Proposta de um modelo de balanço social para fundações universitárias

The Social Audit is the report that informs about the socioeconomic relations of organizations with their social partners. The contemporary approach comprehends the vertices understood as the human resource balance, the demonstration of the added value, the environmental balance, the public and social responsibility of organizations. It is a more eclectic report than the traditional accounting reports, which makes it more capable of disclosing the efforts made by organizations to promote the management of their social responsibility. Although its study is very recent in Brazil, one notices a willingness, both in the business community and in the academia, to contribute to the discussions around the preparation and propagation of such a report. Thus, the article proposes a Social Audit for a university foundation as a useful report for the organization’s management and accountability towards its stakeholders. The adopted methodology consists of an exploratory research with a qualitative approach. The conclusions indicate the need for organizations to supplement the disclosure of information by adding to the economic and financial reports those of a social and environmental nature. The proposal focuses on the characteristics of higher education institutions of a communal nature in order to discuss the social dimension of these organizations and to contribute to the process of management of the social responsibilities resulting from their activities. Key words: social audit, university foundation, management of social responsibility.O Balanço Social é o relatório que evidencia as relações socioeconômicas das entidades com seus parceiros sociais. A abordagem contemporânea abrange os vértices compreendidos como o balanço de recursos humanos, a demonstração do valor adicionado, o balanço ambiental, a responsabilidade pública e social das organizações. É, notadamente, um demonstrativo mais eclético que os demonstrativos contábeis tradicionais, o que lhe concede uma condição propícia para evidenciar o esforço organizacional, no intuito de promover a gestão de suas responsabilidades sociais. Embora seu estudo seja bastante recente no Brasil, nota-se uma predisposição, tanto nos ambientes empresariais quanto nos acadêmicos, em contribuir nas discussões que giram em torno da elaboração e divulgação do demonstrativo. Assim, o objetivo do presente artigo é apresentar o delineamento de uma proposta de Balanço Social para uma fundação universitária, como um demonstrativo útil na gestão das organizações e na prestação de contas aos stakeholders. Os procedimentos metodológicos adotados consistem de uma pesquisa exploratória com abordagem qualitativa. As conclusões do trabalho apontam para a necessidade de as entidades complementarem a divulgação de informações, adicionando aos relatórios de natureza econômica e financeira aqueles de cunho social e ecológico. A proposta contempla as características das instituições de ensino superior de caráter comunitário, no intuito de demonstrar a dimensão social dessas entidades e contribuir no processo de gestão das responsabilidades sociais decorrentes de sua atuação. Palavras-chave: balanço social, fundação universitária, gestão das responsabilidades sociais

Proposta de um modelo de balanço social para fundações universitárias

The Social Audit is the report that informs about the socioeconomic relations of organizations with their social partners. The contemporary approach comprehends the vertices understood as the human resource balance, the demonstration of the added value, the environmental balance, the public and social responsibility of organizations. It is a more eclectic report than the traditional accounting reports, which makes it more capable of disclosing the efforts made by organizations to promote the management of their social responsibility. Although its study is very recent in Brazil, one notices a willingness, both in the business community and in the academia, to contribute to the discussions around the preparation and propagation of such a report. Thus, the article proposes a Social Audit for a university foundation as a useful report for the organization’s management and accountability towards its stakeholders. The adopted methodology consists of an exploratory research with a qualitative approach. The conclusions indicate the need for organizations to supplement the disclosure of information by adding to the economic and financial reports those of a social and environmental nature. The proposal focuses on the characteristics of higher education institutions of a communal nature in order to discuss the social dimension of these organizations and to contribute to the process of management of the social responsibilities resulting from their activities. Key words: social audit, university foundation, management of social responsibility.O Balanço Social é o relatório que evidencia as relações socioeconômicas das entidades com seus parceiros sociais. A abordagem contemporânea abrange os vértices compreendidos como o balanço de recursos humanos, a demonstração do valor adicionado, o balanço ambiental, a responsabilidade pública e social das organizações. É, notadamente, um demonstrativo mais eclético que os demonstrativos contábeis tradicionais, o que lhe concede uma condição propícia para evidenciar o esforço organizacional, no intuito de promover a gestão de suas responsabilidades sociais. Embora seu estudo seja bastante recente no Brasil, nota-se uma predisposição, tanto nos ambientes empresariais quanto nos acadêmicos, em contribuir nas discussões que giram em torno da elaboração e divulgação do demonstrativo. Assim, o objetivo do presente artigo é apresentar o delineamento de uma proposta de Balanço Social para uma fundação universitária, como um demonstrativo útil na gestão das organizações e na prestação de contas aos stakeholders. Os procedimentos metodológicos adotados consistem de uma pesquisa exploratória com abordagem qualitativa. As conclusões do trabalho apontam para a necessidade de as entidades complementarem a divulgação de informações, adicionando aos relatórios de natureza econômica e financeira aqueles de cunho social e ecológico. A proposta contempla as características das instituições de ensino superior de caráter comunitário, no intuito de demonstrar a dimensão social dessas entidades e contribuir no processo de gestão das responsabilidades sociais decorrentes de sua atuação. Palavras-chave: balanço social, fundação universitária, gestão das responsabilidades sociais

