Características do federalismo no Brasil

Dissertação (mestrado) - Universidade Federal de Santa Catarina, Florianópolis, 1978

Biological Therapy for Inflammatory Bowel Diseases: Screening Prior to Initiating and How to Proceed When Surgery Is Necessary

Biological therapy has revolutionized the management of inflammatory bowel disease (IBD) in the last 30 years. However, these drugs have side effects and adverse events. Before starting this therapy, screening is necessary for specific infection diseases and monitoring protocols. Screening for human immunodeficiency virus, hepatitis C, hepatitis B, and Mycobacterium tuberculosis infections must be included. In addition, vaccination should be checked and updated, if necessary. Despite the advent of biological therapy, a significant number of patients with IBD will need surgery in their lifetime due to either clinical intractability or disease complications. Many of them will be on biological therapy, and there is a considerable controversy about adverse effects of biologics on surgical outcomes. In this chapter, we will approach the screening required to start this therapy and how to proceed when surgery is necessary in these patients

Variation Of The Anal Resting Pressure Induced By Postexpiratory Apnea Effort In Patients With Constipation.

Intestinal constipation--a common symptom among the general population--is more frequent in women. It may be secondary to an improper diet or organic or functional disturbances, such as dyskinesia of the pelvic floor. This is basically characterized by the absence of relaxation or paradoxical contraction of the pelvic floor and anal sphincter during evacuation. To analyze, by manometric data, the anal pressure variation at rest, during evacuation effort by using the Valsalva maneuver and forced post-expiratory apnea in subjects with secondary constipation. Twenty-one patients (19 females--90.4%) with a mean age of 47.5 years old (23-72) were studied. The diagnosis was performed using anorectal manometry, with a catheter containing eight channels disposed at the axial axis, measuring the proximal (1) and distal (2) portions of the anal orifice. The elevation of the pressure values in relation to the resting with the evacuation effort was present in all patients. The Agachan score was used for clinical evaluation of constipation. The variables studied were: mean anal pressure of the anal orifice for 20 seconds at rest, the effort of evacuation using Valsalva maneuver and the effort of evacuation during apnea after forced expiration, as well as the area under the curve of the manometric tracing at moments Valsalva and apnea. The analysis of the mean values of the anal pressure variation at rest evidenced difference between proximal and distal channels (P = 0.007), independent of the moment and tendency to differ during moments Valsalva and apnea (P = 0.06). The mean of values of the area under the manometric tracing curve showed differences between moments Valsalva and apnea (P = 0.0008), either at the proximal portion or at the distal portion of the anal orifice. The effort of evacuation associated with postexpiratory apnea, when compared with the effort associated with the Valsalva maneuver, provides lower elevation of anal pressure at rest by the parameter area under the curve.4830-

Oxigenoterapia hiperbárica e resistência mecânica das anastomoses cólicas em ratos com peritonite

PURPOSE: To analyze the effects of hyperbaric oxygen therapy (HBO) on the mechanical resistance of anastomosis performed in rats' distal colon presenting peritonitis induced by ligature and cecal punction using the Total Energy Rupture biomechanical test (ETR). METHODS: It was used 45 rats divided into three groups of 15 animals each. In Control Group (CG), it was performed anastomosis in distal colon without peritonitis. In Peritonitis Group (PG), it was performed anastomosis six hours after the induction of peritonitis by ligature and cecal punction. In Hyperbaric Chamber Group (HCG), it was performed six hours after the induction of peritonitis by ligature and cecal punction. The animals on CG and PG were kept at place air while the animals on HCG were placed on an experimental hyperbaric chamber in order to inhale oxygen at 100%, two absolute atmospheres, for 120 minutes, for four consecutive days. Euthanasia took place on the fifth day of the experiment. All the animals underwent to Total Energy Rupture Biomechanical Resistance test (ETR). Total Energy Rupture was defined as the necessary internal energy stored up to promote the colon rupture after an external traction force imposition. RESULTS: The Peritonitis Group presents smaller average ETR than Control Group. There was no statistical difference between Peritonitis Group and Hyberbaric Chamber Group. CONCLUSION: Hyperbaric oxygen therapy did not alter the mechanical resistance of anastomosis performed in distal colon of rats under the presence of peritonitis induced by ligature and cecal puncture.OBJETIVO: Analisar o efeito da oxigenoterapia hiperbárica (HBO) sobre a resistência mecânica de anastomoses realizadas em cólon distal de ratos na presença de peritonite induzida por ligadura e punção cecal utilizando o teste biomecânico de Energia Total de Ruptura (ETR). MÉTODOS: Foram utilizados 45 ratos distribuídos em três grupos de 15 animais. No Grupo Controle (GC), realizou-se anastomose no cólon distal sem peritonite. No Grupo Peritonite (GP), realizou-se anastomose seis horas após a indução da peritonite por ligadura e punção cecal. No Grupo Câmara Hiperbárica (GCH), realizou-se anastomose seis horas após a indução da peritonite por ligadura e punção cecal. Os animais dos GC e GP foram mantidos em ar ambiente. Os animais do GCH foram colocados em uma câmara hiperbárica experimental para inalarem oxigênio a 100%, a duas atmosferas absolutas, durante 120 minutos, por quatro dias consecutivos. A eutanásia ocorreu no quinto dia do experimento. Todos os animais foram submetidos ao Teste de Resistência Biomecânico Energia Total de Ruptura (ETR). A Energia Total de Ruptura foi definida como a energia interna acumulada necessária para promover o rompimento do cólon após a imposição de uma força externa de tração. RESULTADOS: O Grupo Peritonite apresentou menor média de ETR que o Grupo Controle. Não houve diferença estatística entre o Grupo Peritonite e o Grupo Câmara Hiperbárica. CONCLUSÃO: A oxigenoterapia hiperbárica não alterou a resistência mecânica de anastomoses realizadas no cólon distal de ratos na presença de peritonite induzida por ligadura e punção cecal.36837

