Patentes farmacêuticas: a mitigação do direito à propriedade industrial no âmbito farmacêutico em face do direito constitucional ao acesso a medicamentos

O presente trabalho tem como objetivo analisar as influências dos direitos resultantes da propriedade industrial, no âmbito da indústria farmacêutica, no acesso a medicamentos pela população. Trata-se de trabalho de conclusão do curso de direito cuja pesquisa, que utilizou tanto de métodos dogmáticos quanto da análise de situações reais, ou seja, empíricas, é centrada nas prejudicialidades que as patentes farmacêuticas podem trazer na esfera do direito à saúde, principalmente, nas políticas públicas voltadas à distribuição de medicamentos. Diante dessa premissa, analisam-se as formas possíveis de se contornar essa interferência, muitas vezes negativa, das patentes farmacêuticas no direito ao acesso a medicamentos

Healthcare Built Environment and Telemedicine Practice for Social and Environmental Sustainability

The practice of telemedicine started at the beginning of the 20th century but has never been widely implemented, even though it is significantly sustainable compared to traveling to healthcare However, the ongoing COVID-19 pandemic pushed organisations and patients to accept this technology. During the pandemic, telemedicine consultations took place in ad hoc environments without much preparation and planning. As a result, there is a knowledge gap in the field between telemedicine’s clinical care services and healthcare built environment, in terms of design. This research focused on addressing the quality of service and experience of telemedicine in primary healthcare settings and how this could be influenced by the digital infrastructure. Our aim was to understand the correlations between telemedicine and healthcare built environment and whether the latter could have a significant impact on telemedicine practice. The methodology included interviews with professionals involved in healthcare planning, architecture and ethnography, and end user research involving telemedicine sessions. The interviews highlighted that professionals involved in the design of healthcare environments demonstrated limited consideration of telemedicine environments. Yet, the ethnographic, end-user research identified areas where the telemedicine environment could affect user experience and should be taken into consideration in the design of such spaces

3D Bioprinting and Near-Field Electrospinning Composite Scaffolds for the Bone-Ligament Interface

3D bioprinting is an additive manufacturing technique that can utilize a range of bioactive materials to construct specific architectures that mimic native tissue. Near-field electrospinning (NFE) offers precise alignment control to create non-woven mats with high tensile strengths. We built a custom E-spin printer that enables layer-by-layer alternating deposition between 3D bioprinting and NFE to create composite scaffolds for the bone-ligament interface. This complex region is difficult to simulate due to its functionally graded mechanical and biochemical properties. We created NFE poly(caprolactone) highly aligned micro-fibers which formed collagen fibril-like bundles. Poly(ethylene glycol) diacrylate with decellularized bone was encased in the PCL fibers to create bony ligament support structures in a composite scaffold. Cytotoxicity of all materials was determined through a Live/Dead assay (Thermo Fisher) with NIH/3T3 cells. The materials and the composite scaffold were seeded with 3T3 cells and cultured for three days before undergoing an immunocytochemistry staining (ICC) to assess cell adhesion and spreading. Increased adhesion and spreading on decellularized bone scaffolds along with cell elongation in the direction of the fibers suggests the ability of the scaffold to encourage osteoblastic differentiation and ligamentous tissue formation, though a longitudinal study is still underway. Mechanical results suggest that the composite scaffolds have increased compressive strength over PEGDA alone as the PCL fibers constrict horizontal elongation, thus yielding a higher compressive modulus. The PCL fibers demonstrated a tensile strength approaching native ligament (3.96 ± 1.10 MPa), which shows promise as the ligament phase of the scaffold. The E-spin printer’s versatility with materials of disparate viscosities enabled the layer-by-layer fabrication of composite (PCL/PEGDA+bone) scaffolds that begin to mimic the complex nature of the bone-ligament interface

Transtornos psiquiátricos nos acadêmicos de medicina / Psychiatric disorders in medical students

Os problemas psicológicos com os quais se deparam os universitários, em particular os estudantes de medicina, são extremamente complexos e os acometem antes mesmo deles iniciarem o curso médico. Inicia-se com a escolha da profissão, competitividade no vestibular e os acompanham até o final do curso. Devido à fadiga, o cansaço e o estar constantemente sob pressão existem uma maior intensidade de problemas emocionais entre os estudantes de medicina se comparados com os outros estudantes universitários tornando os mais suscetíveis a desenvolver algum transtorno psiquiátrico maior ou menor. O objetivo dessa revisão de literatura consiste em identificar a etiologia, prevalência e elucidar os principais transtornos mentais que afetam esse grupo de risco. Foram selecionados artigos em português e inglês de caráter relevante para que pudessem contribuir com a pesquisa, tendo como base os bancos de dados Medline, Embase, LILACS e SciELO