Progressão da fibrose hepática em portadores de coinfecção HIV/vírus da hepatite C com níveis de aminotransferases normais

INTRODUCTION: Approximately 30% of hepatitis C virus (HCV) monoinfected patients present persistently normal alanine aminotransferase (ALT) levels. Most of these patients have a slow progression of liver fibrosis. Studies have demonstrated the rate of liver fibrosis progression in hepatitis C virus-human immunodeficiency virus (HCV-HIV) coinfected patients is faster than in patients infected only by HCV. Few studies have evaluated the histological features of chronic hepatitis C in HIV-infected patients with normal ALT levels. METHODS: HCV-HIV coinfected patients (HCV-RNA and anti-HIV positive) with known time of HCV infection (intravenous drugs users) were selected. Patients with hepatitis B surface antigen (HBsAg) positive or hepatitis C treatment before liver biopsy were excluded. Patients were considered to have a normal ALT levels if they had at least 3 normal determinations in the previous 6 months prior to liver biopsy. All patients were submitted to liver biopsy and METAVIR scale was used. RESULTS: Of 50 studied patients 40 (80%) were males. All patients were treated with antiretroviral therapy. The ALT levels were normal in 13 (26%) patients. HCV-HIV co-infected patients with normal ALT levels had presented means of the liver fibrosis stages (0.77±0.44 versus 1.86±1.38; p<0.001) periportal inflammatory activity (0.62±0.77 versus 2.24±1.35; p<0.001) and liver fibrosis progression rate (0.058±0.043 fibrosis unit/year versus 0.118±0.102 fibrosis unit/year) significantly lower as compared to those with elevated ALT. CONCLUSIONS: HCV-HIV coinfected patients with persistently normal ALTs showed slower progression of liver fibrosis. In these patients the development of liver cirrhosis is improbable.INTRODUÇÃO: Aproximadamente, 30% dos portadores de hepatite crônica C apresentam níveis de aminotransferases persistentemente normais (APNL). A maioria destes pacientes tem lenta progressão da fibrose hepática. Em portadores de coinfecção VHC-HIV, estudos têm demonstrado que a progressão da fibrose hepática é mais rápida que a observada em indivíduos infectados somente pelo VHC. Há poucos estudos que verificaram as características histológicas da hepatite crônica C em pacientes coinfectados pelo HIV APNL. MÉTODOS: Portadores de coinfecção VHC-HIV (HCV-RNA e anti-HIV positivos) com tempo de infecção pelo VHC conhecido (uso de drogas intravenosas) foram selecionados. Aqueles com hepatitis B surface antigen (HbsAg) positivo ou que tenham sido submetidos à terapia antiviral para hepatite C antes da biópsia hepática foram excluídos. Pacientes com pelo menos 3 determinações normais da ALT nos últimos 6 meses antes da biópsia hepática foram considerados como tendo APNL. Todos foram submetidos a biópsia hepática que foi classificada de acordo com a escala METAVIR. RESULTADOS: Foram incluídos 50 pacientes, 40 (80%) homens. Todos receberam terapia antirretroviral. Os níveis de ALT foram persistentemente normais em 13 (26%) pacientes. Pacientes coinfectados com APNL apresentaram menor média dos estágiosde fibrose hepática (0,77±0,44 versus 1,86±1,38; p<0,001), dos índices de atividade inflamatória periportal (0,62±0,77 versus 2,24±1,35; p<0,001) e progressão mais lenta da fibrose hepática (0,058±0,043 unidades de fibrose /ano versus 0,118±0,102 unidades de fibrose/ano) quando comparados àqueles com aminotransferases elevadas. CONCLUSÕES: Portadores de coinfecção VHC-HIV com APNL apresentam progressão mais lenta da fibrose hepática. Nesses pacientes o desenvolvimento de cirrose hepática é improvável.Universidade Federal de Juiz de Fora Centro de Referência em Hepatologia Departamento de GastroenterologiaUniversidade Federal de Juiz de Fora Unidade de Endoscopia DigestivaUniversidade Federal de São Paulo (UNIFESP) Divisão de Gastroenterologia Seção de HepatitesUNIFESP, Divisão de Gastroenterologia Seção de HepatitesSciEL

