Over the cuckoo’s nest: memories of a former president of Fundação Oswaldo Cruz

Submitted by Maria Morais ([email protected]) on 2018-01-28T17:02:59Z No. of bitstreams: 1 pdf6.pdf: 351354 bytes, checksum: 89cdedfdc59f9b3ca3b2e2d8d2f6dc01 (MD5)Approved for entry into archive by Maria Morais ([email protected]) on 2018-01-28T19:12:39Z (GMT) No. of bitstreams: 1 pdf6.pdf: 351354 bytes, checksum: 89cdedfdc59f9b3ca3b2e2d8d2f6dc01 (MD5)Made available in DSpace on 2018-01-28T19:12:39Z (GMT). No. of bitstreams: 1 pdf6.pdf: 351354 bytes, checksum: 89cdedfdc59f9b3ca3b2e2d8d2f6dc01 (MD5) Previous issue date: 2001Fundação Oswaldo Cruz. Casa de Oswaldo Cruz. Rio de Janeiro, RJ, BrasilFundação Oswaldo Cruz. Casa de Oswaldo Cruz. Rio de Janeiro, RJ, Brasi

Pesquisa Científica e Inovação Tecnológica: A Via Brasileira da Biotecnologia

Submitted by Maria Morais ([email protected]) on 2018-01-28T20:36:41Z No. of bitstreams: 1 pdf9.pdf: 260778 bytes, checksum: e410472e671718716591607e2eb72152 (MD5)Approved for entry into archive by Maria Morais ([email protected]) on 2018-01-28T20:57:39Z (GMT) No. of bitstreams: 1 pdf9.pdf: 260778 bytes, checksum: e410472e671718716591607e2eb72152 (MD5)Made available in DSpace on 2018-01-28T20:57:39Z (GMT). No. of bitstreams: 1 pdf9.pdf: 260778 bytes, checksum: e410472e671718716591607e2eb72152 (MD5) Previous issue date: 2002Fundação Oswaldo Cruz. Casa de Oswaldo Cruz. Rio de Janeiro, RJ, BrasilFundação Oswaldo Cruz. Casa de Oswaldo Cruz. Rio de Janeiro, RJ, BrasilFundação Oswaldo Cruz. Casa de Oswaldo Cruz. Rio de Janeiro, RJ, BrasilFundação Oswaldo Cruz. Casa de Oswaldo Cruz. Rio de Janeiro, RJ, BrasilO objetivo deste texto é analisar o processo de institucionalização da biotecnologia no Brasil, relacionando-o às características peculiares das relações entre ciência, tecnologia e sociedade estabelecidas no contexto das políticas estatais de desenvolvimento científico e tecnológico implementadas a partir da década de 70. Focalizando a experiência particular de configuração das atividades biotecnológicas na FIOCRUZ, considerada uma das principais instituições públicas de pesquisa em saúde do país, pretendemos contribuir para o debate atual sobre a difusão dos modelos internacionais de inovação nos países em desenvolvimento

Pesquisa Científica e Inovação Tecnológica: A Via Brasileira da Biotecnologia

The objective of this study is to reflect on the institutionalization of biotechnology in Brazil, relating it to the historical and institutional context marked by the national science and technology policy implemented since the 1970s. We focus on the configuration of biotechnology at the Oswaldo Cruz Foundation (FIOCRUZ) to exemplify developing countries' difficulty in disseminating an innovation model based on networks originally established in developed countries. The research shows that the lag between scientific capability and technological development at FIOCRUZ resulted from the institutional dynamic related to its process of reconstruction beginning in 1975, governed by both S&T policy and health policy for the production of immunobiological products in the country during that period

Scientific Research and Technological Innovation: The Brazilian Approach to Biotechnology

Le but de ce travail est de réfléchir à linstitutionnalisation de la biotechnologie au Brésil, dans le cadre historico-institutionnel marqué par la politique nationale de science et technologie mise en place dans les années 70. On est parti des aspects de la biotechnologie à la Fondation Oswaldo Cruz (FIOCRUZ) en tant quexemple des difficultés de diffusion, dans les pays en voie de développement, du modèle dinnovation basé sur des réseaux, constitué à lorigine dans les pays développés. Ce travail montre que le décalage entre la formation scientifique et le développement technologique existant à la FIOCRUZ résulte de la dynamique institutionnelle liée à son processus de révision depuis 1975, régi aussi bien par la politique de science et technologie de lépoque que par la politique de santé concernant la production déléments immunobiologiques dans le pays