Desmoid Tumor In Patients With Familial Adenomatous Polyposis.

Desmoid tumors constitute one of the most important extraintestinal manifestations of familial adenomatous polyposis. The development of desmoids is responsible for increasing morbidity and mortality rates in cases of familial adenomatous polyposis. To evaluate the occurrence of desmoid tumors in familial adenomatous polyposis cases following prophylactic colectomy and to present patient outcome. Between 1984 and 2008, 68 patients underwent colectomy for familial adenomatous polyposis at the School of Medical Sciences Teaching Hospital, University of Campinas, SP, Brazil. Desmoid tumors were found in nine (13.2%) of these patients, who were studied retrospectively by consulting their medical charts with respect to clinical and surgical data. Of nine patients, seven (77.8%) were submitted to laparotomy for tumor resection. Median age at the time of surgery was 33.9 years (range 22-51 years). Desmoid tumors were found in the abdominal wall in 3/9 cases (33.3%) and in an intra-abdominal site in the remaining six cases (66.7%). Median time elapsed between ileal pouch-anal anastomosis and diagnosis of desmoid tumor was 37.5 months (range 14-60 months), while the median time between colectomy with ileorectal anastomosis and diagnosis was 63.7 months (range 25-116 months). In 6/9 (66.7%) patients with desmoid tumors, the disease was either under control or there was no evidence of tumor recurrence at a follow-up visit made a mean of 63.1 months later (range 12-240 months). Desmoid tumors were found in 13.2% of cases of familial adenomatous polyposis following colectomy; therefore, familial adenomatous polyposis patients should be followed-up and surveillance should include abdominal examination to detect signs and symptoms. Treatment options include surgery and clinical management with antiestrogens, antiinflammatory drugs or chemotherapy.47373-

Estudo comparativo da resistência de ruptura de cólon descendente por meio de ensaio uniaxial força de ruptura à tração e energia total de ruptura em ratos

PURPOSE: To compare total energy of rupture and traction force of rupture tests within a rupture resistance study of descendent colon of rats. METHODS: Twelve descendent colon segments of rats were considered to perform the study. For each one of the specimens, total energy of rupture and traction force of rupture necessary to promote colic wall burst were evaluated through the biomechanical total energy of rupture test using the Biomechanical Data Acquisition and Analysis System, version 2.0. Average, standard deviation, standard error of average and coefficient of variation were considered for analysis of results. RESULTS: Traction force of rupture average, standard deviation, standard error of average and coefficient of variation were 380.05 gf, 98.74, 28.5 e 25.98%, respectively while total energy of rupture presented average of 244.85 gf, standard deviation of 57.76, standard error of average of 16.67 and coefficient of variation of 23.59. CONCLUSION: Although, total energy of rupture considered a larger number of attributes to its calculation related to non-linear viscoelastic materials, such as colic wall, it presented a smaller coefficient of variation when compared to traction force of rupture, thus demonstrating to constitute a possible parameter to analyze intestinal resistance of rats.OBJETIVO: Comparação das grandezas físicas Energia Total de Ruptura e Força de Ruptura à Tração no estudo da resistência de ruptura do cólon descendente de ratos. MÉTODOS: Doze segmentos de cólon descendente de ratos foram utilizados como corpos de prova. Por meio do Teste Biomecânico Energia Total de Ruptura, obteve-se, de cada espécime, a Força de Ruptura à Tração e a Energia Total de Ruptura necessárias para promover o rompimento da parede cólica. Com esses valores, calculou-se a média, o desvio padrão, o erro padrão e o coeficiente de variação, sendo esse último atributo usado para a comparação das grandezas físicas. RESULTADOS: Os valores da média, do desvio-padrão, do erro-padrão e do coeficiente de variação da Força de Ruptura à Tração foram 380,05 gf, 98,74, 28,5 e 25,98%, respectivamente. A Energia Total de Ruptura apresentou a média de 244,85 gf, o desvio-padrão de 57,76, o erro padrão de 16,67 e o coeficiente de variação de 23,59%. CONCLUSÃO: A Energia Total de Ruptura, mesmo considerando em seus cálculos maior quantidade de atributos pertencentes aos materiais com propriedade viscoelástica não linear, tal qual a estrutura da parede cólica, apresentou menor coeficiente de variação em comparação com o coeficiente de variação da Força de Ruptura à Tração, demonstrando ser um possível parâmetro para a análise da resistência intestinal de ratos.9710