Immunotherapy for gliomas: shedding light on progress in preclinical and clinical development

Gliomas are infiltrating brain tumors associated with high morbidity and mortality. Current standard of care includes radiation, chemotherapy and surgical resection. Today, survival rates for malignant glioma patients remain dismal and unchanged for decades. The glioma microenvironment is highly immunosuppressive and consequently this has motivated the development of immunotherapies for counteracting this condition, enabling the immune cells within the tumor microenvironment to react against this tumor.Areas covered: The authors discuss immunotherapeutic strategies for glioma in phase-I/II clinical trials and illuminate their mechanisms of action, limitations and key challenges. They also examine promising approaches under preclinical development.Expert opinion: In the last decade there has been an expansion in immune-mediated anti-cancer therapies. In the glioma field, sophisticated strategies have been successfully implemented in preclinical models. Unfortunately, clinical trials have not yet yielded consistent results for glioma patients. This could be attributed to our limited understanding of the complex immune cell infiltration and its interaction with the tumor cells, the selected time for treatment, the combination with other therapies and the route of administration of the agent. Applying these modalities to treat malignant glioma is challenging, but many new alternatives are emerging to by-pass these hurdles.Fil: Garcia Fabiani, Maria Belen. University of Michigan; Estados Unidos. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Ventosa, Maria. University of Michigan; Estados UnidosFil: Comba, Andrea. University of Michigan; Estados Unidos. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Candolfi, Marianela. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Investigaciones Biomédicas. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Investigaciones Biomédicas; ArgentinaFil: Nicola Candia, Alejandro Javier. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Investigaciones Biomédicas. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Investigaciones Biomédicas; ArgentinaFil: Alghamri, Mahmoud S.. University of Michigan; Estados UnidosFil: Kadiyala, Padma. University of Michigan; Estados UnidosFil: Carney, Stephen. University of Michigan; Estados UnidosFil: Faisal, Syed M.. University of Michigan; Estados UnidosFil: Schwendeman, Anna. University of Michigan; Estados UnidosFil: Moon, James J.. University of Michigan; Estados UnidosFil: Scheetz, Lindsay. University of Michigan; Estados UnidosFil: Lahann, Joerg. University of Michigan; Estados UnidosFil: Mauser, Ava. University of Michigan; Estados UnidosFil: Lowenstein, Pedro R.. University of Michigan; Estados UnidosFil: Castro, Maria Gabriela. University of Michigan; Estados Unido

Size-dependent activity of carbon dots for photocatalytic H2 generation in combination with a molecular Ni cocatalyst

Carbon dots (CDs) are low-cost light-absorbers in photocatalytic multicomponent systems, but their wide size distribution has hampered rational design and the identification of the factors that lead to their best performance. To address this challenge, we report herein the novel use of gel filtration size exclusion chromatography to separate amorphous, graphitic, and graphitic N-doped CDs depending on their lateral size to study the effect of their size on photocatalytic H2 evolution with a DuBois type Ni cocatalyst. Transmission electron microscopy and dynamic light scattering confirm size-dependent separation, while UV-vis and fluorescence spectroscopy of the more monodisperse fractions show a distinct response which computational modelling attributed to a complex interplay between CD size and optical properties. A size-dependent effect on the photocatalytic H2 evolution performance of the CDs in combination with a molecular Ni cocatalyst is demonstrated with a maximum activity at approximately 2-3 nm CD diameter. Overall, size separation leads to a two-fold increase in the specific photocatalytic activity for H2 evolution using the monodisperse CDs compared to the as synthesized polydisperse samples, highlighting the size-dependent effect on photocatalytic activity towards H2 evolution

Evaluation of polygenic risk scores for breast and ovarian cancer risk prediction in BRCA1 and BRCA2 mutation carriers