Worldwide Disparities in Recovery of Cardiac Testing 1 Year Into COVID-19

BACKGROUND The extent to which health care systems have adapted to the COVID-19 pandemic to provide necessary cardiac diagnostic services is unknown.OBJECTIVES The aim of this study was to determine the impact of the pandemic on cardiac testing practices, volumes and types of diagnostic services, and perceived psychological stress to health care providers worldwide.METHODS The International Atomic Energy Agency conducted a worldwide survey assessing alterations from baseline in cardiovascular diagnostic care at the pandemic's onset and 1 year later. Multivariable regression was used to determine factors associated with procedure volume recovery.RESULTS Surveys were submitted from 669 centers in 107 countries. Worldwide reduction in cardiac procedure volumes of 64% from March 2019 to April 2020 recovered by April 2021 in high- and upper middle-income countries (recovery rates of 108% and 99%) but remained depressed in lower middle- and low-income countries (46% and 30% recovery). Although stress testing was used 12% less frequently in 2021 than in 2019, coronary computed tomographic angiography was used 14% more, a trend also seen for other advanced cardiac imaging modalities (positron emission tomography and magnetic resonance; 22%-25% increases). Pandemic-related psychological stress was estimated to have affected nearly 40% of staff, impacting patient care at 78% of sites. In multivariable regression, only lower-income status and physicians' psychological stress were significant in predicting recovery of cardiac testing.CONCLUSIONS Cardiac diagnostic testing has yet to recover to prepandemic levels in lower-income countries. Worldwide, the decrease in standard stress testing is offset by greater use of advanced cardiac imaging modalities. Pandemic-related psychological stress among providers is widespread and associated with poor recovery of cardiac testing. (C) 2022 The Authors. Published by Elsevier on behalf of the American College of Cardiology Foundation

Ticagrelor in patients with diabetes and stable coronary artery disease with a history of previous percutaneous coronary intervention (THEMIS-PCI) : a phase 3, placebo-controlled, randomised trial

Background: Patients with stable coronary artery disease and diabetes with previous percutaneous coronary intervention (PCI), particularly those with previous stenting, are at high risk of ischaemic events. These patients are generally treated with aspirin. In this trial, we aimed to investigate if these patients would benefit from treatment with aspirin plus ticagrelor. Methods: The Effect of Ticagrelor on Health Outcomes in diabEtes Mellitus patients Intervention Study (THEMIS) was a phase 3 randomised, double-blinded, placebo-controlled trial, done in 1315 sites in 42 countries. Patients were eligible if 50 years or older, with type 2 diabetes, receiving anti-hyperglycaemic drugs for at least 6 months, with stable coronary artery disease, and one of three other mutually non-exclusive criteria: a history of previous PCI or of coronary artery bypass grafting, or documentation of angiographic stenosis of 50% or more in at least one coronary artery. Eligible patients were randomly assigned (1:1) to either ticagrelor or placebo, by use of an interactive voice-response or web-response system. The THEMIS-PCI trial comprised a prespecified subgroup of patients with previous PCI. The primary efficacy outcome was a composite of cardiovascular death, myocardial infarction, or stroke (measured in the intention-to-treat population). Findings: Between Feb 17, 2014, and May 24, 2016, 11 154 patients (58% of the overall THEMIS trial) with a history of previous PCI were enrolled in the THEMIS-PCI trial. Median follow-up was 3·3 years (IQR 2·8–3·8). In the previous PCI group, fewer patients receiving ticagrelor had a primary efficacy outcome event than in the placebo group (404 [7·3%] of 5558 vs 480 [8·6%] of 5596; HR 0·85 [95% CI 0·74–0·97], p=0·013). The same effect was not observed in patients without PCI (p=0·76, p interaction=0·16). The proportion of patients with cardiovascular death was similar in both treatment groups (174 [3·1%] with ticagrelor vs 183 (3·3%) with placebo; HR 0·96 [95% CI 0·78–1·18], p=0·68), as well as all-cause death (282 [5·1%] vs 323 [5·8%]; 0·88 [0·75–1·03], p=0·11). TIMI major bleeding occurred in 111 (2·0%) of 5536 patients receiving ticagrelor and 62 (1·1%) of 5564 patients receiving placebo (HR 2·03 [95% CI 1·48–2·76], p<0·0001), and fatal bleeding in 6 (0·1%) of 5536 patients with ticagrelor and 6 (0·1%) of 5564 with placebo (1·13 [0·36–3·50], p=0·83). Intracranial haemorrhage occurred in 33 (0·6%) and 31 (0·6%) patients (1·21 [0·74–1·97], p=0·45). Ticagrelor improved net clinical benefit: 519/5558 (9·3%) versus 617/5596 (11·0%), HR=0·85, 95% CI 0·75–0·95, p=0·005, in contrast to patients without PCI where it did not, p interaction=0·012. Benefit was present irrespective of time from most recent PCI. Interpretation: In patients with diabetes, stable coronary artery disease, and previous PCI, ticagrelor added to aspirin reduced cardiovascular death, myocardial infarction, and stroke, although with increased major bleeding. In that large, easily identified population, ticagrelor provided a favourable net clinical benefit (more than in patients without history of PCI). This effect shows that long-term therapy with ticagrelor in addition to aspirin should be considered in patients with diabetes and a history of PCI who have tolerated antiplatelet therapy, have high ischaemic risk, and low bleeding risk