The application of static magnetic stimulation reduces survival of SH-SY5Y neuroblastoma cells

Background/Aim: Central nervous system cancer is still a major public health issue. The effectiveness of treatments is limited and varies depending on the severity of disease. Therefore, there is a demand for the development of novel therapies. Static magnetic stimulation (SMS) emerges as a new therapeutic option. The aim of this study was to evaluate the SMS effects on neuroblastoma cells in culture. Materials and Methods: SH-SY5Y neuroblastoma cells were exposed to 0.3T SMS for 6, 12, 24, 36, 72 h, and 6 days. Cell viability (MTT), cell death (annexin-V/PI staining) and cell cycle (DNA content), cell proliferation (CFSE), autophagy (acridine orange), and total mitochondrial mass (MitoTracker™ Red) were analyzed to establish the cellular response to SMS. Results: The viability of SH-SY5Y cells was reduced after exposure to SMS for 24 h and 6 days (p0.05); however, this effect was not related to cell death or cell cycle arrest (p>0.05). In contrast, the viability of human malignant melanoma (HMV-II) cells, used as a tumoral control, was not affected. In addition, stimulated SH-SY5Y cells presented a decrease in mitochondrial mass at both exposure times and a reduction in autophagy and cell proliferation after 6 days (p<0.05). Conclusion: SMS application appears to be a promising adjuvant therapy for the treatment of neuroblastoma since it decreases the survival of SH-SY5Y neuroblastoma cells

Gene expression of FOXP3, indoleamine 2,3-dioxygenase (IDO), IL10 and CSF1 in the uterus of cows that received an intrauterine infusion of maternal and paternal antigens

Sensitization with conceptus antigens has been shown to be useful for improving reproductive performance facilitating maternal acceptance of an allogeneic embryo through the induction of cytokines and immunoregulatory cells in the uterine microenvironment. As FOXP3, IDO, IL10 and CSF1 in the uterus are important on the recognition and development of embryos during early pregnancy, this study aimed to determine whether simultaneous or isolated administration of paternal (semen) and maternal (PBMCs) antigens in the uterus of cow, on the day of estrus, influence the gene expression of these cytokines. Forty crossbred cows were divided into four treatments: T0: Control; T1: Semen; T2: PBMCs (peripheral blood mononuclear cells) from another cow and T3: PBMCs+Semen. Antigens were administered into the uterine body on the estrus day (D0). Uterine biopsies designed for molecular analysis of gene expression were collected in vivo seven (D7) and fourteen (D14) days after immunostimulation. Transcripts from FOXP3, IDO, IL-10 and CSF-1 were detected in all RNA samples extracted from uterine biopsies. The semiquantitative analysis showed that none of the treatments caused significant increase in the expression of these genes. Furthermore, on D14 all treatments led to a decline in the number of CSF-1 transcripts; moreover, treatment with PBMCs+Semen also led to a drop in the abundance of IL-10 transcripts. Such results suggest that isolated or simultaneous administration of both antigens would not increase maternal tolerance to embryo alloantigens, nor would it create favorable conditions to its growth and pre-implantation development, at least regarding the effects mediated by these genes on D7 and D14 of the estrous cycle

The hotel industry and relationship marketing: The case of Belo Horizonte – Minas Gerais, Brazil

Considerando a proximidade de importantes eventos de nível internacional a serem realizados em Belo Horizonte (Minas Gerais, Brasil), e o aumento na demanda por hospedagem na cidade, o presente artigo busca, por meio de um estudo de caso sobre um hotel quatro estrelas, identificar aspectos das estratégias de marketing de relacionamento passíveis de representar vantagem competitiva para a organização. Foram entrevistados 120 hóspedes e 15 empregados do grupo hoteleiro, por meio de questionários estruturados aplicados nos meses de outubro e novembro de 2011. Os resultados do estudo apontaram que 74,7% das reservas do hotel são provindas de clientes que já haviam se hospedado anteriormente no local, sendo que esses clientes, em diferentes níveis, participaram do programa de marketing de relacionamento do hotel. Ademais, são apresentados resultados que descrevem o nível de satisfação desses hóspedes e a propensão deles em indicar o hotel para outras pessoas. Dessa forma, acredita-se que as estratégias oriundas do marketing de relacionamento possibilitaram um resultado positivo e elevaram a competitividade da organização frente ao mercado.Considering the proximity of important international events to be held in Belo Horizonte (MG), and increased demand for accommodation in the city, this article aims, through a case study in a four stars hotel, identify aspects of relationship marketing strategies that could represent a competitive advantage for the organization. It was interviewed 120 hotel guests and 15 group hotel employees using structured questionnaires applied in October and November of 2011. The results showed that 74.7% of hotel bookings were from customers who had previously stayed in the hotel, and these customers, at different levels, participated in the organization relationship marketing program. Furthermore, the results describe the level of satisfaction of the guests and their propensity to indicate the hotel to others. Thus, it is believed that the strategies derived from the relationship marketing enabled a positive outcome and increased the competitiveness of the organization