Longitudinal Study of a Human Drug-Induced Model of Autoantibody to Cytoplasmic Rods/Rings following HCV Therapy with Ribavirin and Interferon-alpha

Background: A novel pattern in the indirect immunofluorescence antinuclear antibody assay on HEp-2 cells (IIF-HEp-2) characterized by cytoplasmic rods and rings (RR) was reported in HCV patients, but stringent disease specificity studies and longitudinal analysis are lacking. We investigated the clinical significance of anti-RR in an HCV cohort with up to a 12-month treatment follow up.Methodology/Results: 597 patients (342 HCV, 55 HCV/HIV, 200 non-HCV) were screened and titered for anti-RR. Serial samples were available from 78 of 176 treated and 27 of 166 untreated patients. Anti-RR was detected in 14.1% of 342 HCV patients, 9.1% of 55 HCV/HIV, 3.4% of 29 Hepatitis B, and none of 171 non-HCV (p47% tested positive for anti-RR. the anti-RR titer generally increased with sustained treatment and remained high in 53% of patients. After treatment, anti-RR titer was negative in 41%. Non-responders to HCV therapy were 77% in anti-RR-positive versus 64% in anti-RR-negative patients. Response to treatment was not associated with anti-RR titer or the dynamics of anti-RR reactivity during and after treatment.Conclusions: the exquisite association of anti-RR reactivity with combined interferon-a/ribavirin therapy in HCV patients represents a unique model for drug-induced autoantibody generation in humans as demonstrated by the fact that a significant fraction of patients who have anti-RR during therapy becomes anti-RR-negative after completion of therapy.Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Brazilian National Council for Research and Technological DevelopmentUniversidade Federal de São Paulo, Div Rheumatol, São Paulo, BrazilUniversidade Federal de São Paulo, Div Gastroenterol, São Paulo, BrazilUniversidade Federal de São Paulo, Div Infect Dis, São Paulo, BrazilFleury Med & Hlth Labs, Div Immunol, São Paulo, BrazilUniv Florida, Dept Oral Biol, Gainesville, FL 32610 USAUniversidade Federal de São Paulo, Div Rheumatol, São Paulo, BrazilUniversidade Federal de São Paulo, Div Gastroenterol, São Paulo, BrazilUniversidade Federal de São Paulo, Div Infect Dis, São Paulo, BrazilFAPESP: 2010/50710-6Brazilian National Council for Research and Technological Development: 305064/2011-8Web of Scienc

Alterações oculares por uso sistêmico de alfa-interferon em pacientes com hepatite C