Background: Genome-wide association studies (GWAS) have identified 94 common single-nucleotide polymorphisms (SNPs) associated with breast cancer (BC) risk and 18 associated with ovarian cancer (OC) risk. Several of these are also associated with risk of BC or OC for women who carry a pathogenic mutation in the high-risk BC and OC genes BRCA1 or BRCA2. The combined effects of these variants on BC or OC risk for BRCA1 and BRCA2 mutation carriers have not yet been assessed while their clinical management could benefit from improved personalized risk estimates. Methods: We constructed polygenic risk scores (PRS) using BC and OC susceptibility SNPs identified through population-based GWAS: for BC (overall, estrogen receptor [ER]-positive, and ER-negative) and for OC. Using data from 15 252 female BRCA1 and 8211 BRCA2 carriers, the association of each PRS with BC or OC risk was evaluated using a weighted cohort approach, with time to diagnosis as the outcome and estimation of the hazard ratios (HRs) per standard deviation increase in the PRS. Results: The PRS for ER-negative BC displayed the strongest association with BC risk in BRCA1 carriers (HR = 1.27, 95% confidence interval [CI] = 1.23 to 1.31, P = 8.2 x 10(53)). In BRCA2 carriers, the strongest association with BC risk was seen for the overall BC PRS (HR = 1.22, 95% CI = 1.17 to 1.28, P = 7.2 x 10(-20)). The OC PRS was strongly associated with OC risk for both BRCA1 and BRCA2 carriers. These translate to differences in absolute risks (more than 10% in each case) between the top and bottom deciles of the PRS distribution; for example, the OC risk was 6% by age 80 years for BRCA2 carriers at the 10th percentile of the OC PRS compared with 19% risk for those at the 90th percentile of PRS. Conclusions: BC and OC PRS are predictive of cancer risk in BRCA1 and BRCA2 carriers. Incorporation of the PRS into risk prediction models has promise to better inform decisions on cancer risk management

Clinical predictors of encephalitis in UK adults–A multi-centre prospective observational cohort study

Objectives: Encephalitis, brain inflammation and swelling, most often caused by an infection or the body’s immune defences, can have devastating consequences, especially if diagnosed late. We looked for clinical predictors of different types of encephalitis to help clinicians consider earlier treatment. Methods: We conducted a multicentre prospective observational cohort study (ENCEPH-UK) of adults (> 16 years) with suspected encephalitis at 31 UK hospitals. We evaluated clinical features and investigated for infectious and autoimmune causes. Results: 341 patients were enrolled between December 2012 and December 2015 and followed up for 12 months. 233 had encephalitis, of whom 65 (28%) had HSV, 38 (16%) had confirmed or probable autoimmune encephalitis, and 87 (37%) had no cause found. The median time from admission to 1st dose of aciclovir for those with HSV was 14 hours (IQR 5–50); time to 1st dose of immunosuppressant for the autoimmune group was 125 hours (IQR 45–250). Compared to non-HSV encephalitis, patients with HSV more often had fever, lower serum sodium and lacked a rash. Those with probable or confirmed autoimmune encephalitis were more likely to be female, have abnormal movements, normal serum sodium levels and a cerebrospinal fluid white cell count < 20 cells x106/L, but they were less likely to have a febrile illness. Conclusions: Initiation of treatment for autoimmune encephalitis is delayed considerably compared with HSV encephalitis. Clinical features can help identify patients with autoimmune disease and could be used to initiate earlier presumptive therapy

Undertaking Rehabilitation Research During the COVID-19 Pandemic: Emergent Strategies From a Trainee-Faculty Workshop

BackgroundThe COVID-19 pandemic has disrupted everyday rehabilitation research. Many academic institutions have halted in-person human research including rehabilitation sciences. Researchers are faced with several barriers to continuing their research programs. The purpose of this perspective article is to report the results of an interdisciplinary workshop aimed at understanding the challenges and corresponding strategies for conducting rehabilitation research during the COVID-19 pandemic.MethodsTwenty-five rehabilitation researchers (17 trainees and eight faculty) attended a 2-h facilitated online workshop in to discuss challenges and strategies they had experienced and employed to conduct rehabilitation research during the COVID-19 pandemic.ResultsRehabilitation researchers reported challenges with (1) pandemic protocol adjustments, (2) participant accessibility, and (3) knowledge dissemination, along with corresponding strategies to these challenges. Researchers experienced disruptions in study outcomes and intervention protocols to adhere to public health guidelines and have suggested implementing novel virtual approaches and study toolkits to facilitate offsite assessment. Participant accessibility could be improved by engaging community stakeholders in protocol revisions to ensure equity, safety, and feasibility. Researchers also experienced barriers to virtual conferences and publication, suggested opportunities for smaller networking events, and revisiting timeframes for knowledge dissemination.ConclusionThis perspective article served as a catalyst for discussion among rehabilitation researchers to identify novel and creative approaches that address the complexities of conducting rehabilitation research during the COVID-19 pandemic and beyond