs and emotional experiences. To better understand how women and men living with HTLV-1 experience the disease and what issues exist in their healthcare processes, we conducted a qualitative study of both symptomatic and asymptomatic patients at an outpatient clinic at the Emílio Ribas Infectious Diseases Institute in São Paulo, Brazil. We found that the main focus of health staff was on illness risk, but not identifying infected relatives and preventing new infections. This point of view, ultimately neglected patients' complex demands, and overshadows the prevention of new infections and contributes to the lack of care in public health for HTLV-1 infected subjects. Furthermore, this perpetuates the infection among these populations and the patients experience an “invisibility” of their specific needs, such as reproductive rights and feel that their rights as citizens are ignored

Antiviral mode of action of bovine dialyzable leukocyte extract against human immunodeficiency virus type 1 infection

<p>Abstract</p> <p>Background</p> <p>Bovine dialyzable leukocyte extract (bDLE) is derived from immune leukocytes obtained from bovine spleen. DLE has demonstrated to reduce transcription of Human Immunodeficiency Virus Type 1 (HIV-1) and inactivate the nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB) signaling pathway. Therefore, we decided to clarify the mode of antiviral action of bDLE on the inhibition of HIV-1 infection through a panel of antiviral assays.</p> <p>Results</p> <p>The cytotoxicity, HIV-1 inhibition activity, residual infectivity of bDLE in HIV-1, time of addition experiments, fusion inhibition of bDLE for fusogenic cells and the duration of cell protection even after the removal of bDLE were all assessed in order to discover more about the mode of the antiviral action.</p> <p>HIV-1 infectivity was inhibited by bDLE at doses that were not cytotoxic for HeLa-CD4-LTR-β-gal cells. Pretreatment of HIV-1 with bDLE did not decrease the infectivity of these viral particles. Cell-based fusion assays helped to determine if bDLE could inhibit fusion of Env cells against CD4 cells by membrane fusion and this cell-based fusion was inhibited only when CD4 cells were treated with bDLE. Infection was inhibited in 80% compared with the positive (without EDL) at all viral life cycle stages in the time of addition experiments when bDLE was added at different time points. Finally, a cell-protection assay against HIV-1 infection by bDLE was performed after treating host cells with bDLE for 30 minutes and then removing them from treatment. From 0 to 7 hours after the bDLE was completely removed from the extracellular compartment, HIV-1 was then added to the host cells. The bDLE was found to protect the cells from HIV-1 infection, an effect that was retained for several hours.</p> <p>Conclusions</p> <p>bDLE acted as an antiviral compound and prevented host cell infection by HIV-1 at all viral life cycle stages. These cell protection effects lingered for hours after the bDLE was removed. Interestingly, bDLE inhibited fusion of fusogenic cells by acting only on CD4 cells. bDLE had no virucidal effect, but could retain its antiviral effect on target cells after it was removed from the extracellular compartment, protecting the cells from infection for hours.</p> <p>bDLE, which has no reported side effects or toxicity in clinical trials, should therefore be further studied to determine its potential use as a therapeutic agent in HIV-1 infection therapy, in combination with known antiretrovirals.</p