PURPOSE: To describe ocular (specially fundoscopic) changes due to systemic alpha-interferon (IFN) therapy in patients with hepatitis C. This is a prospective, descriptive and observational (non-interventional) study, and its results are preliminary. METHODS: Patients were selected with indication of alpha-interferon therapy for hepatitis C. They underwent ocular examinations before therapy and 1, 3, 6 and 12 months after starting the therapy. HIV patients and those who had a history of previous treatment with alpha-interferon were excluded from the study, but examined. RESULTS: Fifty-one patients were selected from November 1999 to June 2000. The male-to-female ratio was 1.55. The age average was 47 years. The best corrected visual acuity ranged from 20/15 to 20/40. Most of the symptomatic patients complained of foreign body sensation in the eyes, which became more tolerable with time. Complaints comprised flu-like symptoms, joint pain, depression, headache, and general weakness. Ocular findings related to alpha-interferon were: cotton wool spots (3 eyes) and intraretinal hemorrhage (1 eye). One patient died during the study, due to another disease not related to hepatitis, and one patient refused to be examined. CONCLUSIONS: There are retinal vascular changes due to systemic alpha-interferon for hepatitis C. There are no studies in our country describing ocular changes in patients with hepatitis C on therapy with alpha-interferon. General physicians and specially gastroenterologists should pay special attention to this problem, and refer these patients to the ophthalmologist in order to determine and follow any lesion that may be related to the use of this drug.OBJETIVO: Avaliar alterações oculares (em especial lesões fundoscópicas) em pacientes com hepatite C tratados com alfa-interferon (IFN). MÉTODOS: Estudo prospectivo, descritivo e observacional de pacientes com hepatite C do serviço de Gastroenterologia da UNIFESP com indicações de uso de alfa-interferon entre novembro de 1999 e junho de 2000. Esses pacientes foram submetidos a exame oftalmológico completo antes e 1, 3, 6 e 12 meses após o início do tratamento. Pacientes HIV positivos, ou com exposição prévia à droga foram excluídos. RESULTADOS: De um total de 51 pacientes selecionados, 31 foram acompanhados. A relação masculino-feminino foi de 1,55, e a média de idade de 47 anos. A acuidade visual corrigida variou de 20/15 a 20/40. Vinte e dois por cento dos pacientes queixaram-se de sensação de corpo estranho, principalmente nos dois primeiros meses de terapia. Queixas gerais foram: artralgia, cefaléia, depressão, fraqueza muscular. Achados oculares foram: hemorragia retiniana (um olho) e exsudatos moles (três olhos), todos assintomáticos. Em um paciente com história pregressa de tratamento com interferon, observou-se presença de hemorragia vítrea, exsudatos duros e moles e tortuosidade vascular. Um paciente faleceu durante o tratamento por infarto cardíaco. CONCLUSÕES: Existem alterações oculares por uso sistêmico de alfa-interferon. Não existem estudos no nosso país descrevendo essas alterações. Médicos clínicos gerais e gastroenterologistas devem prestar atenção a esse tipo de problema, e encaminhar os pacientes a um serviço de oftalmologia para acompanhamento paralelo.Universidade Federal de São Paulo (UNIFESP) Departamento de OftalmologiaUniversidade Federal de São Paulo (UNIFESP)UNIFESP, Depto. de OftalmologiaUNIFESPSciEL

Bone Mineral Density Measurements, Bone Markers and Serum Vitamin D Concentrations in Men with Chronic Non-Cirrhotic Untreated Hepatitis C

Introduction: the high prevalence of chronic hepatitis C (CHC) and its consequent cirrhosis has been associated with bone fragility. Whether CHC may cause bone and mineral abnormalities in the absence of hepatocellular dysfunction is still unknown. in this study we aimed to determine the prevalence of osteoporotic vertebral fractures and low BMD measurements in men with non-cirrhotic CHC. Risk factors for low BMD and fractures were also investigated.Methods: Morphometric vertebral fractures and BMD measurements were performed in 60 non-cirrhotic untreated men with CHC and 59 healthy controls, matched for age and gender, weight and current smoking. Serum CTx, calcium, phosphate, intact PTH, alkaline phosphatase and vitamin D (25OHD) concentrations were measured in all participants. Clinical risk factors for low BMD and fractures were evaluated by a structured questionnaire as well as details regarding HCV infection.Results: Trochanter and total femur BMD were significantly lower in CHC patients as compared to healthy men (p = 0.04). in men 50 years and older, the prevalence of osteoporosis was significantly higher among CHC patients (p = 0.01). Lower levels of physical activities and more often report of prolonged immobilization were observed among CHC patients (p<0.05). Liver inflammation and fibrosis, viral load and genotype did not correlate with BMD measurements. Bone markers and 25OHD concentrations were similar in both groups. Only a few vertebral fractures were observed.Conclusions: Our results demonstrate that non-cirrhotic untreated CHC patients have lower BMD at the femur as compared to healthy men in spite of the absence of significant bone and mineral abnormalities.Rheumatology Division at the Universidade Federal de São Paulo/Escola Paulista de Medicina (Unifesp/EPM)Universidade Federal de São Paulo, Escola Paulista Med, Div Rheumatol, São Paulo, BrazilUniversidade Federal de São Paulo, Escola Paulista Med, Div Gastroenterol, São Paulo, BrazilUniversidade Federal de São Paulo, Escola Paulista Med, Div Rheumatol, São Paulo, BrazilUniversidade Federal de São Paulo, Escola Paulista Med, Div Gastroenterol, São Paulo, BrazilWeb of Scienc

Chronic hepatitis C: hepatic iron content does not correlate with response to antiviral therapy

The complex interaction between hepatitis C virus infection, iron homeostasis and the response to antiviral treatment remains controversial. The aim of this study was to evaluate the influence of hepatic iron concentration (HIC) on the sustained virological response (SVR) to antiviral therapy in patients with chronic hepatitis C. A total of 50 patients who underwent pretreatment liver biopsy with assessment of HIC by graphite furnace atomic absorption spectroscopy and were subsequently submitted to antiviral treatment with interferon/peginterferon and ribavirin were included in the study. Patients with alcoholism, history of multiple blood transfusion, chronic kidney disease, hemolytic anemia and parenteral iron therapy were excluded. The iron related markers and HIC were compared between those who achieved an SVR and non-responders (NR) patients. The mean age was 45.7 years and the proportion of patients' gender was not different between SVR and NR patients. The median serum iron was 138 and 134 µg/dL (p = 0.9), the median serum ferritin was 152.5 and 179.5 ng/mL (p = 0.87) and the median HIC was 9.9 and 8.2 µmol/g dry tissue (p = 0.51), for SVR and NR patients, respectively. Thus, hepatic iron concentration, determined by a reliable quantitative method, was not a negative predictive factor of SVR in patients with chronic hepatitis C presenting mild to moderate hepatic iron accumulation.A complexa interação entre infecção pelo vírus da hepatite C, homeostase do ferro e resposta ao tratamento antiviral permanece controversa. O objetivo deste estudo foi avaliar a influência da concentração hepática de ferro (CHF) na resposta virológica sustentada (RVS) à terapia antiviral na hepatite C crônica. Foram incluídos 50 pacientes que foram submetidos à biopsia hepática pré-tratamento com determinação da CHF por espectrofotometria de absorção atômica com forno de grafite e tratados posteriormente com interferon/peginterferon e ribavirina. Pacientes com alcoolismo, história de múltiplas transfusões sanguíneas, doença renal crônica, anemia hemolítica e terapia com ferro parenteral foram excluídos. O perfil de ferro sérico e a CHF foram comparados entre aqueles que atingiram RVS e os não-respondedores (NR). A média de idade dos pacientes foi 45,7 anos e não houve diferença na proporção de homens e mulheres entre os grupos RVS e NR. A mediana do ferro sérico foi 138 and 134 µg/dL (p = 0.9), a mediana da ferritina sérica foi 152,5 e 179,5 ng/mL (p = 0,87) e a CHF mediana foi 9,9 e 8,2 µmol/g de tecido seco (p = 0,51), para pacientes com RVS e NR, respectivamente. Concluindo, a concentração hepática de ferro, determinada por um método quantitativo confiável, não foi um fator preditivo negativo de RVS em pacientes com hepatite C crônica e acúmulo de ferro hepático leve a moderado